Fisioterapia e sociedade: ações do Sistema Único de Saúde no Rio Grande do Norte

The work has objective to present actions of Physiotherapy, developed by SUS in the State of Rio Grande do Norte; discuss under the humanization point of view such actions of health; discuss the importance of physioterapy to the Norte-Riograndense, or maybe its role in the perpetuation of actions of health centered in the binomial cause/efect. The study was done in the State of Rio Grande do Norte. The data were obtained through public sources gathered in the health secretrary ship of this State. The collected data talks about physiotherapy sections developed by SUS in several areas of the State; such data was collected and analysed after the aproval of Ethic and Resarch Committee of Federal University of Rio Grande do Norte. Concerning the physiotherapy, along with the State Health Secretaryship of the State fo Rio Grande do Norte, there were only records of attending based on cure/rehabillitation, not being observed during the curse of study, any record or action of prevention, promotion and protection towards health. It s possible to notice that there is a highligth to the interventions focusing on the treatment of illness of rheumatic origin and general complaints related to the vertebral column. Such research evidenced that the Physiotherapy in the SUS in the State priorizes the individualized attending centered in the carteziano health/illness model, where the developde actions are turned to the curative and rehabilliting attention, with role fo some or no highligth in the primary attention

Avaliação do estado nutricional relativo ao selênio e da expressão gênica de selenoproteínas em pacientes com aterosclerose tratados com estatinas

The aim of this study was to determine the effects of the use of rosuvastatin in patients with atherosclerosis, in relation to blood parameters of selenium and selenoproteins, and also observe possible changes in gene expression of selenoproteins in these patients. The sample consisted of 27 adult and elderly patients with a clinical diagnosis of coronary artery disease undergoing angioplasty, treated at Natal Hospital Center hospital, Natal, RN. Patients were treated with rosuvastatin 10 mg/day during four months. Anthropometric variables such as body mass index (BMI) and Waist circumference (WC) were measured before and after treatment, as well as lipid profile, blood glucose and liver enzymes (AST and ALT). The diet of the patients was also analyzed using 24-hour diet recall. We analyzed the concentrations of selenium in plasma and erythrocytes, and also the activity of Glutathione Peroxidase and gene expression by Real Time PCR of selenoproteins GPx1, SelP1 and SelN1. Patients had mean age of 61.0 ± 9.4 years, 59.3% were men and 40.7% were women. After four months of treatment there was significant reduction of CA and, according to BMI, most were overweight. The intake of macronutrients, cholesterol, polyunsaturated fatty acids, monounsaturated and saturated was adequate, but the energy and fiber intake was below the recommendations. Regarding the selenium intake was observed a high prevalence of inadequacy. As expected, after treatment with rosuvastatin, a significant reduction in total cholesterol, LDL and glucose, which was not observed for HDL. Selenium concentrations in plasma and erythrocytes showed no changes, keeping within the established cutoffs. We observed a significant increase in GPx enzyme activity and mRNA expression of GPX1 and SEPN1, but not for gene SEPP1. Thus, it was found that treatment with rosuvastatin did not reduce the expression of selenoproteins. More studies are needed to clarify the effects of rosuvastatin on gene expression of selenoproteins in patients with atherosclerosis

Desvendando o padrão alimentar de famílias rurais: o que tem no prato?

That work looked for to point out the different conceptions on the family agriculture and the established self-consumption practices inside the unit of production. Hypothesis: due to the conditions, more and more restricted of producing for the self-consumption, the rural families are more favorable present her situation of alimentary insecurity as severe as for the urban families, unlike what he/she defends. The research was accomplished in three states of the Northeast: Paraíba; Rio Grande do Norte and Sergipe. The results revealed that among the main factors that expose those families to situations of constant alimentary vulnerability are had: the low quality of the alimentary consumption in what concerns the readiness, to the diversification and mainly, to the accessibility. The analyses can be to subsidize a reflection concerning the alimentary pattern of families rural front to the precepts of Food and Nutrition Security (FNS) politics

Ambiente pesqueiro e saúde: representações sociais sobre saúde e doença de pescadores e marisqueiras nos distritos de Diogo Lopes, Barreiras e Sertãozinho Macau RN

According to Brazil s Ministry of Fisheries and Aquaculture, artisanal fishermen are responsible for a significant fish production at national level, highlighting the importance of this activity. In Rio Grande do Norte State, Brazil, fishing has become an important part of economic and social processes. In this context, there are many inland fishing communities such as Barreiras, Diogo Lopes and Sertãozinho, which are part of Ponta do Tubarão State Reserve of Sustainable Development (RDSEPT), located in Macau and Guamaré, Rio Grande do Norte coastline cities. Fishermen and women, the last ones known as marisqueiras who work alongside the menfolk at sea, especially in the shellfish harvest, have been developing narrow relationships with nature, mainly with the sea, from where they extract their families subsistence. However, those communities have been facing several issues related to living conditions, health and diseases. Social representations have been analyzed in the speeches of fishermen/women who were registered active members in a fishermen association named Associação Colônia de Pescadores Z-41, regarding the period from 2008 to 2011. The analysis involved socio-economic profiles verification, identification and analysis of the group s main representative diseases and representations related to health and illness. This study searched for elements in order to provide the comprehension of the relationships among people s social representations and the fishing environment in which they live.. This qualiquantitative study was performed using recordings and transcriptions of structured and open-question interviews. The Collective Subject Speech tecnique proposed by Lefevre & Lefevre (2002) was applied to perform the interviews analysis using QualiQuantiSoft® software. The results showed that health and illness phenomena as well as social representations related to them in the fishing environment are not only abstract states but also physical ones, which interfere in all life extensions, establishing a set of relevant information that indicates that those people realize their own socio-cultural, economic, environmental and political context

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

Nesta terra, em se plantando tudo dá? Política de Soberania e Segurança Alimentar e Nutricional no meio rural paranaense, o caso do PAA

O tema proposto nesta tese vai ao encontro do atual debate em curso no Brasil e no mundo acerca de duas dimensões da cadeia agroalimentar: produção e consumo. Desse modo, as questões de como se dá essa relação frente às estratégias locais por diferentes atores, terá ênfase. Para isso, como campo empírico foram escolhidos três municípios localizados no território Centro-Sul do estado do Paraná: Irati, Inácio Martins e Fernandes Pinheiro que desde 2004 estão inseridos no Programa de Aquisição de Alimentos (PAA), mais especificamente na modalidade Compra com Doação Simultânea (CDS). A hipótese que embasa este estudo é de que o PAA poderá ser capaz de assumir um caráter estruturante - a partir do seu viés pedagógico, capacidade organizativa de produção, manutenção da diversidade ou resgate da policultura (e aqui se privilegia a agroecologia), bem como uma alternativa viável de acesso a um tipo de mercado (mercado institucional) -, não por altruísmo dos atores, mas por ser mais vantajoso ser parte integrante, do que estar à parte do processo, aliando a isso melhorias nas condições alimentares tanto das suas famílias, quanto das entidades receptoras. O objetivo principal foi analisar as relações sociais e as práticas alimentares de um grupo de agricultores(as) agroecológicos entre as responsáveis pelo recebimento dos alimentos doados buscando compreender se o PAA possibilita a Soberania e Segurança Alimentar e Nutricional (SSAN) de grupos sociais (como das famílias rurais) e das pessoas atendidas por estas entidades. A metodologia utilizada foi a de estudo de caso. Como procedimentos foram empregados entrevistas semi-estruturadas e aplicação de questionários como: Escala Brasileira de Insegurança Alimentar(EBIA) e Questionário de Frequência de Consumo Alimentar(QFCA). A amostra foi composta por agricultores(as)/ fornecedores(as) do PAA, nutricionistas e, coordenadora de uma das entidade dos seus produtos é, de fato, o que os mobiliza a continuar produzindo em maior diversidade e quantidade. Após a vivência dos(as) agricultores(as) /fornecedores de estarem inseridos no Programa foi possível para estes atores se sentirem parte do processo e, assim, repensar suas práticas de produção de alimentos, seja ela destinada ao autoconsumo, seja voltada à comercialização. Para além da discussão acerca da produção destinada ao autoconsumo, ficou claro o processo de recampesinização entre as famílias de agricultores(as). O processo de (re)conexão se apresenta de forma frágil, considerando, sobretudo, as considerações feitas pelas mediadoras. Trazer à tona o debate acerca da produção-consumo de alimentos, tanto na perspectiva de quem produz, como na de quem consome, e tomando por referência a operacionalização de políticas públicas, viabiliza a ampliação de debates e a concretização de ações mais contundentes numa perspectiva de minorar a situação de vulnerabilidade (social e alimentar) e de pobreza rural

Caracterização do nicho alimentar do polvo octopus insularis (cephalopoda: octopodidae): da população ao indivíduo

Octopus insularis, target species in this study, is the dominant benthic octopus of the North and Northeast Brazil. Studies on behavior and ecology of the species have been conducted primarily on oceanic islands, with little information on the continental populations. In this study, two regions of the coast of RN, Rio do Fogo and Pirangi, were chosen for the characterization of the niche by O. insularis populations. The dietary niche, habitat and distribution of O. insularis of oceanic islands and the mainland, were compared. In addition, individual characteristics of feeding behavior in a population at Atol das Rocas was studied, taking into account the size of individuals, the proximity of the dens and characteristics of their "personality". The diet of the Rio do Fogo population was composed mainly of bivalve molluscs (82%), unlike Pirangi population that has a diet consisting mainly of crustaceans Decapoda (68%), similar to that described for the populations of the islands. Consequently, the feeding niches of the island populations were more similar, with greater overlap, but the niche breadth of the continent was larger. The habitats of occurrence on the coast includes reefs, rocks, gravel and an environment called Restinga, a plateau composed of biogenic gravel, sand, sponges and algae, showed a high density of animals. Similarly to that found in the islands, O. insularis in the continent, had a clumped distribution, and a bathymetric segregation between small and large individuals. The differences in diet composition among populations were explained by differences in habitat and coverage of the substrate, which may be directly influencing the diversity and prey availability in these environments. The individual analyzes of the population at Atol das Rocas, showed no relationship between the degree of individual specialization and the different personalities, or the distance between dens. The results suggest that the foraging strategy with greater availability of prey in the environment has an influence on diet octopuses over preferences or personalities

Ingestão alimentar e nutricional de callithrix jacchus: relaçao com hierarquia social e disponibilidade de alimento

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

A tecitura da ação do coordenador pedagógico da EJA: saberes necessários à mediação do trebalho docente em alfabetização.

Este trabajo tiene su origen en nuestra historia profesional, en la que destacamos el rol mediador de coordinación pedagógica en la (re)construcción de nuestra actuación docente. En este contexto de vida profesional, nace la tesis que discute la problemática de la alfabetización y el rol de la escuela y de sus profesores, mediados por la acción de la coordinación pedagógica, en la construcción de una práctica alfabetizadora de jóvenes y adultos. Investigar qué saberes de la acción pedagógica son requeridos del coordinador pedagógico, en la mediación/ orientación de profesores alfabetizadores de jóvenes y adultos fue el objetivo de este trabajo. Para tejer la investigación fue escogido el abordaje caritativo de la encuesta; como metodología, el estudio de caso y como procedimiento el levantamiento de datos, la observación, el cuestionario, la entrevista y el análisis documental. Aprehendimos de la investigación que, en el desarrollo de su práctica, el coordinador pedagógico moviliza Saberes Específicos y Saberes Transversales de su acción pedagógica. En los saberes específicos, encontramos: Joven y Adulto como sujeto del conocimiento y del aprendizaje; Alfabetización del joven y del adulto: Psicogénesis de la lengua escrita; Ciclo de la acción didáctico-pedagógica. En los saberes transversales, fueron aprendidos: Respetar y se hacerse respetar por profesores y alumnos; Priorizar la dimensión pedagógica en el cotidiano escolar; Mediar la acción docente en las distintas etapas: planeamiento; ejecución y evaluación. La investigación ratifica que el trabajo pedagógico en la escuela debe ser construido en una relación entre profesores y coordinadores. Como resultados, evidenciamos, también, que los coordinadores pedagógicos se encuentran, todavía, sin una identidad profesional, inmersos en muchos quehaceres, sin darse cuenta de lo más importante: la mediación del trabajo docente. El coordinador pedagógico es un profesional que se va construyendo en las prácticas escolares y su identidad profesional aún no está definida como en el campo real de actuación. Basado en los estudios hechos, defendemos la tesis de que, la práctica del coordinador pedagógico en la escuela demanda saberes y quehaceres de acción pedagógica; estos adquieren especificidades en ejercicio de la mediación /orientación de la práctica pedagógica de profesores alfabetizadores de jóvenes y adultos. Aprehendemos como recomendación a los cursos de formación de coordinadores pedagógicos que estos deben proporcionar: Embasamiento teóricometodológico consistente sobre las Ciencias de la Educación; Prácticas Supervisadas de larga duración en la Coordinación Pedagógica de instituciones escolares y no escolares; Experiencia como profesor en sala de clase, de manera preferencial, en el nivel en que el que concluye el curso desea actuar. Fue destacada la importancia del lado humano en el ejercicio de la acción coordinadora, como forma de establecer y alimentar la comunicación con el profesor y, de este modo, coordinadores y profesores comparten la apasionante, pero difícil tarea de educar. Esperamos que el estudio, que destaca saberes necesarios para la práctica del coordinador pedagógico, pueda contribuir para ampliar la discusión del rol de este profesional en la escuela que deseamos pública, democrática y con calidad social.

Associação entre consumo alimentar e atividade física com a síndrome metabólica em mulheres na pós-menopausa

Post-menopause is characterized as the period beginning one year after the permanent cessation of menstrual cycles, which is typically related to medical disorders that, in association with Metabolic Syndrome (MS), represent a set of cardiovascular risk factors. Objective: To assess dietary intake and the prevalence of metabolic syndrome in postmenopausal women, according to the level of physical activity. Methods: The sample consisted of 82 women, evaluated in the Northern Zone of the city of Natal / RN who were participants in the Natal Active Program. People completed a Food Frequency Consumption Questionnaire (FFCQ) and were interviewed about physical activity. Anthropometric measurements and biochemical tests were used to diagnose MS (Metabolic Syndrome). Result: The active women consumed more protective foods (flaxseed, nuts, whole wheat bread, brown rice and olive oil) than inactive women. Risky foods (sugar, crackers, white bread, white rice, margarine and beef) were consumed more by the group of inactive women. The prevalence of MS was higher in inactive women (53.30%) than in physically active women (46.70%). Conclusion: Active post-menopausal women had a higher daily intake of protective foods in relation to cardiovascular disease, while the inactive post-menopausal women had higher intake of risky foods for such diseases

Envelhecer entre pássaros e anjos: um estudo etnográfico sobre o processo saúde doença do idoso no contexto familiar

Study, a descriptive-like one, is guided by ethnographic principles which have analyzed the elderly within the familiar context in his/her process of health and aging, in the neighborhood called Felipe Camarão, located in the western administrative region of Natal, RN, a Northeastern city of Brazil. The participants are elders aging 61 to 84 years old, living in this referring neighborhood, whose majority is constituted of migrants from the rural region of the state of the RN, retired, including widows, widowers and married couples, with low school-educational degree. For the information gathering it was utilized a semi-structured interview, the participant observation and the field diary, being put into effect, in majority, in the houses and in the Family Health Unit, in a period between March and October of 2006. For the results discussion it was utilized an analysis of thematic content and the program ALCESTE (In Portuguese, Análise Léxica por Contexto de um Conjunto de Segmentos de Texto or Lexical Analysis by Context of a Set of Text Segments), which through have emerged two corpus: the corpus I, Family and the elderly, and corpus II, The elderly and the aging within society. The analysis of the results has permitted to conclude that the family, also used by the public policies as a strategy of their practices in health, it is a necessary base support for the elderly citizen in his/her process of aging and of health. The elders familiar contexts have allowed this study to identify the existence of minimal social conditions of life, of new rearrangements of the current families by means of the plurigenerational acquaintanceship and the active presence of the elderly woman as a maintainer of this family; also by means of conflicted relationships among one another but in a bearable level of acquaintanceship. Different conceptions about the aging and the elderly generate disagreement and divergency however the family support and help for the solving of these problems and the attention to health are proceeding from the family components. However, it is noticed that loneliness is something present in these elder s everyday lives. About the attention to health, in a basic level of it, it was noticed that there are still a lot of gaps, mainly concerning promotional and preventing actions, deserving a higher sensitization and effort by the local health institutions

Vivendo e aprendendo no ambiente hospitalar: Percepções de crianças sobre a doença

This study focuses on the child within the hospital environment. Its purpose is to describe children s perceptions of their illness and time in hospital and to identify their main hardships during treatment. This study has a qualitative nature and is theoretically and methodologically supported by the creative and sensitive method developed by Cabral (1998), studies by Piaget, Vygotsky and Wallon on child development, and studies conducted by Pinto (2005), Collet (2004), Chiattone (2003), Silva (2002), Lima et.al (1999) on in-patient children. For this study, 13 children between the ages of 7 and 12 at a public hospital institution specialized in child care in the city of Natal, Rio Grande do Norte, were interviewed. As a criterion for taking part in this study the children would have to have been in hospital for over three days and be fully capable of physically and emotionally interacting with the researcher at the time the interview took place. Analysis drew on the study of the empirical material made up of interviews and a field diary where notes had been entered for the children s reactions, expressions and gestures. Results show that there is some understanding, on the part of these children, of their illness, with their parents as the main informants. They accept being in hospital because they need treatment, but they realize that life becomes different especially on account of the constraints resulting from the illness and the hospital itself. The main hardships during treatment are: lack of recreational activities in the evenings and on the weekends within the hospital environment; absence of family members, especially brothers and sisters; and lack of explanation on the part of health professionals regarding some procedures as these are being carried out. Our conclusion is that children perceive illness and the hospital environment as something that changes the rhythm of their lives bringing on them perturbations, fears and anxieties. Hence, we suggest that professionals working with in-patient children should be especially prepared to deal with these children and their parents, aiming at bringing down fears and anguishes, clear their doubts and, in addition, advise the parents in respect of their children s treatment while in hospital and after hospital discharge. The hospital environment should also be cheerful and colorful and have a toy room under the coordination of persons especially prepared for that purpose

Gritos de silêncio: na voz dos familiares cuidadores de portadores da doença de Alzheimer

This work is an investigation related to issues of those who take home care of people who suffer from Alzheimer disease (AD). Thus, it is justified by the need to acknowledge how these relatives perform this task and in which ways they do this. The study has is analytical and qualitative methodology with the use of a thematic oral history approach. The subjects of the research were nine relatives of those who suffer from AD that participate in the home care group in the Candelária neighborhood in the city of Natal in Rio Grande do Norte-Brazil. The data was collected using a semi-structured questionnaire and interview that was booked in advance and had full support from the care takers. After information collection, three thematic axles were defined. After this procedure, three analisys subcategories were also defined. The first thematic axle emphasizes the so called movement of rite of passage, when the relative becomes a care taker of a person with AD. The second category deals with the care takers strategies, either related to their own behalf or on their relative. It is possible to infer that amongst other forms of help, the care taker needs to rely on a support network, such as health services, groups composed by multiprofessionals that enable better articulation between family and collaborators. The dimension related to faith and spirituality was also observed and pointed out as an important aspect in the emotional support process for these relatives. In the third axle the perspectives of struggle, conquests of the right to health and life quality of those who suffer from AD as well as their relatives was observed. These also deal with dreams and hope

Avaliação do impacto do treinamento de clínica em hanseníase e sua contribuição para o aumento da detecção da doença 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): São José de Mipibu URSAP I, Mossoró URSAP II, João Câmara URSAP III, Caicó 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

Tuberculose: conhecimentos, representações sociais e experiências da doença na visão do portador

Tuberculosis is considered one of the most ancient human diseases, cases were registered 3900 years before Christ, and it is currently regarded as a serious public health problem in the world due to several factors such as income mismanagement, precarious standard of life and some sort of prejudice comprised by the word tuberculosis. Taking this into consideration, it was developed a descriptive and exploratory study aiming at analyzing the social representations of tuberculosis made by its patient from the Unidades de Saúde da Família (Family Health Units a public health program) in Campina Grande City PB, in relation to the decentralization of the policies that administrate the disease. It was interviewed 34 tuberculosis patient that were being treated from 2007 to 2008. The age group of the interviewees varied from 10 to 60 years old, but most of them were between 36 and 60 years old (58,8%, n=20), some were young adult and adult (21 35 years old), with 11 (32,3%) respondents, and, less frequent, children and teenagers (11 20 years old), with 03 (8,8%) participants. Data was collected through semi-structured interview. The questions that guided the research were elaborated based on the operational recommendations of DOTS strategy; that is: access to laboratory examinations; medication guarantee; directly observed treatment. Besides that, the experiences of the patient were considered in their relation with the family and the different social groups. The analysis of the discursive material was submitted to the Analyse Lexicale par Context d un Ensemble de Segments de Texte software - ALCESTE 4.7. Data interpretation showed five categories for the social representations of the tuberculosis patient that participated in DOTS strategy: 1) the accessibility of the health assistance service; 2) the patient perspective of the disease; 3) the change in the operation of the productive life; 4) the signals and symptoms of the tuberculosis disease; 5) the rearrangement and mechanisms used to face the disease. The Central Nucleus reveals that tuberculosis is a transmissible disease that can be prevented by people through educational practices, health promotion, active search for symptomatic respiratory and control of the carriers communication; these mechanisms should be incorporated to the routine of all participants of the family health groups. The Intermediate Elements, based on quotidian life, as well as the individual experiences of the tuberculosis patient, reveals prejudiced attitude and beliefs that lead to isolation and restriction of interpersonal relationship. Peripheral Elements were constituted by themes that showed the patient feelings of indignation because of the social barriers they had to face in the Family Health Units during the treatment. These elements demonstrate a negative perspective of the representation concerning the accessibility, i.e. inadequate structure of the health service; long distance to the Health Centre, this factormakes it difficult for the patient to continue the treatment; scheduling delay; and limited service regarding other requests (doctor, dentist etc). One expects to contribute for the construction of a new perspective of the health question between the different agents who make the assistencial institutions and formation of professionals, either in central or local scope