Acompanhando o crescimento e o desenvolvimento da criança : uma intervenção integrada entre enfermagem e família

The accompanying the growth and development of the child is the guiding line of basic health measures directed at this public, acting within the scope of health monitoring and inferring positively in the rate of infant morbidity and mortality, which are still a preoccupation worldwide and in Brazil. However, mostly, this practice is based on the biomedical model of care, individualized, with emphasis on the medicalization and complaints, favoring the passivity of users. Given this issue, aim to develop accompanying the growth and development of the child in a Basic Unit Family Health, through a collective approach of medical care next to a health team, especially nurses and caregivers. This is a qualitative study, with the research-action method. Involved the four nurses and twenty-six of children's caregivers of the area of Basic Unit Family Health of Cidade Nova, in Natal, in the period from February to July 2010. The results were analyzed following the direction of the thematic analysis of Freire. In the situation analysis of the current reality of the accompanying the growth and development the children in the Basic Unit Family Health, through participant observation and applying a questionnaire to the nurses, we realize that despite these professionals have a knowledge tied to the paradigm of health promotion, in practice the monitoring of child is done through individual consultations in outpatient room, based on complaints brought by caregivers, with little solvability in actions employed. Given the need for change in medical care model, we decided jointly, in the focal group, for the collective monitoring of children's the growth and development, featuring then this proposal to the multidisciplinary team, discussing the participation of professional categories and planned collectively the actions. In the implementation stage of collective action, we contemplate the execution by the caregivers of anamnesis and physical examination, recording data in the Child Health Handbook and discussion of clinical findings, under the supervision of nurses and facilitators. In the evaluation, we found that this collective accompanying strategy allowed to caregivers learn new knowledge, exchange experiences, assistance in home care, beyond reduce the waiting time for medical care and creating opportunity of more time for debate about the children‟s health situation, differing of ambulatory care. As difficulties, we face with a high rate of defaulters (53.8%), lack of motivation and passivity of the users, little participation of other health professionals and nurses' involvement in other activities, technical and bureaucratic in the moment of care. Thus, we note also a strong rooting of individual clinical model on the way of thinking and acting of nurses and caregivers

Inclusão da criança com deficiência na estratégia de saúde da família

The objective of analyze the shift of the working process of the ESF team in care of children with disabilities, from awareness-raising actions. It is a qualitative study, with the action-research method. Thirteen health professionals were involved from two teams of ESF unit area of the Unidade de Saúde da Família Dr. Chico Porto (UBSFCP) in Mossoró, from March to August 2011. Data were analyzed following the direction of freirean s thematic analysis. In the situational diagnosis of the current reality of CwD assistance in that UBSFCP, through participant observation and application of semi-structured interviews with professionals, we realize that despite these actions carry some assistance to the CwD, in practice few are used for inclusion and accessibility. The monitoring of the CwD is done through individual consultations by each team professional, home visits when possible, both ruled on the complaints and problems, with little solving in the used actions. Since the need for a change in the treatment model and training requirements as pointed out by professionals in the interview, then we decided to build the proposed of training suggested by the multidisciplinary team and put together collectively the achievement of this moment in all its phases. In the step of implementation (action), aspects related to the current situation in Brazil and Mossoró (Laws, policies and health care) for the CwD and CwD Assistance and their family in the ESF in the first two moments of the first training (action) were contemplate. On the second day we discussed the specialized care to CwD, contribution of the Handicapped Parents and Friends Association of Mossoró and in a second moment a workshop was held in which awareness for inclusion of CwD and actions of ESF were discussed. All these moments were discussed and collectively constructed. In the evaluation, we found that implementation (action) allowed to the professional the comprehension of new understandings about people with disabilities, on ways to include, guiding, caring, watching, and mainly to have a new vision on health assistance of the CwD, expanding assistance beyond clinical aspects and recognizing the educational aspects of the rights and duties of citizens and the inclusion of these children in the social spaces area. As difficulties, we face the need for some professionals to be absent to attend another job, solve personal problems, and little or no participation. Thus, during this action-research, the subjects were able to realize the importance of carrying out their practice to the quality of life for him and to the one they care

Aconselhamento em HIV/AIDS: ações e reflexões dos profissionais do Centro de Testagem e Aconselhamento (CTA)

The counseling on HIV/Aids consists in a prevention strategy that contributes to increase the diagnosis of HIV and start earlier the treatment. The counseling has as pillars the emotional and educational support, risks evaluation that aim at the adoption of safe practices and the individual s responsibility for his own health. To accomplish these results, it is necessary that health workers understand counseling as a unique educational moment that stimulates the user s critical-reflection when it comes to his role as an active subject in this process. This study aimed to analyze the counseling on HIV/Aids conducted by the professionals of the Testing and Counseling Center (CTA), based on the educational perspective of Paulo Freire . This is a descriptive qualitative study with a critical reflexive design based on the principles of Action-Science. All the professionals acting as counselors in the Joao Pessoa, PB CTA, eight in total, took part in the study. Data were collected during the month of March, 2011, through non participative observation and semi-structured interviews with a critical-reflexive focus, analyzed according to the tenets of the critical-reflexive methodology, and discussed taking into consideration the Paulo Freire s pedagogy and pertinent literature. It was observed that most of the professionals expressed the work philosophy of CTA as the diagnosis and prevention of the disease, associated with the utilization and demonstration of condoms. However, upon observation of their counseling sessions, these ideas were not converted in actions. Educational themes were not covered and the condom wasn t offered at any time. The counseling actions focused on the provision of information and filling out the paper forms which are necessary for attendance. The sessions were conducted with brief dialogues and little opportunity for the users to expose or complement their thoughts and needs. The professionals mentioned as facilitating conditions for counseling, the team interaction and physical structure. The difficulties focused on the users low cognition, the large demand for attendance, aspects related to the service organization, and the counselors absences and delays. After reflecting about the actions observed in the counseling, the majority of professionals admitted the need to modify their practice in the incorporation of educational principles for the achievement of a broader prevention, and seemed to be willing to work in this perspective. In conclusion, although the counselors show ideas consistent with the purposes of CTA, these ideas are limited when it comes to the understanding of the meaning of prevention in HIV/Aids. Taking into consideration that they express a certain comprehension and act differently during the counseling, they demonstrate a lack of bond between the theories in use and the proposed ones, in accordance with the contribution of the action-science theory. The counseling, as an educative practice, doesn t materialize in the counseling itself and the orientation for reflection is not given during the attendance. These findings suggest the need to include the process of reflection in the execution of the actions of counseling, so that these practices are guided by reflexive practice, aiming at transforming the way of thinking and acting into a more educational perspective toward a more democratic and holistic assistance.

Sistema de gestão ambiental sob a perspectiva da resource-based view: um estudo de caso no verdegreen Hotel - João Pessoa/PB

The pressure for a new pattern of sustainable development began to require of modern organizations the conciliation between competitiveness and a environmental protection. In this sense, a tool that acts in the implementation of structured strategies is the Environmental Management System (EMS), which focuses on improving environmental performance. This improvement, in turn, can generate to the organizations many benefits , among which, obtaining competitive advantages, susceptible of measurement from different perspectives. One of these is the application of VRIO model, reasoned by the Resource-Based View (RBV), which considers that differences between companies occurs due to differences between its internal resources and capabilities. However, although was been found some studies in the literature that evaluate the competitive potential of certain organizations , such assessments are not performed on specific objects, like the SEM s. Thus, the aim of this study was to evaluate the resources and capabilities (environmental strategies) adopted by the SGA of the Verdegreen Hotel, identifying which of these have the potential to generate competitive advantage. For this, this exploratory-descriptive character study and delineated as field research and case study was used as data collection tools: a literature survey, semi-structured interviews, document research and participant observation. The interpretation of results and consolidation of information were conducted from a qualitative approach, using two techniques of data analysis, namely: content analysis and analysis through VRIO model. The results show that the hotel is quite structured in relation to their EMS, as well as reaching related to improving the management of environmental factors, strengthening the image and gains in competitiveness benefits. On the other hand, the main difficulties for the implementation of the system are related to employees and suppliers. With regard to environmental strategies adopted, of the 25 strategies identified, 10 showed the potential to generate competitive advantage

Cosmoeducação: uma abordagem transdisciplinar no ensino de astronomia

This work proposes a transdisciplinary approach that integrates transpersonal psychology exercises with astronomy teaching, seeking to allow one to reintegrate the sky in his/her daily life, expand his/her environmental awareness and eventually experiment the unity between human and cosmos. This proposal intends to collaborate with the supplying of education, which lacks initiatives of this kind, with the promotion of an integration of the scientific knowledge with the human experience that transcends the materialistic and fragmentary objectives of the current educational system. As a result of that lack, the teachers formation is also poor as for an integral and transdisciplinary approach. Besides, we also approached in this research the necessity to propose alternatives so that the educators may work in a more assertive way with the environmental and anthropological crisis in which we are living. Our working hypothesis is that the contents of astronomy, when they are dealt in a holisticanthropological focus and are related with transpersonal psychology practices, can come to be an efficient cultural-academic vehicle, capable of propitiating an expansion of consciousness and changes in the way one conceives the world. Such changes are necessary so that a more solidary, fair and ecologically balanced life may come to exist and prevail in the planet. Part of the collection of data was done through the ethnographic method, once an anthropological interpretation is inextricably associated with this kind of educational intervention, which will naturally include ethno-visions of the universe as well as specific cultural elements. In the beginning the scope of this research was a group of students attending the Astronomy assignment in an undergraduate Geography course (UFRN), in which we accomplished participant observation, half-open interviews and the first experimental practices mentioned. After the evaluation of the first data collected from that initial group, we elaborated an academic extension course, Laboratory in Cosmoeducation, and we offered it to teachers of the 1st and 2nd cycles of the fundamental level of the Alceu Amoroso Lima State School, located in the North Zone of Natal. We prized self-experimentation in that course, so that the teachers could enrich their repertoire of personal experiences, stimulating meditative reflections and eventual changes in the ways of conceiving the world and in their pedagogical practice. The transdisciplinary attitude permeated all our educational action, because this approach transcends the boundaries of disciplines, seeking essentially the integral development of the human being. The process has made us realize that the practice of looking at the sky , as a way of reintegrating it into daily life, provokes a process of expansion of the consciousness and of reintegration of the self in a wider level of environmental interrelation. According to the results, the occurrence of conceptual and existential changes of the world vision of the participant teachers was evident, reassuring ourselves of the idea that the interface between astronomy teaching and the practices of transpersonal psychology can contribute to the recovery of a holistic relationship between the human being and the cosmos and to inspire the arising of a more wide-ranging ethics, based on universal, impartial and sustainable values

Atividades estruturais de equações polinomiais numa abordagem histórica por meio de e-book

The present study investigates how the inter-relationship of the content of polynomial equations works with structured activities and with the history of mathematics through a sequence of activities presented in an e-book, so that the result of this research will proceed will result in a didactic and pedagogic proposal for the teaching of polynomial equations in a historical approach via the reported e-book. Therefore, we have considered in theoretical and methodological assumptions of the History of Mathematics, in structured activities and new technologies with an emphasis on e-book tool. We used as a methodological approach the qualitative research, as our research object adjusts to the objectives of this research mode. As methodological instruments, we used the e-book as a synthesis tool of the sequence of activities to be evaluated, while the questionnaires, semi-structured interviews and participant observation were designed to register and analyze the evaluation made by the research, participants in the structured activities. The processing and analysis of data collected though the questionnaires were organized, classified and quantified in summary tables to facilitate visualization, interpretation, understanding, and analysis of these data. As for participant observation was used to contribute to the qualitative analysis of the quantified data. The interviews were synthetically transcribed and qualitatively analyzed. The analysis ratified our research objectives and contributed to improve, approve and indicate the use of e-book for the teaching of polynomial equations. Thus, we consider that this educational product will bring significant contributions to the teaching of mathematical content, in Basic Education

Ensino por investigação: contribuições de um curso de formação continuada para a prática de professores de ciências naturais e biologia

Normally initial teacher training has not been sufficient to provide all the tools for an updated and efficient teaching practice. It is presented here one of the ways of working the completion of the initial training through a course of continuing education. This course is based on inquiry teaching which is considered an important teaching strategy for science education. This kind of teaching enables improvement of students reasoning and cognitive skills, the cooperation among them, the understanding of the nature of scientific work, and the motivation to think about the relationship between science, technology, society and environment. For this dissertation a course of continuing education based on this approach was followed in order to evaluate which contributions it can bring to the teaching practice. The course was followed based on three stages: on the first there was a questionnaire and an informal interview; next it happened through participant observation with audio and visual aid; the third stage happened through semi structured interview. The collected information was analyzed based on Content Analysis. An inquiry teaching pedagogical material was produced for the course including some examples and applications of this approach. The aim of the material is that it can be a support for the teachers after de course. The results allowed seeing that the course was very useful, different from the traditional and the teachers that put the approach to use found it to be very positive. Thus it can be said that some of the teachers who participated will try again to apply it, try to contextualize more the teaching situations with the students day to day life, as well make them more active and critic. We can also gather from the study, that the inquiry teaching is a very different tool from what the teacher was taught and is accustomed to use and the theoretical comprehension, acceptance and practice change is a complicated process and demands time

A mídia dos outros somos nós: a experiência audiovisual do Ponto de Cultura Cinema para Todos

This research aims to identify the process of appropriation of audio visual (in digital video) for collective symbolic production (participatory video practice that expresses popular culture) in a socio-cultural context where the minorities are. Therefore, we based this study on the students‟ experience of the film and video workshops held by Cinema para Todos (Culture Point Cine for All), in Natal, RN. Culture Point is the basis of the project Programa Nacional de Cultura, Educação e Cidadania Cultura Viva (National Program of Culture, Education and Citizenship - Living Culture) of the Brazilian Ministry of Culture. In 2010, the Cine for All developed three film and video workshops in the state of Rio Grande do Norte (Northeastern of Brazil), in the municipalities of Açu, Lajes and São Gonçalo do Amarante, within a public policy project of socio-cultural inclusion. These three workshops are the focus of this empirical investigation. To support the analysis of this research we consider that the spaces of workshops are sites of the social practices origin, assuming they show the development of the changes of actions that generate new practices. In this socio-cultural context the students as interlocutors process the communicative culture mediation, where come from the logics of action (using digital video) to become a mediatic practice (video auto ethnographic). With the overall goal set and the field of investigative action delimited we considered the methodology of case study suitable for the observation of the object, because it is a phenomenon of modernity, occurring in a context of real life and with little or no control over events. Participant observation and interviews was also applied to this case study. The analytical theoretical support comes from the notion of mediation by Jesús Martín-Barbero and the concept of habitus by Pierre Bourdieu. The research found that a new way of communicating has been developing by this social group, and this reflects the technological change experienced by them. The auto ethnographic videos, short movies, reveal an allegorical trial of the mainstream media, because while they use the mainstream format, they rework the aesthetic, but without revising the history, in fact they proposing to retell the history of themselves full of colorful details and with richness of their forgotten popular culture.

Mídia e produção de sentido: a reconfiguração da indústria da música e as estratégias discursivas da associação cultural DoSol

This dissertation aims to analyse discursive strategies from Dosol in order to understand the present elements to keep its audience and the marketing activities. Based on French line of discourse analysis We look into the articles posted on its website at http://www.dosol.com.br within 2010 and We foment dialogues among music, media and communications researchers. Participant observation is slightly used on the critical perception and views of researched object to confront situations and step up, with theorists, the major part of closing remarks. The obtained results indicate a website speech paved on afirmative policies and social capital, trying to keep/seduce its audience with the efect of the intended credibility meaning. The economic factor wanders the speech so often that the speaker assumes a entrepreneur/cultural producer. As a niche market, Dosol assumes a main role in music industry for releasing the regional and local cultural production. On the other hand, it is noticeable that its sustainability and media visibility, as it is seen today, depends on the laws tor promote Culture, what denotes a lack of a regional cultural policies to medium and long term at Rio Grande do Norte

Participação e ação política dos psicólogos frente à política de saúde mental no Piauí

It is intended to problematize forms of participation and political action of psychologists toward mental health policy in Piauí. The study was motivated through challenges faced by the local Psychiatric Reform movement, and the one underway in the country, which needs support technical-assistence and sociopolitical to guarantee accomplishments and to move on with the complete reversion of the asylum to psychosocial model. The method was based on institutional analysis and counted with three insertion moments for the field research: a) to identify historical and political events that configure the local Psychiatric Reform (documental research/oral memory) and to identify psychologists that act in Mental Health; b) to realize participant observation and semi-structured interview with 33 psychologists which act in Mental Health in Teresina; c) to follow the sociopolitical contexts/events of the local Psychiatric Reform (participant observation and conversation circles). The data were analyzed considering four discussion axes, achieved through categorization of the collected material: 1) ways of professional insertion of psychologists in mental health; 2) knowledge and practices used to act in this work context of the profession; 3) political professional movements of workers of the reformist local process; 4) political action of psychologists toward the course of Piauí mental health policy. We concluded identifying that the participation of psychologists in Piauí mental health finds strength by the conduction of its macro and micropolitical professional action. The first one follows oriented by the lemma of social commitment, despite this movement doesn t have equivalence in the transformation of practices and political-professional postures of psychologists in the daily of services. The second is constituted in the every day of work, standing to the political action of the profession implicated with the preservation of the classic modus operandi of being psychologist. Therefore, it is about the actions that give little sustainability technicalassistance to the Psychiatric Reform underway in the State, and why not say in the country

Identidade, espaço e tempo: negociações de sentido sobre a "gente de rua"

This research examines the street children s identity construction processes. Recently, the research about this population has focused on the socialization processes that organize their everyday, their situations of interaction, the meanings of their social practices, their street experience. The concept of identitary forms gives coherence to the set of these phenomena, articulating them theoretically, in order to describe their life conditions and details of their trajectories. This research utilized an ethnographic approach with a group of 11 street people, 9 of them boys and girls 16-18 years old, during 3 months. It included participant observation, informal and formal interviews, that resulted in young s narratives of lifestory. These narratives were interpreted according to the principles of positioning analysis and the Labovian Analysis model of oral narratives of personal experience. The observation of interaction among the studied group and other groups has showed that their social practices, supported on many particular bodily technologies, recreate space and time of these interactions semantically, as mediation of meaning negotiations among groups. Such meanings transform again the environment of these interactions, disclosing interpretative systems by means of which the groups apprehend this interaction in a particular way. These street children s bodily technologies imply identitary forms based on scarcity and abandonment, paradoxicalally related to their self-concept. The analysis of narratives revealed diversity and complexity in the meanings assembly for their street experience; it showed that the semantic arrangements reconstruct the temporal experience, creating a moral climate for each lifestory, and determining more or less aperture of identitary forms to change. The study concludes that space and time, builders of interaction regimes, produce identitary forms; that the narratives and the social practices of the studied group are sustained upon a master discourse that opposes the meanings of the home and the life in the streets

O médico diante da morte na urgência e emergência:reflexões sobre o ser médico

The literature pointed that the way which people deal with death have been changing along centuries, and nowadays what is realized it is that, each time more, the human being have difficulties to deal with death. Due to the fact that the main function of the physician is to save their patients lives; responsibility that is aggravated by the necessity of to take decisions quickly, once he need to deal with the unexpected situations of the urgency and emergency, many times these professional have to face of impotency and fail situations, when he lose a patient. The main goal of this study was to understand the experience of physicians that work in the urgency and emergency, in front of death. These questioning it justified by the fact of the physicians do not have, many times, a space to express their suffering and anguish about the issues related to death in their work routine, despite lifedeath question to be often present their everyday. It is still possible to verify in the literature, an appointment of the necessity of to include in the curriculum of Medicine courses, subjects that approach such questions. The method used was based on the existential-phenomenological perspective, using as instrument the participant observation, to the intent of understand the routine in the urgency and emergency context, and semi-structured interview. It was interviewed six physicians that work in the urgency and emergency of the most important hospital of public health system of Natal-RN. The results showed that the physicians reported pleasure in work in the urgency and emergency, despite of they presented stress and the difficulties that they deal with in the public system. Despite of the fact that the death to be considered as a phenomenon that make part of the physician s routine, sometimes, deals with these one is more difficult. Many times losses generate an impotency and guilty feeling, as well as questionings about their performance during the attempts to save lives. We verified, from this study, the importance of the existence of some kind of intervention in the emergency, in order to the physicians can elaborate the questions about death and die emerged in their work. We consider yet that this study corroborates and reiterates the discussions concerning the importance of this thematic to be approached in a more effective way, during the academic formation of these professionals, as well as, the importance of a larger investment from the part of Government in the urgency and emergency sector, in order to propitiate to these professionals a work that brings less harmful for their health

A redução de danos no atendimento especializado em álcool e outras drogas

The harm reduction HR is the official policy of Ministry of Public Health to deal with problem derived from alcohol consumption and other drugs AD. The HR refers to policies and support programs whose purpose is to reduce the risks related to the use of AD, without necessarily decrease individual consumption. This research aim was to analyze the HR conceptions and practices at two specialized institutions for AD users: 1) Psychosocial Care Center Alcohol and Drugs III (CAPSad III); 2) Therapeutic Community Fazenda da Esperança (FE) Dom Bosco. This is a qualitative research that used the following methodological tools: semi-structured interview with 21 professionals; socio demographic file and rounds of conversation with 63 participants users; participant observation and field journal. The interviews with professionals have characterized HR as a less complex and cheap treatment. At FE the HR proposal does not make part of their actions, being considered ―against the human being dignity‖. At CAPSad III is understood as an ―inevitable‖ guideline to service, once users do not remain abstinent. The users understand RD as an improvement in healthy conditions, social relations and work that occurs with the decreasing consumption of AD. They use the HR when they avoid situations that facilitate AD consumption, share relapse prevention strategies and, exclusively at CAPSad III, decrease psychotropic consumption. Stands out as an analyzer the HR comprehension as a less efficient treatment that opposes to the objective of both institutions, which is abstinence. The HR is not operationalize in daily routine by professionals and users as a healthy promotion strategy, however, the users are more affected to HR and produce strategies to face the difficulties arising from the AD consumption

Gênero, trabalho e saúde mental entre trabalhadoras rurais assentadas na região do Mato Grande Potiguar

The lack of studies aimed at the mental health of the rural population, the social, economic, familial and emotional impact that mental disorders produce and the vulnerability that women have in this context, lead us to believe in the need to investigate the mental health demands of female rural workers, in order to subsidize the development of more effective and culturally sensitive public health programs and policies that take into account the specificities of this population. The present study aims to investigate the prevalence of common mental disorders (CMD) and the possible factors associated with the emergence of such disorders among women living in a rural settlement in Rio Grande do Norte. This survey has a quantitative and qualitative character with an ethnographic approach. As methodological strategies, we made use of an adapted version of the socio-demographic and environmental questionnaire prepared by The Department of Geology/UFRN s Strategic Analysis Laboratory to evaluate the quality of life of the families from the rural settlement and the mental health screening test Self-Reporting Questionnaire (SRQ-20) to identify the prevalence of CMD in adult women from the community. Complementing the role of methodological tools, we use the participant observation and semi-structured interviews with women who presented positive hypothesis of CMD attempting to comprehend the crossings that build the subjective experience of being a woman in this context. The results point to the high prevalence of CMD (43.6%) and suggest the link between poverty, lack of social support, unequal gender relations and the occurrence of CMD. We also verified that the settled women do not access the health network to address issues relating to mental health and that the only recourse of care offered by primary health care is the prescription of anxiolytic medication. In this context, the religiosity and the work are the most important strategies for mental health support among women

Entre a hegemonia e a polissemia: a Política de Educação e Desenvolvimento para o SUS no contexto do Brasil contemporâneo

The proposal of the Unified Health System Policy (SUS) has been considered one of the most democratic public policies in Brazil. In spite of this, its implementation in a context of social inequalities has demanded significant efforts. From a socio-constructionist perspective on social psychology, the study focused on the National Policy for Permanent Education in Health for the Unified Health System (SUS), launched by the Brazilian government in 2004, as an additional effort to improve practices and accomplish the effective implementation of the principles and guidelines of the Policy. Considering the process of permanent interdependencies between these propositions and the socio-political and cultural context, the study aimed to identify the discursive constructions articulated in the National Policy for Permanent Education in Health for the Unified Health System (SUS) and how they fit into the existing power relations of ongoing Brazilian socio-political context. Subject positionings and action orientation offered to different social actors by these discursive constructions and the kind of practices allowed were also explored, as well as the implementation of the proposal in Rio Grande do Norte state and how this process was perceived by the people involved. The information produced by documental analyses, participant observation and interviews was analyzed as proposed by Institutional Ethnography. It evidenced the inter-relations between the practices of different social actors, the conditions available for those practices and the interests and power relations involved. Discontinuities on public policies in Brazil and the tendency to prioritize institutional and personal interests, in detriment of collective processes of social transformation, were some of obstacles highlighted by participants. The hegemony of the medical model and the individualistic and curative intervention practices that the model elicits were also emphasized as one of the drawbacks of the ongoing system. Facing these challenges, reflexivity and dialogism appear as strategies for a transformative action, making possible the denaturalization of ongoing practices, as well as the values and tenets supporting them