A interação ensino-serviço no processo de formação dos graduandos em fisioterapia da UFPB: a percepção dos docentes

The health paradigm, consolidated in the last century, directed the training of health professionals, educated under the aegis of the Flexnerian training, fragmentary and hospital-centered model. However, it proved to be insufficient to meet the demands of the Unified Health System and the population. In this sense, the National Curriculum Guidelines for Undergraduate health courses emerge as a normative framework in proposing a new professional profile, as well as the recommendation of strategies for the restructuring of curricula and teaching practices, and one of them is the teaching-service integration. Therefore, the aim of this study was to investigate the process of training of Physiotherapy course students of the Federal University of Paraíba with the guiding principle of teaching-service integration, considering DCN. In this sense, the chosen method was a case study with qualitative approach. The sample was intentional, including all faculty members of the permanent staff of the Department of Physiotherapy at UFPB, linked to curriculum components whose practice scenarios occur in the SUS network and time longer than one year in that component. The data collection technique was the semi-structured interview. Data analysis was performed using the content analysis technique. The following categories were considered: professional training for SUS, integration of students to the SUS network services, the relationship between theory and practice in the training of physiotherapists, teaching and health professional partnership in the teaching-learning process and programs of training reorientation and their integration with the course. The results allowed identifying positive points in the teaching-service integration: recognition of the importance of integration activities between university and health services based on the insertion of students in the network, the combined actuation with health service professionals and the opportunity to work in a multidisciplinary team; the existence of structured and organized School Network; participation of students and teachers in government programs that offer the experience of insertion in the labor market. The following weaknesses stood out: difficulties in agreement, planning and evaluation of activities by the service; gap between theoretical and practical activities; lack of definition of roles of teacher and health service professionals in the training process and the fragile relationship of reorientation of vocational training programs with the curricular activities of the course. The teaching-service integration as a guiding principle in the analysis of the formation of physiotherapists reveals limits and possibilities for training that meets the health needs of the population. Thus, the choices of educational institutions regarding the care model have an influence on health practices, as well as the commitment by management and services and the permeability to social control instances decisively contribute to the improvement in the training of future professionals. Thus, the commitment of all involved for the effective change in the training process of health paradigm is indispensable.

A interação ensino-serviço no processo de formação dos graduandos em fisioterapia da UFPB: a percepção dos docentes

The health paradigm, consolidated in the last century, directed the training of health professionals, educated under the aegis of the Flexnerian training, fragmentary and hospital-centered model. However, it proved to be insufficient to meet the demands of the Unified Health System and the population. In this sense, the National Curriculum Guidelines for Undergraduate health courses emerge as a normative framework in proposing a new professional profile, as well as the recommendation of strategies for the restructuring of curricula and teaching practices, and one of them is the teaching-service integration. Therefore, the aim of this study was to investigate the process of training of Physiotherapy course students of the Federal University of Paraíba with the guiding principle of teaching-service integration, considering DCN. In this sense, the chosen method was a case study with qualitative approach. The sample was intentional, including all faculty members of the permanent staff of the Department of Physiotherapy at UFPB, linked to curriculum components whose practice scenarios occur in the SUS network and time longer than one year in that component. The data collection technique was the semi-structured interview. Data analysis was performed using the content analysis technique. The following categories were considered: professional training for SUS, integration of students to the SUS network services, the relationship between theory and practice in the training of physiotherapists, teaching and health professional partnership in the teaching-learning process and programs of training reorientation and their integration with the course. The results allowed identifying positive points in the teaching-service integration: recognition of the importance of integration activities between university and health services based on the insertion of students in the network, the combined actuation with health service professionals and the opportunity to work in a multidisciplinary team; the existence of structured and organized School Network; participation of students and teachers in government programs that offer the experience of insertion in the labor market. The following weaknesses stood out: difficulties in agreement, planning and evaluation of activities by the service; gap between theoretical and practical activities; lack of definition of roles of teacher and health service professionals in the training process and the fragile relationship of reorientation of vocational training programs with the curricular activities of the course. The teaching-service integration as a guiding principle in the analysis of the formation of physiotherapists reveals limits and possibilities for training that meets the health needs of the population. Thus, the choices of educational institutions regarding the care model have an influence on health practices, as well as the commitment by management and services and the permeability to social control instances decisively contribute to the improvement in the training of future professionals. Thus, the commitment of all involved for the effective change in the training process of health paradigm is indispensable.

Avaliação multidimensional da qualidade de vida em idosos: um estudo no Curimataú ocidental paraibano

The fast growth of the elderly population is a reality throughout the world and has become one of the greatest challenges for contemporary public health. When considering the increased life expectancy and the aging as a multidimensional phenomenon, one should highlight the need to investigate if the increase of longevity is associated with satisfactory levels of Quality of Life (QOL). This study has the objective of assessing the QOL of elderly people from the Paraíba’s Western Curimataú microregion, explained by its health and living conditions. This is a cross-sectional and observational study with quantitative design held with 444 elderly people from five cities: Barra de Santa Rosa, Cuité, Nova Floresta, Remígio e Sossego. In order to obtain information, the following instruments were used: I) Questionnaire for collection data related to the elderly population, for sociodemographic, clinical and behavioral characteristics; and II) WHOQOL-Old questionnaire, with a view to measuring and assessing QOL. Data were processed on the IBM-SPSS Statistics 20.0 software by means of the ANOVA (one-way), Student’s t, Mann-Whitney, Kruskal-Wallis and Pearson’s correlation tests, with p-values<0,05 accepted as being statistically significant. The results indicate a good global QOL (ETT=65,69%), with better assessment by elderly men, aged between 60 and 74 years, married, living with partner and children, without caregiver, physical activity practitioners, with up to one health problem before an aspect of multimorbidity and with very good and/or good assessment of basic needs. The self-reported stress showed a negative significant correlation before the global QOL, where the greater the perception of stress, the worse the assessment of QOL. In the faceted assessment of QOL, the Sensory Operation showed the best performance (ETF= 68,86%) and the Social Participation (SP) the worst (ETF=60,37%). In the multiple linear regression model, SP is singly responsible for 51,8% (R2=0,518) of explanation of the global QOL. In the intercorrelation among the WHOQOL-Old facets, only Death and Dying did not reveal significance. The harmony highlighted among the facets raises the need to ensure a comprehensive health care for the elderly population, especially in understanding the social participation as an intrinsic part of the QOL and that it requires the re-discussion and reconstruction of individual and collective, family and community, political and government actions. Hence, guaranteeing an active, healthy and participatory aging, with QOL, is the major challenge.

Avaliação multidimensional da qualidade de vida em idosos: um estudo no Curimataú ocidental paraibano

The fast growth of the elderly population is a reality throughout the world and has become one of the greatest challenges for contemporary public health. When considering the increased life expectancy and the aging as a multidimensional phenomenon, one should highlight the need to investigate if the increase of longevity is associated with satisfactory levels of Quality of Life (QOL). This study has the objective of assessing the QOL of elderly people from the Paraíba’s Western Curimataú microregion, explained by its health and living conditions. This is a cross-sectional and observational study with quantitative design held with 444 elderly people from five cities: Barra de Santa Rosa, Cuité, Nova Floresta, Remígio e Sossego. In order to obtain information, the following instruments were used: I) Questionnaire for collection data related to the elderly population, for sociodemographic, clinical and behavioral characteristics; and II) WHOQOL-Old questionnaire, with a view to measuring and assessing QOL. Data were processed on the IBM-SPSS Statistics 20.0 software by means of the ANOVA (one-way), Student’s t, Mann-Whitney, Kruskal-Wallis and Pearson’s correlation tests, with p-values<0,05 accepted as being statistically significant. The results indicate a good global QOL (ETT=65,69%), with better assessment by elderly men, aged between 60 and 74 years, married, living with partner and children, without caregiver, physical activity practitioners, with up to one health problem before an aspect of multimorbidity and with very good and/or good assessment of basic needs. The self-reported stress showed a negative significant correlation before the global QOL, where the greater the perception of stress, the worse the assessment of QOL. In the faceted assessment of QOL, the Sensory Operation showed the best performance (ETF= 68,86%) and the Social Participation (SP) the worst (ETF=60,37%). In the multiple linear regression model, SP is singly responsible for 51,8% (R2=0,518) of explanation of the global QOL. In the intercorrelation among the WHOQOL-Old facets, only Death and Dying did not reveal significance. The harmony highlighted among the facets raises the need to ensure a comprehensive health care for the elderly population, especially in understanding the social participation as an intrinsic part of the QOL and that it requires the re-discussion and reconstruction of individual and collective, family and community, political and government actions. Hence, guaranteeing an active, healthy and participatory aging, with QOL, is the major challenge.

Hepatite C crônica em serviço de referência no nordeste do Brasil: um estudo retrospectivo de dezoito anos de acompanhamento

Chronic Hepatitis C is the leading cause of chronic liver disease in advanced final stage of hepatocellular carcinoma (HCC) and of death related to liver disease. Evolves progressively in time 20-30 years. Evolutionary rates vary depending on factors virus, host and behavior. This study evaluated the impact of hepatitis C on the lives of patients treated at a referral service in Hepatology of the University Hospital Onofre Lopes - Liver Study Group - from May 1995 to December 2013. A retrospective evaluation was performed on 10,304 records, in order to build a cohort of patients with hepatitis C, in which all individuals had their diagnosis confirmed by gold standard molecular biological test. Data were obtained directly from patient charts and recorded in an Excel spreadsheet, previously built, following an elaborate encoding with the study variables, which constitute individual data and prognostic factors defined in the literature in the progression of chronic hepatitis C. The Research Ethics Committee approved the project. The results were statistically analyzed with the Chi-square test and Fisher's exact used to verify the association between variable for the multivariate analysis, we used the Binomial Logistic regression method. For both tests, it was assumed significance p < 0.05 and 95%. The results showed that the prevalence of chronic hepatitis C in NEF was 4.96 %. The prevalence of cirrhosis due to hepatitis C was 13.7%. The prevalence of diabetes in patients with Hepatitis C was 8.78 % and diabetes in cirrhotic patients with hepatitis C 38.0 %. The prevalence of HCC was 5.45%. The clinical follow-up discontinuation rates were 67.5 %. The mortality in confirmed cases without cirrhosis was 4.10% and 32.1% in cirrhotic patients. The factors associated with the development of cirrhosis were genotype 1 (p = 0.0015) and bilirubin > 1.3 mg % (p = 0.0017). Factors associated with mortality were age over 35 years, abandon treatment, diabetes, insulin use, AST> 60 IU, ALT> 60 IU, high total bilirubin, extended TAP, INR high, low albumin, treatment withdrawal, cirrhosis and hepatocarcinoma. The occurrence of diabetes mellitus increased mortality of patients with hepatitis C in 6 times. Variables associated with the diagnosis of cirrhosis by us were blood donor (odds ratio 0.24, p = 0.044) and professional athlete (odds ratio 0.18, p = 0.35). It is reasonable to consider a revaluation in screening models for CHC currently proposed. The condition of cirrhosis and diabetes modifies the clinical course of patients with chronical hepatitis C, making it a disease more mortality. However, being a blood donor or professional athlete is a protective factor that reduces the risk of cirrhosis, independent of alcohol consumption. Public policies to better efficient access, hosting and resolution are needed for this population.

Rugosidade superficial e adesão bacteriana em compósitos com nanopartículas após acabamento e polimento

Objective: To evaluate in vitro the surface roughness and bacterial adhesion of nanoparticle composites, after being subjected to different finishing and polishing systems. Materials and Methods: 66 specimens were prepared, and 30 with Filtek Z350 XT (3M ESPE, USA) and 30 with the resin IPS Empress Direct (Ivoclar Vivadent, USA), divided into 6 groups (n = 10 ). Six specimens were prepared for analysis in scanning electron microscopy (SEM) .Each kind of resin was subjected to finishing and polishing systems: Sof-Lex Pop-On discs (3M ESPE, USA) and AstropolTM system (Ivoclar Vivadent , USA), featuring the experimental group. The control group did not undergo any kind of finishing and polishing technique. The average roughness (Ra) in both groups was measured using a roughness in the setting of 0.25 mm (cut off) and surface images obtained with photomicrographs taken with a scanning electron microscope (SEM) magnified 500 times. Bacterial adherence was evaluated by determining the absorbance (OD) of the suspension of adhered cells by spectrophotometer at 570 nm. The results were submitted for analyzed with 2-way ANOVA at α=.05 and Tukey multiple comparison tests. Results: Statistically significant differences were found between the groups in terms of roughness and bacterial adhesion. Filtek Z350 XT for resin were no differences between the tested finishing and polishing systems, where the system of lowest surface roughness was the Sof-Lex Pop-On. To the resin IPS Empress Direct, the finishing and polishing system Astropol, had lower results of surface roughness. As for bacterial adhesion, the lowest optical density value for Filtek Z350 XT was for the group that used the finishing and polishing system Sof-Lex Pop-On and the resin IPS Empress Direct the group that used the Astropol system. In addition, there was a positive correlation between surface roughness and bacterial adhesion on polished surfaces (r = 0.612) Conclusions: surface roughness and bacterial adhesion are closely related. The finishing and polishing Sof-Lex Pop-On system is more suitable for nanoparticulate Filtek Z350 XT and the finishing and polishing system Astropol for resin nanohíbrida IPS Empress Direct.

Aids em idosos no Brasil no período de 2000 a 2012: uma análise de série temporal e dos fatores contextuais associados

The characteristics profile of individuals who develop AIDS in Brazil has changed over time. Among these modifications, a worrying finding is the increased incidence of AIDS in the elderly across the country. But, however, is not yet clear whether the increase in AIDS cases is sufficient to produce a change in the trend of measures in recent years in the Brazilian states, and this increase has an effect from the socioeconomic and demographic indicators. In this sense, the objective of this study is to analyze the AIDS incidence rates among the elderly in Brazil and its effect on socioeconomic and demographic inequalities in the period 2000 to 2012. This is an ecological time-series study to meet behavior of the time series of the incidence rates of AIDS in the elderly from 2000 to 2012. the rates were calculated using the secondary data from Diseases Information System Notification and the Brazilian Institute of Geography and Statistics. Data were analyzed statistically to know the trends in incidence rates, by polynomial regression model and joinpoint log-linear regression model, but also the simple linear regression analysis to find the relationship of trends with variables socioeconomic and demographic. SPSS 20.0® and Joinpoint 4.1.1 programs were used. All tests were carried out considering a significance of 5%. After the analysis, in Brazil were reported 62,052 new cases of AIDS in the elderly from 2000 to 2012. During this period, a significant increase was found for males, both aged 50-59 years (APPC: 3.46 %, p <0.001), such as above 59 years (AAPC: 4.38%; p <0.001). For females, the increase was significant and has the largest increments in the time series, when compared to males in both age groups (AAPC: 4.62%, p <0.001 and AAPC: 6.53%; p <0.001) respectively. The largest increases are observed in women and in the states of North and Northeast. In the Southeast Region is observed stabilization of rates throughout the series. The reason of trends between the sexes had a significant reduction, but also an approach in both age groups of the study, reaching a ratio of 1.7 males for every female in the youngest age group. The trends were related to illiteracy rates, with increasing social inequality and the lowest human development in the Brazilian states. We conclude that in Brazil the incidence of AIDS in the elderly follows an increasing trend in individuals over 50 years. Noteworthy are the highest rates of study in women and in the states of North and Northeast. In this sense, the country needs to enhance policies towards older people with STD / AIDS, training health professionals and developing effective measures for the prevention and early diagnosis of infected people, especially in places with limited resources and high social inequality. In the long term, it is developing new studies to understand whether the measures taken were effective in reducing the trends identified in this study.

Formação profissional do cuidador de idosos em instituições de longa permanência

The old caretaker's work seeks to minimize suffering and morbidity resulting from physical, cognitive and emotional limitations of these individuals, being a practice permeated by the uniqueness of the subjects involved, therefore, a process in constant construction. In this notion, the caregiver's role is crucial to assist the elderly in everyday life, aiming at improving their quality of life. This study has descriptive and analytical character with quantitative and qualitative approach aimed to investigate the professional training of active caregivers in long-term stay institutions for the Elderly (ILPIs) in Natal/RN in the year 2014. For this, semi-structured interviews were conducted with 63 caregivers employed in nine ILPIs, representing 75% of the professionals performing activities in these institutions. The interviews captured data on the socioeconomic profile, the perception about the profession and training of caregivers. Data were analyzed by observation of absolute and relative measures of central tendency of the numeric variables frequencies. It was found that most caregivers had poor socioeconomic status and had no specific training course to practice caregiver role. However, among those who carried out courses, most reported that the content covered during the training gave security to perform the practice, although they have shown a contradiction when referred to the need to build capacity. The perception of care is mainly related to love and care for the other while the choice of profession is associated with care practice itself. The results also indicate the presence of a low level of formal training for the exercise of the occupation, also revealing the weaknesses ranging from the absence of a core curriculum that can guide the formation, compounded by the low educational professionals in focus.

Associação da depressão e distúrbio do sono em pacientes com e sem disfunção temporomandibular

Objective: To evaluate the inter-relationship between TMD (temporomandibular disorder), depression and sleep disorder. Methods: This is a case-control study with questionnaires in 111 patients, allocated from the Dentistry Department of UFRN, Natal, Brazil, from September 2014 to June 2015, for evaluation of depressive symptoms through the BDI (Beck Depression Inventory); sleep disorder, the PSQI (Pittsburgh Sleep Quality Index) and DTM through the RDC / TMD (diagnostic criteria to search for DTM). All indexes were applied by a single examiner previously trained and calibrated. The collected data were analyzed with chi-square tests of Pearson (χ2) and the unconditional logistic regression. Results: women had a risk of 2.85 times more likely to develop TMD (p = 0.046). The OR (odds ratio) shows that sleep disturbance increases by 2.19 the chances of having TMD (p = 0.062) and depressive symptoms increase the risk by 3.16 times in developing dysfunction (p = 0.053). Conclusion: The data of this research allows us to conclude that patients with TMD, in this population, were more likely to develop changes in sleep and depressive symptoms.

Resposta clínica periodontal e controle glicêmico em pacientes com e sem diabetes tipo II portadores de periodontite crônica ao tratamento periodontal “full mouth desinfection”

There is a bidirectional association between periodontal disease (PD) and diabetes mellitus, in which diabetes favors the development of PD and PD, if left untreated, can worsen the metabolic control of diabetes. Thus, periodontal disease should be treated to restore periodontal health and reduce the complications of diabetes. Therefore, the objective is assess the effect of full mouth periodontal therapy decontamination (Full Mouth Desinfection - FMD) in diabetic type II patients with chronic periodontitis during 12 months. Thirty-one patients in group one (G1) and 12 in group two (G2) were followed at baseline, 03, 06 09 and 12 months. There following clinical parameters were accessed: probing on bleeding (BOP), visible plaque index (PI), probing depth (PD), clinical attachment level (CAL) and gingival recession (GR). For diabetic patients, there were also made laboratory tests to evaluate blood parameters: fasting glucose and glycated hemoglobin. The results had been analyzed in two ways: all sites in the mouth and another with diseased sites. The Mann-Whitney, Friedman and Wilcoxon tests were used with 5% significance. Intergroup analysis of all sites it is clear that there was no significant difference over time concerning PD, BOP, PI, CAL and RG. However, when evaluating the diseased sites, we observed significant difference for CAL and PD, with higher values in G1. The intragroup analysis for all sites showed a statistically significant reduction at PD, PI and BOP in both groups. Intragroup analysis of periodontal affected sites showed a statistically significant reduction in PD, BOP and CAL in both groups. There was also a statistically significant increase in RG values. There was no significant change concerning glycated hemoglobin and fasting glucose in the G1. Therefore, it can be concluded that there were improvements in periodontal parameters over the 12 months of research, but without changes in glycemic levels of diabetic patients. Thus, periodontal therapy proved effective in maintaining oral health.

Análise das LER/DORT notificadas no Rio Grande do Norte de 2010 a 2014

The increasing prevalence of Repetitive Strain Injury / Work-Related Musculoskeletal Disorders (RSI / MSDs) has been explained by changes in the work that has been characterized by setting goals and productivity. This fact does not take into account the psycho-physiological characteristics of workers who become ill as a result of professional activities engaged in and also the adverse conditions in which his work was done. This study aimed to analyze the RSI / MSDs reported in the state of Rio Grande do Norte, Brazil, 2010-2014 compared to the profile of the population, epidemiological aspects and features of these diseases. It is a descriptive epidemiological cross-sectional study using secondary data obtained in the Notifiable Diseases Information System (SINAN) in May 2015 was used as the area covered by the Rio Grande do Norte. Data were collected regarding the grievances of work-related RSI / MSDs, assigned by the Worker's Health Reference Center (CEREST) of the State Health Department. Data were processed with the help of Microsoft Excel® 2013 and presented in tables in absolute frequency (n) and relative frequency (%). The results showed a total of 403 notifications of RSI / MSDs, where the vast majority 72% (290) was recorded in Natal. Regarding the profile of notified employees, 88.59% (357) have aged between 25 and 54 years, 62.78% (253) were female, and in relation to education, 31.51% (127) had high school complete. The most affected occupations were seamstresses (the clothing industry) with 24.97% (97), followed by masons, construction with 3.23% (13) and cashiers with 2.99% (12). About the work situation, 75.93% (306) had a formal contract, however, were sent to Communications Occupational accidents (CAT) only 67% (270) of the cases. Regarding the signs and symptoms, pain and limitation of movement were the most mentioned respectively with 98.01% (395) and 95.04% (383) of notifications. Notifications, 94.29% (380) showed exposure to repetitive movements in their workplace. The most frequent specific diagnoses were synovitis and tenosynovitis (CID F 65), with 30.02% (121) of notifications, followed by back pain (CID F 54) to 19.35% (78) and shoulder injuries (ICD M 75) with 15.88% (64). They were away from work 81.64% (329) of workers reported with RSI / MSDs. Evolution more prevalent among cases was temporary disability with 75.68% (305). It was concluded that the SINAN is a database of potential to characterize the profile of RSI / MSDs, requiring, however, an improvement in the coverage of records and data quality. In addition, this study reflects the need to implement protection strategies to workers by companies, signaling promotion, prevention and rehabilitation aimed at reducing these injuries and the improvement of occupational health indicators in Rio Grande do Norte.

Avaliação clínica e da qualidade de vida utilizando dois protocolos para recuperação miofuncional em pacientes que se submeteram à cirurgia ortognática: resultados preliminares

The objective of this randomized, blind and prospective clinical trial was to compare the pain, the edema, the mandibular movements, the masticatory efficiency and life quality, in the first 60 days after surgery using 2 different clinical protocols for myofunctional recovery, in patients who underwent orthognathic surgery. A sample of 19 patients was used and divided into 2 groups. The control group (CG) consisted of 10 patients who had postoperative rehabilitation guided by a standard protocol, conducted by the Service of Surgery and Traumatology Oral and Maxillofacial. In other hand, the experimental group (EC) totaled 9 patients who received the speech therapy rehabilitation protocol specialized, by professionals in the area. The variables pain, edema and mandibular movements were analyzed during 48h, 96h, 7 days, 14 days, 30 and 60 days post-surgery. The masticatory efficiency and the quality of life were classified with 60 days after surgery . The data were submitted an analysis of variance, Student's t-test and Fisher's independence, at the level of 5% probability. It was identified that patients of GE have benefited in the first 14 days(p<0,001), as they have had reported less pain than those in the CG. Significant statistics differences between groups for pain parameters (after 14 days) (p=0,065), edema(p=0,063), mandibular movements(p=0,068), masticatory efficiency(p=0,630) and the impact on quality of life (p=0,813) were not observed on this study. The speech therapy protocol for myofunctional recovery (EG), although it has not obtained statistical results superiors than the CG in the general context, presents itself as a viable alternative to conventional therapy assumed by many maxillofacial surgeons, allowing the surgeon to optimize time with patients in the period postoperatively.

A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”

Promoção da alimentação saudável na atenção primária à saúde: contribuição para construção coletiva do saber-fazer

The recognition of the food as determinant and health-disease process etching requires new explanations and interventions of the food and nutrition policy action and demand health care model based on the completeness of the actions and focused on health promotion. This study, characterized as research-action of interventionist character, sought to develop strategies to support the transverse insertion of healthy eating promotion in professionals practices a core of support for the health of the family and a family health strategy Unit in the city of Natal, capital of Rio Grande do Norte, from the analysis of perceptions and work processes of these teams. Several methodological strategies were adopted: Dialectical Hermeneutical Circle, direct observation, reflective and Thematic Meetings Workshop "Rethinking the educational practices for promoting healthy eating". For data logging, search diaries - SD were used and moments. The analysis of procedural form occurred in conjunction with research participants, in constant movement of reflection-action-reflection, based on hermeneutics-dialectic. About the results, in relation to the promotion of health, showed the following insights: health promotion and disease prevention-related harms; health promotion related to quality of life and well-being, in its various dimensions; health promotion as a responsibility of the State; health promotion related to the actions of health education; health promotion as an expression of efficaciousness and accessibility to health services. Regarding healthy nutrition, predominated the perceptions relating to nutritional aspects. With regard to food and nutritional education - FNE, it was observed a predominance of perception of FNE as information, guidance and knowledge transfer for changes of dietary practices. As regards the working process, it was observed that among the actions for health promotion, educational activities predominate, such as lectures, conversations, groups that mostly occur in fragmentary form, without joint planning teams, varying according to the professionals and the moment of work in which they are carried out. The results pointed to the need for reorganization of the work processes, in the context of intra-and intersectoral coordination and the construction of new technologies, such as: Health project of the territory – HPT, Unique Therapeutic Project- UPT, Expanded Clinic and educational practices, Shared with active teaching and learning methodologies. From the results we believe that it is necessary to "thought reform", from changes in vocational training and strengthening of the permanent education spaces, whereas the complexity that involves feeding, food and nutrition education and health promotion. The reformation of thought must be articulate and closely tied to the production of knowledge and practices that encourage intersectoral approach, the transversality, dialogue and democratic and supportive attitude, based on the collective construction of know-how. We hope that this study can contribute with reflections and initiatives that encourage building practices that promote healthy eating in primary health care, in terms of completeness of the care and the attainment of food security and nutrition.

A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”