O educando com síndrome de down: um estudo sobre a relação entre pais e profissionais na escola regular

This work makes a documental analise about the relationship between families of Down syndrome students and professionals of who teach them, in order to improve the process of developing teaching-learning, in an inclusive perspective. For this, we use a qualitative approach, because we believe that the object of research is not a passive and neutral knowledge, since it has meanings and relationships whose can be better interpreted and understood by the researcher in a real and active situation. For the development of this research, a bibliographical review was made about the subject, and a case studied in two regular education schools, both of them at the city of Natal/RN, one public and another one particular. We work on these educational institutions with professionals and parents of Down syndrome students. As an instrument of building information we used a semi-structured interview and to analise the results a qualitative method. Crossing the stages, we noticed: the pedagogical coordinators who made up both analyzed schools showed interest about doing an effective work with parents, regardless of Educational Policy Project of each school, predict or not the participation on educational undertaken process; On teachers discourses, reporting the relationship with the family, we realize that one of those teachers try to keep a good relationship with parents, permeated by learning exchanges, guidance and knowledge, in relation to another one, even existing an apparent openness to dialogue, when parents have any suggestions or criticism, that attitude is not always well coming. From the parents interviews, we can emphasize, first of all, that both of them recognize the benefits of inclusion, with regard to socialization - in general from the coexistence with pairs and the process of teaching and learning, as shown in a consistent way. Regarding school meetings with teachers, the studied parents agree about importance of such appointments and try to attend them, besides the other events organized by the school, beyond keeping individual touch with the teacher, when necessary. They are always present, looking for get envolved in everything that happens at school, in order to know better what is being done, listening and may suggest alternatives to improving the educational process. We perceive, from the study undertaken, that although the school inclusion is not an easy process to be built, is something that could be achieved. For this, is necessary that professionals of education and families recognize their functions in the educational process and act jointly on this direction

Compreendendo a educação para a inclusão digital: uma análise dos sentidos atribuidos pelos monitores das escolas de inclusão digital e cidadania da EMATER-RN

According to the methodological presuppositions of the understanding interview (KAUFMAAN, 1996), the present work aims to understand the Digital Inclusion starting from the oral speeches of eight monitors of Digital Inclusion and Citizenship Schools of the Technical Assistance and Rural Extension Company EMATER, located in municipal districts that belong to six regions of the state of Rio Grande do Norte. It also had the intention to analyze it (the Digital Inclusion), while educational process and its relation with the citizenship. In its first part, an analysis of the discussions about digital inclusion was developed, and a reflection about the new technologies in current times, followed by a contextualization of the rural space and the methodological course of the study, when its guiding axis and the travelled roads were presented, where the object of study is built slowly and progressively through a theoretical elaboration that increases day by day, as of the technologies forged in the field of research and formation of the subject. The second part presents the study of the collected information, that is organized in three chapters denominated as follows: Conceptions of the local context; What does digital inclusion mean? and The monitor as an educator. The reports do evidence a peculiar dissatisfaction with the social reality where they are found, that contradicts the positive reflections and perspectives of the studied authors, once that, within the actual conjuncture, the rural space has acquired another meaning, no longer being seen as a far late place. By trying to define the digital inclusion, the monitors make an association with change, the access to knowledge, active participation in society and improvement of the life conditions. Here a mission sense stands out, related to the ideological precept, which has been managing its activities. Towards the monitor‟s relation within the classroom, the senses evidence how they are and how they have been developing their daily activities. Tensions, fears and insecurities are identified, but at the same time, a compromise. The final considerations implicate to the need of reorientations in the formative process of this professionals, detaching the importance of their activities while agents of inclusion and social transformation

Construindo um modelo de referência ao despertar do interesse dos sujeitos em projetos educativos em ambiente on-line

This dissertation was written for the making of a model to be used as reference to the construction and diagnoses of educational projects in on-line environments. The model approaches a series of characteristics, technical and humans, which if considered can increase the potential of awake the interests to the active use of these projects for the students and build conditions to the development of an active posture by the students, fundamental factor to the educational advances. Focused in the students, not in the technology in use, we propose this model as a guide, reference to be used in a critical way in relation with every educational context. This research was made from the qualitative category, trough the method of study of case, using as reference to the analysis the use of the website guanabara.info - website outside of the school context - by it users, heard through the internet, by the use of semi-opened interview, in a data taken of the primary type. We follow as theoretical references Paulo Freire´s work, considering his vision of education and the building of knowledge as a process which occurs between man, and Celestín Freinet, in his pedagogy of humanized and critical insertion of the technologies in the school. At the end, we show the practical utilization of the model constructed using it for the diagnostics of an educational project in the on-line educational environmental moodle

A escola rural e o desafio da docência em salas multisseriadas: o caso do seridó norteriograndense

Uno de los principales desafíos colocados a la educación del medio rural está relacionado a la enseñanza de las escuelas rurales con salas multifacéticas. Estas comprehenden alumnos de diferentes comunidades, series, edades, aprendizaje y niveles de conocimientos. Son cursos heterogéneos, que tienen como característica central la diversidad. En muchas regiones rurales de Brasil, la educación escolar es organizada en cursos multifacéticos debido a las grandes distancias entre las comunidades y el bajo número de alumnos en cada serie/año. Es común encontrar a los que están en fase de alfabetización estudiando con quien ya sabe leer y escribir - y todos sobre la orientación de apenas una profesora, que necesita enseñar a partir del contexto y la cultura local. El punto principal a ser tratado en este estudio está relacionado a las prácticas ejercidas en la acción educativa de las profesoras que actúan en escuelas rurales con salas multifacéticas de la región del Seridó do Rio Grande do Norte, precisamente en los municipios de Caicó, Jardim do Seridó y Ouro Branco. Creemos que este es uno de los puntos centrales en la discusión sobre la organización de la educación en el medio rural con fuertes implicaciones para el atendimiento cualificado de la población en condiciones de escolaridad de ese medio. Las contribuciones de Werthein y Bordenave, Calazans, Paiva, Ramalho, Therrien y Damasceno, Leite, Passador, Molina, Arroyo, Nascimento, Hage, además de documentos oficiales del MEC, como cuadernos SECAD, Ley de Directrices y Bases de la Educación Nacional, Directrices Operacionales para la Implantación de la Enseñanza Básica de 9 (nove) años, Proyecto Base del Programa Escuela Activa, entre otros, fundamentaron el análisis sobre la escuela rural y el desafío de la docencia en salas multifacéticas en el contexto del Seridó norteriograndense. El estudio envolvió 24 (veinticuatro) profesoras y 06 (seis) profesionales de la educación que desempeñan sus funciones en los Centros Municipales de Enseñanza Rural (CMER). Los instrumentos de investigación empleados fueron cuestionarios y observaciones aplicados para responder a las siguientes preguntas: ¿cómo se estructura la escuela rural con salas multifacéticas? ¿Cómo las profesoras se posicionan sobre su trabajo en salas multifacéticas esto es, como las concibe en el contexto de la educación rural del Seridó? ¿Qué opinan sobre la formación recibida para actuar en salas multifacéticas? Las profesoras y los/las profesionales de los CMER poseen en general formación superior en pedagogía, sin embargo, presentan limitaciones delante de las situaciones surgidas en el día a día de la sala de clases. El estudio revela que son las deficiencias de las políticas sociales y educacionales de formación docente, el bajo apoyo didáctico-pedagógico, reforzadas por la ausencia de un plano de carrera que dignifique el trabajo docente en ese medio, que generan limitaciones en el desarrollo profesional del magisterio rural, claramente junto a los docentes que actúan en salas multifacéticas en los municipios investigados

Um estudante cego no curso de licenciatura em musica da ufrn: questões de acessibilidade curricular e física

This work aims to discuss and analyze the process of school inclusion of a blind person in the Bachelor's Degree in Music, at the School of Music at the Federal University of Rio Grande do Norte, as well as reflect on the importance of establishing systems of support and to ensure university inclusive process of people with visual impairments. In pursuit to achieve these objectives, this research chose a qualitative methodological approach, the case study, using as procedures for data construction an interview, observation, analysis of documents and photographs. Joined the group of participants in this study, a blind student in the class of 2009.1of the EMUFRN Bachelor's Degree in Music, teachers from two disciplines complied by the student, two classmates, a monitor support in music theory, the course coordinator and school principal, and two other individuals who contributed to the inclusion process in actions not formalized institutionally. The results indicate UFRN proposed initiatives that contribute to inclusion of students with disabilities in this institution, the main one is the creation of the Standing Committee of Support for Students with Special Educational Needs (CAENE), a group that guides administrative sectors, teachers, principals, coordinators and students on the measures needed to enter and remain in quality education for all. Physical accessibility is still under construction at UFRN, and many access and sectors see it being adapted for students with physical or visual disabilities, and those with mobility impairments, have access to various parts of the university, however, as shown in this study, some points need to be reconsidered, as there are several places where the installation of tactile floor does not fully follow the guidelines proposed in the legislation. The proposals for access to the curriculum, mediated by EMUFRN, are actions that propose the inclusion of the blind student, as the existence of an educational monitor to help in the study of music theory, however, we need to rethink these proposals to not became actions of reactive intervention. Assuming a more proactive posture, the EMUFRN will be prepared to receive the diversity of students that expects. The study also points out that the blind student is part of a group of students that are practical musicians, who must work in events and evening shows, and who have little knowledge in music theory, leading, respectively, in low frequency classes and learning difficulties in certain curricular components, which may cause the closing of such components. In this case, the challenge of EMUFRN, considering the inclusive perspective, it is not specifically fit for the academic host a blind student, but to develop an accessibility project curriculum to consider effectively the diversity of all its students, taking into account mainly the economic and cultural conditions. This implies a process of resizing academic practices that be guided for collaborative and coordinated actions involving the various educational actors at EMUFRN and UFRN

Lagoa do Piató: a educação como uma obra de arte

A partir de una concepción de la educación como una obra de arte, la disertación revela los estudios realizados en una escuela de la comunidad de Areia Branca Piató, en la Laguna de Piató en Assú, Estado de Rio Grande do Norte. Como una forma de hacer dialogar conocimientos científicos y saberes tradicionales, la investigación establece el intercambio de saberes y afectos sobre todo por intermedio del intelectual de la tradición Francisco Lucas da Silva. Para construir un conocimiento pertinente (Edgar Morin), el que forma parte de un contexto, buscamos aquí la comprensión de una pedagogía viva e imaginativa. La disertación encontró en la Laguna un laboratorio vivo para pensar en una enseñanza educativa y para ejercer el pensamiento complejo. A partir de estudios e investigaciones anteriores, pude organizar lo que considero que se constituye como constelaciones de saberes que permiten dar continuidad a ese eje de investigación que empezó desde 1986 en el Grupo de Estudios de la Complejidad GRECOM. En la construcción de este trabajo, pude aprender valores que creo que son importantes para una educación compleja: la humildad delante de la vida; la abertura para diferentes lenguajes del mundo; el diálogo con la naturaleza; la apuesta en nuestras creencias; el sueño de resignificar a la realidad a partir del lazo entre la profundidad de nuestro ser y el mundo; el uso pleno de nuestras potencialidades imaginativas y creativas; y, finalmente, la vivencia intensa de los sentidos. Partiendo de ese aprendizaje, la investigación teórico‐práctica tuvo como elemento central el desarrollo de talleres sobre el tema del agua con alumnos de la enseñanza básicas de diversas series, y con la participación activa de dos profesoras de la comunidad de Areia Branca Piató. Fueron llevadas adelante experiencias que contemplaron una visión sistémica de la naturaleza, las fotografías, los atelieres, las clases de campo, el arte de educar, la narración de historias y sobre todo las enseñanzas del intelectual de la tradición Francisco Lucas da Silva

Educar para o lar, educar para a vida :cultura escolar e modernidade educacional na Escola Doméstica de Natal (1914-1945)

La recherche propose un nouveau regard sur l Institution Scolaire École Doméstica de Natal, en essayant de tenir compte de la multiplicité des auteurs et des pratiques développées à l école qui définissaient le mieux et expliquaient les phénomènes de cette réalité éducative et des rapports avec le temps et le lieu où elle s insérait. Pour ce faire, les concepts de mémoire et culture scolaire ont été fondamentaux pour la compréhension de ces pratiques, parce qu ils ont contribué à notre lecture historique-culturelle de l ensemble d aspects institutionnalisés à l école, comme son curriculum, ses finalités, ses façons d enseigner et d apprendre, ses règles de conduite, ses normes, enfin, ce qui caractérisait son organisation et ses pratiques quotidiennes. C était l École Doméstica de Natal l institution pionnière dans le modèle d éducation féminine au Brésil, nous le reconnaissons en priorité et nous visons à le circonscrire à son indélébile contribution à l Histoire de l Éducation de Rio Grande do Norte. Conçue par un modèle d organisation scolaire européen pour l éducation féminine, l École Doméstica de Natal a été inaugurée en 1914, en ayant comme créateur l intelectuel de Rio Grande do Norte Henrique Castriciano de Souza. Sa singularité, s opposant aux écoles féminines existantes au Rio Grande do Norte et au Brésil en ce temps-là, était dû au modèle scolaire adopté, qui appuyait sur la formation d une femme préparée à répondre aux aspirations modernes surgissant avec l avènement de la République. Ce contexte exigeait de l école la formation d un modèle de femme dans les aspects moral, physique, culturel et intelectuel modelés sur les idéaux de l ordre et du progrès. Ce serait une nouvelle méthode d éducation scolaire qui pourrait favoriser la modernisation des anciennes méthodes d enseignement, provoquant le surgissement de modèles qui impliqueraient une nouvelle organisation pédagogique aux écoles de l`État et conduiraient la ville à de nouveaux et hauts paliers de culture et civilité. Avec cela, l école contribuerait à ce que la femme joue un rôle dans la société d une manière plus active, sociale et mieux adaptée. Les mots ordre, nouveau, civilité, moderne et progrès se répandaient et s entrecroisaient avec des valeurs archaïques toujours permanentes et enracinées dans la vision de vie et l idée de monde d alors. Ainsi, on voyait que l École Doméstica était une institution modèle, spécifique dans sa fonction, qui apporterait à la ville et, particulièrement au Rio Grande do Norte, des idées de civilité, ordre et progrès

Efeito do treinamento resistido na função autônomica cardíaca, nos parâmetros bioquímicos e antropométricos de pessoas vivendo com HIV/AIDS

Introduction: The emergence of High Active Antiretroviral Therapy (HAART) increase the life expectancy of the persons living with HIV/AIDS (PLHIV), therefore the prolonged use cause metabolic implications and influences on body fat distribution and increase the cardiovascular diseases prevalence. Aims: Evaluate the effect of resistance training on heart rate variability, biochemical parameters and somatotype on PLHIV. Methods: Participated this study seven sedentary men, with age above 25 years old, living with HIV/AIDS, under HAART use. Were submitted a 16 week intervention with resistance training. Evaluated the heart rate variability, biochemical parameters and somatotype, before, after 8 weeks and 16 weeks, all in paired form. It was found the data normality by Shapiro-Wilk test and conducted the Anova one way combined with Tukey post hoc to samples in each evaluate moment, adopting significance level p<0,05. Also were calculated percentage change deltas. For somatotype was used the somatotype spatial distance (DES), obeying the significance value DES≥1. Results: Was found significance differences only in variable final heart rate delta 60s (p=0,01), however, is not showed changes on heart rate variability, biochemical parameters and somatotype components. Conclusion: 16 weeks of resistance training showed improvement on heart rate recovery after submaximal effort and, despite is not enough to produce significance differences on biochemical parameters and somatotype components, could be realize improvement on average value of fasting glucose and lipid profile, as well as reducing the endomorphic component

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

A organização do dots em um distrito sanitário de Natal/RN, 2009

Tuberculosis is an ancient disease that remains a serious problem of Public Health, requiring a pressing attention. Advances in the knowledge and technology available to control it has not been sufficient to significantly impact on morbidity and mortality, especially in developing countries. To enable patient compliance with TB treatment, preventing the abandonment of this to ensure the correct use of medicines has been suggested the DOTS (Directly Observed Treatment - Short course) or directly Observable Short Course Treatment. This study focuses on the incorporation of two technical components of the DOTS strategy at the Family Health, namely, active search for respiratoy symptoms and Supervisioned Treatment (ST). The West Sanitary District was considered best suited to be the focus of study because it is assumed that those sites that were better structured would provide better information about the situation of the strategy in the municipality. Its purpose is to analyze the organization of DOTS as the active search for respiratory symptoms and Directly Observed Therapy in Health Teams Family belonging to a Health District in the city of Natal, Brazil. An exploratory descriptive study with a quantitative approach which involved health professionals from 11 units of Family Health, West Sanitary District, Natal, Rio Grande do Norte. We interviewed 62 professionals on the professional category, their involvement in the DOTS strategy, managers' contributions to the sustainability of the strategy, actions Search for symptomatic diagnosis and supervised treatment of TB cases and difficulties and facilities for the sustainability of the DOTS strategy. It is concluded that the actions taken by the professionals of the FHS West Health District are organized in more supervised treatment, a fact noted in their perceptions about DOTS

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

Conhecimento do enfermeiro sobre as ações de vigilância epidemiológica no Hospital Universitário Onofre Lopes, Natal, RN

This is an exploratory descriptive study with quantitative approach, aiming to verify the nurses' knowledge concerning the epidemiological surveillance activities at the Onofre Lopes hospital (HUOL), in Natal, Rio Grande do Norte. The study was performed with 63 nurses from the hospital and the data were collected through a questionnaire. All data were analyzed using descriptive statistics. The results were discussed and organized into four sections: nurses' knowledge on hospital epidemiological surveillance; procedures of the professional nurse through compulsory notification diseases; difficulties found by nurses to register the compulsory notification diseases and suggestions of strategies to joint epidemiological surveillance service with the care practices of nurses. The results showed that 55.55% of nurses know the main action of epidemiological surveillance, compulsory notification of diseases, and that 42.86% reported to the Hospital Epidemiology Center , while 57.14% did not allocate the information for this service. Most nurses found it difficult to perform notification for not knowing its flow; for the surveillance service does not operate 24 hours and for vagueness on diagnostic of disorders. Suggestions of strategies to improve the quality of epidemiological information are focused on training of nurses in hospital epidemiological surveillance; working in partnership with the surveillance center; diffusion of information on surveillance and conducting a daily active search. It comes to conclusion that most nurses don't notify the Surveillance Center about Compulsory Notification Diseases and it wasn't observed the incorporation of integrality values between the hospital surveillance and all nurses, since this principle guides the actions of health services based on dialogue, listening, ethical commitment, sharing of knowledge among professionals of various services and respect towards other professionals. Therefore, the integrality gap in the actions of the nurses studied, as well as in the surveillance service does not mobilize the potential of such services to changes in the sense of achievement of practices aimed at a special attention model that combines preventive and corrective actions, proposed and desired by SUS. Through the difficulties presented, it becomes important to recommend educational processes with strategy to transform the conducts, besides proposing actions under the principle of integrality provide responses agile and effective, as the purpose of VE hospital emergency care by the current epidemic

Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

Evidências de validação de um protocolo para assistência às pessoas com úlceras venosas em serviços de alta complexidade

Venous ulcers are lesions resulting from chronic venous insufficiency, venous valvular abnormalities and venous thrombosis. Its occurrence has been growing with the increase in life expectancy of the world population. Considered as fundamental aspects in the approach to the person with venous ulcer care with the interdisciplinary approach, adoption of protocol-specific knowledge, technical skill, coordination between levels of care complexity of the Health System and active participation of patients and their families, a holistic perspective. The construction of a clinical protocol for people with venous ulcers can help professionals of high complexity services in patient assessment and the establishment of quality care in a systematic way and focused on the factors that interfere with wound healing. Thus, this study aimed to analyze the evidence of validation of a clinical protocol for people with venous ulcers treated at high-complexity services. This is a methodological study with a quantitative approach, developed in three stages: literature review, evidence of content validity and evidence of validation in the clinical context. Approved by the Federal University of Rio Grande do Norte Research Ethics Committee (Opinion: 147.452 and CAAE: 07556312.0.0000.5537). The literature review was conducted in August and September 2012, becoming the basis for the construction of the protocol. Then the evidence of content validity, which included 53 judges (experts) selected by the Lattes platform to evaluate the protocol items was performed. The judges were contacted by e-mail and rated the protocol via Google Docs . After analyzing the ratios obtained in this step, which reported kappa between 0.75 and 0.96 and between 0.80 and 0.98 IVC, and the suggestions of the judges, the protocol was adjusted and subjected to empirical evidence to validate the clinical setting at the University Hospital Onofre Lopes in Natal / RN. Evidence of validation in the clinical setting involved 4 judges who acted in pairs (paired) evaluated 32 patients with venous ulcers in the clinical context of high complexity. In both stages, we used the Kappa Index and Content Validity Index to analyze the responses of the judges. The parameters set as acceptable for these indices were: Kappa ≥ 0.61 and Content Validity Index > 0.80. Any evidence of content validity, as evidence of validation in the clinical context, the protocol items that have not reached Kappa and Content Validity Index established indices were excluded and some items were modified or added after suggestions. The process of content validation evidence and evidence of validation in the clinical setting allowed the improvement of the protocol for the care of people with venous ulcers initially proposed. The initial version of the protocol, built from the literature, contained 15 categories and 108 items; after evidence of content validity, remained the reduction to 15 categories with 91 items; the final version, clinically validated, is composed of the same 15 categories, 76 items. The protocol was validated in its content and in the clinical aspect, so we accepted the alternative hypothesis in the study. This protocol may contribute to the care system, allowing tailor behaviors and promote greater resolution in the treatment of people with venous ulcers in health services of high complexity

Estratégias de intervenção utilizadas por enfermeiros da ESF do município de Natal/RN no controle do câncer do colo de útero

Cancer of the cervix (cervical cancer) is the second most prevalent cancer among Brazilian women. The high rates of cervical cancer in Brazil justify the implementation of effective strategies to control this, which include actions to promote health, primary prevention, early detection, screening, treatment and palliative care. Despite the existence of the National Programme for Control of the CCU there was no reduction in the incidence and mortality of this disease in Brazil. The Family Health Strategy (FHS) has the potential to facilitate such control and, in this context, one should consider that nurses play a central role. The study aimed to know the general intervention strategies used by nurses FHS of Natal / RN in CCU control, and how specific: analyzing the knowledge of these nurses on the CCU, the actions developed in the ESF for the control of CCU and identify the difficulties faced by them to perform it. This is a descriptive exploratory quantitative developed through a structured interview guide with 106 nurses who have experience in controlling the CCU in FHS teams of Natal / RN. Data analysis was performed using descriptive statistic s. The results pointed to actions taken in the FHS to control the CCU, collection of cervical cancer screening, health education activities, nursing consultation, referral of suspected cases for medical monitoring and active women with abnormal test result . The actions that were not mentioned by the nurses included: forming groups of prevention and health promotion; expand coverage of exams and office hours of consultations, establishment of alternatives to end the pent-up demand in the health units, participation in treatment or rehabilitation process users with the CCU; interventions for pain management, alliances and partnerships with schools, in dustry and the use of protocols. This study can be seen that the practice nurses partially shares to the CCU in Natal / RN. The participants of this study, when asked about the CCU, specifically for signs and symptoms of disease and risk factors in general showed important gaps. Difficulties such as lack of materials for collection of Pap smear; inadequate physical space in the Health Units; pent-up demand in the service, delay in arrival of the test results; obstacles in the actions of referral and counter-referral and cultural factors make the CCU control is compromised. It is believed in this research contributed to a reflection on the importance of the role of nurses in the development of the ESF control actions CCU, pointing out the factors that affect these. It is important to involve all nurses who comprise the ESF as knowledgeable of the risk factors, signs and symptoms, and existing tools for the early detection of cervical cancer in the pursuit of quality improvement actions to promote women`s health, contributing in planning future interventions that may reduce mortality from this disease in Natal / RN.