A influência da criopreservação nas células mesenquimais indiferenciadas do ligamento periodontal de humanos análise comparativa in vitro

Cryopreservation is a process where cells or biological tissues are preserved by freezing at very low temperatures and aims to cease reversibly, in a controlled manner, all the biological functions of living tissues, i.e., maintain cell preservation so that it can recover with high degree of viability and functional integrity. This study aimed to evaluate the influence of cryopreservation on the mesenchymal stem cells originating from the periodontal ligament of human third molars by in vitro experiments. Six healthy teeth were removed and the periodontal cells grown in culture medium containing α-MEM supplemented with antibiotics and 15% FBS in a humidified atmosphere with 5% CO2 at 37° C. Cells isolated from each sample were divided into two groups: Group I - immediate cell culture (not fresh cryopreserved cells) and Group II - cell cryopreservation, during a period of 30 days. Analyses of rates of cell adhesion and proliferation in different groups were performed by counting the cells adhered to the wells, in intervals of 24, 48 and 72 hours after the start of cultivation. The number of cells in each well was obtained by counting viable cells with the use of hemocytometer and the method of exclusion of cells stained by trypan blue. The difference between groups for each of the times was analyzed by Wilcoxon test. Regarding the temporal evolution for each group, analysis was done by Friedman's test to verify the existence of differences between times and, when it existed, the Wilcoxon penalty was applied. The results showed no statistically significant difference between the two groups analyzed in this study. Therefore, we conclude that the cryopreservation process, after a period of 30 days, did not influence the cell type studied, and there was no difference in growth capacity in vitro between the groups

Expressão imuno-histoquimica de colagenase-1 e gelatinases A e B em mixomas odontogênicos e papilas de germes dentários

The odontogenic myxoma shares cellular and structural aspects with dental papilla, which has been implicated as probable origin of this neoplasm. The aim of the present study was to perform a comparative immunohistochemical analysis for the expression of collagenase-1 (MMP-1) and gelatinases A (MMP-2) and B (MMP-9) in odontogenic myxomas and dental papilla of teeth germs. Twelve cases of odontogenic myxomas and eight specimens of teeth germs were selected. It was taken into consideration the presence or absence of immunoreactivity, the pattern of immunohistochemical distribution of proteases within extracellular matrix, as well as, the number of cells revealing immunostaining for matrix metalloproteinases (MMPs). It was verified a significant difference (p<0,05) in relation to MMP-2 immunoexpression, which was observed only within extracellular matrix of myxomas. Nevertheless, MMP-1 labeling was revealed by most of the cases of odontogenic myxoma, at levels close to those observed in dental papilla. In relation to the pattern of distribution, a significant difference was obtained between specimens (p<0,05), with neoplasms predominantly exhibiting a focal pattern for MMP-1. The quantitative analysis of neoplastic cells labeled for MMPs denoted a significant difference (p<0,05), demonstrating a higher proportion of MMP-1 in comparison to MMPs-2 and -9. It can be concluded that immunohistochemical expression of MMP-1 at levels comparable to those observed in dental papilla and quantitatively superior in relation to MMPs-2 and -9, suggest an implication of this protease on extracellular matrix degradation of odontogenic myxomas. Moreover, the possibility of interactions with receptors involved in cellular adhesion, particularly with integrins, suggests a plausible function on local invasiveness of such neoplasms. Additionally, the presence of a descent immunoexpression gradient for these MMPs on odontogenic myxomas, associated to substrate specificity inherent in each enzyme, suggest the existence of a coordinated mechanism between interstitial collagenase and gelatinases A and B in order to allow an efficient degradation of extracellular matrix and local invasion by neoplastic cells

Expressão imuno-histoquímica das integrinas α2ß1, α3ß1, e α5ß1, em mucosa oral normal, hiperplasia fibroepitelial inflamatória oral e displasia epitelial oral

The objective of this study was perform by the streptoavidin-biotin technique an immunohistochemical analysis of α2β1, α3β1e α5β1 integrins in 11 normal oral mucosa (NOM), 16 oral inflammatory fibroepithelial hyperplasia (OIFH) and 25 oral epithelial dysplasia (OED) (16 mild, 2 moderates and 7 severe), to determine if exists qualitative alteration in the expression of these integrins and if this guard relation with the oral epithelial modifications. It was observed that for the α2β1 integrin the majority of the sample showed a predominantly intense labeling diffusely distributed in the intercellular contacts and the cytoplasm of cells of the basal and suprabasal layers, without difference of this profile between the different types of specimens, however with a trend to weak or loss of expression in 21.1% of the OEDs, being all the specimens that had not expressed this heterodimer, severe OEDs. For the α3β1 integrin the majority of the sample showed a weak or absent labeling in basal layer. The α5β1 integrin showed a predominant strong diffuse labeling in the intercellular contacts and cytoplasm in the suprabasal layer, with difference only in the labeling intensity between the types of specimens, inhabiting this difference in the OEDs, where 12 (48%) specimens had shown a weak labeling. It was concluded that the evaluated integrins can be involved in the cell-cell, cell-ECM interactions modulating the cellular differentiation and maintenance of the epithelial structural arrangement. The variable expression of the α5β1 integrin in the OEDs, could suggest, respectively, a role of this molecule in the cellular survival, with intention to perpetuate the modified phenotype in these lesions, or a suppressor role on the modified phenotype due to lack of interaction of this molecule with the fibronectina of the MEC

Expressão imuno-histoquímica da e-caderina e da ß-catenina em carcinoma epidermóide oral com e sem metástase nodal

The adhesion molecules E-cadherin and β-catenin have been studied as possible markers to distinguish carcinomas with and without metastatic potential. The objective of this research was to study the imunohistochemistry expression of the E-cadherin and β-catenin in oral squamous cell carcinoma (OSCC), aiming to contribute for the better understanding of the biological behavior of this lesion. The sample consisted of 30 cases of OSCC, being 15 of tongue and 15 of lower lip. The profile and intensity of labeling and semi quantitative analysis of the percentage of immunopositive tumoral cells in membrane for E-cadherin and β-catenin had been related with the anatomical localization of the lesion, the presence or not of nodal metastasis and the histological grade of malignancy in the invasive front area of the tumor. It was registered the presence or not of cytoplasmic and nuclear labeling of the β-catenin. The results had been submitted to the statistical analysis, being used the Mann-Whitney Test, the Fisher Test and the Spearman Correlation Coefficient (α=0, 05). The results showed that the expression in membrane for E-cadherin and β-catenin was, predominantly, the heterogeneous profile in the lower lip and tongue carcinomas, as well as in the cases with and without nodal metastasis. It was not observed significant statistical difference between expression profile and amount of immunopositive cells for E-cadherin, β-catenin and the anatomical localization of the lesion and for the presence or not of nodal metastasis. However, there was significant difference of the reduced expression of these proteins with the high score of malignancy. It was verified that the expression of the β-catenin in cytoplasm was present in 22 (73.33%) of the 30 analyzed cases, and 6 cases (20%) showed nuclear expression. The statistical analysis detected significant association between the expression of the β-catenin in the cytoplasm with the histological grade of malignancy, being this molecule more frequently present in the cytoplasm in the cases of high score of malignancy. It was concluded that the reduced immunoexpression of these proteins in membrane can be related with the lowest cellular differentiation, as well as with the pattern of invasion in nests and isolated cells, demonstrated in the cases of OSCC with high histological grade of malignancy

O Psicólogo no campo do Bem-Estar: cartografias de práticas na saúde e assistência social

The study focuses on the psychology and Social Well-being Policy encounters. The objective is to understand how the psychologists in the health services of Natal, RN, specifically in the Basic Health Units and social assistance, experience their daily practices. The methodology included observation and interviews of 13 psychologists regarding their daily activities and forms of practice in these services. We utilized an interview protocol directed at the affective memory and the professional life history of these technicians. Field notes were used to produce a cartography of the encounter intensities experienced by the researcher in the investigated context. The data analysis enabled the construction of the following analytic axes: 1) Work processes and proximity/ distancing points between these fields; 2) Forms of government and life management in the well-being context; 3) Experiments of self in the daily services. The first axis showed the precariousness of working conditions (remuneration issues, lack of structure, of training and autonomy for the activities). In the second axis the identified care forms produced in these fields indicated an adherence to the production of ideal subjects characterized as autonomous, productive, healthy and aware of own rights . These were considered normative insofar as they express attempts to break with the established patterns. In the third axis, many technicians experienced constraint with the daily activities because they found themselves in contexts that were adverse to the habitual forms of action. This situation provoked two distinct forms of positioning: a) action expressed by compassion, pity and resentment; b) investment in the practices themselves, so as to overcome its limits and to respond innovatively to the difficulties and/or challenges that these contexts provoke

Evidências de validade do Millon Behavioral Medicine Diagnostic (MBMD) na avaliação psicológica de candidatos à cirurgia bariátrica

the Millon Behavioral Medicine Diagnostic is an instrument, developed from a consensus among health professionals, to identify psychological factors that may compromise the conducting of medical treatment in order to allow a better adhesion. As it has been one of the most used tools to assess bariatric surgery, the objective of this research is to verify the evidence validity of Millon Behavioral Medicine Diagnostic (MBMD) for psychological assessment of candidates for bariatric surgery. Method: males and females volunteers, aged 18 to 70, grouped in 150 patients admitted for surgical procedures or suffering from chronic diseases (control group) and 426 patients candidates for bariatric surgery, contacted in person or by the internet. For the study in the face group were also administered Millon Index of Personality Styles (MIPS), the Millon Clinical Multiaxial Inventory-III (MCMI-III) and the General Health Questionnaire of Goldberg, just in bariatric surgery patients. Results: there are indicators of semantic adaptation of the instrument, with 27 factors in five areas of the instrument, all with satisfactory levels of validity. The reliabitity indicators were satisfactory in 18 of the 32 scales that comprise the MBMD, while relations with the other three instruments showed significant variations compared to the original indicators. The MBMD was sensitive to differences between groups about gender, age, education, marital status, body mass index, comorbidities and chronic disease patients and with or without obesity. The use of this instrument in the assessment of candidates for bariatric surgery presents indicators of validity in view the limitations as to the realiability of certain scales

Tomada de decisão de Psicólogos em avaliação Psicologica

Psychological assessment is a procedure that is inserted in all areas of a psychologist s professional field of work. When starting any psychological intervention, it is necessary to carry an analysis of how individual operate in order to identify and define their demands to adequately meet them. It is important to study this practice because the choice of instruments, techniques and procedures to be employed influences the efficiency and effectiveness of the work and the image of the profession towards society in general, also impacting the scientific community. This study aimed to identify, in the subjects, the percentage of professionals in psychology who make use of the Psychological Assessment in the Northeastern region of Brazil; another objectives were to analyze the profile of these professionals in terms of gender, time after graduation, additional training in PA, the state of the country where he/she works; to check how psychologists do their planning when using PA as well as to identify which differences can be observed in terms of time from graduation and additional training in the process of planning the assessment different extents. The instrument used was an online questionnaire and the sample was by adhesion to the application. The attendance was of 159 professionals and most of them were females with a specialist degree. It was found that the majority of the professionals perform the planning of the PA, establishing a method and choosing the most appropriate strategies to be used. It was also verified that most of the subjects fulfill the steps of the whole process, and when planning the techniques of data collection, integrating database from different sources, reporting the results and returning the information, the professional demonstrates his/her goals to understand their demands and accomplish the decision making and/or proposed intervention for individuals assessed. It was found that the undergraduate degree may not have produced a more complete effect in the professional qualification and therefore, of the quality of the actions in PA, and that there is a need for training and continuing education

Participação de moradores no programa de coleta seletiva em três bairros de Natal/RN: explorando determinantes psico-socio-ambientais

The general purpose of the study was the analysis of residents' participation in the program of door-by-door collection of recyclable residuals in Natal, Rio Grande do Norte. Even though the conception of such program by municipal managers was basically aimed at providing job opportunities and income for the collectors, the main objective of the investigation was to verify whether residents' participation could be attributed to their environmental commitment. Data collection involved three municipal districts and was performed in three stages, with complementary methodological strategies (observation, questionnaire, and interview), and characterized by selfevaluation, by residents, and hetero-evaluation, by collectors. Social, demographic, situational/contextual, and dispositional data were identified to help in the analysis of residents' adherence to the program. Separating and delivering recyclable residuals was the most frequent type of residents' participation, which demonstrates their low level of appropriation of decisions related to the program, taking part on it as passive agents. Two forms of motivation towards participating in the program were found: environmental and social. Despite the first being more frequent, it was associated to lack of environmental awareness related to the process, which may very well imply a mere reproduction of pro-environmental discourse. Motivation towards social issues was strongly connected to philanthropic forms of help. Knowledge was revealed as na important predictor for participation, as well as social networks, formed by neighbors, relatives and friends. Despite the social emphasis in the design of the program, it is possible to conclude that some residents also perceive its environmental benefits, possibly as consequence of a knowledge originated outside the program. Initiatives of environmental education should be promoted in order to minimize the allegation of lack of knowledge as justification for non-participation. Similarly, actions to put together municipal management and population would be welcome, to promote joint decisions towards sustainable styles of life

Uso do pó da palha de carnaúba em compósitos de quitosana

In this work a biodegradable composite using the carnauba straw s powder as reinforcement on chitosan matrix polymeric were manufactured. Firstly, were carried out the chemistry characterization of the carnauba straw s powder before and after treatments with NaOH and hexane. Goering and Van Soest method (1970), flotation test, moisture absorption, FTIR, TG/DTG, DSC and SEM have also being carried out. Composites were developed with variations in granulometry and in powder concentrations. They were characterized by TG/DTG, SEM and mechanicals properties. The results of chemical composition showed that the carnauba straw s powder is composed of 41% of cellulose; 28,9% of hemicellulose and 14% of lignin.The flotation test have indicated that the chemical treatment with NaOH decreased the powder s hidrophilicity.The thermal analysis showed increased of thermal stability of material after treatments. The results of FTIR and SEM revealed the removal of soluble materials from the powder (hemicelluloses and lignin), the material became rougher and clean. The composites obtained showed that the mechanicals properties of the composites were decreased in respect at chitosan films, and the composites with the powder at 150 Mesh showed less variation in the modulus values. The speed test of 10 mm/min showed the better reproducibility of the results and is in agreement to the standard ASTM D638. The SEM analysis of fracture showed the low adhesion between the fiber/matrix. The increase of volume of powder in the composite caused a decrease in values of stress and strain for the samples with untreated powder and treated with hexane. The composite with 50% of the powder s treated in NaOH didn t have significant variation in the values of stress and strain as compared with the composites with 10% of the powder, showing that the increase in the volume of fiber didn t affect the stress and strain of the composite. Thereby, it is concluded that the manufacture of polymeric composites of chitosan using carnauba straw s powder can be done, without need for pre-treatment of reinforcement, become the couple of carnauba straw s powder-chitosan a good alternative for biodegradable composites

Remoção, por flotação, de óleo em águas produzidas na indústria de petróleo: eficiência e modelagem do processo

The separation oil-water by the use of flotation process is characterized by the involvement between the liquid and gas phases. For the comprehension of this process, it s necessary to analyze the physical and chemical properties command float flotation, defining the nature and forces over the particles. The interface chemistry has an important role on the flotation technology once, by dispersion of a gas phase into a liquid mixture the particles desired get stuck into air bubbles, being conduced to a superficial layer where can be physically separated. Through the study of interface interaction involved in the system used for this work, was possible to apply the results in an mathematical model able to determine the probability of flotation using a different view related to petroleum emulsions such as oil-water. The terms of probability of flotation correlate the collision and addition between particles of oil and air bubbles, that as more collisions, better is the probability of flotation. The additional probability was analyzed by the isotherm of absorption from Freundlich, represents itself the add probability between air bubbles and oil particles. The mathematical scheme for float flotation involved the injected air flow, the size of bubbles and quantity for second, the volume of float cell, viscosity of environment and concentration of demulsifier. The results shown that the float agent developed by castor oil, pos pH variation, salt quantity, temperature, concentration and water-oil quantity, presented efficient extraction of oil from water, up to 95%, using concentrations around 11 ppm of demulsifier. The best results were compared to other commercial products, codified by ―W‖ and ―Z‖, being observed an equivalent demulsifier power between Agflot and commercial product ―W‖ and superior to commercial product ―Z‖

Estudo da descelularização tecidual na produção de arcabouços biológicos para enxertos

The regeneration of bone defects with loss of substance remains as a therapeutic challenge in the medical field. There are basically four types of grafts: autologous, allogenic, xenogenic and isogenic. It is a consensus that autologous bone is the most suitable material for this purpose, but there are limitations to its use, especially the insufficient amount in the donor. Surveys show that the components of the extracellular matrix (ECM) are generally conserved between different species and are well tolerated even in xenogenic recipient. Thus, several studies have been conducted in the search for a replacement for autogenous bone scaffold using the technique of decellularization. To obtain these scaffolds, tissue must undergo a process of cell removal that causes minimal adverse effects on the composition, biological activity and mechanical integrity of the remaining extracellular matrix. There is not, however, a conformity among researchers about the best protocol for decellularization, since each of these treatments interfere differently in biochemical composition, ultrastructure and mechanical properties of the extracellular matrix, affecting the type of immune response to the material. Further down the arsenal of research involving decellularization bone tissue represents another obstacle to the arrival of a consensus protocol. The present study aimed to evaluate the influence of decellularization methods in the production of biological scaffolds from skeletal organs of mice, for their use for grafting. This was a laboratory study, sequenced in two distinct stages. In the first phase 12 mice hemi-calvariae were evaluated, divided into three groups (n = 4) and submitted to three different decellularization protocols (SDS [group I], trypsin [Group II], Triton X-100 [Group III]). We tried to identify the one that promotes most efficient cell removal, simultaneously to the best structural preservation of the bone extracellular matrix. Therefore, we performed quantitative analysis of the number of remaining cells and descriptive analysis of the scaffolds, made possible by microscopy. In the second stage, a study was conducted to evaluate the in vitro adhesion of mice bone marrow mesenchymal cells, cultured on these scaffolds, previously decellularized. Through manual counting of cells on scaffolds there was a complete cell removal in Group II, Group I showed a practically complete cell removal, and Group III displayed cell remains. The findings allowed us to observe a significant difference only between Groups II and III (p = 0.042). Better maintenance of the collagen structure was obtained with Triton X-100, whereas the decellularization with Trypsin was responsible for the major structural changes in the scaffolds. After culture, the adhesion of mesenchymal cells was only observed in specimens deccelularized with Trypsin. Due to the potential for total removal of cells and the ability to allow adherence of these, the protocol based on the use of Trypsin (Group II) was considered the most suitable for use in future experiments involving bone grafting decellularized scaffolds

Promoção da saúde: estratégias para a autonomia e qualidade de vida do sujeito com diabetes

O diabetes é uma doença crônico-degenerativa de grande prevalência na população mundial configurando-se enquanto sério problema de saúde pública. Por ser crônico exige dos sujeitos autocuidado e autogoverno longitudinal. A autonomia, por sua vez, é um direito fundamental e também um dos princípios da bioética mais discutidos na atualidade. Seu conceito é complexo e leva em conta a vida experimentada ao longo dos anos. Quando a discussão sobre autonomia se trata de diabetes, a dependência do outro e os conflitos no controle da doença, diante de novas regras e estilos de vida, nem sempre condizentes com os valores dos pacientes, torna-a fragilizada. Embora a autonomia seja claramente parte integrante do tratamento e alicerce para uma vida digna e de qualidade, observamos que os sujeitos se tornam ainda mais dependentes dos serviços de saúde, quando se deparam com o diagnóstico e não têm confiança para tomar suas próprias decisões diante da patologia limitadora. Por isso, há a necessidade dos serviços de atenção primária à saúde traçarem estratégias para promover a saúde desses sujeitos. Os Grupos de Promoção da Saúde são estratégias recentemente utilizadas para influenciar no nível de autonomia dos sujeitos, pois possibilitam, respeitando os limites éticos, a garantia de participação decisória no grupo, através de estratégias e treinamentos de habilidades com competências claramente definidas, que favorecem o empowerment e o protagonismo dos sujeitos. Desse modo, este trabalho objetiva identificar estratégias no âmbito da promoção da saúde na ESF, que contribuam para melhor autonomia e qualidade de vida dos sujeitos com diabetes mellitus, a partir de sua percepção. E, mais especificamente, analisar o perfil clínico e socioeconômico dos portadores de diabetes da ESF; identificar as experiências, necessidades e expectativas dos sujeitos com diabetes sobre autonomia, autocuidado e qualidade de vida; e realizar um levantamento em conjunto com os sujeitos com diabetes, sobre aspectos que sirvam de evidências para construção de propostas para implantação de um Grupo Estratégico de Promoção da Saúde GEPS, com foco na autonomia. Para isto, foi realizada uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, com 65 sujeitos com diabetes acompanhados por uma Unidade de Saúde da Família do Município de Santa Cruz/RN. A pesquisa foi realizada em três etapas interdependentes: 1) coleta de dados clínicos e socioeconômicos, para o qual foi utilizado entrevista estruturada e análise retrospectiva dos registros feitos em seu prontuário; 2) a análise das experiências, necessidades e expectativas dos sujeitos sobre autonomia, autocuidado e qualidade de vida, que se utilizou de entrevista semiestruturada com 6 sujeitos, sendo 3 com mais e 3 com menos complicações autorreferidas e verificadas no prontuário; e 3) a construção coletiva de propostas para melhor autonomia e qualidade de vida dos próprios participantes do estudo, por meio de roda de conversa. Para a análise dos dados utilizamos software de estatísticas simples para os dados das questões fechadas de cunho quantitativo e os dados qualitativos foram analisados através da análise de conteúdo. Observamos que o perfil clínico e socioeconômicos dos sujeitos com diabetes aproximam-se das estatísticas nacionais, embora existam variáveis, como cor da pele, com variação significativa. A autopercepção dos sujeitos diante de algumas complicações divergem de registros encontrados em seu prontuário o que aponta uma possível desvalorização de queixas como hipoglicemia e disfunção sexual, como também baixa adesão ao tratamento por, muitas vezes, não terem suas opiniões valorizadas. As categorias encontradas: vida, qualidade de vida, diagnostico e enfrentamento do problema, autonomia, limites e dependência assim como as práticas coletivas de promoção da saúde, apontam para a necessidade de estratégias por meio de grupos que considerem as crenças e valores dos sujeitos, favoreçam sua emancipação e torne-os protagonistas de sua própria história e de seu processo saúde doença. A autonomia é fundamental para o exercício da cidadania efetiva. É por meio dela que os sujeitos transformam sua realidade e a si mesmo. A contribuição desta pesquisa consiste em identificar estratégicas que se propõe a potencializar a autonomia dos sujeitos, através dos GEPS, norteando a atuação dos profissionais na atenção primária à saúde, que deve sustentarse em ações de prevenção e promoção da saúde e também no incentivo à participação popular e protagonismo dos sujeitos

Limites e possibilidades da educação em saúde na estratégia de saúde da família de Pau dos Ferros/RN

A Estratégia Saúde da Família (ESF) apresenta-se como um espaço privilegiado para a efetivação de práticas de educação em saúde orientadas pelo diálogo entre o saber científico e o saber popular, uma vez que é nesse espaço de saúde que profissionais e indivíduos/família se interrelacionam, criam vínculos, dialogam e constroem soluções para o enfrentamento dos problemas de saúde da população. O objetivo geral deste estudo foi analisar os limites e as possibilidades de efetivação da educação em saúde voltada para a coletividade na ESF de Pau dos Ferros/RN. Nesse sentido, buscou-se conhecer as concepções de educação em saúde dos profissionais de nível universitário da ESF; observar onde as práticas de educação eram desenvolvidas; conhecer os conteúdos e metodologias utilizadas para a efetivação das práticas de educação em saúde e caracterizar os espaços onde tais práticas eram desenvolvidas. Trata-se de uma pesquisa qualitativa, de caráter descritivo-exploratório realizada junto a nove equipes localizadas na zona urbana do município. Foram investigados 28 profissionais que atuam nessas equipes, dentre os quais elencamos: quatro médicos, oito enfermeiros e dezesseis cirurgiões dentistas. Fez-se uso da entrevista semiestruturada e da observação baseada em princípios etnográficos. Os dados foram analisados com base na técnica de análise de conteúdo de Bardin. O estudo obedeceu aos aspectos éticos contidos na Resolução 196/96 que regulamenta as Pesquisas Envolvendo Seres Humanos. Os resultados apontam que as concepções e práticas de educação em saúde dos profissionais da ESF são orientadas por uma educação bancária , pautadas pela transmissão e reprodução de conhecimentos. As temáticas são desenvolvidas de forma verticalizada, dissonantes da realidade de vida e saúde dos usuários. As práticas educativas são ofertadas majoritariamente por enfermeiros e estudantes de graduação em estágio na USF. Em sua maioria não são planejadas em equipe, e estão direcionadas à prevenção de doenças, distanciando-se da promoção da saúde. As principais dificuldades apontadas para a efetivação da educação em saúde dizem respeito à dificuldade de trabalhar em equipe, à falta de apoio da gestão, à estrutura física inadequada e a pouca adesão dos profissionais as práticas educativas. Portanto, a educação em saúde praticada na ESF não consegue instrumentalizar os sujeitos para que estes tenham autonomia e possam tornar-se sujeitos de suas vidas, de sua história. A prática educativa centrada na transmissão de conhecimentos ainda é uma realidade presente na ESF, constituindo-se em um desafio a ser superado

O trabalho profissional dos(as) assistentes sociais no INSS pós as contra-reformas da Previdência Social

The present research study the work professional of the Social worker in the National Institute of Social Security of Rio Grande do Norte s State, especially about the working terms, the demands and working process of Social worker in consequence of the limits established with disorganization of his institutional space derived of the Counter-Reforms of the State and of Social Security. In decade of 1990 there was in Brazil adhesion to the neoliberal politics what configured a new organization of work and a new performance of the State. Inside this context, it was accomplished the Counter-Reforms with emphasis in the privatizations, reform of the Social Security and of the device of the Brazilian State, among other actions. Particularly, in Social Service reforms brought profound consequences for the Social workers of INSS, among it: reduction of professionals and in his institutional space. This study situates the Social Worker of Social Security in front of the contemporary modifications in the world of work as well as in front of the consequences come upon of the Counter-Reforms implemented and executed by the neoliberal governments in the country of way the of frame and to enter to the globalized world and the new order of the capital. From the qualitative research based in the critical and dialectic theoreticianmethodological perspective that study the phenomena from your relations, mediations and contradictions, was possible unveil the limits and the possibilities of the professional work of the Social worker in INSS placed the Counter-Reforms of Social Security. Synthetically, the results of this investigation indicate that, there is an worsening in the inconsistency of the work with relation to social worker's functional situation and his working terms in the institution

A gestão do Sistema Único de Assistência Social em Currais Novos (RN)

The present paper analyses the social assistance management in small cities, starting from the reality of Currais Novos City. Its main objective is to analyse the management of this politic in the context of the Nacional Sistem of Social Assistance (SUAS) through the management instruments materialized in the city: Social Assistance Plan, Budget, Management Report, Information Management, Monitorizing and Evaluation. It reveals a discrepancy between the instruments purpose and their concretude, and it identifies the main challenges in order to make them real, revealing the contradictions of such politic, through which the advances relate with the retrocesses. It remarks, in this context, the debate about Public Management and some aspects of the trajetory of the Social Assistance management in the brazilian context and the configurations of (SUAS) and of the politics in Currais Novos city. Such path allows us to identify the feebleness in the city ways to adopt the (SUAS) criteria, which is much more effective in burocratic aspects than in the change of the Social Assistance conception and in the effective incorporation of the (SUAS) principles and guidelines. Thus, problems are identified in what concerns to the important aspects for its effectivation, with the human resources, financing and social control mechanisms. It makes possible to reafirm the importance of the analysed management instruments for the effectivation of one participative and democratic management, as well as the urgency of its materialization as one of the important ellements for this politic to happen as a right and to make a stop to the unconformities between the (SUAS) determinations and its materialization