Avaliação do cuidado na estratégia saúde da família em metrópoles do nordeste brasileiro

Objective: To evaluate the implementation of the Family Health Strategy (FHS) in Brazilian cities of the Northeast, expanding coverage, analyzing the progress, challenges and innovations. Methods: Multicentric Evaluation Research, Studies Baselines in urban centers, using as a case study method. Selected cases of Aracaju, being capital, advanced coverage with extended team, and Fortaleza, capital coverage incipient and minimal staff. In Fortaleza, purposive sample of 11 Units Primary (APS), 03 managers, 53 professionals and 109 users. In Aracaju, 09 units of APS, 02 managers, 36 professionals, and 90 users. Structured interviews for managers, and structured to professionals and users. Descriptive analysis focusing on the political and institutional dimensions, organization and comprehensive care. Results: There was consensus that the ESF is the preferred port users and acts as inducing changes in care. In the case of Fortaleza, the specificities were: care protocols and community activities aimed at chronic conditions (100%) , with greater participation of doctors and nurses (93%) ; conjunction with more complex services, but the teams reported difficulties with the examination center and experts, the long waits and poor access to local services were the main difficulties reported by users., As innovative practice, the therapeutic group of elderly caregivers mentioned by respondents; There was intersectoral initiatives and teams 87 % of users have participated in meetings about health problems. In the case of Aracaju, care protocols were directed to the lines of care and formulated locally, 85 % coverage of the population with FHS counterpart local financing; employees hired by public tender; 70 % of teams with expertise in public health center for continuing education acting; democratization in management; access technologies, welcoming and computerization in different integrated networks, and evaluation matrix. Conclusions: The ESF has promoted access to health care and inclusion of disadvantaged populations. Different perceptions and practices in the organization of care, with distinct trajectories of reorganization. In the case of Fortaleza, predominance of model programs valuing older, with evidence of advances in care practices and teamwork, but restricted to primary care practices and incipient in public policy perspective. In Aracaju, had network integration with technologies related to the family, in which the ESF is consolidated as public policy. It can be argued that the XII APS expanding coverage, exhibited efficacy, despite the challenges inherent to the different degrees of implementation

Neurobiology and clinical implications of lucid dreaming

Several lines of evidence converge to the idea that rapid eye movement sleep (REMS) is a good model to foster our understanding of psychosis. Both REMS and psychosis course with internally generated perceptions and lack of rational judgment, which is attributed to a hyperlimbic activity along with hypofrontality. Interestingly, some individuals can become aware of dreaming during REMS, a particular experience known as lucid dreaming (LD), whose neurobiological basis is still controversial. Since the frontal lobe plays a role in self-consciousness, working memory and attention, here we hypothesize that LD is associated with increased frontal activity during REMS. A possible way to test this hypothesis is to check whether transcranial magnetic or electric stimulation of the frontal region during REMS triggers LD. We further suggest that psychosis and LD are opposite phenomena: LD as a physiological awakening while dreaming due to frontal activity, and psychosis as a pathological intrusion of dream features during wake state due to hypofrontality. We further suggest that LD research may have three main clinical implications. First, LD could be important to the study of consciousness, including its pathologies and other altered states. Second, LD could be used as a therapy for recurrent nightmares, a common symptom of depression and post-traumatic stress disorder. Finally, LD may allow for motor imagery during dreaming with possible improvement of physical rehabilitation. In all, we believe that LD research may clarify multiple aspects of brain functioning in its physiological, altered and pathological states.

Concepões e práticas pedagógicas de professoras da educação infantil na inclusão de alunos com deficiência

This research focuses on inclusive in childhood education. Its purpose was to investigate and analyze the conceptions and expectations of teachers of childhood education, childhood education center form Natal/RN, on the inclusion students with disabilities, school and pedagogical practices developed and implications for students learning. Theoric base of the cultural historic perspective, the search took by qualitative analysis of numbers form the case study method. It was used methodological procedures: documentary analysis, participant observation, field journal and semi structures interview.Three teachers participated in the survey of that school had student with disabilities in their classrooms. These teachers were called: Rapunzel, Snow white e Pretty. The teacher s nouns involved the refered kind of education. The data obtained from the observation indicated the regular school of childhood education provides educational practices that promote the participation and participation and development of students with disabilities, live situation that may create barriers to learning and to the development of these children. The analysing data of interview from Bardin content analysis (1994) was based in Cunha s studies (2001) Brun (2006, 2008), Mantoam (2006, 2008), Palacios, Paniagua (2007), among others. The dada showed that correlation and divergence of perceptions and expectations about the issues surrounding inclusion in childhood education. The results shaved that teaching strategies, affective ties, sensitivity and own routine of childhood education are factors that can promote inclusive proposal, but also needs a greater fulfillment individual differences of each child in order to their potentiality. The study also shaved that the negative of pedagogic support to teacher, the ignorance of them as guidelines and strategies that include the student s diversity, the importance having positive conceptions about the learning and development of student with severe learning disabilities and the need for a pedagogic training and of a collective work at school which everybody collaborates : parents, direction, coordination getting inclusive school. Believe that this study pointed relevant issues to be focus new research, since the theme is still lacking in study, therefore emphasize, the importance of conducting research that continuous this job

Estratégias midiáticas na aprendizagem do tema DST/AIDS: ações em rede para reduzir vulnerabilidades de adolescentes e jovens da comunidade de Mãe Luiza, Natal-RN

Youngsters and teenagers are still a very vulnerable group of DST/AIDS. In order to combat this vulnerability the community intervention project being developed in Mãe Luiza neighborhood in the city of Natal-RN, entitled Strengthening Community Action Network for Prevention in HIV/AIDS: knowledge and Intervene emerged, popularly known as Project Viva Mãe Luiza. The project develops workshops of educomunication whose approach involves the DST/AIDS subject with the following media: video, photography, and theater playbook. This research integrates the activities of the project and has as main objective to investigate how strategies and practices of media communication developed in Project Viva Mãe Luiza through workshops of educomunication, assisted learning for the prevention of DST/AIDS and contributed to the reduction of vulnerability to DST/AIDS among adolescents and young participants of the project residents of Mãe Luiza community. The methodological basis was based on intervention research, with the technique of gathering daily field data, literature and documentary, in-depth interviews and ethnographic observation. The qualitative analysis was based on the monitoring of video workshops, photography, theater and primer, respectively, crossed by transverse to the prevention of DST/AIDS, conducted between June 2012 and December 2013 issues. Interviews with eight multipliers, aiming to understand their perceptions of vulnerability, prevention, multiplication and use of media that were part of the project were conducted. The analyzes show that learning workshops educomunication community health repercussions both in the development of individual skills in communication as changing perceptions about the vulnerabilities to which they are exposed, the awareness about prevention at the individual and differentiated actions multiplication in the community