Fugindo da banalidade: o uso do orkut como extens��o da sala de aula

This dissertation investigated the insert and use of the education technologies in the on-line social net Orkut, as an extension of the classroom, especially for debates. With that experience accomplished in a discipline of a Brazilian public institution of higher education, it was tried to go beyond the use of the atmosphere for entertainment and to look Orkut as a tool of assistance to the process of teaching and learning. The research was based in the Paulo Freire��s communication concept and in the C��lestin Freinet��s school cooperation concept. In this dissertation, in methodological terms, was adopted the category of the qualitative research. The adopted method was a combination of case��s study with research-action. The technique was the application of questionnaires, the collect of data was personal and the types of data were primary. Finally, introduces, then, prognostics about the future of the on-line social nets and finally suggest the formation of academicals on-line social networks

Avalia����o do impacto do treinamento de cl��nica em hansen��ase e sua contribui����o para o aumento da detec����o da doen��a no Estado do Rio Grande do Norte

Hansen��s disease is considered a serious public health problem. In 2006, the Ministry of Health reported that worldwide, Brazil ranked 2nd in the number of cases of the disease, surpassed only by India. The North region is the geographical area in Brazil that presents the most cases. In the state of Rio Grande do Norte, the disease is considered to be eliminated because its prevalence has been identified as 1 per 10.000 inhabitants, criteria established by the State Elimination Letter of 2005. Training programs have been offered by the Coordination for the Control of Hansen��s Disease Program of Rio Grande do Norte, PCH-RN since 1997, with the support of the English governmental agency Leprosy Relief Association, LRA, with no evaluation having been conducted. The objective of this study was to evaluate the training programs in clinical diagnosis of Hansen��s disease and their contribution to the detection of the disease in the state of Rio Grande do Norte. The study was conducted in seven municipalities that are known as Regional Public Health Units (URSAPs): S��o Jos�� de Mipibu URSAP I, Mossor�� URSAP II, Jo��o C��mara URSAP III, Caic�� URSAP IV, Santa Cruz URSAP V, Pau dos Ferros URSAP VI and Natal, capital city of the State, in the Metropolitan Region. Physicians and nurses of the Family Health Program PSF were interviewed as to their perceptions of the implementation of the training program in clinica diagnosis of Hansen��s Disease conducted by the PCH-RN. They evaluated their own practice and the training program. These professionals presented a positive evaluation of the program and gave suggestions for future courses. The results of this study suggest the need for permanent education. Data of the disease obtained from the official records of the Secretariat of Health and from the interviews indicate that health education is the means to control Hansen��s disease effectively

Sa��de da fam��lia: uma estrat��gia de mudan��a no processo de produ����o dos servi��os de sa��de

The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caic��, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors

An��lise de qualidade da aten����o �� crian��a na estrat��gia sa��de da fam��lia: o ��bito infantil evit��vel como refer��ncia

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

Avalia����o da dor p��s-operat��ria: an��lise em pacientes submetidos a cirurgias abdominais em um hospital universit��rio de Natal/RN

It is an exploratory and descriptive study made by a quantitative approach, developed among February and May 2010, aiming to assess the pain of patients underwent abdominal surgeries in a University Hospital, in Natal/RN; to identify the local and intensity of the pain based on Numerical Estimative Scale; to analyze the pain related to the sensorial-discriminative, motivational-affective and cognitive-assessment dimensions, using the McGill Questionnaire pain; to establish a relation between the pain process and age, gender, religion, and king of surgery; to identify the medicines efficiency used to control postoperative pain. The sample was composed by 253 patients underwent abdominal surgeries. The results showed a total of 63.63% females between 38 and 47 years of age (21.34%); illiterates (21.73%); married (64.03%), living in Natal and surroundings (67.97%) and Catholics (74.30%). In their first assessment, 84.19% showed postoperative pain; the pain was considered light in 18.97% of them, moderate in 21.74% and severe in 43.48%. The mean number of descriptors chosen through the McGill Questionnaire Pain was 10.78 (DP= 6.09) and pain rating 23.65 (DP= 15.93). The descriptors selected with higher frequency were: sickening pain (69.01%), tired (65.25%), thin (62.44%), bored (58.69%), ardor (46.48%), pointed (38.50%) and colic (35.21%). In their second assessment, 57.71% of patients didn t relate any postoperative pain and 42.29% were still complaining about the pain. After taking analgesic medication, just 41.90% of patients who had complete pain relief. The Pharmacological groups most used were: simple analgesic (37.86%), weak opioids (32.98%), AINES (19.85%) and strong opioid (9.31%). It was not found a significant postoperative pain variation related to the sexes, religion and kind of surgery. It was concluded there were a high level in the number of patients with postoperative pain, mainly in a severe scale. Less than half of patients had the pain relief. Then, it was observed there was not coherence between the pain intensity and the analgesic it was used. To solve or relieve this kind of problems is necessary a permanent education to the health professionals who works in this area

Aten����o �� sa��de mental na Estrat��gia Sa��de da Fam��lia no Munic��pio de Parnamirim/RN: opini��o dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population��s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user��s care and the promotion of family health

Integridade tissular de pacientes com ��lceras venosas: um estudo baseado na Classifica����o dos Resultados de Enfermagem

The venous ulcer is an epidemiological problem of high prevalence, causing disability and dependence. Assess the tissue impairment level of patients with venous lesions, within a nursing referential, is relevant for the implementation of a directed assistance to specific clientele. Thus, this work aims to characterize the health status regarding the integrity the lower limbs skin of patients with venous ulcers, according to the of tissue integrity outcome indicators from the Nursing Outcomes Classification. A cross-sectional study conducted in a university hospital in Natal - Rio Grande do Norte. The sample consisted of 50 participants, selected through consecutive sampling. Data collection occurred through a interview and physical examination form and a operational definitions tool for indicators of the nursing Tissue Integrity outcome directed to patients with venous ulcer, applied from February to June 2012. Data analysis was done by descriptive statistics and nonparametric tests (Spearman, Kruskal-Wallis and Mann-Whitney tests). The project was approved by the Research Ethics Committee with protocol 608/11 and Presentation Certificate to Ethical Consideration No. 0038.0.294.000-11. The results were presented using three scientific articles derivatives of research. It was found that the indicators show moderate impairment, light and not impaired, as the median. The respondents had an average of 59.72 years, 66% female, 50% were retired, 60% with a partner, 44% had arterial hypertension, 26% allergies, 20% diabetes mellitus, 96% were sedentary, 14% drank alcohol and 6% were smokers. There was a statistically significant correlation of low intensity between age and hydration (p=0.032; rs=-0.304) and skin desquamation (p=0.026; rs=-0.316), family income and necrosis (p=0.012; rs=-0.353); Ankle Brachial Index and tissue perfusion (p=0,044; rs=-0,329); Diabetes Mellitus and texture (p=0.015) and tissue perfusion (p=0.026); allergy and texture (p=0.034), physical activity and hydration (p=0.034), smoking and thickness (p=0.018), and alcohol consumption and exudate (p=0.045). We conclude that the patients had light to moderate impairment, indicating a good state of health on the integrity of the skin of the lower limbs, according to the indicators of the outcome of tissue integrity Classification Nursing Outcomes valued in the present study. It is believed that the evaluation of impairment tissue using a self-nursing system and its relation with socioeconomic, clinical and risk factors are unique tools in the care planning and in the wound healing

Entre orqu��deas e girass��is :o laborat��rio de Enfermagem na vis��o de estudantes

To study the teaching/learning process about the Nursing procedures carried out in the laboratory, and learn both the sapiens and the demens dimensions of such process, is the main purpose of this study. The objectives are to: identify the major laboratory contributions to the teaching/learning process from the point of view of undergraduate students and the feelings they express; describe the difficulties they have identified; and analyze the relevance of the laboratory to this process. As part of the inquiry procedure, four core group meetings were held with 26 undergraduate students who had completed the course on Semiology and Semiotics in Nursing, which is the course where the Nursing laboratory is most needed as a learning space. The analysis, based on a qualitative approach, had as fundamental theoretical support studies made by Friedlander and Hayashida, who deal with learning/teaching in the Nursing laboratory, and by authors who favor humanization in teaching such as, among others, Freire, Maturana, Morin, Assmann. Results point toward the relevance of the Nursing laboratory as a facilitator for the learning/teaching process. In their speech the students repeatedly state that the development of procedures in simulated situations enable them to become more self-assured and technically prepared for caring. In addition, they emphasize that feelings such as fear, lack of confidence, anxiety, anguish and panic become diminished at the time of their clinic experience when they have had previous learning in the laboratory. They have also acknowledged that some difficulties of structural nature have become obstacles to a high-quality learning development. In summary, in spite of the difficulties that have been pointed out by the students concerning the use of the Nursing laboratory in the learning/teaching process, they also recognize that this is the locus par excellence where they can develop their skills and appease their anxieties

Cuidado de enfermagem ao potencial doador de ��rg��os em morte encef��lica: uma reflex��o sobre a pr��tica

Despite of the technological advances that favor the transplant process, there are issues of effectiveness of care necessary for the maintenance of potential organ donors with brain death, which contribute to the no realization of transplants of organs and tissues of these patients. It is presupposed that the problems could be related to perceptions and understandings that the professionals of the units of internment have about the care required by the diagnosis of brain death. The aim of this study was to understand the meaning of the nursing care of the potential organ donor with brain death to the nursing staff. Descriptive study with qualitative approach guided by Action Science Theory and the critic-reflexive research methodology accomplished with five nurses and 19 nursing technicians from Operative Rehabilitation Center in a public hospital at Natal / RN, Brazil, between March and May 2013. Data were collected through semi-structured interviews with individual reflection about the care and through group interview, after approval by the Ethics and Research Committee, CAAE No.: 04255612.7.0000.5537. The analysis was performed in a thematic way according to Bardin. During the group meeting the participants were driven in a discussion about the need for change and how to perform them. The results indicate that the professionals actions are consistent with those required for maintenance of potential organ donors, although the material and human resources are not adequate. That situation leads the professionals to develop a meaning of care as one labor more, demanding more than they can give. They express beliefs and feelings concerning the hope that their care brings a greater good that is to save lives. The reflection for a possible change of action was difficult to accomplish due to professionals not to be able to self evaluate, what lead to direct your changes suggestions for other team members. It is concluded that the care provided to these patients is a difficult care, evidenced by suffering both death situation of the person cared and pain of their families, as the dehumanizing conditions of work, helping themselves to keep distance from patients to not suffer so much. The knowledge impregnated in their act, are scientific, ethical, aesthetic and personal kind with a predominance of the scientific followed by the personal. The study was also relevant to the practice of nursing in maintaining the potential donor, in that it allowed the identification of the knowledge used by nurses in their care practice and the meaning understanding of the professionals on the care provided, as a good action that brings satisfaction when the transplanting is executed. Other experiences are suggested with the critic-reflexive research methodology, both in research as in teaching nursing

Um estudo de aplica����o das teorias da expectativa e da ancoragem na motiva����o para o desempemho de alunos do ensino m��dio

This thesis presents a study on Tversky & Kahneman s (1974) Anchoring theory, and Vroom s (1964) Expectance theory in the context of education and students motivation. It is surveyed 424 students of a secondary and agricultural technical school in Brazil Northeast (EAJ). The survey form try to capture the Vroom s Expectance Theory constructs of Valence, Instrumentality, Expectation and Motivational Force, and also the Tversky and Kahneman Anchoring effect in terms of grade expected. The main findings suggest that the minimum grade required by the school is much strong in driving the students motivation and performance than the Expectancy Theory. It was found that the different grades required drive the students to pursue different grade in the same way

Projetos pol��ticos pedag��gicos dos cursos de Odontologia do RN : forma����o profissional e a perspectiva da aten����o �� 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

Projeto pol��tico de forma����o do enfermeiro: contextos, textos, (re)constru����es

This research analyses politic Project for nursing education, in its articulation with economical, political and social context of 1970s and 1980s in national level and, in special, nurse formation process in FAEN/UERN space, situating it on the context of Brazilian sanitary reformation movement and participation movement. The thesis is firmed on the sense of explaining whether that movement circa the nurse formation process has been able to build necessary instruments for the transformation of biomedical formation model historically consolidated, in the perspective of conceiving another model anchored on social determination of health/illness process, with the purpose of assuring ethical and political commitment with the SUS praised by sanitary reformation. The study visualized the object considering its specificity, its concrete historical determinations and institutional as well as organizational relationships that permeate possibilities of valorizing it, analyzing it, interpreting it and rebuilding it. Its operationalization occurred in three movements, it means, bibliographical review; documents study; interviews and focal groups realized with professors of the institution. We can apprehend as main results that the nurse formation process has incorporated widely spread conceptions by the sanitary reformation movement and participation movement, assuming the commitment with transformation of health services and social reality. Nevertheless it prevails, still, amongst some professors in the same institutional space, the commitment to a predominantly technicist formation, focused on instrumental knowledge. Opinion divergence explicit diversity of conceptions circa education and, as consequence, distinct political commitments, also contradictory to formation. Thus, there is a lacuna between what is foreseen on political pedagogical project and what is rendered in FAEN/UERN, evidencing the clash related to conceptual bases of formation project. Interpretations, divergent political attitudes and resistances to the process allowed several formation ways. However, formation under new conceptual bases, find limits on the context of social politics implemented in Brazil during the 1990s, neoliberal-based, expressed on expansion and consolidation of health private system, managed by market rules, strengthening biomedical formation model. Notwithstanding, there is a favorable to its implementation, starting from the first years of 21st century, moment when Brazilian sanitary reformation reappear on health speech, as well as facing the policy of permanent education in health. This reality explicit a process of dialectical tension between instituted and institutor, anticipating the moment of scission or adaptation and return to what is already known. Despite of clashed, knowledge, accumulated experience, contribution to services, the construction of partnerships out of university space and articulation with national movement of (re)orientation of nurse formation, have been constituted as vital instruments to offer support to formation in FAEN/UERN. Still, we consider necessary the (re)visitation to FAEN/UERN politic pedagogical Project considering the existing and implemented construction, without, yet, depreciate the norther axis of the project at the reaching of its intentionality

Avalia����o da qualidade da assist��ncia prestada pelo servi��o de atendimento m��vel de urg��ncia do Rio Grande do Norte

O objetivo dessa investiga����o foi avaliar a qualidade da assist��ncia prestada pelo Servi��o de Atendimento M��vel de Urg��ncia do estado do Rio Grande do Norte (SAMU 192 RN), na vis��o dos profissionais de sa��de. Trata-se de estudo descritivo, avaliativo com delineamento longitudinal e abordagem quantitativa, desenvolvido em quatro etapas: constru����o de perfil dos atendimentos do SAMU 192 RN; revis��o integrativa para levantamento dos indicadores de avalia����o da qualidade da assist��ncia em servi��os pr��-hospitalares m��veis de urg��ncia; constru����o e valida����o de conte��do do instrumento e defini����o dos indicadores de estrutura e processo; e aplica����o do instrumento aos profissionais de sa��de para avalia����o da qualidade da assist��ncia. A popula����oe amostra foram compostas por todos os profissionais do SAMU 192 RN, atuantes no per��odo do estudo. A coleta de dados foi realizada entre janeiro e dezembro/2012. Participaram do estudo: 11 enfermeiros, 24 m��dicos, 56 t��cnicos de enfermagem e 88 condutores, totalizando 179 profissionais. O estudo foi aprovado (Parecer n�� 437/2010 e CAAE: 0025.0.294.051-10) pelo Comit�� de ��tica em Pesquisa do Hospital Universit��rio Onofre Lopes da Universidade Federal do Rio Grande do Norte. Os dados foram analisados por meio de estat��stica descritiva e inferencial, nesta foram utilizados os programas Microsoft-Excel XP e SPSS 20.0, com uso do ��ndice Kappa (K) e ��ndice de Validade de Conte��do (IVC), considerando K ���0,61 e IVC>0,80. Al��m disso, foi considerando n��vel de signific��ncia estat��stica de ��-valor < 0,05. Entre os 179 profissionais, 100,0% tinham menos de 5 anos de tempo de servi��o, 55,9% tinham menos de 5 anos de experi��ncia na ��rea de urg��ncia, 88,3% referiram trabalhar na institui����o porque gosta, 55,3% possuiam outro v��nculo de trabalho, 54,3% com jornada semanal de 30 a 40 horas, 98,9% participaram de treinamento, 83,2% valorizam o treinamento em servi��o, 87,2% t��m boa frequ��ncia de participa����o no treinamento e 96,6% sentem necessidade de realizar mais treinamentos. Com rela����o �� categoriza����o dos itens em indicadores de estrutura ou de processo, os ju��zes determinaram para estrutura: estado de conserva����o das ambul��ncias; estrutura f��sica geral do servi��o; conforto dentro da ambul��ncia; disponibilidade de recursos materiais; seguran��a para o usu��rio dentro da ambul��ncia; seguran��a para o profissional; educação permanente; seguran��a demonstrada pela equipe profissional; remunera����o do profissional e a satisfa����o profissional. E para processo: acesso ao servi��o; acolhimento; humaniza����o; atendimento realizado; tempo resposta; privacidade ao usu��rio; orienta����es sobre o atendimento; relacionamento entre o profissional e usu��rio; oportunidade do usu��rio realizar reclama����es e articula����o multiprofissional. O instrumento quando submetido �� valida����o de conte��do constatou-se que as contribui����es dos ju��zes permitiram melhorar/otimizar o instrumento de avalia����o da qualidade da assist��ncia pr��-hospitalar m��vel de urg��ncia, uma vez que os ��ndices Kappa e IVC foram considerados bons e ��timos e o conte��do foi validado. Na avalia����o da qualidade da assist��ncia, constatou-se que a qualidade da assist��ncia prestada pelo SAMU 192 RN est�� prejudicada nas dimens��es estrutura, com rela����o �� estrutura f��sica, seguran��a dos pontos de apoio descentralizados, o conforto e o estado de conserva����o das ambul��ncias. J�� com rela����o aos indicadores de processo, os profissionais avaliaram todos positivamente. A avalia����o da qualidade da assist��ncia contribui para a busca de solu����es dos problemas detectados, permite novas perspectivas e colabora para a consolida����o do servi��o.

Promo����o da alimenta����o saud��vel na aten����o prim��ria �� sa��de: contribui����o para constru����o coletiva do saber-fazer

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

Telessa��de como ferramenta de apoio �� aten����o prim��ria �� sa��de: um olhar sobre as teleconsultorias em cardiologia

In order to qualify Primary Health Care in Brazil, the Ministry of Health implemented the Brazilian Telehealth Program to provide health support (telecare) and permanent health education (tele-education). In this respect, one of the primary services offered is teleconsultation. As part of the national expansion of the program, a local Telehealth Center, called Telehealth/RN, was created in Rio Grande do Norte state. The aim of this study was to describe the implementation of cardiological teleconsultations at Telehealth/RN, and analyze the characteristics of the teleconsultations in cardiology requested. Formative Second Opinions in cardiology, available at the web site of the Brazilian Telehealth Program, were also examined. This is a quantitative study with a descriptive, observational design. A total of 56 Formative Second Opinions in cardiology were identified, a majority related to hypertension (29%), focused on treatment support (30%), and requested by doctors (59%). At Telehealth/RN, 47 teleconsultations in cardiology were carried out, a majority also related to hypertension (50%), requested by community health workers (45%) and focused directly on treatment (52%). Cardiological teleconsultation, implemented at the Telehealth/RN in April 2014, is a practical and efficient strategy capable of ensuring health services and reaching those who live in remote areas. Knowing the demand for teleconsultations is extremely important, given that they provide the information needed to correct existing inadequacies related to care, management and/or education, as well as providing the basis for public policies that meet the demands of teleconsultation.