Práticas institucionais/discursivas acerca dos cuidados com os bebês prematuros e/ou de baixo peso: o programa canguru

The Kangaroo Program was implemented in Brazil in 2000 through the Unified Health System (Sistema Único de Saúde SUS) sustained with a humanized rethoric of health care assistance. This program adopts the skin-to-skin contact contributing to the mother-infant bond, breastfeeding and promoting security in mother s care. The users of SUS are encouraged to live in the maternity ward to follow the baby health improvement. However, it was verified in previous observations that mothers participation in the Kangaroo Program has been done through an imposed practice. Therefore, this study intended to understand the texts that permeate the kangaroo practice. This research was developed through two studies: 1) an historic exploration of motherhood concept and an analysis of how the motherhood is presented in the official document that orients the program; 2) an analysis of institutional dynamic of Kangaroo Program, emphasizing the study about the health workers everyday practice, the mothers view about their life in the maternity wards, and the attendance practice. It is highlighted that the relation between this two studies allowed the comprehension abouthow the official discourses can influence the health workers behaviors and how their viewpoint and position can shape the everyday work in a public health program. This research, supported by Institutional Ethnography, considers that people s practices and experiences are socially organized and shaped by broad social forces. The discourse method was used in the documental analysis and in the analysis of qualitative data from empiric research. The research showed that the kangaroo program has been an excellent way to save resources and to improve some baby s biologic and psychological aspects. However, this program has failed to consider the social, economic and cultural complexity of mothers and the structural limitation of the health care system. The official document uses the economic and medical approach, following the hegemonic biomedical model and the life style of the people that don t use the public health system. Consequently, the program has not been successful because it is planned without people participation. On the other hand, it was verified that although some professionals are committed with their work, the mainly does not consider mothers participation as an active process, using the institutional power as a social control to keep mothers uninformed about the possibility to leave the maternity wards. As a result, the research also showed that mothers perceive the program as mandatory and not as option that can improve pleasure moments. It is, therefore, necessary to consider the complex social determinants of health that can increase mothers participation in the Kangaroo Program. Bringing these issues into debate can be a reflective exercise on citizenship and governance, allowing spaces for the improvement of public health programs

Papel da extensão e do trabalho junto à comunidade na formação médica

SILVA, Thiago Demétrio Nogueira Costa e; CORRÊA, Edison José; MARANHÃO, Técia Maria de Oliveira. O papel da extensão e do trabalho junto à comunidade na formação Médica. Revista Eletrônica Pesquisa Médica, v.1, n.3, p.9-13, jul./set. 2007

Racionalidade substantiva no processo decisório: um estudo em instituições que lidam com o tratamento oncológico infantojuvenil na cidade de Natal-RN

The present study regards an applied social research (qualitative) performed in two institutions which lead children s cancer treatment in Natal, Rio Grande do Norte. The main goal of this study is, as of a literature review at works which characterizes the first generations of study about substantive rationality, to detect Decision Making process related aspects that may serve as a basis to elaborate analysis categories from decision making process, aggregating them into a new study that may provide an advance to the theme in administrative science. The academic works based on the analysis model created by Mauricio Serva served as a basis to deep research into such theme, which verifies the predominant rationality in eleven administrative internal processes in productive organizations. This dissertation intends to go beyond the identification of the predominant rationality by elaborating new categories of analysis, and making possible the continuity of the subject in administrative science. Based on Guerreiro Ramos s work, which sees a kind of ideal organization, as known as isonomies, this study still calls upon Karl Polanyi s thoughts, which with the objective of comprehending the independent economic phenomenon of the value that allows considering non-market economies, find that the economy of the men is submerged in his social relations; it also rescues the studies from Max Weber who investigates the meaning of social action to better understand the rationality, and refers to the study of Jürgen Habermas, who proposes a broader conception about rationality, within the theory of communicative action. As a result of this theme s review, seven analysis categories of the decision making process have been formulated. They were applied in the institutions that had been chosen and helped to detect the type of predominant rationality in the categories of the decision making process. The results confirm that, although the decisions making process involves rational elements, such as information, identification of alternatives, there are also specific values of each individual with his experience and view oh the world, permeated not only by instrumental rationality, but also by substantive rationality. The study has verified that two similar institutions may show different types of rationality in the decision making process, when decision factors may tend to instrumental rationality, according to administration classic way, as well as they may emerge from substantive rationality, thus contributing to the process of emancipation of the human being in his sphere of work

Uma cidade para pessoas: funcionalidade, racionalidade e emotividade nas relações mobiliário urbano, espaço público e cidadãos

This research investigates how functionality, rationality, and emotionality applied to urban furniture design contribute to the organization, legibility, and qualification of public spaces, according to different layouts, physical and visual qualities of the urban furniture as well as the quality of urban infrastructure that may influence the uses and appropriation of urban spaces by pedestrians, turning those spaces into socially centripetal or centrifugal places. The work consists of two parts. First refers to a bibliographical review concerning two main issues of the investigation: product design and legibility of public space, defining the conceptual and theoretical bases, linked to methodological strategies aimed at systemic planning and integrated management of urban furniture design and legibility of public spaces (sidewalks), that are necessary to define the existing relationships among the user s interface (pedestrians); product (urban artifacts); built environment (sidewalks). The second part refers to the achievement of empirical approach throughout visual analysis of public spaces and the functional and qualitative evaluation of the existing urban furniture in the central neighborhood of Cidade Alta, Natal, RN, according to the theoretical researched concepts and methodological procedures. The results expose the weaknesses and levels of intensity arising from the relations among public space, urban furniture, and users, revealing the need for theoretical and practical approaches which would help the decision-making in planning, designing and integrating innovative, sustainable, and ethical solutions in order to design attractive public spaces that could provide sociability and citizenship throughout integrated public management, city systemic thinking and urban identity. The suggested guidelines at the end of this research will provide the necessary strategies to design suitable urban furniture systems according to aesthetic and practical urban infrastructure and city context, aiming to ease visual and physical conflicts that may negatively interfere with the appropriation of public spaces by the citizens

Efeitos de um extrato aquoso de buzhong yi qi wan (fórmula magistral chinesa) na marcação de constituintes sanguíneos com tecnécio-99m, na morfologia e na fragilidade osmótica de hemácias de ratos Wistar

Technetium-99m (99mTc) has been used to obtain several radiobiocomplexes utilized to aid in the diagnosis of diseases. Blood constituents, as red blood cells (RBC) and plasma proteins, have been labeled with 99mTc. Natural and synthetic drugs can alter the labeling of these constituents. The aim of this work was to investigate the possibility of a Buzhong YiQi Wan extract to alter (i) the labeling of blood constituents with 99mTc, (ii) the RBC morphology, and (iii) osmotic fragility of RBC withdrawn from Wistar rats. The data showed that the BYQW extract (i) could affect labeling of blood constituintes with 99mTc, (ii) could affect the membrane integrity decreasing the osmotic resistance and (iii) could not alter the shape of RBC. Probably, these findings would be associated with properties of the substances present in the aqueous extract of BYQW. This study has multiple disciplinary aspects in knowledge areas: Radiobiology, Botanic, Phytotherapy and Haematology

A Humanização e a Formação Médica na Perspectiva dos Estudantes de Medicina da Universidade Federal do Rio Grande do Norte

The aim of this study is to understand the perception of medical students at the Federal University of Rio Grande do Norte (UFRN) about humanization in the context of their medical formation, using a qualitative approach. The focus group and participant observation techniques were used, involving a multidisciplinary team composed of professionals from the areas of anthropology and psychology, as well as professors from the medical course, who studied two groups of nine students in their final year. The data were analyzed using the categorical thematic content analysis technique, from which emerged three categories: student/patient relationship, teaching/learning and student/professor relationship. The first allows us to identify that student-patient contact is an essential experience for adopting a more humanized view of the disease process. The second category shows that unqualified professors in the pedagogic practices inherent to the teaching profession and the theory the practical dichotomy hinder the autonomous and holistic formation of knowledge. Similarly, the lack of practices outside the academic environment and the absence of multiprofessional stimulation interfere in the construction of an integral view of the individual. From the third category, the student/professor relationship, emerge two opposing subcategories (professor model and assymetric relationships), which reflect the importance of the professor`s ethical humanist position, as opposed to an authoritarian attitude, to form the professional attitude of the student. The results point important aspects of the medical formation that may open a discussion about humanization, in the context of new national curricular guidelines

Da escala médica de saúde à experiência social do saudável :diálogo entre os espaços dos bares e das academias fisiculturistas na cidade do Natal-RN

Currently, we attend a reverence of concepts ahead as health, life, youth and body. In we widen amount the ideals concerned to the healthful life, to the quality of life, the longevity and joviality and the extremities of the body represented by the illness, for the virus infection, the physical deficiency and the aging. Of the historical shades of the plague, of the hunger and the war that gagged the defenseless individual and its body, in the current days we increase the search for a full and powerful life, independent of a religious imaginary to predict the epidemic curse, the threat represented for the sick people and the incarnate divine anger in the death; or of medical science presented in the spaces of the technology and the physiology, being left fragile the social and psychological dimensions of the human confined to the patient issue and, finally, the commanded urban health politics in quantitative goals of hygienic cleaning, of the medical techniques and the education citizen. For beyond these instances, emerges in our days a plural, close and biographical agreement well of the body and welfare. On the other hand, an understanding of the healthful life and well-being that more certifies the presence of something the one that clear landmarks amongst normality and the irregularity, the esteem and the destructive vice: it has a projection of healthful life measures without conceptual models of body and health under the doctor-scientific standard occidental. This thematic one will confide in way to the enclosure for spaces to the muscles and fitness exercises and the bars from the city of Natal, in the state of Rio Grande do Norte, Brazil, while comprehensive interchange concerning as the individual comes dealing with the notion the body and health and, mainly, if perceiving inside of its body and its health. Amongst these two spaces of typical leisure of the modern urban phenomenon, the hedonism bodily with its muscles and salience and one another form of hedonism in the fruition of allowed drugs will be across itself in a dialogue about which social s relationships are really in game in an imaginary construction amongst an doctor-aesthetic ideal of health and the social and subjective experience in the option for a healthful life

Tramas da (ir)racionalidade contemporânea para a composição do mito-tecno-lógico

The plot myth-techno-logic, contemporary, was developed starting from the dualism myth-reason. In this study, we deepened the alluded dualism taking as reference the historical contexts of the Renaissance and of the Enlightenment, emphasizing the discussion of the economical rationalization as conductive thread of the western development, in which we identified the game of the rational and of the irrational, for assure the superiority of the reason. In the context of that game, we analyzed the implications of the modernization, for the education, in function of the instrumental rationality, responsible for the environment of adaptation of the technological instruments to the scenery of the contemporary modernization. The new context is constituted by points of union and of ruptures among the technique, the science and the myth. Through our analysis, we noticed that the basic needs for the contemporary society were linked to the changes in the production means, for which the machine determine the rhythm of the work and the quality of the product. However, the changes in the productive processes promoted the appearance of the commercial marks that, as we see it, they represented the synthesis of the perfect harmony of the myth, of the technique, of the science and of the technology, in the conduction of the economical rationalization to the contemporary modernization. Thus, the contemporary modernization it arrives us for the economical rationalization, developed with the support of the technician-scientific knowledge and communicated by the articulations of the myth-techno-logical

ISE-SPL: Uma abordagem baseada em linha de produtos de software aplicada à geração automática de sistemas para educação médica na plataforma E-learning

E-learning, which refers to the use of Internet-related technologies to improve knowledge and learning, has emerged as a complementary form of education, bringing advantages such as increased accessibility to information, personalized learning, democratization of education and ease of update, distribution and standardization of the content. In this sense, this paper aims to develop a tool, named ISE-SPL, whose purpose is the automatic generation of E-learning systems for medical education, making use of concepts of Software Product Lines. It consists of an innovative methodology for medical education that aims to assist professors of healthcare in their teaching through the use of educational technologies, all based on computing applied to healthcare (Informatics in Health). The tests performed to validate the ISE-SPL were divided into two stages: the first was made by using a software analysis tool similar to ISE-SPL, called SPLOT and the second was performed through usability questionnaires to healthcare professors who used ISESPL. Both tests showed positive results, proving it to be an efficient tool for generation of E-learning software and useful for professors in healthcare

Ciência e racionalidade em Thomas Kuhn

The work aims to explore the impact that Thomas Kuhn‟s philosophical work had on the philosophy of science, especially on the common idea of scientific rationality. Besides this, it aims to make clear the position of the author about his understanding of what is to be rational in science. In order to achieve this goal we start giving a panoramic view of the philosophical scientific scene of the first half os the twentieth century, to evince the main character of the concept of rationality more accepted at Kuhn‟s time. In a second moment we show how the ideas of this author contrast with that concept, which gives rise to a series of criticisms of irrationalism. Lastly, we show how Kuhn circumvents these accusations by pointing to a new rationality concept, through which we can conciliate his philosophy with a description of the rational development of science

A capitania de São José do Piauhy na racionalidade espacial Pombalina (1750-1777)

Em meio às intervenções políticas, econômicas e administrativas realizadas no Brasil a partir de 1750, é possível observar como se deram as tentativas de organização da capitania de São José do Piauhy e até mesmo o seu reconhecimento como importante área pecuarista da colônia. Neste trabalho, realizou-se um recorte espacial priorizando a região em que a apropriação territorial teria se dado de forma mais diversa em tal capitania, pois além dos procedimentos de aquisição de sesmarias, existiram ainda os processos de herança e confisco. Sobre estes últimos, os mesmos incidiram sobre as fazendas que pertenceram ao sertanista baiano Domingos Afonso Mafrense, e que após serem deixadas de herança para os religiosos da Companhia de Jesus (1711), foram confiscadas pela Coroa Portuguesa (1759). Isso aconteceu em meio ao planejamento e execução de medidas governamentais que atingiram todos os domínios portugueses durante esse período, a chamada Política Pombalina. Tais intervenções administrativas, por sua vez, puderam ser analisadas tomando-se como referência a confecção da primeira representação cartográfica destinada a tal capitania, o Mappa Geográfico da Capitania do Piauhy, produzido pelo engenheiro italiano Henrique Antônio Galúcio. Deste modo, considerando-se as particularidades da política portuguesa destinada ao interior do Brasil, em meados do séc. XVIII, com destaque para as medidas incidentes sobre os modos de vida indígena e rural, observou-se a tentativa de implantar-se uma nova forma de organização espacial, a partir de modos e instalações urbanas. Neste contexto, São José do Piauhy passa a ser alvo de intensas investidas enquanto área oficialmente pertencente ao Estado do Grão-Pará e Maranhão

Relação entre a doença periodontal e doença cardiovascular: há uma preocupação por parte dos que fazem clínica médica e odontológica na cidade de Natal?

The relationship between periodontal and cardiovascular diseases is a reality in the current days. The knowledge about the role of periodontal disease as a risk factor to cardiovascular disease from dentistry and physicians is very important to try to eliminate this risk factor. The aim of this work was to investigate, using a questionary, if physicians and dentistry are aware about this relationship and if they think that it is important. These forms were distributed in 4 groups: cardiologists (n=90), physicians from other specialist (POS) (n=110), periodontists (n=35) and dentistry from other specialist (DOE) (n=85). We had a loss off 32,4% of the total sample due to a lack of response of some professionals. Our results showed that all cardiologists, all dentists and 68,2% of POE said that they had gotten information about the relationship between periodontal and cardiovascular disease, and just 6 POS don t believe that this relationship can occur. When questioned if, even when a periodontal disease is diagnosed, there is a habit to treat or orient the patient for treatment, 29,5% of cardiologists answered no, 25,5% of POE also answered that they did not orient and only 1 DOE answered that he did not treat nor orient. All periodontists said that treat their patients when periodontal disease was identify. The physicians seem not to find important the relationship that exist between periodontal and cardiovascular diseases and the dentistry have shown a good knowledge about this subject. Maybe, if physicians and dentistry work together, the incidence of cardiovascular disease decreases

Lembranças de alunos, imagens de professores: narrativas e diálogos sobre a formação médica

Se trata de una incursión histórica por el pensamiento y por la enseñanza médica, discutiéndose la formación médica de manera contextualizada, con el objetivo de comprenderla para interpretarla a través del recuerdo que haya sido fijado por los alumnos. Se dará un enfoque a la mediación pedagógica de esa formación, intentando proporcionar el diálogo entre la historia social de la Medicina y los recuerdos de alumnos, ubicándolas en un contexto histórico-social y cultural, al mismo tiempo en que se ha buscado sujetar las imágenes de los profesores que hayan dejado huellas significativas en la vida de los alumnos, en cuestiones profesionales, sociales y culturales. Se configura, asimismo, una memoria de la formación médica de la Faculdade de Medicina da Universidade Federal do Rio Grande do Norte (UFRN), desde su creación en el 1955, como Faculdade de Medicina de Natal, hasta el 1963, como Faculdade de Medicina da UFRN. Los recuerdos han sido recolectados por medio de entrevistas temáticas con alumnos ya formados de las tres primeras turmas concluyentes, de los años del 1961, 1962 y 1963, de la referida Facultad y fueron interpretadas utilizándose la cartografía como técnica que envuelve la construcción de cuadros interpretativos, teniendo como unidad de análisis las palabras representativas de los elementos constituyentes de la mediación pedagógica, sacadas de las narrativas de los sujetos, que cargan también las imágenes de los profesores que han compuesto dicho diálogo por sus contribuciones para la existencia del saber y hacer de la educación médica en Natal/RN. Aún se comprende que esa Facultad fue creada en un momento histórico-social y cultural en que Brasil y el mundo todavía intentaban encontrar nuevos caminos, después de turbulencias causadas por la Segunda Guerra Mundial, y la intelectualidad natalense visualizaba el encaje de la ciudad en los parámetros de la modernidad. El currículum implantado era técnico/racional, pero al ser interpretado por la acción, a través de la reconstrucción de los recuerdos de los alumnos, en los vestigios de la mediación pedagógica de la formación médica y en las imágenes de los profesores todavía vivas en sus memorias, se vuelve posible entender que a esos alumnos ha sido enseñado: un saber relacional que permitía el diálogo, la transmisión de experiencia y el compromiso médico con vista a un atendimiento a la populación en primer lugar, siguiéndole el sentimiento que fomentaba deseos de ayuda al próximo, siendo los propios profesores el ejemplo, conformándose, así, con un saber contextual, agregado a una participación política y de responsabilidad ética para con la sociedad

A concepção de humanização no contexto da formação médica: o caso da UFRN

This thesis aims at understanding the aspects related to the concept of humanization that contribute to a humanized education in the pedagogical project of the medicine graduation course of the Federal University of Rio Grande do Norte (UFRN). It has been used a qualitative research through non - structured interviews to six professors and through the focus group technique with participant observation of 30 students of the 2 nd , 4 th and 6 th terms of the med program. The data has been analyzed through the cate gorical thematic subject analysis technique from which two categories have emerged: tendency changes and initial changes. In the former we ’ ve identified aspects related to the social reality based in the experiences of professors and students in their work field; the competencies such as stimulation to the students ’ critical and reflexive knowledge through professors ’ encouragements and learning to learn as a way of developing professors ’ education towards the process of learning and evaluation of students. In the latter, we ’ ve noticed positive and negative aspects. While in the positive aspects we ’ ve testified actions and attitudes that were crucial for the development of the curricular proposals, in the negative ones we ’ ve verified controversial arguments between the students and teachers ’ speeches regarding the process of medical education in a humanized approach. For last, we ’ ve got large different results within the period investigated. However, we understand that the data found in the study has contribu ted to reach the proposed objectives regarding what has been perceived between the professors and students ’ point of views in relation to a humanized based education. Even if it ́s an initial perception, it is moving towards a medical education more humaniz ed and centered in the human being.

Imitating art – estratégia inovadora de educação médica: identificando desafios e possibilidades

Este estudo de caráter qualitativo, com base em metodologia pesquisa – ação, procurou descrever características funcionais da estratégia de ensino „Imitating Art”, construída com base em métodos de dramatização, solução de problemas e tempestade cerebral e alicerçada no processo de ensino de arte do conhecer, apreciar e fazer arte. Participaram da pesquisa 96 alunos do ensino em saúde com idade média de 21 anos. Com o objetivo de desenhar as características funcionais da estratégia, a mesma foi planejada, descrita, modificada e avaliada em 4 etapas: experimentação, metodização, adequação e replicação. Cada etapa foi verificada a partir de avaliação observacional pelos docentes envolvidos e análise de conteúdo sobre as respostas dos alunos participantes, em instrumento de avaliação próprio. Da fase experimental participaram 14 alunos dos quais 100 % aprovaram a estratégia. A análise de conteúdo mostrou Identificação de ferramentas cognitivas e afetivas (30,6%), características da atividade (22,2%), e mediação de trabalho em grupo (16,7%). A observação identificou ativo trabalho atitudinal em uma dinâmica de grupo criativa. Na fase de metodização participaram 31 alunos, dos quais 96,9% aprovaram a estratégia. Na análise de conteúdo, as ideias mais presentes foram, dificuldades encontradas pelos participantes (28%), identificação de ferramentas cognitivas e afetivas (17,6%), Implicação da estratégia no cotidiano profissional (13,2%) e mediação do trabalho em grupo (13,2%). Na fase de Adequação, participaram 32 alunos, dos quais 90,7% demonstraram aprovação da estratégia. A avaliação dos participantes evidenciou como mais importante a mediação do trabalho em grupo (29,6%), identificação de ferramentas cognitivas e afetivas (21,3%) e características da atividade (19,7%). A fase de replicação teve 19 alunos, dos quais 100% aprovaram a estratégia e cuja avaliação demonstrou principalmente dificuldades encontradas pelo participante (27,8%), mediação do trabalho em grupo (25%) e Habilidade criativa da atividade (22,2%). A avaliação bidimensional mostrou que se constitui como uma estratégia de abordagem ativa e colaborativa, podendo ser usada como instrumento linear de diagnóstico e incremento de competências atitudinais tais como criatividade e trabalho em grupo.