Educação ambiental: mediações sociais e políticas e a indolência do Poder Público à sua inclusão no ensino formal

As a result of the prediction of irreversible changes on necessary conditions to maintain life, including human, on the planet, environmental education got the spotlight in the political scenario, due to social pressure for the development of individual and collective values, knowledge, skills, attitudes and competences towards environmental preservation. In Brazil, only in 1999 the right for environmental education was officially granted to people, having the status of essential and permanent component in the country s education. Since then, it has been Government s duty, in each federal branch, to plan actions to make it happen, in an articulate way in all levels and modalities of the education process, both formally and informally. This work of research has environmental education in the school as subject matter, and aims on analyzing social and political mediations established between this National Environmental Education policy and the contexts associated to the legislative production process, the political nature of the conceptions about environmental education that underlie Law 9.795/99 (Brazil, 2009c) and also Rio Grande do Norte Government s actions and omissions related to the imperative nature of the insertion of environmental education in the schools ran by the state, during the ten years this law has been in force. The investigation of the subject matter was led by a social and historical understanding of the social and environmental phenomena, as well as of the education system as a whole, considering that only through a dialectical view we can see the real world, by destroying the pseudo-concreteness that surrounds the topic. While analyzing, we assumed that in face of the dominance of a social organization in which market regulations rule on environmental ones, by developing individual and collective critical conscience, environmental education can become a threat to dominant economical interests in exploiting natural resources. The results of this research suggest that as an educational practice to be developed in an integrated, continuous and permanent fashion in all levels and modalities of formal education, environmental education has not yet come to pass in the state of Rio Grande do Norte, due to the neglect and disrespect of the government when facing the need of promoting the necessary and legally appointed measures to make it present in the basic education provided by the state. The legislators silence when it comes to approving a regulation on environmental education essential to define policies, rules and criteria to teaching the subject in the state and the omission from the public administration regarding critical actions in order to integrate in public schools the activities related to the National Environmental Education Policy, represent a political decision for not doing anything, despite the legal demand for an active position. This neglecting attitude for the actualizing of strategically concrete actions, urgent and properly planned for the implementation of environmental education in schools in a multidisciplinary way, exposes the lack of interest the predominant classes have in such kind of education being made available, as it could be developed based on a critic political view, becoming a political and educational action against dominance. When analyzing the basic principles and fundamental goals in Law 9.795/99 (Brazil, 2009c) the development of a critic environmental education is really possible and concurs with the National Environmental Education Policy, reflecting the social and political mediations established between this public policy and the contexts associated to its legislative production process, which are responsible for approving a regulation which also represents the mind of the people about environmental protection above anything else

Projeto político-pedagógico: instrumento de ação educativa na Escola Municipal Ascendino de Almeida Natal-RN (2002-2003)

In this dissertation, we investigate the process of elaboration of the Political-Pedagogical Project in the Municipal School Ascendino de Almeida , situated in the west zone of Natal city, in Rio Grande do Norte State, Brazil. We performed a qualitative research, using information provided by several sources as: interviews carried out in the Municipal Department of Education and also in the mentioned School, document analysis, and literature reviews, mainly with the objective of knowing more about the complexity of this particular reality. This was done in order to establish a mediation between the actual reality and the social, political, and economic context that surrounds it. We analyze the Political-Pedagogical Project according to the visions of Education theoreticians, under the political-normative plan, and also as a process of educational planning that can collaborate significantly for the introduction of changes in school Education. This instrument of the educative action, as a fruit of the participation of the school community, may constitute itself in an important learning instrument of the participation in the social sphere, demanding from the educators the development of complex abilities so that they can construct the Project. In the data analysis, we describe and analyze the process of elaboration of the Political-Pedagogical Project of the mentioned School. We also determine how participation of the school community was constructed as well as the consequences of this envolvement. We also discuss the abilities they needed to develop, the process of studies and dialogues that gave support to the whole process, and the democratic participation in the school decisions, including a dialogical interaction

Proposta Curricular para Educação infantil: (re) significando saberes docentes

The theory contemporary in the field of early children education, as well the legal discourse and official texts valid in our country point to the need for systematization of proposals pedagogic / curriculum in institutions, built and carried out by subjects that act as factor of assurance care quality. Quest us about what knowledge are required to teachers in developing a proposed curriculum for children education. Defined as an object of study, the knowledge teachers necessary for the development of a proposed curriculum for children education. As goals, assume: investigate teachers knowledge necessary for the development of a proposed curriculum in a Public Institution for children education and contribute to the (new) meaning on the part of teachers, knowledge needed to build a proposed curriculum for children education. Assuming the principles of the paradigm of qualitative research, we have developed a research institution of a children education Network Public Hall of Ceará-Mirim-RN, which serves children of four and five years old (preschool) with the participation of 17 teachers and two supervisory (teachers) that institution - subject of our research. Therefore, we have adopted the principles of action research, according to which the knowledge gained through research should build so shared / dialogue in the relationship between researcher and participants, what is the implementation of an effective action formative. As the search procedures developed observations no-teaching participants in the meetings and activities of the classroom; semi-structured interviews (individual and collective) with teachers and supervisors; analysis of school documents and participant observation in the seminars of studies reflective. The latter is implemented as key moments of speech and thought, and finally to (new) meaning of knowledge, the subject of the research-action. For these knowledge, the systematization of the register built was developed based on the principles of analysis of Content that guided us to the definition of two categories 1) knowledge teachers concerning conceptions of curriculum / proposed curriculum and 2) knowledge teachers concerning specifics of children education. From these were built subs representing thematings more specific and significant, among the many that emerged in the analysis: 1.1) Definitions of curriculum and curriculum proposal; 1.2) The subjects makers / implementing a curriculum / proposed curriculum; 1.3) elements constituting a curriculum / proposed curriculum for children education and 2.1) Functions of children education and conception of child; 2.2) The space of the play in the organization of routine. Under the intervention could significant advances with regard to (new) meaning of such knowledge from the subjects, with major disruptions to their original designs. These are presented and reflected in this work. In front of this movement, transformation, made the need for a permanent work in the context of the institution of in-service training, or mediated by pedagogical coordinator or other to assume this role with teachers, in order to provide the development and effectiveness of proposed curriculum consistent and contextualized in practice effective with the children concrete envisage the service to their specificities and a quality education

Programa alfabetização solidária: um estudo sobre a experiência no município de Lagoa de Pedras/RN (1997 - 2003)

The educational reform of the 90 s was tainted by the objectives of the fiscal adjustments, resulting in the redefinition of the state s role in the financing and offering of teaching services, and bringing about a shuffling of the responsibility between the public and private sectors to promote education to young people and adults. The 90 s also highlighted the proliferation of providers and the multiplication of Educational Programs for Youths and Adults (EJA), implemented through partnerships between governmental and nongovernmental agencies. During this period of time, the agenda of educational responsibilities concerning analphabetism was organized in a process of decentralized of the state, with the following political, social, and economic objectives: to reduce the public deficit, increasing public savings and the financial capacity of the state to concentrate resources in areas considered indispensable to direct intervention; to increase the efficiency of the social services moffered or funded by the state, giving citizens more at a lower cost, and spreading services to more remote areas, expanding access to reach those most in need; to increase the participation of citizens in public management, stimulating communitarian acts as well as developing efforts towards the effective coordination of public figures in the implementation of associated social services. Thus, Assistance Programs co-financed by the government try to deal with the problem of analphabetism. Within the sphere of the 90 s educational policy decentralization, we come to see how the agenda dedicated to the reduction of analphabetism was formed by the Solidarity Alphabetization Program (PAS). Between 1997 and 2003, the latter agenda s decentralizing proposal was integrated in the management partnership for the operationalization of tasks and resources faced with the execution of the formal objectives. In this study, we identify the dimensions of the implantation and progress of the tasks carried out by PAS, in the municipality of Lagoa de Pedras/RN. However, we consider these Programs to assist in the process without guaranteeing the reduction of the causes or substituting the responsibility of the system once the monetary resources for program maintenance provided by the partners is exhausted

Conselho de Escola: cenários e desafios de uma escola pública de Natal

This dissertation work studies the Board of Director , created in 1995, in the public schools of the Rio Grande do Norte. It aims to analyze if the creation of this collegiate at Berilo Wanderley State School contributes to accomplish the participation of school segments, democratizing the decision-making in the interior of the institution. This research configures itself as a study of case with information collected together to the representatives of Board through of semi-structuralized interviews. Also they had been essential in the investigation , the informal talks and the registered direct comments in a field diary. For the data analysis we contemplate the following dimensions of the object: the institutionalization process of the Board at Berilo Wanderley State School; the insertion form of the representatives in the collegiate one; the participation of the members in the Board decisions ; the Board s role in the school management and the Board as democratization space. Based in the theoretical and empirical information that we made use, we look for to identify the limits and possibilities of the Board performance in a state public school. The research results indicate that the institutionalization of the Board of Director at the Berilo Wanderley State School presents limits to materialize an effective participation of school community in the essential decisions to the functioning of the school. Also it was possible to underline the fragility of an understanding on the part of school community, the potentialities that the Board in the process of democratization of the school has, translated in the discrepancy between the saying and making of the council members. It can be highlighted that the Board in the school only exists to correspond to a educational policy guideline, with a little significant role , without corresponding to the democratizing possibilities of the collegiate participation. In spite of all the evidenced debilities in the Board of Director experience of the Wanderley Berilo State School , it is worth clarifying that the actor participation, for more limited than either, it represents new something in the setting of the school. In this direction we detach the importance to invest in the improvement of the Board s role, because it can form itself in an educative space for the building of democratic practices in the scope of the school

SINAES: as diferentes faces da avaliação na UFRN

This thesis entitled SINAES: the different faces of the evaluation at UFRN, aims to analyze the configuration that the national policy for assessment in higher education has taken on UFRN. We assume that in recent years there are an oscillation between the concepts of evaluation, according with the logic of public administration it has preferred an approach that presents itself as a promoter of quality, sometimes with regulatory aspects, sometimes with educational ones. The text discusses the use of the new assessment tools for higher education placing them under the new demands on state reform context in which this is to promote and measure quality based on the values of excellence and competitiveness. This movement arises from the redefinition of the role of the State that has been taking features of Evaluator State. From a historical review of government initiatives in the field of evaluation, we analyze the characteristics of assessment policies outlined over the past decades. We are based on the theoretical method that aims to examine the multiple determinants that shape a particular reality from the larger movement of totality. To identify, in this case, connections and ruptures that have emerged over the history of assessment policies aimed at higher education by checking their determinants in order to better explain the reality. To investigate the object of this study we used as instruments: the research literature and research documents, the semi-structured interviews and non-participant observation. The study revealed that there are different practices of evaluation and that before to establishment the SINAES program, the UFRN already had a culture of an institutional assessment, more participatory and democratic, opposing to the rigidity of the self-assessment in SINAES program that it was instituted by the Commission for assessment (CPA). We also noticed that the implementation of the SINAES at URFN has been performed very slowly and the breadth and complexity of the evaluation process has contributed to hinder its implementation in all dimensions provided by MEC. Although it was observed that in its operationalization the SINAES has assumed a more normative assessment and directed to establish rankings between courses and higher education schools than to establish a more qualitative assessment in this system. As regards the evaluation of the undergraduate course studied on this research and subjected to the three dimensions of evaluation proposed by SINAES (self-assessment, Evaluation of Courses and ENADE) it was not possible to verify an effective integration between the methods of assessing conducted. The results are considered separately, in only a partial view of the course evaluated the proposal what pits the SINAES as a system that involves the totality

Ateliês de história e pedagogia da matemática: contribuições para a formação de professores que ensinam matemática nos anos iniciais

This paper presents a discussion about the use of the History of Mathematics as an educational resource and conceptual mediator in the formation of teachers who teach mathematics in the years of elementary school. It was a qualitative action method, in order to show the importance of holding workshops of History and Pedagogy of Mathematics as contribution to overcome the conceptual difficulties of teaching and teachers regarding the content covered in the course of education and afterwards they have to teach in the early of elementary school. We assume that understanding the historical, social and cultural comprehension as a conceptual and didactic focus effectively nurture the pursuit of a teaching and learning of mathematics students safe and justified in order to contribute to overcoming the difficulties of teaching and learning usually occurred in the classroom of the early years. In this sense, we organized a study group formed by students of Bachelors in Education and Mathematics at the University of Piauí. We developed five training workshops in History and Pedagogy of Mathematics, with a workload of 20 hours each and four follow-up sessions and advicement, totalizing 180 hours. The purpose of workshops was to develop studies on the History of Mathematics that could support the formation of a conceptual and didactic group with a view to prepare teaching materials and activities based on information drawn from undertaken historical studies .The products designed were used in formation of the group itself and will later be used in training teachers of public school in Teresina, in the form of workshop of History and Pedagogy of Mathematics in order to overcome problems arising from teaching and conceptual this education degree in Education Based on the obtained informations it was possible to suggest new referrals procedural level of education and university extension that may contribute to the reorientation of initial and continuing training of teachers in the early years elementary school

O currículo escolar: uma análise na perspectiva da inclusão de alunos com deficiência intelectual

A mid the many transformations and advances that the contemporary society is going through, the right to education is a topic that does not end and becomes increasingly present, given the urgency of including students with disabilities in education. Given this new reality, schools are challenged to receive them with quality, and implement actions that promote favorable conditions for their development at school. Accordingly, it is fundamental the organizational restructuring of education to meet the specific needs of students. Thus, it is imperative that educational institutions defining the type of person who intend to form and the society proposing to build. These are aspects that precede any question, since the knowledge covered in the curriculum will contribute directly to the creation of human beings are involved there. Based on this theme, this assignment reports aspects of a survey of a local public school, located in Natal/RN, which deals with the analysis of the curriculum and its implementation in teaching practice in the classroom, before the inclusion of students with disabilities intellectual. Thus, to undertake a study of case with five professionals at school, involving documentary analysis and observation of the curriculum of the pedagogical practice of teachers in the classroom, as well as conducting an interview with all stakeholders. To this end, the data analyzed shows that, although the right of citizens with disabilities is guaranteed by constitutional law, the school, locus of this study, have not realized the extent of conquest. Does not recognize the fact of being in school and learn together with others is also a right of persons with disabilities. Thus, while your resume is to present a progressive vision, believed to be open, concerned with the selection and organization of content, with flexibility in defining the goals, with the search for diversification of the procedures adopted, as well as the planning activities teaching and learning based on the level of student learning, this is not effective in teaching practice, either through ignorance of the guidelines defined either by lack of knowledge about the proposal and an inclusive curriculum can provide answers to all educational students, including those with intellectual disability

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

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

Educação inclusiva: práticas de professores frente à deficiência intelectual

The present work is a survey of pedagogical practices of teachers who experience the daily school with students with Intellectual Disability (ID) in their classrooms, considered inclusive. The study was conducted in academic year 2010 in a municipal school in Natal-RN, aimed at investigating the pedagogical practices developed by the participating teachers as well as its view of the front of Intellectual Disabilities students who are inserted in the initial years of Elementary School. In methodological choice, considering the nature of the phenomenon, we chose the qualitative approach and the case study method. The observation and semi-structured interview were used as procedures, which contributed to a significant collection of data in an attempt to answer the objectives. The study subjects were selected by convenience and were formed into two teachers from Elementary School I, linked to the public educational system, which volunteered to collaborate in this research. The analysis of the observations and of the speeches made possible build pedagogical considerations on the action with students with Intellectual Disabilities in a regular school. The results point to a practice covered with a traditional pedagogy, with a few adjustments, although there is an initial process of change, what we observe in the classroom and captured in the words, because, at various times, we saw an interest in developing a pedagogy of Freire. One aspect that caught our attention refers to the formative action at school for these teachers. We found its incipiency, because this does not happen in a systematic way at school. Throughout the years investigated, the teachers had no access to any form of training neither to any form of specialized monitoring. We realize that there is still a concept of Intellectual Disability that makes difficult to "see" this student as a human being having learning opportunities. The aspects that interfere in the formation hinder the development of a pedagogical practice that meets the uniqueness of its customers and promotes a truly effective school inclusion, consistent with social rights proclaimed in this century. We believe in the irreversibility of the inclusive process initiated a few decades ago and that obstacles to the practice of teaching students with ID are visible and possible to overcome if they are turned into challenges for all those who compose the school, the municipal education system and those who build public policies for inclusive education

A aplicação dos temas transversais nas aulas de educação física - ensino médio integrado

A escola tem se guiado por ações pedagógicas do professor consideravelmente limitadas, as quais têm dificultado configurar com nitidez intenções educativas que contemplam a sua organização curricular. Nesse sentido, esta dissertação tem por objetivo apresentar uma experiência pedagógica da educação física a partir da operacionalização de temas transversais com os conteúdos curriculares no ensino médio integrado no IFRN, campus SGA. Os fundamentos teórico-metodológicos seguiram a linha qualitativa da pesquisa-ação. Participaram desta pesquisa estudantes dos cursos de Edificações e Informática do 1º ano do ensino médio integrado e a professora-pesquisadora, que é servidora efetiva do instituto. Optando pela pesquisa-ação, estruturamos uma intervenção pedagógica com intenção de promover a construção de conhecimento dos conteúdos da educação física com os temas transversais, tanto em amplitude como em profundidade, alicerçada no aporte teórico da teoria da ação dialógica (FREIRE, 2011) e da concepção aberta no ensino da educação física (HILDEBRANDT, 1986). A pesquisa teve como procedimentos a observação participante e a filmagem das aulas de educação física. As observações e os discursos dos estudantes foram organizados em categorias de questões, a saber: 1. Percepção dos estudantes sobre a educação física; 2. Sentidos e significados dos conteúdos da educação física na interfase com os temas transversais nas aulas; 3. Diálogos sobre a interação do conhecimento na relação professor-estudante. As observações e a análise dos depoimentos dos estudantes apontaram, em alguns momentos, que as aulas de educação física ainda são estruturadas no modelo rola bola , sem planejamento, configurando-se mera atividade, e não como prática pedagógica que trata dos saberes do campo da cultura de movimento. Por não constituir-se prática pedagógica que aborda os conteúdos de forma sistematizada, não se tem de forma precisa a ordenação e sequenciação dos aprendizados de práticas corporais, tampouco a introdução de temas transversais, os quais não poderiam ser aprendidos sem uma ação pedagógica concreta do professor. A interação professor-estudante afetiva e dialógica favoreceu que os estudantes se permitissem participar das experiências corporais de um jeito diferente, aceitando aprender os conteúdos curriculares em conjunto com os temas transversais, passando a perceber as aulas de educação física como espaços de experiências de movimento que lhes permitiram atribuir sentido/significado, além do conhecimento sobre o universo da cultura de movimento. A nosso ver, acrescentamos também que a escola não valorizou o trabalho com os temas transversais, pois a recente discussão sobre a inserção desses temas como temáticas relevantes, que devem ser tratadas pedagogicamente em conjunto nos componentes curriculares, ainda não é contemplada expressivamente no projeto curricular da escola

Custo-efetividade da terapia compressiva no processo de cicatrização de úlceras venosas

Analytical study of therapeutic nonrandomized intervention type, intra-group controlled, with the aim of analyzing the cost-effectiveness of compression therapy with manipulated Unna boot in relation to conventional therapy in the healing of venous ulcers (VU) of patients treated in ambulatory clinic. The study population was composed by patients with VU treated by angiologists in Surgical Clinic Ambulatory of the Onofre Lopes University Hospital (HUOL) with a sample of 18 patients. It obtained the assent of the HUOL Ethics in Research Committee (Protocol 276/09). Data collection was performed over a period of four months by the own master's student and 34 nursing students, through the application of the research instrument in the admission of patients to the study and in the ten subsequent evaluations, performed at the time of changing Unna boot, weekly, for a maximum period of 10 weeks. The data were analyzed with SPSS 15.0 software, using descriptive and inferential statistics, and presented as tables, charts and graphs. Among those surveyed, prevailed: females, mean age 57.6 years, low education and income levels, most retired, unemployed or off work, with the standing position more than six hours per day and up to eight hours daily of domestic or occupational activities. In health status profile of respondents there were predominantly sleep, rest and inadequate elevation of the lower limbs, no smoking and/or alcohol use, presence of hypertension and no use of drugs. Most presented the first VU for over 10 years, recurrences, present VU for more than five years, involvement of left leg, in malleolar and / or distal leg region, mild edema, hyperpigmentation, lipodermatosclerosis, telangiectasies, reticular and varicose veins, mild pain, serous exudate in moderate quantity, small lesions (up to 50cm2), with predominance of granulation tissue and / or epithelialization and demarcated, elevated and irregular borders, with crusts and macerated. Most patients reported that in the 10 weeks prior to admission, made bandages at home and / or Basic Health Unit and / or ambulatory, with nursing aides or technicians, daily, and on weekends or holidays, performed by patients themselves, using healing ointment on the lesion, being observed granulation / epithelialization and increase in VU prevalent in the 10 weeks of traditional treatment. After follow up with manipulated Unna boot, was observed a decrease of lesions in all study patients, with complete healing in 27.8% of those between 1 and 5 weeks of treatment, with satisfactory evolution of the lesions, pain and ankle and calf circumferences, and unsatisfactory development of the borders of ulcers, edema, sleep, rest and elevation of the lower limbs, especially in more chronic patients. Furthermore, patients who achieved total healing and exhibited the greatest percentage reduction of lesions had a higher number of wound healing factors (ρ = 0.01 and ρ = 0.027, respectively). The manipulated Unna boot showed better results in those patients with shorter duration of injury, leading them to a satisfactory outcome within a short period of treatment. After the cost-effectiveness analysis, we conclude that the manipulated Unna boot is more effective than conventional therapy in the healing process of VU and is more cost-effective in patients with shorter lesions (ρ = 0.001), shorter treatment (ρ = 0.000) and greater number of wound healing factors (ρ = 0.005).

Redução de danos e o saber-fazer de profissionais de um CAPS ad em Natal-RN

The present study had as a main objective to analyze how the professionals at a CAPS ad unit in Natal-RN conceive the knowledge-practice process with regard to the Harm Reduction Policy (HRP) towards alcohol and other drugs. For the accomplishment of this proposal, it was intended: 1) Verifying the possibilities and limits of the HRP implementation at a CAPS ad unit in Natal-RN; 2) Relating the professionals knowledge at a CAPS ad unit in Natal in regard to the Harm Reduction Policy; 3) Enumerating the HRP programmatic actions at the institution. The research had exploratory, descriptive and qualitative approach aspects, guided by the concepts of biopower and self care proposed by Michel Foucault. Data collection occurred in June and July 2011, in which the focal group technique was used. After that, collect field material was analyzed through the content analysis method proposed by Minayo. The results showed some conceptual and practical approach between the harm reduction strategy and the knowledge-practice of the professionals at this CAPS ad unit. The discursive models about drug usage, especially the moral-legal model, still have a significant role in the daily lives of these professionals, being amplified by some demands of their jobs or even through the instituted discourse. The individuals recognize the need for less prohibited practices and more socializing ones, identifying them with the Harm Reduction (HR) logic, when there is a coherent and well-founded understanding about HR among the professionals. Distorted and reductionist views about HR as considering the simple instrumental function of this strategy (distribution of basic supplies) among the professionals, represent one of the main barriers for its implementation. There are few programmatic activities that are related to the RD strategy at this CAPS ad unit which makes a more effective appropriation by the working team difficult to reach. The working processes and the postures adopted by this CAP ad unit professionals have been showing that many of their practices and conceptions were modified to the detriment of new necessities emerged from the demands. Consequently, the self care notion is revealed which brings the need for the valorization of these care agents roles, that is, their collective and individual contribution.

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.

Segredos da alma: a dádiva da assistência de Enfermagem

The present study is an analysis of interpersonal relationships between the nursing staff and the patients under their care. Its objectives are to analyze ties/links that may possibly exist in such relationships and to describe, based on the experience of the patients, how they are received by the nursing staff, and what is the extent of their reliability on the nursing staff within the hospital. This investigation is analytical in nature and qualitative in approach, having as its leading thought Marcel Mauss s gift-exchange theory. The study involved eighteen in-patients, eight of them from government institutions, at a large hospital school and ten others from a private specialty hospital; both in the city of Natal, state of Rio Grande do Norte, Brazil. Data were collected between January and March 2006. Results point to ties being created between the nursing staff and patients irrespective of their social status, involving especially the development of friendship and reliability. We have noticed that in both services the interpersonal relationship is associated with the circulation of the symbolic goods mentioned in the patients discourse, such as attention, loving care and concern, among others, marking the formation of ties during hospital stay. Likewise, reliability is also present in close relationship with the technical competence of the professional. Patient hospitality is associated with the manner in which the patients were treated on being admitted to the hospital, although they also refer to hospitality at later moments, during the course of their treatment. Finally, we are in a position to say that there are ties/links between in-patients and nursing staff, irrespective of the patient s social status and class divide. It is thus evident that the antiutilitarian symbolism of gift to give, receive, give back -, which shapes the setting of social ties also takes place in today s utilitarian, individualistic and competitive societies. Thus, human beings whose existence is dependent on mutual relationships try to save their humanity, especially those who are fragile and dependent as is the case of the hospital in-patient