A preceptoria na estratégia saúde da família: o olhar dos profissionais de saúde

The proposal of teaching-service integration from work experience brings a challenge to the professionals involved in health services: to combine their healthcare practice to the preparation of new professionals in accordance with the national health model. In Recife, the assistance network is known as school network, since it provides all its health equipment for Higher Education Institutions, in special for professionals who work as preceptors, making this activity an important component of the services network. The objective of the present study was to analyze preceptorship experience herein Multidisciplinary Residences in Health in the look of health professionals. This is a qualitative descriptive study, involving physicians, dentists, and nurses that have worked as preceptors for at least two years in multidisciplinary residency linked to two Higher Education Institutions. A semistructured interview was used as research instrument and data were processed by using the software Alceste 4.9. Results indicated four semantic classes which were divided into two axis. Axis 1, composed of class 4, and Axis 2, composed of classes 3, 2 and 1. Categorization considered the relation between classes. It was observed that in class 4 work overload is a dilemma for professional participation in preceptorship. This is noted by the words manage, time, patient, give, and complicated. However, it is also observed that the preceptorship involves positive learning and teaching actions, reinforced by the words say, explain, and discuss. Class 2 shows the preceptorship as an experience exchange, a positive moment that provides theoretical upgrade to the preceptor, associated to the professional practices performed by the binominal preceptor-student in health services and communities. In this perspective, everyone is benefited since preceptorship is structured according to dynamic aspects of knowledge, experienced in settings permeated by people´s health necessities. In class 3, potentialities of this practice are shown, and personal compromise is the main reason of acting as a preceptor in this network of education/attention, demonstrated in the words reason, formation, to like and professionals. Last, but not the least, class 1 suggests the importance of preceptorship and one of the strategies to create the National Politics of Humanization, from the teachingservice-community integration, observed in the words: arrives, university, fundamental, manner, partnership, service, and student. Besides, it rates perspectives and challenges for the improvement of the preceptorship in health services. Integrating teaching and service can enhance the proposals of changes concerning the healthcare model practiced in services, but this relation is still superficial. The preceptor is an actor in action, playing real life roles, and that is when he becomes essential to seek training with the profile defended in the proposed training of a professional who is capable of learning to learn

Ser gestora da educação infantil: quais sentidos atribuídos na cultura profissional?

This research has been the aim understanding the senses that managers attribute to school management of the Child Education from his owner teacher high degree formation and his professional culture. The need to research about the sense attributed to the school management of the Child Education by the managers could be considered as contribute to school management studies in the manager team perspective itself. It depart from idea that attributed senses reveal the reinvention process of the professional culture those escape from a regard less attentive and take divers forms, been construct and reconstruct in the social interactions in the live quotidian of school community. The empirical investigation has developed in the Centro Municipal de Educação Infantil (CMEI) Marilanda Bezerra, located in Natal city (RN), during the years of 2012-2013. The methodology is endorsed in the qualitative approach with character of an ethnography type research in education having as main information’s construction tools the semi structured comprehensive interview. This permit (by the interlocutor’s oral discourse) the interpretation of the senses and values selfattributed to hers actions, the personal notebook of ground registers, the record of the interpretative analysis, the evolutionary plans and the participant observation. It distinguish auteurs as Jean-Claude Kaufmann, Adir Ferreira, Sônia Kramer, Álvaro Marchesi, Júlia Oliveira-Formosinho, Maurice Tardif, Telmo Caria, Andy Hargreaves; those supported this paper theoretically and methodologically. The analysis and the experience interpretation point to the possibilities of sharing actions of the Child Education unity with the community, featuring the importance of a participant and collaborative school management practice of the CMEI, highlight the value of this school management possibilities more horizontal and interactive in an essay of constitute a democratic and critical space to the professional culture, with a decisive participation of the managers team. This educational manager form has demonstrated sensibility, creativity, innovation and the possibility of social transformation through institutional action and Child Education teacher’s practices, cohabiting with the challenges, the dilemmas and the problems of work quotidian and the lacunas of a fragmentary formation.

A terapia comunitária e a vivência de estudantes de medicina: uma estratégia de ensino aprendizagem do cuidado humanizado na ESF?

Before the scenario full of criticism about a medical model that gives privilege to the diseases and not to the diseased, there are many arguments that defend the need of redeem the humanized relationship between doctor and patient. It became indispensable to mold during the medical graduation a professional capable of perform a special care, less instrumental and more humanized; however, even though the advances of the pedagogical program of the medical graduation, we still face numerous challenges in the process of molding. This study has as general goal to understand if the students medicine experience with the Integrative Community Therapy (TCI) at the Primary Attention – APS/Family Healthy Strategy-ESF, presents potential to configure itself while strategy of teaching-learning to the integral and humanized care. It was held a qualitative research with the students of the medical graduation from the tenth to the twelfth semester that had experience with the TCI, as part of the Boarding of Family and Community Medicine – MFC. We used interviews with script and we resorted to analyze the narratives to Gadamerian Hermeneutics. It was possible to find that before join the boarding of MFC, the students were unaware the TCI and their preconceptions lined up with depreciated character. The experience with the TCI enabled the reframing of the prejudices and the build of new concepts. Internship in ESF and participate of TCI revealed potential to learning of the humanized care by the practical exercise with experiences that privilege the built of ties; the autonomy of the patient; the fulfillment of the longitudinality at the care of the patient; the acknowledgment of the power of resilience of the patients, at the strength of the collective, at the pain sharing, at the strength of a good communication, at the gains of qualified listening exercise. The absence of models of what to do was replaced by experiences of pains and joys at the learning of becoming a doctor. The pains spoke of the structural difficulties (inputs), at the get along with the socials vulnerabilities of the users and the difficult of perform a good communication with the patients. The joys were experienced at the finding of the humanized care exercise. Questions as structural difficulties, low number of people with TCI degree, a shortly experience of with TCI, show up as limitations to its utilization as pedagogical tool. In turn, the reflective potential is capable of cause resignifications about the know-how before the pain of the other being very much present at the narratives, signaling the potential of the learning of TCI. Therefore, this study advocate that the participation of the students at the TCI, beyond the power of offering the students a teaching-learning strategy to the humanized care, represents the possibility of enlarge the horizons of those future doctors at a glance much more conscious of the difficulties and potential of a professional at the ESF, contributing to the graduation of more sensitized professionals and prepared to perform an integral and humanized approach of the person and his/her community, contributing to an APS/ESF more resolute and rewarding to everyone.

A atenção à crise e o apoio matricial: analisadores da estratégia atenção psicossocial

The National Policy on Mental Health is characterized as a territorial - political community , and it has the Psychoso cial Care Strategy (Eaps) as guideline for the proposal and the development of their actions. In its design, CAPS is idealized to be a strategic equipment within the Psychoso cial Care Network/RAPS. Matricial support and at tention to the crisis constitute strategic areas of action of CAPS in its replacement mission , and as it is g uided by the scope of deinstitutionalization, those are essential to the success of these services. We argue that sustain crises in existential territories of life is a condition for the effectiveness of psychosocial care and, ultimately, to the sustainability of its Reform. In this direction, the matricial support tool reveals a territorial supporter, intercessory and powerful in building a psychosocial care to the crisis. Recognized as one of the major challenges by the Brazilian Ministry of Health, forward these fronts materializes for workers in their mi cropolitical crafts. Our research arises as an investment toward empower them , and aimed to understand the operationalization of attention to the crisis and matricial support in a CAPS II, in the view of its workers . Besides, it aims to examine such practi ces forward the principles and purposes of Psychosocial Care Strategy. Inspired by the research - intervention and by the political and social ideas of Institutiona l Analysis, we offer a space for reflection and exchange, by implicational interviews , enablin g workers to launch them in analysis of practices in the EAPs view. We have done a documentary consulting CAPS Technical Project, and a return stage to the institution, by organizing workshop and conversation groups with CAPS workers. The results have show n that there are institutional logics in competition on that service. When operating the logic risk, some difficulties in sustaining most intense crisis situations were identified, the psychiatric hospital internment is used as a facility, particularly in view of some cases, in which the aggressiveness of the person in crises becomes aggressive, and when the brackets SAMU, the CAPS III and Comprehensive Care Beds do not respond satisfactorily to their users requests. Order weaknesses were indicated in this thesis as macropolitical and micropolitical interfering in network support. The matricial actions were identified as a powerful intercessor resource in crisis care appeared weakened, and indicates little porosity in the relationship between the Service and the territory where it takes place. Noticed by the logic of home care, without operate primarily as a knowledge exchange device, we saw capture points in the logic of assistance with ambulatoriza tion production of CAPS, welfare practices and "ext empore " . T he E APs , although it emerge s as a guiding, it is not seen to workers as effective practice. On the one hand, the results signaled that the attention to the crisis and the matricial actions are developed without tenacious connection with the purposes of EA Ps, on the other hand, successful cases were indicated with the main leads to conducting wire of intersectoral actions to the powerful bonds and to the participation of user in their care process es , indicating insurgent forces tha t intend by traditional lo gic .

A gestão do programa saúde na escola no município de Natal/RN: um estudo de caso

The current conception of health deals with several influential factors, having education among them. Intersectoral organization is essential for Young and adult healthcare services. In this context the Healthcare in School Program was created which foresees a continuous articulation between health and education aiding the effectuation of the Healthcare Single System. The objective of this research is analyze the Healthcare in School Program (HSP) in Natal city in Rio Grande do Norte State taking into consideration the Intersectoriality of actions from the standpoint of the management. The chosen method was the case study, with qualitative approach. The sample was of the intentional kind including all components of the Natal city Intersectorial work group, composed by representatives of the Municipal Education Bureau, the State Education Bureau and Healthcare Municipal Bureau. The collecting data technique was the semi-structured interview. The data analysis was performed through the analysis of contents technique. For Data Show the following analysis categories were considered: Meaning of Intersectoriality; Actions Planning; Permanent and ongoing training for autonomy regarding to Healthcare Promotion; Difficulties and Potentials for actions operationalization. The outcomes allow us to indentify in Natal HSP intersectoral practices not developed yet. The manager professionals of Healthcare and Education do not get to acknowledge the power of Intersectoriality yet. The lack of commitment of some professionals stands out, planning is performed in a sectorial basis and without active participation of learners and community, there is duties accumulation and discouragement group, structural inadequacy and difficulty on the ongoing of the program actions. Despite the existing fragmentation, the program has contributed to the professional qualification and development of education actions regarding to healthcare along with learners. Therefore we conclude that healthcare, education and society have lots of challenges to face in order to consolidate Intersectoriality and the Healthcare in School Program and the and the implementation of the guidelines of the Healthcare Single System in Natal city in the state of Rio Grande do Norte.

Núcleos de acessibilidade e o atendimento a alunos com necessidades educacionais especiais nas universidades federais do nordeste brasileiro

In the current context of policies for inclusiveness in the Brazilian higher education, the accessibility centers are responsible for the organization of actions toward the fulfillment of the legal requirements regarding accessibility and the elimination of barriers that interfere with the participation and learning of persons with special learning needs (SLN), providing conditions for the full inclusion of these students in the activities of learning, research and community outreach in this learning level. This research had the goal to analyse the work developed by the accessibility centers in the federal universities in the northeastern region of Brazil towards the care of students with SLN. It is a descriptive work, with quantitative and qualitative approaches. Twelve federal universities participated through their accessibility center’s coordinators. The data - gathered by means of an electronic survey filled out in 2014 - was organized and analyzed through descriptive statistics and content analysis; their discussion was made around four topics: organization of accessibility centers for the care of students with SLN, kinds and numbers of students with SLN cared for, actions developed, and suggestions for the improvement of the accessibility centers. It was found that in the sphere of the researched universities, the accessibility centers have been taking actions involving many parts of the academic community towards the improvement of the conditions and permanence of students with SLN. However, in some institutional realities, these action need to be expanded and/or consolidated. The coordinators suggest further actions towards the betterment of these centers, regarding expansion of financial and human resources, professional qualification, awareness of the academic community, institutionalization and the formation of a collaborative network among the accessibility centers. Thus, although there are still challenges to overcome, the presence of the accessibility centers is shown to advance the realization of policies for the inclusion of students with SLN in the post-secondary education, towards the democratization of learning starting from the universal right to education.

Núcleos de acessibilidade e o atendimento a alunos com necessidades educacionais especiais nas universidades federais do nordeste brasileiro

In the current context of policies for inclusiveness in the Brazilian higher education, the accessibility centers are responsible for the organization of actions toward the fulfillment of the legal requirements regarding accessibility and the elimination of barriers that interfere with the participation and learning of persons with special learning needs (SLN), providing conditions for the full inclusion of these students in the activities of learning, research and community outreach in this learning level. This research had the goal to analyse the work developed by the accessibility centers in the federal universities in the northeastern region of Brazil towards the care of students with SLN. It is a descriptive work, with quantitative and qualitative approaches. Twelve federal universities participated through their accessibility center’s coordinators. The data - gathered by means of an electronic survey filled out in 2014 - was organized and analyzed through descriptive statistics and content analysis; their discussion was made around four topics: organization of accessibility centers for the care of students with SLN, kinds and numbers of students with SLN cared for, actions developed, and suggestions for the improvement of the accessibility centers. It was found that in the sphere of the researched universities, the accessibility centers have been taking actions involving many parts of the academic community towards the improvement of the conditions and permanence of students with SLN. However, in some institutional realities, these action need to be expanded and/or consolidated. The coordinators suggest further actions towards the betterment of these centers, regarding expansion of financial and human resources, professional qualification, awareness of the academic community, institutionalization and the formation of a collaborative network among the accessibility centers. Thus, although there are still challenges to overcome, the presence of the accessibility centers is shown to advance the realization of policies for the inclusion of students with SLN in the post-secondary education, towards the democratization of learning starting from the universal right to education.

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.

Gestão democrática nas escolas: a atuação dos diretores escolares e os desafios para sua consolidação na rede municipal de Natal/RN

The democratic management is a challenge for education, on the one hand for its actualization needs a link between the government and the educational institution. From that, research aims to understand the main challenges faced by the school administration to consolidate the management of public schools in Natal/RN. Against this context the methodology used was multiple cases, qualitative approach in which respondent were manager (director, deputy director and coordinator) of the four municipal schools and two representatives of the Democratic Management Commission of a Government departament of Education, Natal/RN. The analysis was made by peers, between schools that had grade superior IDEB that average stipulated by the federal government and two that had grade lower and between managers and representatives of the Secretary. Were used techniques of categorization and content analysis of the speeches of respondents. Was note that managers understand the importance of the participation about whole community in the democratic management, however only one school highlighted means of attracting the parents against to the difficulty of representing these. The lack of knowledge about the democratic management is evident mainly in the pair of schools with lower IDEB. That schools with a lower IDEB adhere to this management as a way to meet rules. So unanimous, the broad role of director hampers knowledge about the legislation. About relationship of the Government department with managers, there are some contradictions between the understanding of the role of the coordinator by managers and representatives of the Government department. It was perceptible the no uniformity about a good relationship between managers and Government department. It was notable features of democratic management in all school units, well as the efforts of the Government department in this scope. However there are also undemocratic features that deserve further study