Avaliação da qualidade da assistência a pessoas com úlceras venosas atendidas na estratégia saúde da família

A úlcera venosa constitui importante problema de saúde pública, gera repercussão social, econômica e mudanças nos hábitos de vida, dor, sofrimento, acarretando diminuição da qualidade de vida. O estudo objetivou avaliar a assistência prestada às pessoas com úlceras venosas atendidas pela Estratégia Saúde da Família. É um estudo analítico, transversal e quantitativo, realizado com 59 pessoas com úlceras venosas, atendidas em 36 unidades da Estratégia Saúde da Família. O estudo obteve aprovação do projeto de pesquisa pelo Comitê de Ética da Universidade Federal de Alagoas. Para a coleta dos dados utilizou-se instrumento testado, entrevista, exame físico e informações dos prontuários. Os dados foram organizados em planilha do Microsoft Excel 2007, exportados e analisados em software estatístico por meio de estatística descritiva e inferencial, considerando nível de significância estatística de ρ-valor < 0,05. As pessoas com úlcera venosa eram do sexo feminino (71,2%), ≥ 60 anos (67,8%) e estavam em tratamento > 1 ano (69,5%). Possuíam tempo de lesão > 6 meses (64,4%), dor na úlcera/membro (86,4%) e leito com ≤ 30% de granulação/epitelização (78,0%). A qualidade da assistência foi ruim (< 5 aspectos positivos) em 57,6% (ρ=0,000) e os aspectos que mais interferiram foram as seguintes inadequações: profissional que acompanha/realiza curativo (ρ=0,002, coeficiente de contingência (CC) =0,458, razão de chance (RC) =13,9), produtos nos últimos 30 dias (ρ=0,038, cc=0,334, RC=7,3) e acesso a consulta com angiologista (ρ=0,041, cc=0,305, RC=4,1). Os aspectos clínicos que contribuíram para o aumento do tempo de assistência foram: tempo de lesão >6 meses (ρ<0,001), dor (ρ=0,043), recidiva (ρ<0,001); nos aspectos assistenciais: inadequação dos produtos com 83,1% (ρ=0,036). Essas características dificultaram a cicatrização tecidual, prolongando o tempo de tratamento das lesões,que podem ter contribuído para a cronicidade das úlceras

Efeito de um extrato de Ganoderma lucidum (Reishi) na marcação de constituintes sanguíneos com tecnécio-99M e na sobrevivência de Escherichia coli

Clinical evaluations have been made possible with radiobiocomplexes marked with tecnecium-99m (99mTc). Natural or synthetic drugs are able to interfere in the marking of blood structures with 99m Tc. Also, the toxicity of several natural products has been described. The aim of this study was evaluating the effect of an extract of Ganoderma lucidum (Reishi) in the marking of blood constituents with 98m Tc and in the survival of Escherichia coli. Blood samples from Wistar rats were treated with reishi extract. Radiomarking procedure was performed. Samples of plasma (P), blood cells (CS), and insoluble (FI) and soluble (FS) fractions of P and CS were separated and the radioactivity was counted to determine radioactivity percentages (%ATI). Escherichia coli AB1157 cultures were treated with stannous chloride in the presence and absence of the reishi extract. Blood samples and bacterial cultures treated with NaCl 0.9% were used as controls. Data indicated that the reishi extract has significantly altered (p<0,05) the %ATI of P, CS, FI-P, FS-P, FI-CS e FS-CS, as well as it has increased survival of bacterial cultures treated with stannous chloride. Our results suggest that the Reishi extract would be able to present a redox/ chelant action by altering blood constituent marking with 99mTc and by protecting bacterial cultures against stannous chloride-induced oxydating lesions. The study had a multidisciplinary character, with the participation of the following areas of knowledge: Biophysics, Radiobiology, Botanics, Phytotherapy, and Hematology

A importância da atividade física regular como estratégia complementar na promoção de resiliência de idosas e sua importância para suas vidas

O conceito de saúde, na concepção mais abrangente, é uma condição multidimensional de bem-estar físico, psicológico e social e não apenas a inexistência de enfermidades. Os benefícios da atividade física são tão relevantes quanto os benefícios psicológicos, porque ambos contribuem para a saúde. A literatura aponta um conjunto de ligações diretas e indiretas entre a atividade física e a qualidade de vida. Apesar destes benefícios, o processo de envelhecimento é caracterizado por grandes perdas biopsicossociais, que geram várias situações de adversidades que causam preocupação e podem colocar em risco a saúde do idoso. Deste modo, surge a resiliência como um conjunto de processos sociais e intrapsíquicos, que possibilitam o desenvolvimento saudável do idoso, mesmo diante de experiências negativas. Nesta direção, observou-se a necessidade de executar uma pesquisa de conhecimento multidisciplinar conciliando a Educação Física com a Psicologia, a Medicina, a Terapia Ocupacional e a Gerontologia, com o objetivo de investigar o efeito da atividade física sobre os níveis de resiliência em mulheres idosas, bem como conhecer a importância desta atividade para suas vidas. Para tanto, realizou-se um estudo comparativo descritivo, de caráter transversal. Assim sendo, 230 mulheres idosas foram divididas em dois grupos: ativas (n=115; 65,8±5,8 anos de idade), constituído por idosas matriculadas em um programa de atividade física orientada para idosos com período de prática igual ou superior a dois anos, e sedentárias (n=115; 69,2±7,2 anos de idade). Em seguida, foram submetidas à avaliação do nível de resiliência psicológica e da aptidão física (resistência muscular de membros superiores e inferiores, flexibilidade e resistência aeróbia). As idosas ativas apresentaram valores significativamente (p=0,001) maiores do fator 3 da resiliência psicológica quando comparados àqueles do grupo de idosas sedentárias, o qual está relacionado à autoconfiança e à capacidade de adaptação a situações diversas. Não foram observadas diferenças significativas (p>0,05) entre os grupos para os demais fatores (1 e 2). Quando comparados os testes de aptidão física com o nível de resiliência psicológica moderada (n=28) e alta (n=202) do fator 3, observou- se que idosas com nível de resiliência psicológica alta apresentaram maior flexibilidade (p=0,004). E para a avaliação da percepção da importância da atividade física para as idosas foi aplicado um questionário semiestruturado. A partir da Análise de Conteúdo proposto por Bardin (2009) os resultados foram: saúde/prevenção (85%), interação (47%), autonomia (40%), alegria/felicidade (33%), resiliência (33%), lazer (15%). E para avaliar a resiliência utilizou-se a Escala de resiliência de Wagnild e Young (1993). Quanto aos níveis de resiliência os resultados demonstraram que todas idosas apresentaram alto nível. Considerando os achados do presente estudo, sugere-se o emprego da atividade física como método de intervenção para melhora da saúde mental e, por conseguinte, da resiliência psicológica na população em questão, uma vez que os resultados apontam que idosas fisicamente ativas apresentam escores de resiliência psicológica superiores àquelas estratificadas como sedentárias. O resultado desse estudo possibilitou também concluir que a importância da atividade física parece estar relacionada, na sua maioria, às características de saúde/prevenção, interação social, autonomia, resiliência, alegria/felicidade e lazer. Além disso, as mulheres do presente estudo apresentaram um alto nível de resiliência quando comparado à tabela normativa

Avaliação do cuidado na estratégia saúde da família em metrópoles do nordeste brasileiro

Objective: To evaluate the implementation of the Family Health Strategy (FHS) in Brazilian cities of the Northeast, expanding coverage, analyzing the progress, challenges and innovations. Methods: Multicentric Evaluation Research, Studies Baselines in urban centers, using as a case study method. Selected cases of Aracaju, being capital, advanced coverage with extended team, and Fortaleza, capital coverage incipient and minimal staff. In Fortaleza, purposive sample of 11 Units Primary (APS), 03 managers, 53 professionals and 109 users. In Aracaju, 09 units of APS, 02 managers, 36 professionals, and 90 users. Structured interviews for managers, and structured to professionals and users. Descriptive analysis focusing on the political and institutional dimensions, organization and comprehensive care. Results: There was consensus that the ESF is the preferred port users and acts as inducing changes in care. In the case of Fortaleza, the specificities were: care protocols and community activities aimed at chronic conditions (100%) , with greater participation of doctors and nurses (93%) ; conjunction with more complex services, but the teams reported difficulties with the examination center and experts, the long waits and poor access to local services were the main difficulties reported by users., As innovative practice, the therapeutic group of elderly caregivers mentioned by respondents; There was intersectoral initiatives and teams 87 % of users have participated in meetings about health problems. In the case of Aracaju, care protocols were directed to the lines of care and formulated locally, 85 % coverage of the population with FHS counterpart local financing; employees hired by public tender; 70 % of teams with expertise in public health center for continuing education acting; democratization in management; access technologies, welcoming and computerization in different integrated networks, and evaluation matrix. Conclusions: The ESF has promoted access to health care and inclusion of disadvantaged populations. Different perceptions and practices in the organization of care, with distinct trajectories of reorganization. In the case of Fortaleza, predominance of model programs valuing older, with evidence of advances in care practices and teamwork, but restricted to primary care practices and incipient in public policy perspective. In Aracaju, had network integration with technologies related to the family, in which the ESF is consolidated as public policy. It can be argued that the XII APS expanding coverage, exhibited efficacy, despite the challenges inherent to the different degrees of implementation

Nutrição social no Brasil: [mais] uma estratégia biopolítica?

Inspirés par la « méthode » artisanat intellectuel propose par le sociologue Wright Mills, notre étude porte sur la formation du champ de pratiques discursives et non discursives (Michel Foucault) de la nutrition sociale dans le contexte de la société brésilienne dans lequel s insère le champ de la santé. Le travail empirique s épuise sur une source de documents normatifs de ce champ et s oriente à vérifier et à comprendre comment le praticien de la nutrition émerge dans le scènario des pratiques de la santé au Brésil à partir du milieux du 20ème siècle, tout en construisant son « regime de vérité » fondé dans des processus biopolitiques du champ de la médecine sociale. Nous avons relié deux phénomènes: a) l émergeance du champ biomédical de la nutrition comme une instance biopolitique, en approchant cette formation à l'histoire de la médecine sociale, depuis ses débuts européens jusqu'au contexte brésilien ; b) les pratiques discursives et non discursives du champ de la nutrition lequel est compris dans le Sistema Único de Saúde (SUS - Système Unique de Santé) brésilien. La démarche de recherche comprend l'élaboration et analyse d'une archive composée de publications qui contiennent l'Histoire du praticien de la nutrition au Brésil et des publications officielles disponibles dans le site web « Política Nacional de Alimentação e Nutrição » (Politique Nationale d'Alimentation et de Nutrition) lesquelles sont considérées comme des guides d actions des praticiens de la nutrition sociale dans le Sistema Único de Saúde (SUS). Le concept de biopouvoir, décrit par Michel Foucault entre 1974 et 1979, et la notion de biopolitique, dans son sens réinterprété et mis à jour par Giorgio Agamben, Antônio Negri et Michael Hardt, ont fourni le support théorique de cette recherche

A experiência humana como estratégia : a comunicação como jogo & o jogo como comunicação

En la interface de las Ciencias Sociales y de la Comunicación, la tesis expone una discusión sobre la Comunicación Social como área de conocimiento y discute las bases fenomenológicas de la producción de significado utilitario sobre el mundo. Para dar cuenta de esa reflexión se tiene como referencia la película Slumdog Millionaire? del director Danny Boyle. La experiencia vivida por el personaje principal llamado Jamal Malik sirve de apoyo a su éxito en un programa de TV cuyos desafíos consigue vencer uno a uno y transformarse en un millonario. El film, y en consecuencia la trayectoria de Jamal, es el operador cognitivo para que se presente la estrategia del personaje que transforma su conocimiento experimental en conocimiento pertinente, objetivo. La investigación sirve de base para ofrecer el argumento central de que solo existe conocimiento por medio de la experiencia vivida. A partir de esa concepción, la comunicación es vista en este ensayo como entrecruzamiento de caminos y nudos que se asemejan a un rizoma donde cada construcción de sentido, cada palabra que gana significación representa diversos enlaces de esos nudos sistémicos. Aseguramos que la comunicación es una condición sine qua non a los humanos y puede ser comprendida por la paradoja natural-artificial. Es de esta paradoja, que presentamos una contribución de la complejidad de la comunicación creyendo de forma dialógica que sí, hay una condición innata de la comunicación (y así mismo post humana) concomitantemente con la hipótesis de la artificialidad comunicacional. Corroboramos así, la idea de que el conocimiento fenomenológico de la comunicación es un juego de la construcción científica y, por lo tanto, un juego de la humanidad. En este mismo juego podemos comprender la comunicación por intermedio de algunos macro conceptos de la compleja actividad de comunicar (retroalimentación, recursividad y holograma) constelando así una estrategia de ligazón/estímulo/respuesta que nos permite conocer bien y saber organizar mejor el conocimiento adquirido en la práctica. La tesis tiene como interlocutores principales Claude Lévi-Strauss, Edgar Morin, Jean-Marie Pelt, Norval Baitello Junior y Vilém Flusser, entre otros

Limites e possibilidades do programa nacional de alimentação escolar enquanto estratégia de promoção da segurança alimentar e nutricional no municipio de Macaíba/RN

This dissertation aims to understand the importance of the National School Feeding as a strategy for ensuring the promotion of food and nutrition security in the municipality of Macaíba / RN, taking into account the implementation of the Law School Feeding, 11,947, 2009. The program was extended to all public basic education, youth and adults, in addition to ensuring that 30% of transfers from FNDE, were intended for the purchase of products from family farms. The survey was conducted with 160 students from public schools and farmers nesting Quilombo dos Palmares II, who produce on their land vegetables, fruits and cereals for their own consumption, for sale in local markets, in addition to providing for PNAE. The reciprocity between neighbors, such as mutual aid and sharing of common goods was noticeable in this group of farmers, since it was necessary to meet weekly deliveries of products to schools. As students, we applied a test of acceptability in two schools located in rural and in urban areas, to learn the opinion of ourselves in relation to school food consumed. It was concluded that to be most effective program in the region, there must be a better match in school menus, so that it can be attractive to students and to ensure greater use of fresh food, the main ingredient of same, practice of nutrition education in schools, to teach students the importance of food to health. In relation to local management, noted the need for adjustments bureaucratic as hiring staff for the departments, in order to be more agile in releasing payments to farmers, in addition to hiring assistants general services for schools, one Since the cooks exert dual role, the cooking while being responsible for cleaning the entire school environment. Government investments in the rural sector would be extremely valuable for farmers, since they need financial resources to purchase inputs, irrigation projects for gardens, availability of land for planting, transportation to facilitate the delivery of its products to schools and technical assistance more frequently

Barreiras de sobrevivência: angústias e dilemas de jovens infratores pós-institucionalização

This study critically examines the effects of public policies, implemented by Fundação Estadual da Criança e do Adolescente (FUNDAC/RN), along with adolescents of both sexes, perpetrators of illegal acts in compliance by court order, by socio-educative measures , identifying the contradictions that permeate the understanding and treatment of issue. The aim is to investigate the chances that youths have by living in Centro Educacional Pitimbu and Centro Educacional Padre. João Maria (CEDUC), to become subjects in the exercise of their citizenship. The methodology adopted is the verbal history of life (MEIHY, 2005) of youths that had life experiences in these institutions from 2002 to 2005, allowing researchers to access directly to investigated individuals, through the place where they currently reside, and enabling the reconstitution of their life story, from semi-structured interviews. The young people s statements interviewed were grouped and analyzed from the following categories of analysis: the egress and family, the school and egress, the community and egress, the egress and work, the egress and CEDUC, the egress and experience infringement. The results indicate that, despite the advances in Brazilian legislation for the sector, the actions promoted by these institutions generally would have produced innocuous and stigmatized consequences. Moreover, they show in essence that they carry on their inner contradictions which fundamentally correspond to the interests of the dominant system and a society which uses mechanisms of social policy, in addition to favoring the control and repression. And thus, while such actions remain unable to produce important changes in the conditions of existence of young people who meet by social deprivation of liberty, it is possible to say that the chances are minimal so that they become autonomous subjects in a society that, preferring their punishment, denies them, stubbornly, access to their basic rights. In theory, the researcher dialogues with authors as Foucault, Goffman, Bourdieu, Offe, Bauman, Boaventura Santos, Takeuti, Germano, Ariès, Wacquant, among others

A política de humanização e a estratégia saúde da família: visões e vivências

This study approaches the topic of humanization in health that involves the set of policies implemented by the Ministry of Health in Brazil. Its aims are directed towards a reflection on the guiding theoretical and organizing axes of the National Humanization Policy (NHP) and their repercussions on municipal health policy of Natal, Brazil; an analysis of the results of the policy at the local level; knowledge of the views and experiences of the humanization agents in the daily work process and identification of the main challenges of the policy. The empirical field of investigation was the Family Health Strategy (FHS) of the city of Natal. The assumption of the study is that the FHS has produced local experiences with potentialities that must not be wasted, in which there are difficulties and discrepancies between the real and proposed model. The contradictions and challenges in the social and political context of Brazil in the early XXI century and their consequences in the field of health reflect anti-utilitarian aspects anchored strongly in the theoretical concepts of Boaventura de Sousa Santos about the sociology of privations and emergencies as well as of the work of translating. The predominantly qualitative approach collects some complementary quantitative data. The study procedures used were the following: bibliographic research; documental research; interviews; and direct observation. Interpretation of the information obtained was based on documental analysis and on the symbolic cartography of the social representations. Cartographic evidence suggests that practices still take place under dehumanizing conditions that compromise the quality of care given. However, there is a movement aimed at changing the work process that has been strengthening the link and widening the measures developed, incorporating new directions in diversity, integrality and solidarity. The map drawn shows a reality manifested by explicit intentions in a political agenda, by concrete solutions marked by an assortment of difficulties and expressed in the words of the agents and by latent clues identified in successful local experiences, posing many challenges for the consolidation of the proposed changes

Reestruturação produtiva na Petrobrás e ação sindical dos petroleiros do RN

Ce travail a l objectif d analyser la question de la restructuration productive dans la Petrobrás/ RN et les implications possibles sur l action syndicale du Sindipetro/RN pendant la période 1995 2003. La restructuration productive dans la Petrobrás/RN commence dans la décennie 1990 quand l entreprise, au niveau national, décide d adhérer au Programa Brasileiro de Qualidade e Produtividade PBQP lancé par le gouvernement Collor comme motivation et priorité pour que les entreprises s adaptent à l ouverture de l économie brésilienne au marché extérieur. De ce fait, la Petrobrás/RN afin de se maintenir dans le marché compétitif et mondialisé , adopte des techniques administratives basées sur la philosophie de la qualité totate, met au point des inovations technologiques et organisationnelles, tout en altérant sa base technique et adopte, encore, la tertiairisation de quelques activités visant à la reduction des coûts. De telles mesures ont atteint de façon remarquable l action du Sindipetro/RN qui commence alors à agir selon la logique de la politique néo-libérale du gouvernement de conduite anti-syndicale. Face à ces faits le syndicat a rédéfini ses actions dans le but de trouver des manières de poursuivre les luttes syndicales dans cette conjoncture de difficultés dans les relations de travail. Celui-ci s engage donc à entamer les négociations comme stratégie afin de préserver les privilèges de la catégorie et d éviter la perte des droits acquis

Sobrevivência e tamanho populacional do Tiê-preto Tachyphonus Rufus (aves: thraupidae) em fragmento de restinga no extremo Norte da Mata Atlântica

For a long time, we believed in the pattern that tropical and south hemisphere species have high survival. Nowadays results began to contradict this pattern, indicating the need for further studies. Despite the advanced state of the study of bird population parameters, little is known about their variation throughout the year and the factors affecting them. Reproduction, for example, is one factor that may alter adult survival rates, because during this process the breeding pair allocates resources to maintain itself to maintain offspring, making itself more susceptible to diseases and predation. The aim of this study was to estimate survival and population size of a Central and South America passerine, Tachyphonus rufus (Boddaert, 1783), testing hypotheses about the factors that define these parameters. We performed data collection between Nov/2010 and ago/2012 in 12 ha plot, in a fragment of Atlantic Forest in northeastern Brazil. We used capture-mark-recapture methods to generate estimates using Closed Design Robust model in the program MARK. We generated Multi-state models to test some assumptions inherent to Closed Robust Design. The influence of co-variables (time, rain and reproductive cycle) and the effect of transient individuals were measured. Capture, recapture and apparent survival parameters were defined by reproductive cycle, while temporary dispersal was influence by rain. The estimates showed a higher apparent survival during the non-breeding period (92% ± 1%) than during breeding (40% ± 9%), revealing a cost of reproduction and suggesting a trade-off between surviving and reproducing. The low annual survival observed (34%) did not corroborate the pattern of high rates expected for a tropical bird. The largest population size was estimated to be 56 individuals in Nov/11, explained by high recruitment of juveniles, while the lowest observed in May/12: 10 individuals, probably as a result of massive influx of competitor species. Results from this study add to the growing literature on life history of Neotropical species. We encourage studies like this especially in Brazil, where there are few information, and suggest that covariates related to habitat quality and environmental changes should be tested, so that we can generate increasingly reliable models

Sobrevivência de adultos e estimativa populacional da guaracava-de-topete-uniforme elaenia cristata (aves: tyrannidae) em fragmento de mata atlântica no Nordeste do Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Prototexto, narrativa poética da ciência: uma estratégia de construção do conhecimento e religação de saberes no ensino de física

In this thesis I present the prototexto notion and to I base as a complex system while strategy of knowledge construction and reconexion of you know in physics teaching. Prototexto is a poetic narrative of the science, proposal and used initially as "instrument of creative" learning for students apprentice of science of the medium and technical teaching of the Vitória da Conquista's CEFET-BA, in the period of 1997-2004. Later become pregnant as a strategy of knowledge construction, in the Universidade Estadual da Bahia - UESB, the prototexto notion configures a complement to the mathematical formulation. The proposal of a poetic narrative of the science is that the apprentice of science starts to organize in an aesthetic-literary way your knowledge, dispersed in disciplines, starting from a theme of the physics. The prototexto emerges of my reflections concerning the classic science, identified for Edgar Morin as tends a thought excessively numeric, and that it has been reproduced in physics teaching, in most of the schools, limiting him/it to an order pattern with the mistake absence. They are operations of the prototexto: the poetic language, the pedagogic stamp, the unfinished of the argument, the system character and the apprentice's of science inclusion as subject implicated in the construction of the knowledge. the theoretical foundations are based Morin's proposition of the method as strategy, the beginning of the complementarity of Niels Bohr in conceiving excluding categories as face of a same phenomenon and the conception of creative time of Ilya Prigogine that enunciates the alliance among the nature and the man that it describes her

Praxiologia, representação social de menopausa e práticas educativas de enfermeiras na estratégia saúde da família

This research, whose theme is related to climacteric, aims to know the social representation of menopause developed by the nurses working for Estratégia Saúde da Família (Family Health Strategy) in João Pessoa PB, as well as identifying its structure and verifying the way it interferes with the assistance and educational practices to the climacterial user. In the theoretical level, it is based on a model that articulates the social representations theory, the central nucleus complementary theory and the central concepts of Pierre Bourdieu s praxiology: habitus, cultural capital, social field and symbolic power. A hundred and forty-seven female nurses who work for Estratégia Saúde da Família (Family Health Strategy) in João Pessoa (PB) took part in this research, and the data collection period was from February 2008 to March 2009. As to the methods and techniques, we used the method to determine the central nucleus based on the free association of words, a questionnaire to identify certain regularities that constitute the nurses habitus, and the semi-structured interview to explore opinions and attitudes when facing assistance situations and educational practices and to collect other relevant information. The data analysis was developed, when referring to the free associations, with the help of the EVOC software, which is a group of articulated programs which carry out the statistical analysis of the evocations and the identification of the possible elements of both the central nucleus and the peripheral system of the social representation. As to the questionnaire, we used the descriptive statistical analysis and the analysis of correlation between the variables. The interviews were submitted to a categorical analysis of the content. The EVOC result indicated that the cognition hormone was the only element of the central nucleus of the social representation of menopause. Due to its symbolic value and structuring power, this central nucleus ensures the strict and, at the same time, flexible character of the representational content. The analysis of the social advancement, of some fundamental features of the group habitus, as well as the analysis of its insertion in the health field and of the attitudinal opinions and dispositions concerning the assistance given to the climacterial user, and the analysis of the pedagogical dimension of this assistance, all these analyses lead to the conclusion that the nurses who took part in this research share a social representation of the menopause resulting from the association of different technical and scientific knowledge. These derive from the biomedical pattern as well as from hegemonic values which disqualify old age and overvalue youth, from pedagogical conceptions arising from patterns that are presently regarded as authoritative and old-fashioned and from cultural references (responsible for the semantic variations concerning the central nucleus) which are specific to the subgroups the nurses belong to. This research enables the creation of opportunities for discussion between active nurses working for Estratégia Saúde da Família, and the nurses who are teachers at institutions of higher education, aiming at linking theory to practice, so that they can find ways of thinking about the climacteric and working, in a more comprehensive way, with users who are experiencing this stage of life

O Evangelho segundo a Pastoral da Criança :por uma pedagogia da sobrevivência

This work aims to analyze social and educational actions at Pastoral da Criança, using education as a survival tool. This was done at Parque dos Coqueiros, a neighborhood in Natal, Rio Grande do Norte. The methodology for data collection was composed of comprehensive interview (Jean Kaufmann), participant observation (Robert Bogdan) and documental analysis (Le Goff); all os which bring reflections related to concepts such as strategies, tatics and know how (Michel de Certeau), configuration (Nobert Elias), and control technology (Michel de Foucault), care ethics (Leonardo Boff) and etno-theories (Natália Ramos). Pastoral da Criança is a social action organism that belongs to the National Conference of Bishops of Brazil, originated at Florestópolis, Londrina (Paraná), in the year of 1983. These actions have been an expression of a new logic of actions of the Catholic Church. It values the participation of laymen in the activities of the Pastoral. Thus, the parish is seen as a nucleus that irradiates the Church s Social Doctrine. At Rio Grande do Norte this institution has guided poverty stricken families on issues related to children s health as well as working with laymen for volunteer work. This is considered devotion, that is firmed by an individual and group mystique. The social and educational actions are done in three axes: 1) Monthly home visits, where there is mother-child support; 2) Life Celebration Day, where they weigh children and promote nutritional surveillance; 3) Meeting for Evaluation and Reflection, that aims to articulate community leaders to think about problems attached to the social actions they realize. This action tripod , as it is called by the Pastoral Agents are the types of actions that fundament survival education for poor children ranging from 0 to 6 years old. The families learn to deal with prevention, the essential, the alternative and probabilities of survival tactics due to exclusion matters or even social extermination. The Pastoral da Criança aims to recover childhood emotions in poverty stricken areas. It also has influence in the diminishing of malnutrition and mother and child mortality. This education for survival is the base on the art of teaching and learning of poverty stricken children. It is a social educational action, non assistencialist, but considered a shy action in order to promote mobilization of the communities that are accompanied for the emancipation and change of social conditions