Implementation of a digital tool for population management in Primary Health Care.

OBJECTIVE: Describe the implementation of a digital diagnostic and territorial monitoring tool in primary healthcare. METHODS: Quantitative and qualitative study, developed in 14 basic healthcare units in São Paulo, with community health workers, coordinators, nurses, and physicians. Data collection occurred in four phases: analysis of the instruments used by the team for territory management; development of the digital tool; training and implementation; and evaluation after 90 days using focus groups. Descriptive analyses were conducted by calculating absolute and relative frequencies to treat quantitative data. Qualitative data were subjected to content analysis. RESULTS: Three hundred thirty-four professionals participated in the study. In the first step, territory management's main challenges were filling out various instruments, system failures, data inconsistency, internet infrastructure/network, and lack of time. Therefore, a digital tool was developed consisting of 1) a spreadsheet recording the number of family members and markers of health conditions, date of visit, and number of return visits; 2) a spreadsheet with a summary of families visited, not visited, and refusals; and 3) a panel with a summary of the data generated instantly. In the evaluation, after the initial use of the tool, the themes that emerged were integration of the tool into daily work, evaluation of the digital tool implementation process, and improvement and opportunities for improvement. CONCLUSIONS: Faced with the challenges faced by family healthcare teams when filling out systems and managing the territory, the tool developed provided greater reliability and agility in data visualization, reduced the volume of instruments, and optimized the work process.

Carcass Yields and Meat Composition of Roosters of the Portuguese Autochthonous Poultry Breeds: "Branca", "Amarela", "Pedrês Portuguesa", and "Preta Lusitânica".

Poultry meat is an important part of the human diet, and the valorisation of autochthonous breeds is a determinant for the sustainability of the rural areas. The increasing demand for niche products demands for better knowledge of the carcass characteristics and meat quality of these local populations. The present study aims to characterise the roosters' meat from the "Branca" (BR), "Amarela" (AM), "Pedrês Portuguesa" (PP), and "Preta Lusitânica" (PL) breeds. A total of 80 birds (n = 20 per breed) between 38 and 42 weeks old were slaughtered. The physicochemical and nutritional composition were determined in the breast and drumstick meat. The meat of the PL breed had a higher (p ≤ 0.05) pH value, the AM meat revealed a water-holding capacity (WHC) of superior value and moisture content (p ≤ 0.05), while the BR breed had the highest (p ≤ 0.05) ash content. On the other hand, it was observed that the PP meat had a higher (p ≤ 0.05) yellowness index (b*). The breast meat exhibited, in all breeds, a lower pH value, WHC, redness (a*), and lipid content and greater (p ≤ 0.05) lightness (L*), b*, moisture, and ash and protein contents compared to the drumstick. Furthermore, it presented higher (p ≤ 0.05) K, P, and Mg contents and a superior proportion of total and sensorial relevant amino acids. Regarding the fatty acid profile, the breed differences were more significant in the drumstick, with the AM breed lipids presenting a higher (p ≤ 0.05) percentage of MUFAs in the fat, a lower atherogenic index, and a higher (p ≤ 0.05) value for the hypocholesterolemic/hypercholesterolemic fatty acids ratio, while the BR breed lipids presented a higher (p ≤ 0.05) percentage of PUFAs and PUFAs/SFAs ratio and a lower n-6/n-3 ratio. Considering the results obtained, it can be concluded that the meat from these breeds is a wholesome dietary option, distinguished by a favourable overall nutritional composition marked by elevated protein content, reduced lipid amounts, and amino and fatty acid profiles with desirable nutritional indices.

Healthy eating markers among adolescents from the municipal school system in Pelotas, Rio Grande do Sul, Brazil, 2019: a cross-sectional study.

MAIN RESULTS: Around 3% of the students regularly consumed the five healthy eating markers, with beans being the most frequently consumed; strong association was found between healthy eating markers and behavioral variables. Implications for services: The results obtained can contribute for interventions, programs and actions, particularly in the school environment, aimed at promoting an adequate and healthy diet. PERSPECTIVES: Better targeting of interventions, programs and actions developed in the school environment, seeking to increase consumption of fresh and minimally processed food, along with the adoption of healthy behaviors. OBJECTIVE: to analyze the consumption of healthy eating markers among adolescent students in Pelotas, Rio Grande do Sul, Brazil, in 2019. METHODS: this was a cross-sectional study carried out in schools taking part in the Health at School Program. Consumption of the five markers (beans, milk, fruit, cooked vegetables and raw salads) within five days prior to the study, obtained through a self-administered questionnaire, was defined as regular. Association between demographic, socioeconomic and behavioral variables and the outcomes was analyzed using Poisson regression. RESULTS: among the 797 respondents, 2.8% (95%CI 1.8;4.1) reported regular consumption. Beans were the most regularly consumed food (48.3%); fruit, cooked vegetables and raw salads were consumed regularly by less than 30% of the students. Doing physical activities, having breakfast and having meals with the family were associated with regular consumption of the foods assessed. CONCLUSION: regular consumption of healthy foods was low in this population, and was associated with behavioral factors.

Marcadores de alimentação saudável entre adolescentes da rede municipal de ensino de Pelotas, Rio Grande do Sul, 2019: estudo transversal / Healthy eating markers among adolescents from the municipal school system in Pelotas, Rio Grande do Sul, Brazil, 2019: a cross-sectional study / Marcadores de alimentación saludable entre adolescentes del sistema escolar municipal de Pelotas, Rio Grande do Sul, Brasil, 2019: estudio transversal

Objetivo: analisar o consumo de marcadores de alimentação saudável entre adolescentes escolares de Pelotas, Rio Grande do Sul, Brasil, em 2019. Métodos: estudo transversal, realizado nas escolas vinculadas ao Programa Saúde na Escola; o consumo dos cinco marcadores (feijão, leite, frutas, vegetais cozidos, saladas cruas) em até cinco dias antecedentes ao estudo, obtido mediante questionário autoaplicado, foi definido como regular; a associação de variáveis demográficas, socioeconômicas e comportamentais com os desfechos foi analisada por regressão de Poisson. Resultados: entre os 797 entrevistados, 2,8% (IC95% 1,8;4,1) referiram consumo regular; o feijão foi o alimento mais consumido regularmente (48,3%); frutas, vegetais cozidos e saladas cruas foram consumidos regularmente por menos de 30% dos escolares; praticar atividade física, tomar café da manhã e realizar refeições com a família estiveram associados ao consumo regular dos alimentos avaliados. Conclusão: o consumo regular de alimentos saudáveis, encontrado baixo nessa população, associou-se com fatores comportamentais.

Objective: to analyze the consumption of healthy eating markers among adolescent students in Pelotas, Rio Grande do Sul, Brazil, in 2019. Methods: this was a cross-sectional study carried out in schools taking part in the Health at School Program. Consumption of the five markers (beans, milk, fruit, cooked vegetables and raw salads) within five days prior to the study, obtained through a self-administered questionnaire, was defined as regular. Association between demographic, socioeconomic and behavioral variables and the outcomes was analyzed using Poisson regression. Results: among the 797 respondents, 2.8% (95%CI 1.8;4.1) reported regular consumption. Beans were the most regularly consumed food (48.3%); fruit, cooked vegetables and raw salads were consumed regularly by less than 30% of the students. Doing physical activities, having breakfast and having meals with the family were associated with regular consumption of the foods assessed. Conclusion: regular consumption of healthy foods was low in this population, and was associated with behavioral factors.

Objetivo: analizar el consumo de marcadores de alimentación saludable entre estudiantes adolescentes de Pelotas, Rio Grande do Sul, Brasil, en 2019. Métodos: estudio transversal realizado en escuelas vinculadas al Programa Salud en la Escuela. Se definió como regular el consumo de los cinco marcadores (porotos, leche, frutas, vegetales cocidos y ensaladas crudas) dentro de los cinco días previos al estudio, obtenidos a través de un cuestionario autoadministrado. La asociación entre variables demográficas, socioeconómicas y conductuales con los resultados se analizó mediante la regresión de Poisson. Resultados: entre los 797 encuestados, el 2,8% (IC95% 1,8; 4,1) informó un consumo regular. Los porotos fueron el alimento más consumido (48,3%). Frutas, verduras cocidas y ensaladas crudas fueron consumidas regularmente por menos del 30% de los estudiantes. La práctica de actividad física, el desayuno y las comidas en familia se asociaron con mayor consumo de los alimentos evaluados. Conclusión: el consumo regular de alimentos saludables fue bajo en esta población y se asoció con factores conductuales.

Carcass and Meat Quality Traits of Males and Females of the "Branca" Portuguese Autochthonous Chicken Breed.

The "Branca" breed is a dual-purpose Portuguese autochthonous chicken breed, produced in extensive systems and in small flocks, especially in the Entre Douro and Minho regions. A total of 40 birds (n = 20/sex) were slaughtered between 38 and 42 weeks (males) and 110 and 120 weeks (females), and carcass and meat quality parameters were evaluated. The results showed significantly higher weights and differences for males between sexes and pieces (p ≤ 0.05) in the meat physicochemical composition. Water holding capacity (WRC), moisture and ash contents were influenced by sex. They were higher in males in the breast and drumstick and lightness (L*) and lipid content were higher in females (p ≤ 0.05). The breast meat presented greater lightness, moisture, ash and protein contents, while the drumstick showed a higher pH value, redness (a*) and lipid content, in both sexes (p ≤ 0.05). Regarding the nutritional properties, "Branca" meat revealed a good proportion of minerals and the female meat showed, in both pieces (p ≤ 0.05), significantly lower values for total saturated fatty acids (SFAs) and higher values for monounsaturated fatty acids (MUFAs). Breast meat was richer in n-3-PUFAs (C22:5n-3 and C22:6n-3) in both sexes (p ≤ 0.05). Considering the results obtained, it can be concluded that "Branca" breed meat is a healthy food characterized by a good general nutritional profile.

Chemical Composition of the "Galo de Barcelos" (Barcelos Rooster Raw Meat).

Ten roosters produced according to "Barcelos Confraria" rules and ten roosters of autochthonous "Amarela" breed, reared on a similar traditional production system, were analyzed, and the chemical profile of two of the most significant meat portions, breast and drumstick, was determined. The results demonstrated that the "Barcelos" rooster raw meat is rich in proteins (22.3%) and fat (4.31%), particularly in monounsaturated fatty acids (39.1%). Significant differences (p ≤ 0.01) were observed, with the breast having a higher protein content (25.1 vs. 19.7%) and less fat (1.9% vs. 6.7%), compared to the drumstick. The fatty acid profile revealed (SFA 30.0%, MUFA 39.1%, and PUFA 24.6%) a similar composition to the roosters reared in the traditional or organic production systems, such as the "Amarela" autochthonous rooster. The "Barcelos" rooster can be regarded as a highly nutritional meat, with an interesting chemical profile ensuring a high-quality traditional product to consumers.

Implementation of the drive-through strategy for COVID-19 vaccination: an experience report.

OBJECTIVE: To describe the experience of implementing a satellite vaccination unit in a drive-through system during a campaign against COVID-19. METHOD: This is an experience report carried out in a drive-through vaccination satellite unit. The study development was guided by the triad structure-process-results, proposed by Donabedian. RESULTS: The unit was structured in a soccer stadium, allowing it to serve large audiences safely. Care flow occurred in stages and professionals were organized by sectors, with emphasis on the nursing team' work. Initially, screening was performed; later, users went to the registration sector, and, finally, they were forwarded to the application station. The unit also had emergency sectors, a cold chain, space for professionals and a Basic Health Unit as a point of support. In 25 days of operation, 9698 doses were administered, with 1.8% of doses lost. CONCLUSION: The implementation of this system required planning, structure, process development and intense team articulation, with emphasis on the fundamental and strategic role of nurses in different points of action and leadership.

Implementation of the drive-through strategy for COVID-19 vaccination: an experience report / Implementación de la estrategia drive-through para la vacunación contra el COVID-19: relato de experiencia / Implementação da estratégia drive-through para vacinação COVID-19: um relato de experiência

Abstract Objective: To describe the experience of implementing a satellite vaccination unit in a drive-through system during a campaign against COVID-19. Method: This is an experience report carried out in a drive-through vaccination satellite unit. The study development was guided by the triad structure-process-results, proposed by Donabedian. Results: The unit was structured in a soccer stadium, allowing it to serve large audiences safely. Care flow occurred in stages and professionals were organized by sectors, with emphasis on the nursing team' work. Initially, screening was performed; later, users went to the registration sector, and, finally, they were forwarded to the application station. The unit also had emergency sectors, a cold chain, space for professionals and a Basic Health Unit as a point of support. In 25 days of operation, 9698 doses were administered, with 1.8% of doses lost. Conclusion: The implementation of this system required planning, structure, process development and intense team articulation, with emphasis on the fundamental and strategic role of nurses in different points of action and leadership.

RESUMEN Objetivo: Describir la experiencia de implementación de una unidad de vacunación satélite en un sistema drive-through, durante la campaña contra el COVID-19. Método: Se trata de un relato de experiencia, realizado en una unidad satélite de vacunación drive-through. El desarrollo del estudio estuvo guiado por la tríada estructura-proceso-resultados, propuesta por Donabedian. Resultados: La unidad se estructuró en un estadio de fútbol, lo que le permitió atender grandes audiencias de manera segura. El flujo de la atención ocurrió por etapas, y los profesionales fueron organizados por sectores, con énfasis en el trabajo del equipo de enfermería. Inicialmente se realizaba el cribado, posteriormente el usuario se dirigía al sector de registro y finalmente se enviaba a la estación de aplicación. La unidad también contó con sectores de urgencia y emergencia, cadena de frío, espacio para profesionales y una Unidad Básica de Salud como punto de apoyo. En 25 días de operación, se administraron 9698 dosis, con un 1,8% de dosis olvidadas. Conclusión: La implementación de este sistema requirió planificación, estructuración, desarrollo de procesos y una intensa articulación de equipos, con énfasis en el papel fundamental y estratégico de los enfermeros en diferentes puntos de acción y liderazgo.

RESUMO Objetivo: Descrever a experiência de implementação de uma unidade satélite de vacinação em sistema drive-through, durante a campanha contra COVID-19. Método: Trata-se de um relato de experiência, realizado em uma unidade satélite de vacinação em sistema drive-through. O desenvolvimento do estudo foi norteado pela tríade estrutura-processo-resultados, proposta por Donabedian. Resultados: A unidade foi estruturada em um estádio de futebol, permitindo o atendimento de grandes públicos de forma segura. O fluxo de atendimento ocorreu por etapas, e os profissionais foram organizados por setores, com destaque para atuação da equipe de enfermagem. Inicialmente, realizou-se a triagem, posteriormente, o usuário dirigia-se ao setor de cadastramento, e, por fim, era encaminhado à estação de aplicação. A unidade contava também com os setores de urgência e emergência, rede de frio, espaço para os profissionais e uma Unidade Básica de Saúde como ponto de apoio. Em 25 dias de atuação, foram administradas 9698 doses, com 1,8% de doses perdidas. Conclusão: A implementação deste sistema exigiu planejamento, estrutura, desenvolvimento de processos e intensa articulação em equipe, com destaque para o papel fundamental e estratégico do enfermeiro em diferentes pontos de atuação e liderança.

The use of histológical parameters to assess intestinal and liver health on broilers challenged isolatedly and simultaneously with cyclopiazonic acid and aflatoxin / B1 El uso de parámetros histológicos para evaluar la salud intestinal y hepática en pollos de engorde desafiados de forma aislada y simultánea con ácido ciclopiazónico y aflatoxina B1

Abstract Mycotoxins contaminate agricultural commodities, which contaminates animals. These toxins can damage vital organs, such as the liver, as well as the epithelial tissue. Among these mycotoxins are aflatoxin B1 (AFB1) and cyclopiazonic acid (CPA), which can occur simultaneously in food. In broilers, mycotoxicosis has an economic impact due to several factors, such as low feed conversion rate, incidence of other diseases, and interference with reproductive capacity, all of which may lead to a public health problem. The aim of the present study was to histologically assess, through the I See Inside (ISI) method, harmful effects on broiler liver, duodenum, jejunum, and ileum in the presence of AFB1 and CPA isolatedly and simultaneously. Groups challenged with mycotoxins showed significant damage to both gut and liver fragments. All challenged-groups in all fragments impaired the parameters analyzed for intestinal epithelium. In the liver, AFB1 was predominantly harmful when the parameters were analyzed separately, but when analyzing the total ISI score, CPA was also found to be harmful to this organ. The other point analyzed was the great variation between the weights of the birds contaminated by mycotoxin while the negative control group presents a lesser variation.

Resumen Las micotoxinas contaminan los productos agrícolas, que a su vez contaminan a los animales. Estas toxinas pueden dañar órganos vitales, como el hígado y el tejido epitelial. Entre estas micotoxinas se encuentran la aflatoxina B1 (AFB1) y el ácido ciclopiazónico (CPA), que pueden hallarse simultáneamente en los alimentos. En los pollos de engorde, la micotoxicosis tiene un impacto económico debido a varios factores, como la baja tasa de conversión alimenticia, la incidencia de otras enfermedades y la interferencia de la capacidad reproductiva, que pueden llevar a un problema de salud pública. El objetivo de la presente investigación es la de evaluar histológicamente, a través del método "I See Inside" (ISI), los efectos nocivos sobre el hígado, duodeno, yeyuno e íleon de pollos de engorde en presencia de AFB1 y CPA de forma aislada y simultánea. Los grupos desafiados con micotoxinas presentaron un daño significativo tanto en el intestino como en los fragmentos del hígado. Todos los grupos tratados tuvieron alteraciones en los parámetros analizados para el epitelio intestinal. En el hígado, AFB1 fue predominantemente dañino cuando los parámetros se analizaron por separado, pero al examinar la puntuación ISI total, también se encontró que el CPA era perjudicial para este órgano. Otra cuestión que fue investigada fue la gran variación entre los pesos de las aves contaminadas por micotoxinas mientras el grupo de control negativo presentó una variación menor.

Fermentação em estado sólido de Aspergillus parasiticus e produção de aflatoxinas / Solid state fermentation of Aspergillus parasiticus and aflatoxin production

Aflatoxinas são metabólitos secundários de fungos com grande potencial carcinogênico, produzidos principalmente por Apergillus flavus e Aspergillus parasiticus. Em vista da ampla variedade de alimentos em que se encontram essas micotoxinas, o presente estudo teve como objetivo determinar condições de cultivo para o Aspergillus parasiticus e produção das quatro principais aflatoxinas (AFB1, AFB2, AFG1 e AFG2) considerando diferentes substratos conhecidos pela contaminação por estas micotoxinas, entre eles arroz branco, arroz cateto, amendoim, milho e farinha de trigo integral, e diferentes valores de umidade e pH. Ao analisar por cromatrografia em camada delgada os extratos dos diferentes substratos, verificou-se a produção de aflatoxinas em todos os alimentos, porém na cromatografia líquida de alta eficiência foi possível perceber a maior produção de aflatoxinas no arroz cateto e na farinha de trigo integral. Para a continuidade do trabalho, utilizou-se o arroz cateto e então preparou- se diferentes meios sólidos com valores de pH entre 3,5 e 7,5 e umidade entre 42 % e 62 %. Ao analisar por CLAE, todas as amostras apresentaram produção de AF, porém as amostras com o maior valor de água agregada (62%) apresentaram maior produção enquanto a variação de pH não apresentou influência nesta produção.

Aflatoxins are secondary metabolites of fungi with great carcinogenic potencial, mainly produced by Aspergillus flavus and Aspergillus parasiticus. In order of the wide variety of foods where mycotoxins are found in, this study aimed to determine growth conditions for Aspergillus parasiticus and production of four major aflatoxins (AFB1, AFB2, AFG1 and AFG2) considering different substrates known for contamination by these aflatoxins, including white rice, cathetus rice, peanuts, maize and whole wheat flour, and different pH and humidity values. When extracts of different substrates were analyzed by thin layer chromatography, it has been verified the production of aflatoxins in all foods; however, when high performance liquid chromatography (HPLC) analysis was performed, the greater production of aflatoxins was observed in cathetus rice and whole-wheat flour. Cathetus rice was then selected to continue the study and different solid medium with pH values between 3.5 and 7.5 and humidity percentages between 42 % and 62 % were prepared. When analyzed by HPLC, all samples showed production of aflatoxins, but the samples with higher humidity value (62%) showed greatest production while the pH changes had no effect on this production.

A percepção dos trabalhadores do programa saúde da família sobre a intersetorialidade / The perception of family health program workers about intersectoriality

As ações intersetoriais emergem, contemporaneamente, como uma possibilidade de se enfrentar de forma mais integrada as necessidades da população, que são complexas, buscando reflexos de saúde a partir de intervenções na cadeia de determinação social do processo saúde-doença. Parte-se do princípio de que não é possível promover a saúde com o setor agindo isoladamente. Neste estudo se valoriza o Programa Saúde da Família pela possibilidade de inserção dos trabalhadores no território e por ser a estratégia nacional para reorientação do modelo assistencial, o que implica em mudanças na concepção de saúde-doença, na prática e paradigma sanitários. Buscou-se conhecer, então, a percepção dos trabalhadores do Programa numa região de São Paulo, Brasil, sobre trabalho intersetorial, através da análise hermenêutica-dialética das discussões realizadas numa oficina sobre o tema. Obteve-se que, apesar da percepção sobre a influência das precárias condições de vida e trabalho na saúde da população atendida, os trabalhadores não identificam a intersetorialidade como estratégia, apresentam esporádicos relacionamentos intersetoriais permeados por relações de poder e frágil participação social. As categorias analíticas que emergiram a partir do referencial teórico e da base empírica foram: relações de poder, empoderamento e participação social. Sugere-se a reavaliação do processo de capacitação desses trabalhadores visando a transformação gradual das relações de poder emautoridade compartilhada e sensibilização dos atores sociais sobre a importância do trabalho intersetorial.

The intersectorial action emerge nowadays, as a way of facing the needs of the population in the most integrated form which are complex, aiming at transmitting health through intervention in the chain of social determination of the health-illness process. The belief is that it is not possible to promote health if the sector works in an isolated manner. In this study the Family Health Program is emphasized through the possibility of the placement of workers in the territory and because it's a national strategy for reorientation of the support model, which implies changes in the conception of health-illness in sanitary use and paradigms. Due to this, information on the perception of the Program workers was gathered in a region of Sao Paulo, Brazil, on intersectorial work through an analysis of the discussion held in a workshop on the subject. It was discovered that, although the workers know of the influence that bad working and life conditions affect the assisted population, they don't identify intersectorialism as a strategy, they present sporadic intersectorial relationship permeated by relations of power and weak social participation. The analytical categories which emerged through theoretical reference and the empirical basis were: relations of power, empowerment and social participation. A reevaluation of the training process of these workers is suggested aiming at a gradual transformation of the relation of power in shared authority and sensibilizationof the social actors on the importance of intersectorial work.

O toque: percepçäo de idosos hospitalizados / Touch: the perception of the hospitalized aged

Devido à intensa utilizaçäo do toque no ambiente hospitalar e sua importância na transmissäo de mensagens tanto por aquele que toca, como pelo que é tocado, é que as autoras têm estudado o tema através de pesquisa em hospoitais e instituiçöes asilares. Os idosos têm sido o enfoque do estudo pela constataçäo do envelhecimento populacional e de que estes säo tocados com menor frequência. Através de um questionário com perguntas sobre como e quando ocorre o toque, sentimentos que deperta e outros, averiguamos a percepçäo de 20 idosos internados no Hospital Umiversitário de Säo Paulo. Como pricipais resultados, obtivemos que a maioria da populaçäo se sente bem quando tocada, concorda que há predominância do toque instrumental e considera importante a maneira como se toca.

Uma janela para a alma: olhando a morte e a criança / A window to the soul: looking at the death and the child

Trata-se de uma monografia com características de ensaio, apresentada à Disciplina Enfermagem Pediátrica em 1995. Envolve o tema morte relacionado à criança e foi desenvolvido com base na experiência de vida da autora,acrescido ao referencial bibliográfico obtido sobre o tema nas áreas de Psicologia, Enfermagem e História. Inclui o aspecto auto-biográfico, bem como uma breve análise do relato, relacionando-o com a Enfermagem. A autora busca mostrar como foi seu processo de conscientizaçäo acerca da morte, relembrando fatos de sua infância e adolescência, e procura compreender o seu próprio processo e as influências dessas vivências no exercício profissional.

Idosos asilados: como percebem o toque? / Institutionalized Elderly - What do they think about touch?

Pela importancia do toque como transmissor de mensagens, como responsavel por alteracoes fisiologicas significativas e por ser um instrumento na assistencia de enfermagem, e que realizamos este estudo. Verificamos a percepcao de 20 idosos asilados sobre o toque, numa instituicao privada filantropica da cidade de Sao Paulo, atraves de questoes semi-abertas. Estas questoes envolveram aspectos do tocar como: significado a que conduz, frequencia com que ocorre, reacoes que desperta, entre outros. Obtivemos que os idosos desta instituicao perceberam que o toque, quando ocorria, era instrumental, estando tambem associado a sentimentos agradaveis. A comunicacao nao verbal predominou nas demonstracoes de agrado ou desagrado dos idosos quando eram tocados e eles referiram preferir, na sua maioria, o contato com as pessoas de fora da instituicao (familiares, amigos).