Discursos e práticas na formação de profissionais fisioterapeutas: a realidade dos cursos de fisioterapia na região nordeste do Brasil

This study had a multidisciplinary focus, investigating the areas of health and education, and proposes to discuss the formation of health professionals, requiring their understanding of the factors involved in the production of knowledge, given that this formation has an impact on the quality of human and social life. The aim of this work was to investigate the relationship existing between the process of physical therapist formation and the practical activities developed during the undergraduate course in the Northeast of Brazil. This is an exploratory descriptive study with qualitative significance. The sample consisted of 73 subjects (33 professors and 40 students) from 6 physical therapy courses at different institutions in the Northeast of Brazil. Data collection was conducted through focus group interviews. In addition, we used a school assessment instrument from the health area. The data, analyzed using dialectical hermeneutics, showed that the Northeast of Brazil has the second largest number of physical therapy courses in the country, with 93 (11 public and 82 private) out of a total of 510. These numbers represent a growth of 1062.5% since 1991. The pedagogical projects are guided by National Curricular Directives as well as by the country s health system. The prevalent pedagogy is that of transmission, and the contents/disciplines are generally not integrated with practice, a situation that hinders the integrality and interdisciplinarity of health care. It can be concluded that there is a need for implementing integrated curricula and for better qualified professors to effectively put this process into practice

Atuação dos profissionais de saúde no atendimento à criança vítima de violência

This study had the purpose of identifying the health professional performance during the care of children victimized by violence. Its objectives were the evaluation of how health professionals diagnose violence on the hospitalized child during the care process; the identification, according to the experience of each health professional, of the types of violence on the hospitalized child, the child's aggressors and the most frequent1y injured area in the body and the analysis of conducts adopted by health professionals upon the recognition of a violence case on a hospitalized child. The study was of the descriptive-exploratory type, using a quantitative approach, performed on Hospital da Criança Santo Antônio (HCSA) in Boa Vista - RR. The population consisted of 235 health professionals, with data collected from June to August 2006. The results show a clear predominance of the female gender, (76,17%); aged 31 to 35 (26,81%); married (45,96%). As for professional formation, 63,9% were nursing auxiliaries and technicians,16,2% physicians, 14,8% nurses, 3,9% social assistants and 2,1% psychologists; 45,96% had completed middle-level education, 51,06% of which coming from private education establishments and 48,94% from public education institutions.; 97,66 % have specialization or improvement courses on their area; 32,77% among 05 to 09 years of work time; 32,06(10 worked on pediatric infirmaries; 75,74% state they have experience with children victimized by violence; 96,22% consider themselves capable of identifying the types of violence suffered by children; 29,00% consider physical violence the most common kind; 91,57% sought to identify the aggressors; 27,72% consider the mother to be the child's main aggressor, 26,36% the father, and 22,28% the stepfather; 26,55% consider the limbs and pelvic waist to be the body region most affected by violence; 26,91% take the attitude of reporting to the nurse and 20,13% to the social service; 70,79% state that the conducts were performed as a team; 26,25% of the professionals consider that the social assistants helped the most on deciding which conduct to adopt; 76,40% state there was no one opposed to the performing of these conducts; but 23,60% that stated there was no one opposed to the performing of these conducts, 77,08% reveal that the family members were against the conducts taken by the team. We conclude that, the hea1th professionals who were part of the study, apparently are not adequate prepared to diagnose and report the violence on child. The results were more drastic when we related the physicians and the nurses' answers, considering that they give directed assistance to these victims social assistants and psychologists are the ones best prepared to conduct cases of child mistreatment. However, we are conscious of our responsibility with professional education not only in upper grade institution but also on the middle-level. We believe also, that a continued education program can help to improve the professional knowledge and improve the quality of care

Análise de redes do cotidiano a partir do encontro entre usuários e profissionais da estratégia saúde da família

O presente estudo discute a formação de Redes Sociais no cotidiano da Estratégia Saúde da Família, a partir de aportes da teoria sociológica sobre redes, interações, dádiva e reconhecimento. O objetivo geral é analisar as redes sociais locais em saúde a partir da interação de usuários e profissionais da Estratégia Saúde da Família na Unidade de Saúde de Ligéia, em Natal, RN. Seus objetivos específicos são: Mapear as redes sociais locais em saúde existentes no território adscrito; Identificar os tipos de interações cotidianas entre os sujeitos; Compreender a percepção dos sujeitos sobre o processo de formação de redes sociais a partir das interações. Caracteriza-se enquanto pesquisa qualitativa exploratória cujos sujeitos foram profissionais e usuários vinculados à referida unidade de saúde. Para a coleta de dados foram utilizadas entrevistas individuais semiestruturadas e debates em grupos focais, estimulados pela Metodologia de Análise de Redes do Cotidiano (MARES), pertinente para abordar a complexidade das relações sociais e mapear os diferentes conteúdos expressos e as formas de mobilização coletiva. A análise dos dados foi realizada através da Técnica de Análise Temática de Conteúdo, proposta por Minayo. Os resultados foram interpretados à luz das Teorias da Dádiva (Mauss) e do Reconhecimento (Honneth). Os sujeitos visualizaram: Rede Virtual (28,20%); Rede de Atenção à Saúde (25,64%); Redes de Usuários (17,95%); Rede Pessoal (10,26%); Conselho Comunitário (10,26%); Escolas (7,69%). Os participantes não perceberam os arranjos familiares enquanto Redes Sociais. Os tipos de interações sociais identificadas foram: Confrontação/Negociação (41.02%); Harmônicas (25,70%); Correlativas (17,90%); Definidas pela Organização (15,38%). A formação de redes sociais ocorre a partir de interações cotidianas entre pessoas, pela articulação inseparável de conteúdos e formas, catalisadas pelo contexto, experiência e cognição, valorizando a liberdade, a expressividade e a diversidade dos parceiros de significação. Foram encontradas duas categorias, na percepção dos sujeitos, sobre a formação de redes sociais do cotidiano: Diálogo e Encontro. Validamos e recomendamos o uso da metodologia MARES: Na formação, para despertar uma visão mais tolerante e humana de si e do outro; Na avaliação qualitativa dos serviços, por facilitar a reflexão sobre a prática e (re)organização do processo de trabalho; Na comunidade, para estimular movimentos sociais existentes ou emergentes. A aposta no circuito da dádiva e do reconhecimento recíproco, durante o trânsito nas redes sociais em saúde, pode ser capaz de tecer uma práxis transformadora, pela busca e alcance de confiança, respeito e estima, nos espaços de encontro entre usuários e profissionais da Estratégia Saúde da Família

Lixo hospitalar: na estrutura curricular de cursos superiores de saude na cidade de Imperatriz – MA

SILVA, Dany Geraldo Kramer Cavalcanti e et al. Lixo hospitalar: na estrutura curricular de cursos superiores de saude na cidade de Imperatriz-MA. Educação Ambiental em Ação, v. 27, p. 00-10, 2009.

Saúde bucal no programa de saude da família: o caso do distrito sanitário norte em Natal - RN

The inclusion of the dentist in the Family Health Program (FHP) teams designates a reorganization of the mouth health care in your country and establishes a new scenario in Brazilian odontology, through of a new way to organize the basic health care, creating conditions to consolidate in mouth health practice actions, in the level of the basic attention, the validation of Unique Health System (UHS) constitutional principles. The purpose of this research is to verify if the actuation of mouth health teams (MHT) dentists, in Natal city north sanitary district, is tuned with FHP goals.The target research population was composed by all dentists working in Basic Health Units (BHU) of Natal north sanitary district. Fifth-eight questionnaires were applied and using open and closed questions we look for identify the functional characteristics of each BHU, the dentists professional attributions on each BHU, as well as the clinical procedures that they execute. This research also searched to identify the factors that facilitate and/or difficult the inclusion process and the dentists activities performance on these BHUs, as well as the necessary actions to north sanitary district MHTs to fulfill the objectives proposed by FHP. The results point that the inclusion of mouth health actions in north sanitary district FHPs brought the incorporation of new values to the used practices. Whoever, its necessary a more frequent evaluation of the carried actions, in a way they can be adapted to the real community necessities, and, is fundamental the data accompaniment, for that these serve of base for planning and redirecting activities, in a way that we do not have only a reproduction of traditional practices, fragmented and isolated, but a truly substitution of the traditional practices and a new way of promoting health

Gestão democrática nas escolas: a atuação dos diretores escolares e os desafios para sua consolidação na rede municipal de Natal/RN

The democratic management is a challenge for education, on the one hand for its actualization needs a link between the government and the educational institution. From that, research aims to understand the main challenges faced by the school administration to consolidate the management of public schools in Natal/RN. Against this context the methodology used was multiple cases, qualitative approach in which respondent were manager (director, deputy director and coordinator) of the four municipal schools and two representatives of the Democratic Management Commission of a Government departament of Education, Natal/RN. The analysis was made by peers, between schools that had grade superior IDEB that average stipulated by the federal government and two that had grade lower and between managers and representatives of the Secretary. Were used techniques of categorization and content analysis of the speeches of respondents. Was note that managers understand the importance of the participation about whole community in the democratic management, however only one school highlighted means of attracting the parents against to the difficulty of representing these. The lack of knowledge about the democratic management is evident mainly in the pair of schools with lower IDEB. That schools with a lower IDEB adhere to this management as a way to meet rules. So unanimous, the broad role of director hampers knowledge about the legislation. About relationship of the Government department with managers, there are some contradictions between the understanding of the role of the coordinator by managers and representatives of the Government department. It was perceptible the no uniformity about a good relationship between managers and Government department. It was notable features of democratic management in all school units, well as the efforts of the Government department in this scope. However there are also undemocratic features that deserve further study

Prevalência de oclusopatias e caracteríticas cefalométricas e dentais de escolares cearense da cidade de Fortaleza

The people of Ceará state are descended from miscegenation between the Portuguese colonizers and the native population, resulting in a different facial pattern from other populations. It is important that this pattern be thoroughly understood, along with its minimum and maximum values so that they can be assessed and respected, allowing professionals who deal with the craniofacial complex to work more efficiently and scientifically. Aim: To characterize the morphological pattern of individuals from Ceará state, whose father and grandfather are also native from Ceará, in the 10-12 year age group, not submitted to previous orthodontic treatment, in order to determine: 1) the prevalence of occlusal pattern; 2) the prevalence of dental anomalies (DA) and, 3) the skeletal and dental cephalometric characteristics of individuals that present with normal occlusion and harmonious facial pattern. Methodology: A list of 10-12 year-olds was obtained from 515 schools containing 162,713 students (Education Secretariat of Ceará State), from which 234 individuals were examined (107 boys and 157 girls). The assessment criteria adopted were: 1) Angle s Classification System to determine occlusal pattern. The occlusal characteristics were measured through overbite, overjet, crowding and interincisal diastema. 2) DA are anomalies of number, shape, size, eruption and structure and, 3) in the group that presented with normal occlusion, we used cephalometric analysis measures proposed by Downs, Steiner, Tweed, Holdaway, Jacobson and McNamara. Results: 1) 25.8% of the schoolchildren had normal occlusion, 47.5% class I malocclusion, 22.3% class II malocclusion and 4.2% class III malocclusion. No statistically significant difference was found between the age group studied and sex. Thirty percent of the individuals had normal overbite, while 36.7% and 19.7% had increased and reduced overbite, respectively. Normal overjet was found in 33.7% of the individuals, increased overjet in 50% and reduced in 16.3%. Dental crowding was observed in 62.5% of the individuals and the presence of interincisal diastema in 14.8%. 2) The prevalence of DA was 56.1%, 6.8% in the number, 10.8% in shape, 4.1% in size, 34.5% in eruption, 26.4% in structure and 17.4% had more than one DA. No association was found between DA and sex, but DA was significantly associated to malocclusion (p<0.05); 3) there was no association between sex or facial type between the measures of nasal-labial angle, position and effective maxillary length, effective mandibular length and the sagittal relationship between the molars, overjet and overbite, position of upper incisors, lower incisors and between the incisors themselves. There was a difference between sex, on the VERT index and in lower anterior facial height, upper incisor inclination and line-H, between facial types for the occlusal plane angles, mandibular plane, facial axis, lower incisor inclination, mandibular position, upper incisor position, lower anterior facial height, ANB and line-H. It was concluded that: 1) the most prevalent occlusal type was class I malocclusion, with no distinction for sex or age group, and the assessment of occlusal characteristics showed that excessive overbite and overjet were the most predominant findings, along with a high occurrence of tooth crowding; 2) a high prevalence of DA was found, particularly eruption anomalies, not influenced by sex but significantly associated to malocclusion and 3) individuals from Ceará are predominantly brachyfacial, exhibiting a number of similarities inherent to their facial pattern, such as a convex profile, retracted jaw, reduced lower third and protruded lower incisors. This study was multidisciplinary, involving researchers from the areas of epidemiology, radiology and dentistry, thereby meeting the multidisciplinarity requirements of the Postgraduate Program in Health Sciences

Prevalência de excesso de peso em pré-escolares na cidade do Natal

Obesity is currently considered a public health problem and there has been growing interest in the study of various aspects related to this infirmity such as: epidemiology, diagnosis, treatment, prevention and others. Thus, the purpose of this study was to determine the prevalence of weight excess and overweight in preschoolers in Natal, Brazil and relate them to variables such as gender, age, type of school (public or private) and zones of the city (east/south and north/west). This is a transversal study, carried out in Natal, Brazil between August and September 2004, in 20 public and 20 private schools/day care centers selected by the systematic sampling method. We measured the weight and height of 3721 students between the ages of 2 and 6 years. The children were stratified, according to age, into age group 1 (2 to 4 years) and age group 2 (5 and 6 years) and according to the region of the school, into north/west and east/south zones, the regions with the smallest and highest quality of life indices in the city, respectively. Children were considered to have weight excess when BMI ≥ 85th percentile, including those with BMI ≥ 95th percentile and overweight when BMI ≥ 95th percentile. The prevalence of weight excess was 26.5%, and of overweight 12.4%. There was greater prevalence of weight excess in the private schools and in the east/south zones. Overweight displayed the same epidemiologic profile, with a greater prevalence in private schools and in the east/south zones. The prevalence of weight excess in preschoolers in Natal, Brazil is high and is related, above all, to private schools and to those located in the highest quality of life areas. Therefore, prevention programs should be implanted in elementary schools in order to decrease weight excess and possible associated co-morbidities. This research project met the norms established by PPGCSa/UFRN and aimed at promoting the interrelation between different researchers and between different fields of knowledge, using multi and interdisciplinary concepts. This study was enriched by the interaction between the following professionals: pediatrician, pediatric gastroenterologist and physician nutrition specialist, pediatric endocrinologist, epidemiologist and biostatistician

A experiência da pré-eclâmpsia vivenciada por gestantes e profissionais de saúde

The aim of this study is to understand the perceptions of pregnant women, mothers and health professional about preeclampsia and the relation between professional and patient. A qualitative approach was chosen, together with semi-structured interviews, participative observation and Test of Free Association of Words (TFAW). The data were collected in February and June 2007 at Maternidade-Escola Januário Cicco (MEJC), Natal, RN, Brazil with 61 pregnant women and 87 professionals, 20 of each group were interviewed. An interpretative and understanding perspective was used similar to that of Gadamer s hermeneutics and with the construction of themes and empirical categories. The pregnant women showed fear preeclampsia and its consequences, and to know very little about the subject and also a desire to know more. The changes that occurred with the illness were more related to the emotional order than to the healthy lifestyle they have adopted. Some lack of preparation of the basic units was observed, in order to meet and guide the pregnant women to the reference unit. Professionals knew the customers characteristics, about their fear and about their little knowledge on this illness. Nevertheless, they did not include them in the treatment. It was observed the absence of conversation over the illness between professionals and patients and also the inability of the former to deal with emotional issues. A new way of looking into the preeclampsia assistance is necessary. A way that focuses on the collective construction of intervention and approach strategies; one which includes subjective aspects in an hermeneutic perspective of health

Avaliação da atenção à saúde de portadores de HIV no centro de referência para o tratamento da Aids em Natal/RN por profissionais e usuários do serviço

Objective: The aim of this study was to evaluate the health care of HIV/AIDS Reference Center for treatment of AIDS in Natal/RN for professionals and service users. Methods: This is an evaluative study with a quantitative approach, performed in the outpatient Giselda Trigueiro Hospital, in Natal (RN). The target population consisted of 313 patients with HIV and 34 professionals of the center. Data collection occurred from august 2007 to july 2008, with a structured form of interview, validated through a pilot study. The data were analyzed by descriptive and inferential statistics. Results: The evaluation of the service was considered unsatisfactory by 85.6% users. However, 58.8% of professionals considered it satisfactory. There was difference in the evaluation of the following indicators: the relationship professional users, offering support, timeliness of professional guidelines on the treatment. There was similarity in the following indicators: physical structure, respect for privacy, opportunity to make complaints, hospitality, convenience of schedules, availability of ARVs and laboratory tests, and ease of access. Conclusion: The results point to dissatisfaction of the users and professional satisfaction with the health care of people with HIV / AIDS in the service searched. It was found that the indicators used in this study may be considered relevant to evaluate the service in question, as well as monitoringparameters provide acceptable quality of health care by the National STD/AIDS

Avaliação das condições higiênico-sanitárias de manipuladores de alimentos e utensílios de mesa de escolas públicas municipais de Natal, RN

In Brazil school food is constitutionally guaranteed to public school students at the preschool and elementary level. This food must be nutritious, hygienic and sanitary. The aim of the present study was to assess the hygienic/sanitary conditions of food and table utensil handlers in municipal public schools in Natal, Brazil. In total, 27 public schools were assessed, using a checklist and microbiological analysis of the hands and table utensils. For the microbiological analyses of the hands, coliforms were analyzed at 45ºC and for the utensils aerobic mesophilic bacteria, using methods recognized by AOAC, 2002 and APHA, 1992, respectively. Most of the schools studied did not exhibit good food and utensil handling practice procedures in any of the variables analyzed. It was shown that 74.1% of the handlers received no periodic training, 51.9% did not undergo annual health examinations and 100% did not practice proper hand hygiene, which reflected significantly (p < 0.05) in hand contamination, where fecal coliforms were detected on 55.6% of the hands analyzed. With respect to the utensils, it was found that 100% of the schools studied did not follow correct hygiene practices and most were classified as very bad ; that is, aerobic mesophilic bacteria values above the limits established by PAHO (Pan American Health Organization), with schools in the north and south districts recording the highest percentages. The results show that the hygienic-sanitary conditions of the food and utensil handlers in the schools studied were inadequate, demonstrating the need for implanting good handling practices aimed at protecting the health of children that take part in the program and offering safer foods. Researchers from the areas of food microbiology, nutrition, public health and statistics participated in this study, a decisive factor for characterizing it as multidisciplinary

As repercussões dos serviços hospitalares em diferentes contextos: uma análise de profissionais de saúde

This study has as general object: to verify as the health professionals that work in different hospitals evaluate the hospital services; and specific objectives: identify how health professionals evaluate the work conditions in different hospitals and verify the central nucleus and the peripheral elements of the social representations elaborated by these professionals about these institution. This is a descriptive study realized in Natal, capital of Rio Grande do Norte. Were collected 213 questionnaires. Concerning the evaluation of the health services, high averages had been verified in the philanthropic hospital, for example, quality of the customer service. At the state hospital was observed lowest ones: respect to the privacy of the patients. Similar results were found about work conditions. It was observed as central nucleus the categories Overcrowded and Humanized care, in the state and philanthropic hospital respectively, and as peripheral elements Low wages and Overcrowded. Being thus the conflicts in this scene are inevitable because of the poor structure of some public hospitals, however, these problems can be foresee and solvable if the hospital has a free expression channel accessible to all agents. The evaluation has to become integrant part of the culture of the organization, a time that this will guide the steps in direction to the best quality in the hospital assistance

Sanções disciplinares aplicáveis em caso de doping a atletas profissionais e não profissionais

A presente pesquisa descritiva do tipo documental centrou-se em analisar as sanções disciplinares aplicadas em caso de doping, a atletas profissionais e não profissionais que atuam no Brasil. A amostragem foi levantada através de um processo de seleção não probabilística intencional, utilizando-se como sujeitos, 18 atletas de uma modalidade esportiva dita não profissional: atletismo e 19 de uma modalidade profissional: futebol, de ambos os sexos, os quais tenham sido flagrados pelo exame de controle de dopagem da Confederação Brasileira de Atletismo (CBAt) e da Confederação Brasileira de Futebol (CBF). Como instrumentos de análise, foram utilizados os diagnósticos de dopagem positiva, arquivados junto a CBAt e CBF; além dos processos julgados pelo Superior Tribunal de Justiça Desportiva (STJD) do atletismo entre os anos de 2003/2007 e os processos julgados pelo STJD do futebol no ano de 2007. Os resultados demonstram que as sanções aplicadas aos desportistas diferem muito entre as modalidades incluídas no estudo. Enquanto encontramos, no atletismo a aplicação de sanções em conformidade com o Código Mundial Anti Doping (CMAD) com penalidades de no mínimo de dois anos, no futebol encontrou-se grande número de absolvições ou aplicação de penalidades conforme o Código Brasileiro de Justiça Desportiva (CBJD) que prevê penalidades muito inferiores. Por outro lado verificou-se ser a modalidade Futebol a que mais realiza controles, sendo certo que durante o ano de 2007 o desporto profissional realizou 4832 testes, ao passo que o desporto dito não profissional realizou tão somente 281. O caráter multidisciplinar do trabalho 12 pôde ser caracterizado pelo emprego de técnicas que envolveram direito, educação física, farmacologia

Percepção e realidade da política de atenção à saúde do idoso nas equipes de profissionais do programa de saúde da família do estado da Paraíba

Investigar os fatores relacionados á percepção que os profissionais das equipes do Programa de Saúde da Família (PSF) possuem frente à realidade da política de atenção à saúde do idoso nas Unidades Básicas de Saúde dos municípios litorâneos do Estado da Paraíba. Trata-se de um estudo observacional descritivo com uma amostra constituída por 120 profissionais de saúde de três categorias distintas (enfermeiro, médico e odontólogo), sendo 104 respondentes como profissionais e 16 respondentes como coordenadores de equipes. A coleta de dados foi realizada através de um questionário auto-aplicável de avaliação fechada e de questões de múltiplas escolhas. Os dados foram processados e armazenados no Programa Estatístico SPSS versão 15.0 e analisados à luz da estatística descritiva. Os resultados indicaram que os profissionais tiveram dificuldade em perceber a realidade da política integral e integrada de saúde do idoso junto aos serviços de saúde em que atuam. O estudo revelou ainda a necessidade de uma definição de estratégias para qualificação dos profissionais garantindo à atenção integral à saúde do idoso sob uma nova visão de atuação

Formação em odontologia: um estudo sobre as clínicas integradas em cursos do Brasil

Dental education is going through important changes in preparing workers to meet the needs of the society and the labor market. For that reason, we studied the offering of comprehensive dental care clinics in Brazil with the aim of encouraging future curriculum changes focused on the training of general dental practitioners. An email questionnaire on educational organization and comprehensive care clinics of undergraduate programs was sent to each academic dental affairs dean. Sixty-seven (41.6%) dental schools agreed to participate. We observed that curriculum changes have contributed to modify the format of comprehensive care clinics. This was felt mainly (88,1%) with regards to workload and course offerings in different levels of the dental curriculum, thereby creating a favorable environment for generalist training. Most schools shared the following characteristics: clinical procedures were being prioritized according to level of complexity (95,5%), students were having the chance to attend courses in other programs (37,3%), and attempt to diversify teaching methods was being challenged (58,2%). Although progress in combining teaching and clinical services was reported by 83,6% of schools, most clinical procedures were still being performed intramurally (50,7%) in partnership with public service. There was also improvement in clinical mentorship due to the hiring of instructors qualified to work in comprehensive care clinics and with aptitude to supervise a wider range of dental procedures (58,2%). Further changes to Brazilian comprehensive care clinics should hence be encouraged and intensified to ensure appropriate generalist training for dental practitioners