Práticas educativas e integralidade na saúde da família: um estudo etnográfico

Primary Health Care, especially in the family health strategy, it is expected that the joint assistance and actions of health promotion. The Ministry of health (BRAZIL, 2007) defines health education as an eyeshadow strategy of prevention and health promotion, based on reflective practices, which allow the user to their condition of historical, social and political subject, under the vision of an expanded clinic on the part of health professionals. In this sense, there are guidelines for it professionals to develop educational activities and that they can interfere in the health/disease process of the population, with a view to the development of autonomy of the subject. This research had as objective to understand in the light of the integrality of the care, as is the production of health education practices, within the framework of the family health strategy from ethnographic study in a family health unit (USF). The location of the research was the unit of USF Felipe Camarão II in West Health District, in the city of Natal, RN, Brazil, selected from preliminary mapping of educational practices deployed in units of health of the family of this municipality, based on criteria such as time-to-deployment of USF and sustainability of existing actions. Immersion in the field consisted of participant observation with journaling, held during the period of August 2012 to January 2013, in which she accompanied team work processes in clinical-welfare actions on the USF, in households and in educational activities of group character. The results presented in ethnographic description were analyzed based on the axes proposed by Ayres (2009) for identification of integrality in health practices:the axis of the needs; the axis of the purposes; the joint axis; and the axis of the interactionsThe evidence described from observation point the presence of each axle up health education practices developed by the teams, even incipient form, namely: articulation and appreciation of knowledge and practices of popular culture with local initiatives (Pastoril do Peixe Boi Encantado, Auto de Natal e Grupo Terapia e Arte); Clinical integration with health promotion actions and coordination of multidisciplinary knowledge, with professional-user link (course for pregnant women). However, a few challenges were identified to be faced in order to move forward in these practices in integral care: the need to break with the fragmentation of actions; strengthening teamwork; need for greater sustainability policy of collective actions; intersectoral work aimed at a better role of the State in the face of the health-disease process, adding to the action of individuals.The analysis produced from observation of the processes experienced indicates the need for a better recognition of local managers that actions similar to those that occur in the USF Felipe Camarão II enable advances in completeness as allows inclusion of actors involved in the processes of health work, and stimulate participation and shared responsibility in the fight for health-disease situations

Diferenças entre critérios normativos e autopercebidos na identificação da necessidade de tratamento ortodôntico, satisfação com a aparência e mastigação em adolescentes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

MoSAC: um módulo para seleção de configurações arquiteturais baseado em critérios de QoS no contexto de sistema distribuídos autoadaptativos

The process for choosing the best components to build systems has become increasingly complex. It becomes more critical if it was need to consider many combinations of components in the context of an architectural configuration. These circumstances occur, mainly, when we have to deal with systems involving critical requirements, such as the timing constraints in distributed multimedia systems, the network bandwidth in mobile applications or even the reliability in real-time systems. This work proposes a process of dynamic selection of architectural configurations based on non-functional requirements criteria of the system, which can be used during a dynamic adaptation. This proposal uses the MAUT theory (Multi-Attribute Utility Theory) for decision making from a finite set of possibilities, which involve multiple criteria to be analyzed. Additionally, it was proposed a metamodel which can be used to describe the application s requirements in terms of the non-functional requirements criteria and their expected values, to express them in order to make the selection of the desired configuration. As a proof of concept, it was implemented a module that performs the dynamic choice of configurations, the MoSAC. This module was implemented using a component-based development approach (CBD), performing a selection of architectural configurations based on the proposed selection process involving multiple criteria. This work also presents a case study where an application was developed in the context of Digital TV to evaluate the time spent on the module to return a valid configuration to be used in a middleware with autoadaptative features, the middleware AdaptTV

Reavaliação de critérios estruturais na hidrogeologia de terrenos cristalinos, com ênfase na neotectônica e sensoriamento remoto

Hydrogeological prospecting in Northeast Brazil and in other crystalline terrains has been developed on the basis of structural and regional geology concepts that date back to the 50-60 decades and, as such, demand a natural re-evaluation and update. In this kind of terrain, the percolation and accumulation of ground water are controlled by fractures and other types of discontinuities, such as foliations and geological contacts that, through weathering, impart porosity and permeability to the rocks, allowing water flow and storage. Several factors should be considered in the process of locating water wells, as discussed in the literature. Among these, the kind of structures, fracture geometry (including aperture and connectivity) and their geological and chronological context. It is important to correlate fracture systems with the regional neotectonic framework. Fractures at low angle (sub parallel) with the principal stress axis (s1) are those which tend to open (actually they work as tension joints) and, in principle, would present major hydric potential; in the opposite side, fractures at high angle to s1 would behave as closed by a compressional component. Fractures diagonal to the compression and tension axes correspond to shear fractures and, due to their connectivity with second fractures, are also important in terms of hydric potential. Uplift followed by terrain denudation leads to decompression and a general tendency to open (aided by weathering processes) fractures and other rock discontinuities, at different orientations. Low angle fractures, formed in this context, are equally important to increase connectivity, collection of water and recharge of the aquifer systems. In a general way, an opening component (neotectonic or by terrain decompression) and several models to increase fracture connectivity correlate with a greater hydric potential of these structures. Together with parallel research, this thesis addresses models of ground water occurrence in crystalline terrains, either improving well established concepts like the (Riacho-Fenda model), but also stressing other possibilities, like the role of alluvium and paleo-regoliths (the Calha Elúvio-Aluvionar model) and of strongly altered, permo-porous zones placed at variable depths below the present surface, flanking several types of discontinuities, especially interconnected fracture arrays (the Bolsões de Intemperismo model). Different methodological approaches are also discussed in order to improve success rates in the location of water wells in crystalline terrains. In this methodological review, a number of case studies were selected in the eastern domain of the State of Rio Grande do Norte, involving the localities of Santa Cruz, Santo Antônio, Serrinha, Nova Cruz, Montanhas, Lagoa de Pedras and Lagoa Salgada. Besides the neotectonic analysis of brittle structures, this Thesis addresses the validation of remote sensing as a tool for ground water prospecting. Several techniques were tested in order to detect and select areas with higher potential for ground water accumulation, using Landsat 5-TM and RADARSAT images, besides conventional aerial photos. A number of filters were tested to emphasize lineaments in the images, improving their discrimination, to identify areas with higher overburden humidity, which could reflect subsurface water accumulation, as well as alluvium and other sedimentary covers that might act as recharge zones. The work started with a regional analysis with the orbital images, followed by analysis of aerial photos, up to a detailed structural study of rock exposures in the terrain. This last step involved the analysis of outcrops surrounding wells (in a ray of approximately 10 to 100 m) with distinct productivities, including dry examples. At the level required for detail, it was not possible to accomplish a statistical approach using the available well data catalogs, which lack the desired specific information. The methodology worked out in this Thesis must undergo a testing phase through location of new water wells. An increase in the success rates as desired will led to a further consolidation step with wider divulgation of the methodology to private companies and governmental agencies involved in ground water prospecting in crystalline terrains

Proposta de critérios adicionais para definição de Área Prioritária para Conservação no Semiárido brasileiro

Environmental changes and their consequences on the global level have challenged the different fields of study to integrate towards effective solutions to minimize and /or equate the negative impacts of these changes in different types of environments. In this context, the Environmental Perception has been a widely used and relevant in studies that consider the relationship between the environment and human actions, by allowing analysis of perceptions, attitudes and values, key influencers of topophilia that resonates in conservation tool. Allied to Environmental Perception, Integrated Analysis of the Landscape is relevant because it allows to analyze in a systematic way the geographical space where all its elements are interrelated in a way that supports needed to understand the complex physical and human environment of a given environment. In this perspective, we have studied the João do Vale Serrano Complex, located in semiarid of Rio Grande do Norte state, which features a set of landscapes with different faces, which are being replaced by various economic activities and disordered population growth, with consequent exploitation the potential of natural resources. This thesis main goal was to combine the Environmental Perception of rural communities to the of Serrano Complex Landscape Analysis as additional criteria for the definition of Priority Areas for Conservation. The perception data were collected through direct observation, questioning, interviews and application forms to 240 people (100 % of occupied households in the mountain community) during the months of february and august 2011, with theoretical and methodological basis Environmental Perception. Integrated Landscape Analysis was performed by GTP (Geosystem - Territory - Landscape) method, using the Geographic Information System (GIS), using the technique of GIS for mapping the landscape. The results showed that respondents have a sense of topophilia by where they live, hold a vast knowledge of the natural resources in this Serrano Complex, and responded positively regarding the choice of an exclusive area for conservation. The Integrated Analysis of Landscape possible to identify the different forms of existing uses and occupations in Serrano Complex, have caused significant changes in space, especially on the plateau where vegetation was virtually replaced by human dwellings and cashew plantations. Through the maps of slope and environmental vulnerability was identified that areas with high slopes (gullies) are limiting factor for occupation by communities and therefore relevant and amenable to conservation, including by being Permanent Preservation Areas. These results, together, made possible to define a map of Priority Areas for Conservation in Serrano Complex, with three priority categories: low, medium and high. Therefore, the use of these additional criteria are relevant for the definition /designation of Priority Areas for Conservation

Estruturas de acumulação de água subterrânea em rochas cristalinas: estudo geofísico e geológico de casos no Estado do Rio Grande do Norte

Geological and geophysical studies (resistivity, self potential and VLF) were undertaken in the Tararaca and Santa Rita farms, respectively close to the Santo Antônio and Santa Cruz villages, eastern Rio Grande do Norte State, NE Brazil. Their aim was to characterize water acummulation structures in crystalline rocks. Based on geological and geophysical data, two models were characterized, the fracture-stream and the eluvio-alluvial through, in part already described in the literature. In the Tararaca Farm, a water well was located in a NW-trending streamlet; surrounding outcrops display fractures with the same orientation. Apparent resistivity sections, accross the stream channel, confirm fracturing at depth. The VLF profiles systematically display an alignment of equivalent current density anomalies, coinciding with the stream. Based on such data, the classical fracture-stream model seems to be well characterized at this place. In the Santa Rita Farm, a NE-trending stream display a metric-thick eluvioregolith-alluvial cover. The outcropping bedrock do not present fractures paralell to the stream direction, although the latter coincides with the trend of the gneiss foliation, which dips to the south. Geophysical data confirm the absence of a fracture zone at this place, but delineate the borders of a through-shaped structure filled with sediments (alluvium and regolith). The southern border of this structure dips steeper compared to the northern one. This water acummulation structure corresponds to an alternative model as regards to the classical fracture-stream, being named as the eluvio-alluvial trough. Its local controls are the drainage and relief, coupled with the bedrock weathering preferentially following foliation planes, generating the asymmetry of the through

Caminhos para a avaliação da formação em odontologia: desenvolvimento, validação e aplicação de critérios

The need for universal access to health and the failure of the pedagogical model centered on the transmission of knowledge has led to changes in the training of health professionals. The objective of this study was to provide a new alternative for evaluating dental students through the development, validation and application of evaluation criteria based on the National Curriculum Guidelines (DCN in Brazil). Therefore, the study was conducted in three phases: development and validation of evaluation criteria of Dentistry courses based on the DCN; a pilot study to verify the applicability of the validated criteria and evaluation of the dentistry courses in the Northeast. In the first stage, a logical model was formulated, allowing for the construction of a criteria matrix, validated by a modified Delphi consensus technique. The validated matrix has the following dimensions: Profile of graduates, health care guidance, teaching and service integration, and pedagogical approach. The pilot study was conducted in five dental courses through a documentary study of the pedagogical project course (PPC), and application of validated questionnaires and interviews with course coordinators. The results of the pilot study indicate the possibility of being verified by means of validated criteria and using different methodological proposals, advances and curricular limitations facing the proposed reorientation of training recommended by DCN. The evaluation of Northeast Dentistry courses was carried out by applying a questionnaire validating a matrix of 30 course coordinators, including public and private institutions. The data were submitted to descriptive analysis, and also tested the difference between means and the correlation between the assessment of the coordinators in the dimensions and sub-dimensions with each other, among the general evaluation of courses and between the following variables: administrative category, time since last curriculum updating, participation in reorienting the training of health professionals programs, ENADE and CPC (Preliminary Concepts of the Course) scores in the year 2013. Positive correlation (p <0.01) was found between the means obtained by the perception of the coordinators in most dimensions, and also between them and the overall performance of the course. There were no significant differences between the coordinators’ perception about course performance and the administrative category (public / private). This difference is slightly higher when the average performance is compared with respect to time due to the last curriculum update, getting better performance in courses with the latest updated curriculum, even with there not 11 being this significant difference between dimensions. Better averages of performance were obtained in courses that do not participate in reorientation programs of professional training, with a significant difference (p<0.05) for the overall score and for all dimensions except the dimensions of teaching-service Integration (p = 0.064). There was no significant correlation between the assessment of coordinators in all dimensions, in the overall assessment or ENADE and CPC scores in 2013. The final instrument proposed in this study is a different alternative assessment for health training of both dentists and other professionals, considering that the DCN providing for the training and graduation of professionals is focused on the health needs of the population, integrated with the SUS (the National Brazilian Health System) and based on student-centered learning.

Capital social e desenvolvimento de territórios: estudo multicasos nos territórios da cidadania do Rio Grande do Norte

This study aims to systematize elements for territorial development analyzing attributes of social capital present in the territories of Rio Grande do Norte. Unlike other studies about the subject, it is not intended to measure the stock of social capital, but rather to reveal the phenomenon of social organization and its implications, considering territories examined are already made around social capital structures. Case study were used as strategy research because it is enables to understand holistic features and significant events within the context of real life. For this research were selected representatives of public and social institutions involved in territorial collegiate specifically those of the governing core, selected from the more effective involvement of discretion in structure, functioning and meetings. The three territories have similar realities, are products of a public policy that is based on common criteria and present interdependence between categories of analysis of social capital. The presence or absence of any relationship - link, bridge or connection - influences the performance of territorial policy, affecting the social organization and fostering processes of access to information. In the cases at hand, despite the similarity of the general conditions of structure and function, the Apodi has qualities superior to the other. The presence of Dom Helder Camara project that articulates, in parallel to the Territory of Citizenship, the same actors of public policy with social mobilization capacity and effectiveness of actions, is able to encourage different development processes at Apodi. This can be explanatory factor, the tangent construct social capital, so that the territory present living conditions and better levels of development than the other two addressed here.

Um estudo do gênero ata de audiência na esfera jurídico-trabalhista

The activities in labor judicial sphere are permeated by the use of diverse text genres, which are indispensable instruments to the accomplishment of actions that involve the jurisdictional realm. Among the genres that circulate in this domain, we selected the genre minutes of hearing as the object of study of this research, because it is a document supporting the actions, procedures and deliberations agreed, in hearings, by members involved in work-related litigation. In this study we aim to describe the elements that constitute the referred genre in what concerns its pragmatic, organizational and linguistic dimensions. Therefore, we use the postulations of Sociodiscursive Interactionism as theoretical framework, through the writings of Bronckart (2006; 2007; 2012), supported by Marcuschi studies (2008; 2010; 2011), Koch and Favero (1987), Elias Koch (2011; 2012) and Zanotto (2012). In methodological terms, it is characterized as a qualitative approach research (BOGDAN; BIKLEN, 1994; CHIZZOTTI, 2000; MOREIRA; CALEFFE, 2006) with aspects of an ethnographic work (ANDRÉ, 1995; CANÇADO, 1994). The discussion proposed inserts into the field of Applied Linguistics for it focalizes ―social issues and creates intelligibility about the social practices in which language plays the main role‖ (MOITA LOPES, 2006, p.14). The analyses indicate – regarding the pragmatic dimension – that the genre in focus constitutes artefact that enables the register of actions, deliberations, testimonials, procedures and occurrences established during the hearings and has as its interlocutors judges, litigants and their legal representatives. Concerning the organizational dimension, despite the genre in scope present a proposal of standardized writing, their examples contemplate variations and flexibility especially with regard to the development and outcome of the text. As for linguistic aspects, it is noticeable the presence of lexical choices inherent in the language used by labor law discourse community. Lastly, stand out the relevance of the research lies in the fact that it approaches, from the perspective of the Applied Linguistics, the forensic writing and, consequently, offers contributions to the understanding of such genre.

A leitura e a produção textual no ensino fundamental I: uma proposta de como trabalhar com os gêneros textuais

The little interest in reading and the large presence of deviations in writing observed in the texts of students of the 5th grade of a public school in RN, led us to question the motives of this problem. Thus, the idea to organize and develop teaching sequences with a variety of possibilities of reading and production through the text genres. The practice with the textual genres in elementary school extends the use of reading and writing and improves the quality of learning. In this way, the school, as one of the most active spheres in social practices of the language, we justify this work with the use of text genres as facilitators for teaching and learning the mother tongue. For this purpose, we draw as the main objective to talk about the work with textual genres from the development of didactic sequences, as well as encourage students to take a more reflexive attitude toward language and its uses, as discursive social practices. The development of the study with the text genres was made through the application of didactic sequences in the school context of elementary school classes, from 5th grade. Specifically were chosen, the letter, note, music, poetry, fable and the tale. The study is anchored in the reflections of the following theorists and researchers: Bakhtin (2011), Miller (1994), Marcuschi (2008) and Bronckart (1999) on the text genres; Marcuschi (2005) and Dolz and Schneuwly (2004) that approve a teaching-learning proposal focused on textual genres, giving a meaning to language in the construction of the knowledge and Dolz and Schneuwly (2004) regarding the didactic sequence; other theoretical orientations: PCN (1998), Lerner (2005), among others. The methodology followed the action research guidelines, in a qualitative approach perspective. The instruments of research included questionnaire, observations, readings and productions. The results pointed the students' interest in relation to the activities developed in the didactic sequences and consequently improvement in the students‘ own writings. In this sense, we reiterate the need to contamplate in the teaching activities the diversity of texts and genres and, not only due to its social relevance, therefore the student should be able to use the language in various way and adapt their texts to situations of oral and written interlocution.

Validade científica de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003

Indicators and analyses that used the database from SB Brazil 2003 (the most recent nationwide oral health survey) have been criticized as unreliable due to sampling problems. The current study countered that this critique was based solely on statistical concepts, unsupported by empirical evidence. The critique's essentially epistemic approach leads to peremptory reductionism that denies other forms of knowledge and fails to recognize the multidisciplinary nature of epidemiology. The current study retrieves information on the implementation of the oral health survey and its impact on knowledge output in the field. The article draws an analogy between science and art, demonstrating the multifaceted images obtained by both. Thus, recognition of validity requires a full grasp of the field and appropriate use of value criteria. The current article concludes that use of the SB Brazil 2003 database is a reliable and relevant application of epidemiology to oral health.

Validade científica de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003

Indicators and analyses that used the database from SB Brazil 2003 (the most recent nationwide oral health survey) have been criticized as unreliable due to sampling problems. The current study countered that this critique was based solely on statistical concepts, unsupported by empirical evidence. The critique's essentially epistemic approach leads to peremptory reductionism that denies other forms of knowledge and fails to recognize the multidisciplinary nature of epidemiology. The current study retrieves information on the implementation of the oral health survey and its impact on knowledge output in the field. The article draws an analogy between science and art, demonstrating the multifaceted images obtained by both. Thus, recognition of validity requires a full grasp of the field and appropriate use of value criteria. The current article concludes that use of the SB Brazil 2003 database is a reliable and relevant application of epidemiology to oral health.

Diagnóstico e tratamento do TDA/H: investigação dos critérios utilizados por diferentes categorias profissionais da cidade de Natal-RN

TDA/H is usually considered among the most frequent psychological malfunctions in both childhood and adolescence. It covers a complex combination of neurocognitive deficits leading to developmental troubles linked to attention failure, hyperactivity and impulsivity. On the other hand, diagnosis of TDA/H is frequently a hard task, since sociocultural aspects concerning the evaluation of symptoms lead to some etiologic vagueness. Additionally, the large extent of evaluation tools, together with the diversity of therapeutic approaches referred by specialized literature justify the interest of investigating the diverse ways of diagnosing and treating TDA/H by medical doctors, psychologists and psycho-pedagogues developing professional activities in Natal-RN (Brazil) in the assistance of children and teenagers with TDA/H diagnosis hypothesis. A sample of thirty-four professionals participated in this study in a convenience-basis, and submitted to a semi-directed interview. Information from this procedure was analyzed, categorized and submitted to a multidimensional descriptive analysis (cluster analysis procedure), allowing to verify the partition of the sample in two groups: Group 1, basically composed by medical professionals, and Group 2, composed by psychologists and psycho-pedagogues. The categorized variable “Number of sessions” – average time used for arriving to a diagnosis – was the partition-variable showing the larger amount of statistical contribution for the partition, followed by the variables “Professional formation” and “Use of diagnostic tools”. Variables such “Comorbidity”, “TDA/H Definition” and Modalities of Intervention” also showed contribution to the partition obtained, even though their lesser amount of statistical contribution. Despite some similarity between these two groups, data allowed to demonstrate specific association between academic source-formation of the professional concerned and diagnosis and intervention modalities shown by these professionals when dealing with TDA/H. These data confirm relevant heterogeneity in dealing with TDA/H due to professional formation of professionals involved in diagnosis and treatment tasks.

Diagnóstico e tratamento do TDA/H: investigação dos critérios utilizados por diferentes categorias profissionais da cidade de Natal-RN

TDA/H is usually considered among the most frequent psychological malfunctions in both childhood and adolescence. It covers a complex combination of neurocognitive deficits leading to developmental troubles linked to attention failure, hyperactivity and impulsivity. On the other hand, diagnosis of TDA/H is frequently a hard task, since sociocultural aspects concerning the evaluation of symptoms lead to some etiologic vagueness. Additionally, the large extent of evaluation tools, together with the diversity of therapeutic approaches referred by specialized literature justify the interest of investigating the diverse ways of diagnosing and treating TDA/H by medical doctors, psychologists and psycho-pedagogues developing professional activities in Natal-RN (Brazil) in the assistance of children and teenagers with TDA/H diagnosis hypothesis. A sample of thirty-four professionals participated in this study in a convenience-basis, and submitted to a semi-directed interview. Information from this procedure was analyzed, categorized and submitted to a multidimensional descriptive analysis (cluster analysis procedure), allowing to verify the partition of the sample in two groups: Group 1, basically composed by medical professionals, and Group 2, composed by psychologists and psycho-pedagogues. The categorized variable “Number of sessions” – average time used for arriving to a diagnosis – was the partition-variable showing the larger amount of statistical contribution for the partition, followed by the variables “Professional formation” and “Use of diagnostic tools”. Variables such “Comorbidity”, “TDA/H Definition” and Modalities of Intervention” also showed contribution to the partition obtained, even though their lesser amount of statistical contribution. Despite some similarity between these two groups, data allowed to demonstrate specific association between academic source-formation of the professional concerned and diagnosis and intervention modalities shown by these professionals when dealing with TDA/H. These data confirm relevant heterogeneity in dealing with TDA/H due to professional formation of professionals involved in diagnosis and treatment tasks.

“Oi, meu nome é Ana” - um estudo fenomenológico-existencial da experiência de mulheres com anorexia nervosa

This research deals with anorexia nervosa through the look of those who lived this experience. Eating Disorders have been presented as psychopathology increasingly recurrent in contemporary, being almost doubled incidence in the last 20 years, reaching mainly teenagers and bringing consequences and implications of various kinds. The literature points to the relevance of the current ideal of beauty, in which thinness is overvalued. In this case, the study’s objective was to understand, from an existential-phenomenological perspective, anorexia experience. Thus, when assessing the experience, seeking to understand the possible directions that the non-eating is for the person who lives such an experience. The study, of Heidegger's existential-phenomenological inspiration, used semi-structured interviews as a means of access to the experience. Female two people were interviewed, at the age of 17 and 30, began with a starter question ("How was, or how is, your anorexia experience?"), which allowed the interviewee to talk about their experience. For the selection of the study participant was publicized among health professionals, as well as in social networks and blogs, in which the research objectives and approaches have been made explicit. The field diary was also used as a methodological resource, seeking a greater approximation of the experiences of the interviewees and the researcher. The interviews were interpreted in the by Heidegger's hermeneutics. The meanings unveiled in the narratives revealed issues beyond the physical and pathological issue, being involved family, wishes, friends, experiences, life projects. The corporal, as thought by Martin Heidegger, became very present in the statements of the interviewees, as it is part of existence. Among the Heidegger´s ideas, emphasizes care, inhospitality, live, boredom, openness to possibilities and factuality, that might be discussed from interviewees' discourse, engendering reflections about their senses, in their lives.