Efeitos de um programa de intervenção precoce baseado no modelo mais que palavras - HANEN, para crianças menores de três anos com risco de autismo

In the last decades, studies on early intervention involving children with autism have suggested that there is no single intervention model capable of addressing the needs of all individuals in the spectrum. The role of parents as active intervention agents is, however, highly recommended. The More Than Words-HANEN Program has been specifically created for parents of children, under five years of age, who are in the autism spectrum. This intervention aims at improving the social competence and language comprehension of the child, as well as their parents empowerment. Until now only three studies have been performed in order to evaluate the effectiveness of the HMTW program. The purpose of this investigation is to evaluate the effects of an early intervention program inspired on HMTW model on the level of caregiver responsiveness and child communication skills. The present study adds to the existing research literature on family-centered early intervention that uses a developmental paradigm. A two year boy in risk for autism, his mother and nanny took part in this investigation, which was carried out in the child´s home in Mossoró, Rio Grande do Norte. The caretakers were given one fifty-two hours of training, divided into thirteen weekly meetings. A quasi-experimental A-B-C design (baselineintervention- follow-up) showed improvement in the caretakers level of responsiveness and meaningful social-communicative gains in the child´s response

A inserção da família no processo socioeducativo de adolescentes em privação de liberdade

This master thesis has the main goal investigate how families are inserted in the socioeducational process of teenagers who are undergoing social measures of liberty deprivation. The specific objectives are: to characterize the family´s living together of adolescents deprived of their freedom and their families, from the actions and routines of the socio-educational system; to assess the professional working links in the context of socio-education, in order to care and strengthening families of the adolescents; to investigate how families evaluate the operation of socio-educational process in which adolescents are met. Method: to achieve the proposed objectives, data collection occurred in complementary steps: the first phase took place from visits to socioeducational units of liberty deprivation of RN, and dialogues with professionals working in socio-education. Subsequently, action research stage was carried out, from the insertion of the researcher in the extension project Family and the struggle for the effectiveness of the National Socio Service System, that aimed to strengthen monitoring the adolescents socio-education by their families, and had as methodology the conversation circles and thematic workshops. Lastly, were performed reading and analysis of the references to the family in the Individual Care Plans (PIAs) for adolescents. The information gathered was recorded in field diaries and subjected to thematic content analysis. This research was guided by the Marxist theoretical framework, structured on the understanding of the involvement of adolescents with illegal acts as a development and expression of the social question. From this theoretical framework, the prevailing view in the capitalist society of adolescents in conflict with the law as individuals who are treated by means of repression and segregation and the weakness of social policies is questioned, both in the execution of their own socioeducational measures as the articulation of network services for adolescent protection and strengthening your family. Results: in relation to the operation of the socioeducational system in RN in general, it was observed a state of unhealthy physical spaces and institutional practices that violate human rights, idleness and lack of access to social rights, and criminalization and institutionalization of poor young people and their families. With regard to family´s living together, it was noticed great distance between principles and guidelines recommended by the SINASE, about acquaintanceship and family strengthening, and every day practices of socio-education in RN: serious violations were observed that undermine the family´s living together, as the distance between the socio-educational units of deprivation of liberty and the cities where families live; absence, irregularity and poor conditions in carrying out the family visits; lack of conjugal visits; restricted and unarticulated actions for the care and strengthening of the families of adolescents, most of whom live in poverty or extreme poverty. Finally, it was found a number of blamefully and punishments to the family, including practices such as inward inspection (visual inspection while naked and squant), plus a series of violence and omissions care that sick family members and weaken the links between adolescents and their families.

Saberes e práticas em experiência de construção da sustentabilidade no meio rural nordestino

The purpose of this work is to analyze the knowledge relationships that articulate in projects of maintainable rural development construction for the paraiban semi-arid, analyzing the farmers daily practices and their relationship with the technological practices spread by ONGs. We took as empirical object the rural community of Lajedo de Timbaúba, municipal district of Soledade-PB, located in the very small region of paraiban Curimataú. It is a community where registers one of the first cases of maintainable rural development planning in the state of Paraíba. The analysis was centered on the farmers experiences of life in sustainability experience, trying to understand how they acquire new knowledge and how they interact with them. In methodological terms, it was considered feasible to place the knowledge interaction between the farmers and technicians from ONGs by placing the analysis according to Paulo Freire s questioning (2006): extension or communication? To understand the farmers daily practices, it was resorted to the theoretical contribution by Michel de Certeau (2008) in order to discern a microresistance movement of inversion/rejection/changing by the farmers in relation to their external knowledge. Just from the theoretical point of view and resorting to the imaginary social by Cornelius Castoriadis (1982), it was considered the way of living of the farmers researched, having as reference the experience in the material and symbolic production of their lives. It became indispensable, therefore, not to dissociate the knowledge relationships between farmers and technicians from ONGs from the sustainability concepts, maintainable rural development, and rural extension. The results of the study revealed that the farmers from Lajedo de Timbaúba while dealing with the technological practices proposed by ONGs that work in the community, express those practices from their daily logic, and they constitute them in survival strategies that are inserted in their own idiosyncrasy. It was verified, therefore, that the external knowledge presented by the proposals of sociability alternatives with the droughts in the perspective of maintainable development while placed in the farmers daily relationship, they are judged as advantageous or disadvantageous when they are confronted with their peculiar way of doing their daily work. The technological practices are incorporated, denied, or recreated starting from evaluative criteria related to the preservation of the soil and to the economical and social reproduction of the unit of production of family agriculture

Os Centros de Especialidades Odontológicas como suporte da atenção básica: uma avaliação na perspectiva da integralidade

The public dental services in Brazil were limited, practically, to the basic care, so that the specialized services acted, up to 2002, no more than 3,5% of the total of clinical procedures. That lower offer reveals the difficulty of continuity of the attention, that is, the comprehensiveness in the assistance, particulary, the reference and counter-reference system. Brasil Sorridente search to supply those needs when proposing Speciality Dental's Centers(CEOs Centros de Especialidades Odontológicas, Brazil) to compose the services of average complexity. In 2005, Ministry of Health enabled the three CEOs of Natal, located in the North II, East and West Sanitary Districts. This investigation evaluated the implantation of these CEOs, as support of the family health care teams, in the perspective of organization of the services in assistencial nets in Natal/RN. It was a study of evaluation, with qualitative approach and some quantitative data as contribution. Dentists, users and managers were interviewed to identify and to understand their perceptions, relationships and experiences in the daily of the services. The conceptual base that orientated the investigation was the principle of comprehensiveness, in its operational sense of the hierarchization in health attention levels. The collection of data was done with documental research, direct observation and semi-structured interview. The analysis was accomplished by triangulation of the extracted content from the used techniques and sources of interviewed groups depositions, looking for theoretical-conceptual support in specific bibliography. The results pointed aspects that go away from the comprehensiveness like: low resolution of problems in the basic net; little valorization of the space in the health units; traditional models of access to health services, insufficient offer for some specialties, compromising the reference and counter-reference system; practices centered in procedures in the CEO; bureaucratic directions from basic care to the specialized service; disintegrated and disjointed system among levels of attention; disrespect to the municipal protocol. On the other hand, there is an approach of compreensiveness in situations like: increase of the access and covering in the Family Health Strategy (ESF Estratégia Saúde da Família, Brazil); larger approach between professional and user; tendency to the quantitative and qualitative growth of specialized actions; punctual initiatives of relationships among levels; existence of protocol to guide professionals

Avaliação da saúde bucal na atenção básica: a perspectiva do usuário

Nowadays, the basic attention in health works according to the Health Family Program (HFP), which is responsible for the organization of the health services with view to provide an appropriate attendance to the needs of the population. Its expansion is expressive in whole country and, the oral health, included in this process, has been seen as a possibility of change the health practices centered in the disease. In face of this perspective, the proposal of study is to discover possible changes in the health care model of oral health in a district, made possible through the perception, evaluation and degree of satisfaction of the user s health service. To reach such objectives, the district of Macaíba in the State of Rio Grande do Norte, was chosen for operational subjects, such as time of implantation of HFP and great covering of this program. The current research used interviews structured with objectives and subjectives questions and questionnaires of socioeconomic characterization addressed to two hundred and seventy (270) individuals (ninety users of an Urban PSF, ninety of a Rural PSF and ninety of an unit non PSF). The analysis of the data was accomplished through the software SPSS/99, that made possible a statistical and analytic appreciation. The HFP units and non HFP units has shown to sort the common odontology problems of the community, and this didn't establish a direct relationship with the general satisfaction. On the other hands, the programmed consultation is related with lager satisfaction of the users. The access form to the odontology treatment of the Units, the satisfaction with the attendance rendered by the dentist and the equip, enough dentists for the community and the social class of the user were decisive for the general satisfaction with the service of oral health. On the other hand, variables as age and education, resolution of the problem and physical conditions of the unit didn't influence the general satisfaction. In spite of the progresses in the implantation of the oral health in ESF, preventive activities, visits at home, access and social participation still reproduce the traditional model of attendance, showing a primary change process