A incorporação da saúde bucal no programa saúde da família do Rio Grande do Norte: investigando a possibilidade de conversão do modelo assistencial

The Health Family Program (HFP) was founded in the 1990s with the objective of changing the health care model through a restructuring of primary care. Oral health was officially incorporated into HFP mainly through the efforts of dental professionals, and was seen as a way to break from oral health care models based on curative, technical biological and inequity methods. Despite the fast expansion of HFP oral health teams, it is essential to ask if changes are really occurring in the oral health model of municipalities. Therefore, the purpose of this study is to evaluate the incorporation of oral health teams into the Health Family Program by analyzing the factors that may interfere positively or negatively in the implementation of this strategy and consequently in the process of changing oral health care models in the National Health System in the state of Rio Grande do Norte, Brazil. This evaluation involves three dimensions: access, work organization and strategies of planning. For this purpose,19 municipalities, geographically distributed according to Regional Public Health Units (RPHU), were randomly selected. The data collection instruments used were: structured interview of supervisors and dentists, structured observation, documental research and data from national health data banks. It was possible to identify critical points that may be impeding the implementation of oral health into HFP, such as, low incomes, no legal employment contract, difficulty in referring patients for high-complexity procedures, in developing intersectoral actions and program strategies such as epidemiologic diagnosis and evaluation of the new actions. The majority of municipalities showed little or no improvement in oral health care after incorporating the new model into HFP. All of them had failures in most of the aspects mentioned above. Furthermore, these municipalities are similar in other areas, such as low educational levels in children from 7 to 14 years of age, high child mortality rates and wide social inequalities. On the other hand, the five municipalities that had improved oral health, according to the categories analyzed, offered better living conditions to the population, with higher life expectancy, low infant mortality rates, per capita income among the highest in the state as well as high Human Development Index (HDI) means. Therefore, it is possible to conclude that public policies that include aspects beyond the health sector are decisive for a real change in health care models

Os significados do tabagismo construídos na dinâmica social

The present study has the purpose of catching the significances of smoking in the social dinamics based on the Theory of Social Representations. It was developed among adults with ages from 20 to 59 years, low social and economic conditions, at Natal RN, Brazil. The Free-words Association Test was applied as the instrument of data collection and a semi-structured interview with the smokers and non-smokers, besides a structured interview with smokers, non-smokers and ex-smokers. All data was analyzed by the descriptive statistics using the Analysis of Content Technique of the thematic kind and by the softwares ALCESTE and EVOC 2000. Elaborations about smoking were marked by social, cultural and historical dimension, however they showed sensibility to changes and revealed positive and negative aspects of the habit. The analysis of the semi-structured interviews showed the following categories and under-categories respectively: Initiation of the habit (Friends and Family and Appreciation and Beauty); Psychosocial Implications of smoking (Personal relationship, Work and Financial); Behavior when facing smoking (Positive, Negative and Neutral); Smoking Effects (Smokers´ health and the other people health); Description about oral diseases ( Bad breath, Oral cancer and Dental problems); Smoking treatment (Physician and psychological, Supernatural and Difficulties). ALCESTE analysis presented 4 classes: Ambivalence between pleasure and get ill, Smoking as a trouble and danger to society, Social discrimination of smokers and Mouth as a place of reaffirmation of the discrimination. Those helped us to understand the psychosocial repercussion of the habit. On the social representation structure we identified as a probable central nucleus of the smoker group the categories Pleasure and Bad to the health and as peripheral elements Alcoholic Drink, Financial damage and Nervousness. For the non-smoker group the category Bad to the health comes first and Stop Smoking comes as a peripheral element. Finally, we hope that the knowledge of these representations can contribute to plan and/or to rethink over the professional practices and public policies related to smoking. Besides that, for an amplified comprehension of the study object the discussions over the identified representations should be deepen and amplified to other population and social groups

Atividades preventivas realizadas pelos cirurgiões-dentistas do PSF de Natal-RN

Family Health Program (FHP) presents itself as a restructured model on basic cares besides having prevention practices and promotion in health as essential parts. According to that, the purpose of this study is to perceive which prevention practices in oral health are accomplished by the dentists from the FHP of Natal-RN as well as the way they have been developed, the knowledge basis to execute the procedure and the use of evaluation instruments by the dentists and by the Oral Health Co-Ordinator. A list of dentists participating on the FHP of Natal in March, 2006 (n= 91) was obtained so it was possible to formulate a structured interview. After excluding those with less than six months attending to the program, and considering the loss, eighty dentists got to be interviewed. It had questions about individual and group preventive procedures, sources of basement to develop the activities and to verify the impact and evaluation instruments. Besides that, an interview was made with the Oral Health Co-Ordinator about the evaluating process and the existence of a protocol as well as about document analysis in the Ambulatory Informations System Unique Health System (AIS-UHS), Information of Basic Care System and Pact of Recorder. The main individual activities consist on Oral Hygiene Orientation (87,5%) and Fluoridization (95%). Group activities remain at scholar groups acts(91,25%) being fluoridization done by 91,25% and educative activities by 86,25% mainly through speeches (61,25%).Orientations about oral cancer were detached on the aged group (39,96%)and hypertensive and diabetic group (19,51%), as well as integration with the health team was respectively 21,93% and 39,02%. Speeches and talk rounds are the main activities for aged, hypertensive and diabetics, and are also expressive to pregnant women. For pregnant women and babies group predominate hygiene and diet orientation. About the evaluation instruments 73,75% of the dentists do not consider their existence, despite 73,75% consider that actions have impact specially due to a increase of hygiene and decrease of caries index on the children. The main sources of basement are clinical experience (42,5%) and preparative courses (33,75%), only 7,5% mentioned population need and local reality. The Oral Health Co-Ordinator related the Attention Pact Recorder and records from the AIS - UHS as evaluation source but also detached the lack of epidemiologic surveying. She mentioned the increase of supervised brushing as a positive result and detached the hardness of the professional to act inside the family and as a team. The AIS-UHS records showed that fluoridization is more used individually and the supervised brushing is predominant as a group action, besides that educative activities at the Health Establishment predominate due to actions at the community. Facing the results, it was verified the act in different groups, special attention given to scholars, as well as focus the activities on caries giving less emphasis to other oral problems. Despite that, there was no epidemiologic instruments or data of the local reality to guide the actions and to be part of the planning and evaluation process

A educação em saúde pública na práqtica cotidiana: atuação dos cirurgiões-dentistas do PSF de Natal-RN

Considering education a support to health promotion, care integration and citizenship formation,the purpose of this research was to analyze the perception of the oral surgeons from the Family Health Program of Natal-RN over education in health as well as their performance as educators based on their activities on the program. A qualitative study was accomplished by a semi-structured interview and a Free Association of Words Test with 80 oral surgeons from the Family Health Program of Natal-RN. The instruments were analyzed through the meaning analysis and the Central Nucleus of Vergès Theory. The results showed a lack of planning in health actions so there is no standardization on the educative practices done by the oral surgeons which mostly are focused on scholars. There was an agreement among the group according to the oral surgeons´ perception about education in health that education is related to its function of recall prevention ideas to the population. Most part of the context units analyzed by the professionals´ speech show the knowledge of education in health as an inadequate behavior change instrument of the individuals. An interesting point was a quotation cited by some professionals that included actual themes such as citizenship, motivation and life quality, put inside the speech of education in health. To the oral surgeons the biggest difficulties on the development of the educative actions are due to the lack of incentive by the Municipal Health Bureau and to the detachment and lack of valorization of the themes by the population. The oral surgeons consider themselves co-responsible for the formation of a population which is able to request its health. They also mention the knowledge about the need of the community participation on the planning of the Family Health Program actions. Finally, it is notable the need for more encouragement so the oral surgeons can be more capable and have more interest in applying education in health on the perspective of a new model in health, because once capable and stimulated they can awake the population to education importance as a great transformation instrument for people searching for a fair, equalitarian and citizeness society

Ecologia alimentar e comportamento de forrageamento de Ameivula aff. ocellifera (Squamata: Teiidae) em área de caatinga do nordeste do Brasil

This study investigated the influence of intrinsic and extrinsic factors on the feeding ecology and foraging behavior of the whiptail lizard Ameivula aff. ocellifera, a new species widely distributed in the Brazilian Caatinga, and that is in process of description. In attendance to the objectives, the Dissertation was structured in two chapters, which correspond to scientific articles, one already published and the other to be submitted for publication. In Chapter 1 were analyzed the general diet composition, the relationship between lizard size and prey size, and the occurrence of sexual and ontogenetic differences in the diet. Chapter 2 contemplates a seasonal analysis of diet composition during two rainy seasons interspersed with a dry season, and the quantitative analysis of foraging behavior during two distinct periods. The diet composition was determined through stomach analysis of lizards (N = 111) collected monthly by active search, between September 2008 and August 2010, in the Estação Ecológica do Seridó (ESEC Seridó), state of Rio Grande do Norte. Foraging behavior was investigated during a rainy and a dry month of 2012 also in ESEC Seridó, by determining percent of time moving (PTM), number of movements per minute (MPM) and prey capture rate by the lizards (N = 28) during foraging. The main prey category in the diet of Ameivula aff. ocellifera was Insect larvae, followed by Orthoptera, Coleoptera and Araneae. Termites (Isoptera) were important only in numeric terms, having negligible volumetric contribution (<2%) and low frequency of occurrence, an uncommon feature among whiptail lizards. Males and females did not differ neither in diet composition nor in foraging behavior. Adults and juveniles ingested similar prey types, but differed in prey size. Maximum and minimum prey sizes were positively correlated with lizard body size, suggesting that in this population individuals experience an ontogenetic change in diet, eating larger prey items while growing, and at the same time excluding smaller ones. The diet showed significant seasonal differences; during the two rainy seasons (2009 and 2010), the predominant prey in diet were Insect larvae, Coleoptera and Orthoptera, while in the dry season the predominant prey were Insect larvae, Hemiptera, Araneae and Orthoptera. The degree of mobility of consumed prey during the rainy seasons was lower, mainly due to a greater consumption of larvae (highly sedentary prey) during these periods. Population niche breadth was higher in the dry season, confirming the theoretical prediction that when food is scarce, the diets tend to be more generalized. Considering the entire sample, Ameivula aff. ocellifera showed 61,0 ± 15,0% PTM, 2,03 ± 0,30 MPM, and captured 0,13 ± 0,14 per minute. Foraging mode was similar to that found for other whiptail lizards regarding PTM, but MPM was relatively superior. Seasonal differences were verified for PTM, which was significantly higher in the rainy season (66,4 ± 12,1) than in the dry season (51,5 ± 15,6). It is possible that this difference represents a behavioral adjustment in response to seasonal variation in the abundance and types of prey available in the environment in each season

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

Comportamento sócio-espacial de pessoas em movimento :um estudo exploratório no calçadão da Avenida Engenheiro Roberto Freire

People-environment interaction, focus of Environmental Psychology studies, presupposes that space influences behavior and vice-versa. Despite of the importance of dynamic reciprocity, there are a few works that treat the mobility condition of the people experimenting space. The present study investigates environmental perception of users of the Engenheiro Roberto Freire Avenue sidewalk, one of the few places in Natal for physical activities practicing, where most people are in intense and continuous movement. A few questions for this study where made: In what way does the individual realize the environment while he is moving? How do reciprocal man-environment relations occur there, according to a mobility context? What are the main difficulties and easiness in man-environment interaction under this condition? The search for these answers is based on concepts of social-spatial human behavior - especially personal space, territoriality, density and crowding and contributions of Barker´s Ecologycal Psychology. Considering that the physical space in this case is multifaceted and the perception of theses scenarios is governed by multiples senses and stimuli, it was defined a multi-methodological route: (i) observation participative in loco; (ii) identification of the main behavior settings at the area; (iii) categorization of the activities occurring at the place; (iv) application of a semi-structured interview; (v) images registered and (vi) construction of the researcher s log. The perception of oneself and others in movement in the environment, immersed in a intricate web of inter-actions, makes people develop mobility strategies, many times unconsciously, with the aim of ensuring satisfaction in its activities. Since the Eng. Roberto Freire Avenue sidewalk is an equipment public-urban largely used by the population of Natal, the reflection of the mobility effectiveness in the users environmental perception is expected, providing suggestions for future studies in this field of knowledge

Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

Sexo não é brincadeira: o sentido de infância para adolescentes inseridas na exploração sexual comercial

The childhood has being highlighted by the great concern about the several contexts in which children are inserted, amongst them, commercial sexual exploitation (CSE). The experience of this violence process brings implications to the person constitution. Thus, this research aimed to understand how commercial sexual exploited adolescents to signify the childhood. Participated of this research four female adolescents that had been assisted by Programa de enfrentamento ao Abuso e Exploração Sexual de Crianças e Adolescentes (Sentinela) , with ages between 12 and 17 years. The corpus was composed by the combination of the semi-structured interview and other procedures, like childish stories, draws and photography. Moreover, we used another instruments to constitute the corpus, like the documental research and we proposed the construction of a life story book of each participant. The corpus was analyzed through the Thematic Content Analysis. Five thematic axes emerged from the participants discourse and theoretical perspective: dynamical of family, scholar process, ludic behavior, conception of childhood and insertion on CSE process. The participants presented a conception about childhood as been a preparation and education phase to ingress in adult life. In other words, while children do not grown up, they go to the school, plays, lives with family, are happy and do not have any responsibilities. Nevertheless, the life experience of these girls was implicated by negligence, sexual abuse, child labor, institutionalization and, evidently, the commercial sexual exploitation. Understanding that the childhood experienced by adolescent, as well as, her insertion on CSECA, constitutes her, while person, we investigated how the interrelation expresses it on participants future perspectives. Their goals are defined based on family constitution and professional improvement, although feelings of disillusion and pessimism had been showed up in some moments. According these results, we pointed to the necessity of the effective proposals that promote real improvement of adolescents life quality, through, in which they could to create alternatives to get over the several risks in which they are exposed, mainly, the CSECA condition

Prática de coordenação pedagógica e concepções acerca da atuação em psicologia escolar: desvendando um contexto, repensando caminhos

Considering the necessary approaches with the quotidian of the pedagogical field mentioned in the recent productions in Psychology about the insertion of psychologists in the school field, the objective of this work was to know and to understand the dynamics of functioning of a team of pedagogical coordination, intending to produce reflections on the possibilities of action in school psychology with these professionals. Our field of research was the Municipal School Teacher Emília Ramos (EMPER), considering its peculiar history, distinguished by a constant effort of achievement of the school success by its pupils. As subject of the study, six pedagogical coordinators participated, who worked at the school in the diurne turns, where regular classrooms of 1º cycle of basic education functioned. As procedures, we use participant observations and open interviews, focusing the activities performed by the coordinators and its possible demands to psychology. We use the analysis of content for the production of results. These results evidenced a work of coordination realized on a structured routine, but flexible, centered around the activity of conduction of groups of studies with the teachers. We grouped the demands to psychology in four thematic groups: diagnosis and attending the pupils; orientation to the families, contribution in the formation of the professionals and clinical listening of the professionals of the school. In this way, it is made clear that, in a context where happens a well articulated and consistent pedagogical work, the possible performance in school psychology is not scrumbled or confused with social and pedagogical practical others which many times takes attendance. With these information, we expect to contribute for the theoretical and practical elaborations, in Psychology and the Pedagogy, compromised with the success of the educative work realized in the public schools

Infância na publicidade: um estudo sobre o trabalho de crianças na publicidade na cidade de Natal-RN

In Brazilian scene the child labor is a serious and relevant theme regarding issues that involve infancy, arousing the interest and concerning of public and private institutions, and organized civil society. Thus, the child labor is forbidden by the law, considered that the child worker have a distinguished life experience, especially because it is demanded them the early mature of some skill, generating implications on their physical, emotional, cognitive, social and psychological development. Observing those issues, we proposed think the child labor, over and above those considered the worst forms of one and more found in literature, what lead us to think the child labor in the advertising. In that way, this research aimed to investigate the insertion and development conditions of children who work in advertisements, and the possible effects on their lives in the face of that insertion. Participated of this study: three advertising agencies, six video producers companies, one child model s agent and five children with their respective families. Those children were four boys and two girls, with ages between seven and eleven years old, which one that have accomplished four or more advertisements, in Natal city, Rio Grande do Norte. Based on social-historical perspective, we used the semi-structured interview as methodological instrument, which underlays the comprehension of the data obtained in field research processes. This study revealed that when children are inserted in the advertising activities they are submitted to irregular and adverse work situations, what occurs in others productive activities mentioned in the literature. The data still exposed that the family is the main responsible to the children insertion in the advertisement work; moreover, there is an ambiguousness of wishes in relation of that activity. On the other hand, we realized that the legal content concerning to the child labor forbidding, carries contradictory aspects in face of the ECA s 149 article, that one, under some conditions, allows that a child take part in the activities of advertising context. This highlights the necessity of a rigorous evaluation of the children insertion in the advertising, in order to ensure the whole children and adolescents protection. This study put in evidence the complexity that involves the child labor in this context, mainly, due to the exposition and manipulation of the childish image on the media. Besides, we understand that the discussion on this subject should be stimulated and, therefore, enlarged this on over and above those considered the worst forms of child labor

Dependência química em mulheres :um estudo sobre o consumo de medicamentos ansiolíticos no serviço público de saúde de Natal/RN

This work was concerned to investigate the meaning attributed to anxiolytic drugs by women, in public health service. It proposes a joint analysis through a link between three dimensions: the woman, the drug, and public health service itself, in an hegemonic medical assistance model. It is observed that the relation between these elements has a great influence over the use and construction of a particular meaning, by the user. The medication is analysed as a consumption merchandise and as an health symbol. In this way, it reflects a biologized vision, which believes the drug as a solution for all health problems. It tries to analyse the generalized medical prescription for anxiolythics and it s consequences. It focalizes also the production and utilization of public health services by patients, mainly women. The question related to the use of anxiolytics and the meaning construted by women is analysed focusing the way that relations of masculine/feminine gender are organized in our society. At this point of view, it tries to understand the dimension that these questions have in subjectivity production, and how it acts in the health/disease process. Finally, this work tries to understand, in a broad sense, the use of anxiolytics looking at the problem not only as a biological question, but also as a cultural matter. The research was done over seventeen women, all of them anxiolytic users. It was used, as research instrument, semi-structured interview associated with methodological analysis of user s speeches

Produção de subjetividade em trabalhadores rurais na condição de luta pela terra no Rio Grande do Norte

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

A auto-estima da criança que sofre violência física pela família

This research investigates the self-esteem of children who suffered physical violence by family members. Seven children took part in the research: three boys and four girls, aged between six and twelve years old. The analysis were done from the constructed data obtained from: semi-structured interview, activities about human feelings, activities that included facial expressions, unfinished phrases, Pinocchio s story, a drawing of a family and a drawing of their own family. Data were analyzed from the Content Analysis. The Thematic Units were: violence, intrafamily violence, and self-esteem. The synthesis of the categories studied evidenced that the physical violence and the psychological violence present in the lives of children affect the positive development of their self-concept and, consequently, of their self-esteem. Among the results, we emphasize some negative feelings that are present in children s lives such as fear, a sense of guilt, and sadness, arising out of the situations of violence they have experienced

Terceiro setor em HIV/AIDS: mapeando o ativismo social na contemporaneidade

The struggle against AIDS is a kind of action in favor of life and the organized Brazilian civil society incorporated it in a meaningful dimension. This struggle matured the creation of non-governmental organizations (NGOs) and advanced with the discoveries about the disease. Since the very early 90 s, the consolidation of the partnership involving the movement anti-aids with State came up with a dilemma for the entities of civil society: are they just executors of governmental policies or do they take up the role of effective demands concerning public policies? Since then, activism against aids started to stand for execution of projects and one considers that the institutional way of anti-aids work has problems because it constructs a basic strategy to take off the political aspect of the third sector. The NGOs/aids consolidate the reconfiguration of capital and get far from street activities. This is important to be studied because the relationship between society and aids, contemporarily, can prevent them from accomplishing their agenda referring to political mobilization and collective resistance. This research started to be carried after some visits, previously arranged, to an institutional life support group called Grupo de Apoio à Vida-GAV, in Campina Grande. A semi-structured interview was applied to 31 users and to 6 technicians of the entity mentioned. One aimed at investigating the activist anti-aids practice, identifying the conceptions of activism and knowing how social actors assess those practices. Preliminary results indicate that one of the conceptions on activism among the interviewees refers to the execution of projects through partnership of NGOs and supporting institutions, governmental or non-governmental. Although this new conception on activism consolidates a non-political aspect, there are other ways of executing projects and participating actively, according to some users, such as: meetings, lectures and other sorts of events promoted by the group, which are also legitimate actions representing anti-aids activism at the present context