Estudo representacional da participação familiar nas atividades dos centros de atenção psicossocial no município de Natal-RN

Comprehending social representations of users relatives of Psychosocial Care Centers (CAPS) from Natal-RN, about their participation in the activities of these services, was the purpose of this study. The research instrument used was a semi-structured interview, led to 28 relatives of users of East and West CAPS II, East and North CAPS-ad, involved in the Relative Therapeutic Group, in Relative Meeting, in the Assembly of Users, Technicians and Relatives, according to the therapeutic schedule of each health services, between August to November 2007. Data obtained in family and users identification were characterized with the aid of charts and boards in absolute and/or percentage values. The discursive material from the guide from interviews was submitted to the informational resource ALCESTE (Analyse Lexicale par Contexte d'un Ensemble of Segments of Texte), and analyzed on the basis of the Theory of Social Representations and Central Nucleus Theory. Most of the relatives were women, married, aged over 50 years, who participated for more than two years in CAPS activities, and a coexistence of more than 11 years with the user. From the classification system of ALCESTE were selected categories, identified by: Category 1, Treatment Improvements and Expectations; Category 2, Living User Before and After; Category 3, Activities Relevance, Contradictions and Suggestions; Category 4, Guidelines -- Psychopharmacology and Medicalization; Category 5, Family Participation and Activities; and Category 6, Therapeutic Conditions Thanks, Tips and Vulnerability. The social representation of the family exists in the desire for change, identifying that we need to promote change by the continuity of therapeutic activities and overcome the detected inconsistencies, targeted by strengthening and by the stability of improvements in living and health conditions of users, experienced in CAPS treatment. The central nucleus had corresponded to positive changes in health and living conditions of users, and the peripheral elements were constituted by family conducts before and during treatment, and the expectations of changes in activities, especially in workshops. Despite this family participation be considered important, it still does not meet conditions to promote the inclusion of family, under an emancipating point of view, capable of causing in subject the hope for autonomy, initiative, individual and collective growths, a closer and active involvement in therapeutic activities, in workshops and discussions

A banalização da injustiça social no cotidiano de trabalho : a propósito da violência no trabalho e ameaça à saúde do trabalhador

Analyzes the factors that unleash violence by banalization of the problems and health questions of workers in a federal public institution, in Natal/RN. It analyzes transformations in the world of the work, with its politic, social and economic determinatives and its relation to the worker health. Boarding the violence in the work enviroment and its implications to the worker health, focusing on the banalization of problems faced by the workers as a kind of violence in and with the work. It was chosen an analitic methodology with qualitative approach, through the collection tecnic and information analyzes according to the thematic oral history, with recorders of authorized personal narratives, through individual interview with a semi-structured guide. In the analyzis of results it were made empiric cathegories: the daily work enviroment and its influence to the worker profession and life; the violence presents in the work enviroment and its consequences to the worker life and health; the banalization of the social injustice, due to violence against the worker that broked their dreams concerned to the nursing contribution. The results revealed the ordinary work of these workers showing enviromental and organizational unhealthy conditions, caracterized by physical and tecnical insecurity; absence and disqualification of instrumental and human supplies; overload and complexity service; bad distribution of the duties and pressure to the deadline and productivity, producing tension, conflict and anxiety related to the users, colleagues, superiors and to the duties. In the work enviroment, it were identified a external violence, caracterized by physical and verbal aggresion, psychic suffering, worker depreciation; and internal, caracterized by: moral and psychological molestations and accupational structural violence. These kinds of violence bring consequences to the life, that is, professional, economic and moral order of factors and to the health by biological, mental and emocional factors. The banalization of social injustice during the daily work was discussed in the aspects of banalization of problems and work conditions, the health, qualification banalizations and professional valorization. The workers expectatives pointed out to the necessity of: secure conditions of work; trainning and tecnical assistance; politics of attention to the physical, mental and social health to the workers and their family. We conclude the enviromental and organizational conditions of the workers interviewed do not offer physical and tecnical security that they need to the execution of their activities, neither offer comfort or physical and psychological satisfactions. The politic the instituition has used points out to the depreciation and inhumanization of them producing feelings as unsatisfaction, frustation and indignation related to the institution and the work, bringing suffering and physical and mental sicking. We noticed the most terrible violence found in the work enviroment is the banalization of social injustice related do the problems and health of these workers, producing a slowly debility and simbolic death of their lifes. Therefore, it is necessary the implementation of a politic that promotes assurance, health and integral education, valorization and humanization of these workers

Análise de qualidade da atenção à criança na estratégia saúde da família: o óbito infantil evitável como referência

Alma-Ata declaration bring the Primary Attention to the Health (PAH) as first level of health attention for individuals, family and community, which considers infant group as priority. Several initiatives that gave bases to integral attention to the children health formalized in the principles of Unique Health System. Family Health Strategy (FHS) comes to strengthen this attention, instituting new ways of work organization and professional practices that gave impact in their quality indicators. One of them is children mortality, showing decline in their values. Though, studies indicates persistence of avoidable infant deaths. In Natal RN, this reality is also perceptible leading to inquietudes, mainly at the space of services production, it means, which motivated the accomplishment of the present study intending to analyse the way that the organizational and structural processes as long as the professional practices in FHS interfered in the quality of children s health attention who died by avoidable death in the year of 2007 in municipal district of Natal-RN. It treats, therefore, to an exploratory and descriptive survey of cases study type, thar had as primary sources the oficial documents of MH, the family prontuary, pregnant card, child card and testimony obt ined from instrument of research elaborated based in investigation form of infant death by MH, applied to 10 mothers of children who had avoidable death. In analysis it was appealed silmultaneous triangulation of methods and sources, allowing a bigger aproximation from obtained informations. To elucidate the cases, the aspects studied were analyzed to the light of explicative model of Social Determinants of Health. Among individual and family aspects were highlighted the related to age, schooling, family habits and customs and mother s economic condition, besides of pregnancy age, newborn weight and associated diseases, which don t differ from literature about the theme. Reffering to the factors organizational and structural processes and professionals practice, highlihgted, the treatment given by the professionals, the territorialization and adscription of areas, the difficulty of having access to the services or sleepers and the reference and counterreference. But also, the ausence or few greet, the lack of communication, few assiduity and ponctuality by professionals in service, among others. In a general way mothers considers the attendance received in the hospital good and very good , opnions that in the Basic Attention weren t so favorable, in spite of many of predictible actions in this level have been performed in the studied cases. It is observed, therefore, that the social determinants of health has a strong influence in ocurrence of infant deaths, what implicates in a large actuation by Infant Mortality Committee from municipal district. This way, it becomes fundamental the reflection and evaluation about the effectiveness and execution by the processes of vigilance to health in FHUs; the rethink about the social determinants of health in a wide and articulate way to the services quality, to permanent education, to management in service, to the given attention and to the way how it is installed the popular participation and social control. To the professionals it is presented the great challenge to review their daily practice, their values, behaviors and commitment, which ones must be guided by logical of sharing, work in team, humanescence and alterity, not only by the accomplishment of a professional duty

A palavra cantada nos espaços intersubjetivos de um centro de atenção psisossocial do município do Natal/RN

The psychiatric care and mental health are undergoing constant change over the History. The Brazilian Psychiatric Reform, which brings up the deinstitutionalization as a structuring in the restorative care process. The Reform has as one of the mainly substitutive services the Centers for Psychosocial Care (CAPS), which work from the Singular Therapeutic Project (PTS) in order to restore the autonomy and restore the dignity of users. The therapeutic workshop is some of the resources used and work several kinds of activities as: writing, handcraft, music, poetry, and so forth. This study set up to apprehend the social representations of helping of the music workshop carried out in the CAPS II east of Natal/RN, from the reports given by the participants of the workshop, using the focal group as technique. This is a descriptive exploratory study with a qualitative approach. A total of 16 users participated in four musical therapeutic workshops from April to May 2010. The study was approved by the Ethics and Research Committee of UFRN. The discursive material from the workshop was submitted to the informational resource of Analyse Lexicale par Contexte d um Ensemble de Segments de Texte, ALCESTE, and analyzed based on the Theory of Representations and the Central Core Theory. The majority of subjects were men (62.5%), single (62.5%), aged 40-49 years (37.6%) and elementary school level (56.2 %). The reports were transcribed and submitted to the classification system of ALCESTE, which elected the following categories: Category 1 - Experience in the Word Family Sung, Category 2 - Musical Experiences and Approaches, and Category 3 - Feelings and emotions evoked by music. The representation of these individuals is anchored in the experience they have with the CAPS, lived and socialized by common sense, through this particular social group workshop objectified in music therapy as a therapeutic modality enjoyable. The central core revealed the intrinsic relationship between users and the music, establishing a relationship of openness to use the same while its therapeutic use in workshops of substitute services for mental health. Peripherals elements issues are related to listen, share and experience music in the family. Intermediary Elements relate to the feelings and emotions evoked by music, given her close relationship with it. It was found in the study that music can be construed as an artifact of good therapeutic responsiveness to users, configuring it as an invigorating and enjoyable therapy, confirming the need for continuity of this activity, as well as its expansion into the service

Terapia comunitária integrativa: construção de um espaço de escuta para os trabalhadores na atenção básica da saúde

This research, which appears in the form of a dissertation, entitled: Integrative Therapy Community: construction of a listening space to health care workers in primary care, addresses the Integrative Community Therapy (ICT) as a tool to create meeting spaces between health professionals where they can be receptive among one another. With the completion of this study aimed to analyze the ICT as a therapeutic approach and space of listening and speaking for health professionals cited here in order to identify their anxieties, doubts, worries and uncertainties arising from the context of labor relations and the impact of therapeutic experiences under the view of the participants. It was developed as an action-science research, involving several steps. The field of research was the ICT meetings of workers from the units under the Family Health Strategy of Northern Health Districts I and II of the city of Natal, using a qualitative approach. The interpretation of data collected was based on content analysis proposed by Bardin. Finally, this study showed the ICT as a space for dialogue and sharing, with repercussions on labor relations and expansions beyond the ICT meetings, reaching out to family and social relationships, contributing to creating bonds and solidarity networks. Under the view of the participants it was recognized as an experience that optimized the socialization, promoting the alleviation of suffering and increasing the well-being. Based on the study findings, it is inferred that ICT can be considered a viable tool for the receptiveness and humanized care of health care workers.

Reinternações psiquiátricas no Rio Grande do Norte: implicações e impacto das novas estratégias de atenção à saúde mental

The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital João Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care.

Atenção à saúde da pessoa idosa na estratégia saúde da família no município de Santo Antônio/RN: um estudo de caso

According to demographic estimates, by the year 2025 Brazil will be the sixth country in the world in number of elderly. For this reason, it is a purpose of public policies to help people to reach that age being healthier. The current health care model of health surveillance through the Family Health Strategy (EFS, in portuguese) is configured as a gateway into the care of the elderly in the Unified Health System (SUS, in portuguese). It is also an area of development of practices to promote health, prevention and control of chronic nondegenerative diseases. The aim of this study was to analyze the health care of the elderly provided by ESF professionals for the achievement of a full care. The study is descriptive case study with a quantitative approach, performed in the city of Santo Antônio/RN. The population included all health professionals, who are FHS members of the city that agreed to participate of the survey, a total of 80 professionals. Data were collected using a structured questionnaire, having mostly closed questions and divided into two parts: one containing sociodemographic information of health professionals and vocational training and the other, the activities carried on by the professionals in senior care, being analyzed from a database tabulated in a spreadsheet and discussed according to the descriptive statistics in tables, graphs and charts using frequencies, medians and values of central tendency. It was verified a predominance of professionals who finished highschool, mostly female, aged from 30 to 34 years old, with training completed in the last 10 years, without being graduated in the field of geriatrics or gerontology and mostly without training in gerontology. Family members and caregivers were the components of the social support network most identified by the professionals (66.3%).The elderly access to the Family Health Basic Unit was considered by83.8% of professionals as the most important factor that interferes in the activities of health care of the elderly. Considering the inclusion of the family in care: 98.8% of professionals consider the family as one of the goals of care, but 82.5% assist the family to know their role and participate in the care of the elderly, emphasizing that no professional makes use of tools for evaluating the functionality of the family. Regarding the actions taken to assist the elderly, 91.25% have home visits program to the elderly, 88.75% use the host program; 77.5% know the habits of life, cultural, ethical and religious values of the elderly, their families and their community ;51.25% complement the activities through intersectoral actions, 50%participate in groups of living with the elderly; 33.75% keeps track and maintain updated the health information of the elderly; 11.25% of the professionals perform the Single Therapy Planning (PTS, in portuguese) and few implement the actions to promote health according to PTS; there is a deficit in the number of professional categories in the identification and monitoring of the frail older people in their households. It is concluded that the health care of the elderly developed by ESF professionals differs among the professional categories. It was identified weaknesses in the promotion of an active and healthy aging and also in the establishment of an integrated and full care of the elderly. It is recommended the adoption of permanent educational activities by the City Management, initially for ESF professionals in the the perspective of the guidelines of the National Policy of Health Care for the Elderly and later to the other professionals that are part of the health care network of the elderly, at all levels of care in the city for the development of strategies and practices that promote the improvement of the quality of healthcare for the elderly, expecting concrete and effective results in terms of promoting health within Brazilian reality

O conhecimento e as atitudes das famílias de pacientes em tratamento em tuberculose na atenção primária à saúde

This study thus sought to examine knowledge about TB and attitudes of patients families in disease treatment in Primary Health Care in Natal- RN. To this end, a cross-sectional study was undertaken through a questionnaire with families of patients diagnosed with TB and follow up by APS from Natal. The study subjects were recruited from a non-probabilistic way, by convenience, contemplating a sample of 50 families. Among the criteria considered for inclusion of subjects, older than 18 years were considered, as well as residing with the TB patient and in Natal and availability to participate in the research. Data collection was performed by own researcher and an assistant, through a questionnaire with families of patients diagnosed with TB following the double independent digitalization of data. In the analytical phase, was initially conducted an exploratory phase and univariate data, with description of the position measurements (mean, median, mode) and dispersion (confidence interval and standard deviation). In bivariate analysis, it was conducted an intersection of dependent variables of knowledge e and changes of attitude dichotomous, with each of the independent variables, using contingency tables and calculating the chi-square test and, when appropriate, the Fisher exact test. In 2x2 tables, calculated the odds ratio (OR) with confidence intervals of 95% (95% CI). From the selected sample, 43 (86%) subjects were female, average age and median respectively of 46.64 and 46.50 years, 25 (50%) had elementary school. The knowledge expressed by family members about TB was considered satisfactory. However, the lack of interest of the family (54%) in seeking information about tuberculosis; the wrong way of reply in relation to the organism causing the disease (64%); the water content (62%) and contaminated food (54% ) as a means of spreading TB was a weakness identified in the investigation. Regarding the time of transmission, 90% of respondents indicated not know or answered wrong. From investigated independent variables, only two were associated with lack of knowledge of TB, and they did not have religion (OR: 0.146, 95% CI: 0.027 to 0.800) and income below 1, 7 minimum wages (OR: 0.155, 95% CI: 0.029 to 0.813). Thus they seem to exercise a protective effect on this outcome. As for the changes in attitude, most of the found variables had no association with statistical significance, except no internet access (OR: 0.212, 95% CI: 0,048-0, 935). Most attitudes were positive in relation to TB patient. Results have demonstrated weaknesses in TB care, which has taken on a more individual and welfare character. Data not only express health outcomes produced by health services, but also the political and social situation of the families that are affected by TB

Desistência ao tratamento de usuários de crack no centro de atenção pssicosocial em Campina Grande/PB

This study aimed to analyze the phenomenon of abdication of monitoring/treatment of crack users in a CAPS AD in Campina Grande-PB. That s an exploratory , description approach ,whose theoretical focus was historical-dialect of public politics on alcohol and drugs. The information collected was realized by using the technique of semi-structured interviews, combined with the crack users registered in CAPS AD in Campina Grande between 2007 and 2011.The material collected was subjected to thematic analysis method, obtaining the extraction of the following categories and subcategories of analysis: CATEGORY 1: Factors of abdication of monitoring/treatment in CAPS AD in Campina Grande PB with subcategory 1.1. Abdication on their own , 1.2. To take work/employment, 1.3 . Search for more intensive treatment , 1.4. Due to relapse; CATEGORY 2 : Treatment/monitoring in CAPS AD to the subcategory, 2.1. The dependence of crack and family support as reasons that led to frequent CAPS AD. CATEGORY 3: Living with crack addiction without treatment/monitoring in CAPS AD with the subcategory, 3.1. Religiosity as a therapeutic tool .The results showed a distance between priority for community treatment and the reality where there is lack of information about this kind of treatment and the admission as a solution. The discourse about the abdication of treatment of crack users make reference to the importance of family support, to the influence for the phenomenon of relapse and the affection to religious conceptions. Although the subjects recognize the qualifications of CAPS AD treatment, they try by themselves or by family influence, another ways of hospitalization. This leads us to conclude that it is necessary reflection and assessment of the work of CAPS AD. Counting on the social changes and the need of answers that the phenomenon requires

Autoestima e qualidade de vida de pessoas com úlcera venosa atendidas na atenção primária

Venous ulcers (VU) is a chronic injury of the lower extremities and because of its high incidence and recurrence implies long and complex treatments, damaging the quality of life (QOL) and self-esteem (SE) of the people. This study aimed to analyze the association between self-esteem with the quality of life of people with venous ulcers treated in primary care. Cross sectional analytical study with a quantitative approach conducted with 44 people met with VU at 13 primary care units 2 and Mixed units in Natal/RN. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte (UFRN), CAAE: 07556312.0.0000.5537. Held data collection from February to April 2014 and used three instruments: a structured form covering sociodemographic, health care and clinical variables, the Rosenberg Self-Esteem Scale and the SF-36. The collected data were entered into a database and processed on computerized software for descriptive and inferential analyzes. The results showed a predominance of people with UV females (65,9%), with more than 60 years (59,1%), married or in a stable relationship (52,3%), low education (86,4%) without occupation (68,2%) and less than one minimum wage income (81,8%). Regarding assistance characteristics was observed that most patients performed the dressing with appropriate material (72,7%), professional or trained caregiver (61,4%) did not use compression therapy (81,8%), treating the injury for more than 6 months (77,3%), lack of guidelines for the use of compression therapy, elevation of legs, and regular exercise (77,3%) and consulting the angiologist last year (52,3% ). Regarding clinical features of the lesion was found that most of the recurrent lesions are (77,3%), over one year of current lesion (52,3%) medium to large lesions (54,8%), without signs of infection (61,3%) and pain (79,5%). The mean SE of respondents was 9,3 (± 5,1). The relations between the SE and the sociodemographic variables, health care and clinics showed that individuals without a partner (a) (p = 0,01), who did not wear compression therapy (p = 0,04), with more 6 months of treatment (p = 0,01) and larger lesions (p = 0,01) had a lower SE. The mean domain and the dimensions of the SF-36 were lower emphasizing the functional capacity 36.5 (± 27,6) and the physical aspects of 15.3 (± 30,6). There were significant correlations between AE people with VU and the domains and dimensions of the SF-36: physical functioning (r = -0,432), general health (r = -0,415), vitality (r = -0,573), aspects social (r = -0,517), mental health (r = -0,612) and mental health dimensions (r = -0,612) and physical health (r = -0,473). Based on these results it is concluded by rejecting the null hypothesis and accept the alternative proposed in the study in which it was found that there is a negative correlation between the SE and the QOL of people with venous ulcers

Análise do modelo de gestão implantado no Centro de Atenção Psicossocial CAPS II OESTE de 1995 a 2005, situado no distrito sanitário Oeste do município de Natal/RN, à luz da Co-gestão

This dissertation has as aim the praxis of co-management of the health service of CAPS II OESTE of Natal-RN, where health workers, family members got to materialize guidelines and principles of psychiatric Brazilian reform in real possibilities of subjectivity construction, whereas they changed social relations in daily life. The path chosen to record was from testimonials and contributions of those who meant their done. Redeeming this story from social representations of the majority of their builders was an instigating, delicate and rewarding task, emphasizing the living memory, rebuilt in a line of time which could not be found in simple documentary collections. Mainly, by knowing that service routine was intense and had as characteristic the singular mobility itself from a creation process and therefore not always its dynamic allowed adequate records. At the same time, from this occurred the field and bibliographic research which allowed the detailed information from the prior milestones and motivated to the practice here reported. The rereading of concepts in an interface with the reports of the interviewees enabled the verification that the model of mental health advocated by psychiatric reform was understood. Once noticed the presence of the beliefs and values of people in motivating energy for the progress of reform, it has gone to fetch theoretical subsidies of administrative order to understand how they saw this building and that uniqueness has been printed. The theoretical way and praxis have tracked here has allowed to analyze how occurred such a process of production and subjectivity and collectives that when organize enabled themselves for analysis and intervention, including in crisis situations. Therefore, it was revealed that ethical and multi-disciplinarity, the humanitarian sense, the coresponsibility, co-production and horizontal management were the key factors for spread from a changing protagonist. One can thus conclude that co-management from that collective has been multi-disciplinary weaving a cross

Os Centros de Especialidades Odontológicas como suporte da atenção básica: uma avaliação na perspectiva da integralidade

The public dental services in Brazil were limited, practically, to the basic care, so that the specialized services acted, up to 2002, no more than 3,5% of the total of clinical procedures. That lower offer reveals the difficulty of continuity of the attention, that is, the comprehensiveness in the assistance, particulary, the reference and counter-reference system. Brasil Sorridente search to supply those needs when proposing Speciality Dental's Centers(CEOs Centros de Especialidades Odontológicas, Brazil) to compose the services of average complexity. In 2005, Ministry of Health enabled the three CEOs of Natal, located in the North II, East and West Sanitary Districts. This investigation evaluated the implantation of these CEOs, as support of the family health care teams, in the perspective of organization of the services in assistencial nets in Natal/RN. It was a study of evaluation, with qualitative approach and some quantitative data as contribution. Dentists, users and managers were interviewed to identify and to understand their perceptions, relationships and experiences in the daily of the services. The conceptual base that orientated the investigation was the principle of comprehensiveness, in its operational sense of the hierarchization in health attention levels. The collection of data was done with documental research, direct observation and semi-structured interview. The analysis was accomplished by triangulation of the extracted content from the used techniques and sources of interviewed groups depositions, looking for theoretical-conceptual support in specific bibliography. The results pointed aspects that go away from the comprehensiveness like: low resolution of problems in the basic net; little valorization of the space in the health units; traditional models of access to health services, insufficient offer for some specialties, compromising the reference and counter-reference system; practices centered in procedures in the CEO; bureaucratic directions from basic care to the specialized service; disintegrated and disjointed system among levels of attention; disrespect to the municipal protocol. On the other hand, there is an approach of compreensiveness in situations like: increase of the access and covering in the Family Health Strategy (ESF Estratégia Saúde da Família, Brazil); larger approach between professional and user; tendency to the quantitative and qualitative growth of specialized actions; punctual initiatives of relationships among levels; existence of protocol to guide professionals

Perspectivados cirurgiões-dentistas sobre a inserção da fisioterapia na atenção básica de saúde

This work aims at investigating the surgeons-dentists acceptability in the field of public health in the city of Natal, State of Rio Grande do Norte, about the possibility of medicinal plants insertion in basic attencion of health. Moreover, it searchs to know if during their professinal formation it had some theoretician-pratical basement on this subject, as well as investigating their confidence on the medicinal plants. The basic motivation for developing this study is the possibility of contributing to the insertion of a tradicional health pratical at public assistance scope, endorsed by popular use, but now scientifically proven. For in a such way, the medicinal plants use is emphasized as a way to be followed to increase basic pharmaceutical assistance, improving the acess to the medicine and diminish expenses. Following this logic, family health program constitutes the way through which this pratical will be available to the users of health services. The research was done over thirty surgeonsdentists, all ofthem pertaining to public service ofNatal, state ofRio Grande do Norte. It was used, as research instrument, semi-estructured interview associated with methodological analysis user s speeches. On this form, this work is inserted in a trend observed nowadays not only in Brazil, where the use of the medicinal plants has been stimulated and defended to be inserted at programs ofprimary attenction of health

Centros de especialidades odontológicas: avaliação da atenção de média complexidade na rede pública da Grande Natal

The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems

Projetos políticos pedagógicos dos cursos de Odontologia do RN : formação profissional e a perspectiva da atenção à terceira idade

Brazil has been undergoing major demographic change.According to IBGE, the next 20 years the country's elderly population may reach over 30 million people. This tariff provides specifics regarding the process of health / disease. It is essential that higher education institutions are committed to this demand in view of the integrated training of health needs of society. The aim of this study is to analyze the Pedagogical Political Projects (PPP) of courses in dentistry in Rio Grande do Norte (RN), according to the national curriculum guidelines (DCNS) and training from the perspective of health care for the elderly. This is an exploratory study with a qualitative approach: with records and interviews. The study subjects were an Assistant Professor in the development of PPPs for each institution. The scenario in this study were dental training institutions in the newborns. Initially, the analysis of the PPP was by using the Alceste 4.9 software. The interpretation of the contents of interviews with teachers was done through content analysis of Bardin (2010). The PPPs are based on the DCNS, meet the characteristics of regional and seek a generalist, but still strongly directed to technical and scientific aspects of professional practice. Efforts and institutional approaches, involving teachers and students of the courses are being mobilized for training with more articulated network of health services. However, the emphasis on content pertaining to the health care of the elderly, is still limited when compared to those targeted content inherent in children and adolescents in all three curricular structures. It is reasonable to conclude that the historical, political, scientific, cultural and social, present in society, influence the formation of the dental professional RN. The greater participation of society in the process of vocational training in dentistry is needed. This can be done from the involvement of universities with health councils, bodies representing the dental profession and other segments of civil society in order to induce changes that generate ideas and educational practices integrative and interdisciplinary, with emphasis on continuing education for teachers, servants, employees and students. Containing conduct this process inherent flexibility of curriculum, teaching-service integration and coordination abilities and professional skills that are essential to understanding the human being and its complexities