Os batistas regulares e as armadilhas históricas do iluminismo

Taking the Regular Baptist Churches of Rio Grande do Norte as the research field, this paper seeks to contribute to a new, more appropriate vision of the new picture of the religiosity of the Brazilian Protestantism. Established since 1938, the Regular Baptists Churches have been representing and producing their speech through their 58 churches spread throughout the state, besides a Theological School, two camps, an association (AIBRERN) and a House of Spiritual Assistance to Drug Dependents (CAEDD). A reflection of the symbolic substratum of the spirituality of the group agrees with the external description of its presence in RN. We understand that the Regular Baptists represent yet one more translation of a modern religious speech and that their focus is on the inheritance of a Christian fundamentalism based on the illuminist rationalism. In this way, we observed this group trying to find in its doctrines, practices and rules of conduct a demonstration that the spirit of the post-modernism challenges the group to new dynamics in the conservative model of its spirituality

Irregularidade do ciclo menstrual no Menacme como marcador para fatores de risco cardiovasculares na pós-menopausa

A associação entre fatores de risco cardiovascular (FRCV) na pósmenopausa e o antecedente de irregularidade menstrual no menacme foi avaliado em estudo caso-controle envolvendo 414 mulheres na pósmenopausa com idade de 60,4 ± 5,5 anos e IMC de 25,3 ± 4,7 kg/m2. As variáveis consideradas foram: caracterização do ciclo menstrual entre 20 e 35 anos (independente) e relato atual sobre ocorrência de hipertensão arterial, dislipidemia, diabetes mellitus e doença arterial coronariana (dependentes). Utilizou-se o teste qui-quadrado e modelos de regressão logística, ajustados para outras variáveis implicadas no risco para doenças CV, com nível de significância 5%. Observou-se que mulheres que relataram irregularidade menstrual prévia estiveram associadas com risco aumentado para ocorrência de algum FRCV [odds ratio ajustado (OR)= 2,14; IC-95%= 1,02–4,48], quando comparadas àquelas com ciclos regulares. Análise estratificada demonstrou as seguintes associações significativas com o antecedente de irregularidade menstrual: hipertensão arterial (OR= 2,4; 95% IC= 1,39–5,41), hipercolesterolemia (OR= 2,32; 95% IC= 1,17–4,59), hipertrigliceridemia (OR= 2,09; 95% IC= 1,10–4,33) e angioplastia coronariana (OR= 6,82; 95% IC= 1,44–32,18). Os dados sugerem que o antecedente de irregularidade menstrual, indicativo da ocorrência da síndrome dos ovários policísticos na idade reprodutiva, pode estar relacionado com aumento do risco para doenças CV na pós-menopausa __________________________________________________ABSTRACT Menstrual Cycle Irregularity as a Marker of Cardiovascular Risk Factors at Postmenopausal Years.To evaluate the association between cardiovascular risk factors (CVRF)during postmenopausal years and previous menstrual irregularity during reproductive years, we performed a case-control study in 414 postmenopausal women (mean age 60.4 ± 5.5 years; BMI 25.3 ± 4.7 kg/m2). The variables assessed were: menstrual cycle characteristics at age 20–35y (independent) and records of arterial hypertension, dyslipidemia, diabetes mellitus, and coronary heart disease (dependent). Statistical analysis used the chi-square test and logistic regression, adjusting for potential confounders for cardiovascular risk, with significance set at 5%. Women reporting previous menstrual irregularity were associated with increased risk for some CVRF [adjusted odds ratio (OR) 2.14; CI-95%= 1.02–4.48], when compared with those reporting regular menstrual cycles. Stratified analysis demonstrated significant associations of previous menstrual irregularity with: arterial hypertension [OR= 2.74; CI-95%= 1.39–5.41), hypercholesterolemia (OR= 2.32; CI-95%= 1.17–4.59), hypertriglyceridemia (OR= 2.09; CI-95%=1.10–4.33), and coronary angioplasty (OR= 6.82; CI-95%= 1.44–32.18). These data suggest that a prior history of menstrual irregularity, as indicative of polycystic ovary syndrome, may be related to increased risk for CVD during postmenopausal years

Associação dos níveis de motivação e autoestima na aderência à prática de atividade física de universitários

A aderência à prática da atividade física se constitui na maior dificuldade encontrada pelos profissionais da área da saúde. É importante ter conhecimento de determinantes que podem influenciar na aderência. Os objetivos do presente estudo foram o de elaborar, desenvolver e validar uma escala para avaliar a Autoestima referenciada na aderência da prática da atividade física e verificar a associação da Motivação e Autoestima à prática de atividade física. A Escala de Autoestima proposta para validação é uma escala de auto-resposta com dezesseis itens, cinco dimensões e com respostas com três níveis de concordância. Os participantes no estudo de validação são 312 universitários de ambos os sexos, com idades compreendidas entre 18 e 35 anos. Metade deles é praticante regular de atividade física. A Análise Fatorial dos itens mostra cinco dimensões: Introspecção, Imagem Física, Satisfação com a vida, Aceitação e Confiança. As propriedades psicométricas são aceitáveis, com Alfa de Cronbach igual a 0,75. O estudo de validação baseado nas correlações entre esta escala e a de Rosenberg, segundo o teste Qui-quadrado de Pearson, com sig. p < 0, 001 nas classificações e na correlação sugere que a escala pode ser utilizada em estudos de investigação e programas de promoção da saúde. As escalas de Autoestima e de Motivação (MPAM-R) foram aplicadas a um grupo de 110 universitários, 65% do sexo feminino e 35% do sexo masculino, com idade média compreendida entre 18 e 35 anos. Segmentados em dois grupos de praticantes regulares e não regulares de atividade física. Foram controladas as variáveis demográficas, ambientais e antropométricas. Verificou-se associação significativa entre as variáveis Autoestima e Motivação pelo teste Qui-Quadrado, e que denotam que a dimensão da Autoestima Imagem Física, quando cruzada com as dimensões da Motivação, mostra-se em alto grau discricionário e associação direta. Motivação Diversão (sig.p = 0,002), Competência (sig.p = 0.007) e Social (sig.p = 0.016). Ainda, no cruzamento do Escore Total da dimensão Autoestima e a dimensão Diversão da variável Motivação, apresenta associação diretas e significativas (sig.p = 0.020). A síntese dos resultados denota ações combinadas de estímulo na melhora da percepção positiva da Imagem Física do indivíduo, tendo como plano de fundo, ambiente divertido, desafiador (competência) e social (interação com os pares), traduz em aderência a prática da Atividade Física

Avaliação de concentrações do C-Telopeptideo de Colágeno (CTX) em mulheres no climatério

Fundação de Apoio à Pesquisa do Estado do Rio Grande do Norte

O aluno surdo em classe regular: concepções e práticas dos professores

Le texte se rapporte à une recherche sur les conceptions d enseignants concernant l inclusion scolaire d élèves sourds , et leurs ralations avec les pratiques qu ils développent dans les classe régulières. Elle a été conduite dans une école publique régulière appartenant à la commune de Assu RN, et dont le choix méthodologique a été une approche qualitative, du genre ethnographyque. La construction des données devient d un processus d observation, de l application d entretiens demi-structurés et de l analyse de documents, ayant pour sujets quatre enseignants des années initiales de l enseignement fondamental. L apport théorique de base a été la théorie socio-culturelle proposée par Vygotsky (2003 ; 2005), censée traduire la compréhension de l homme dans sa dimension historique et culturelle, et mettre en évidence l interaction sociale en tant que condition pour le développement des individus. Les données font connaître que les enseignants sujets de la recherche sont favorables à l inclusion scolaire des élèves sourds dans les classes régulières, néanmoins soulignent le besoin d un changement à l école pour que l inclusion devienne une réalité. Les enseignants sont d avis que l apprentissage des élèves sourds se fait d une façon qui met trop de temps, moyennant l utilisation de recours spécifiques, tels que l usage du langage des signes (Libras). Ils signalent les difficultés qu ils doivent faire face quand il s agit de travailler pédagogiquement avec ces élèves dans le quotidien, telles que : manque d un travail collectif à l école ; besoin d une formation spécialisée ; démonstration de sentiments de peur, ou préjugés de la part de quelques uns du personnel de l école , tout celà interférant directement dans leurs attitudes et leurs actions faces aux élèves ; manque d appui des instances administratives de l école ; absence de politiques consistentes pour guider l éducation sous un regard inclusif. Quant aux pratiques pédagogiques développées à l école, la recherche laisse voir que, par rapport à la présence des élèves sourds, très peu d adaptations y ont été introduites, d où se dégage que la planification des actions éducatives à l école se tourne, prioritairement, vers les élèves qui écoutent, c est-à-dire, vers un groupe apparemment homogène. On a constaté, en plus, qu il n existe pas à l école aucun professionnel habilité pour l établissement d un processus de communication avec les élèves sourds. Malgré ces difficultés, les enseignants avouent, quand même, que travailler avec ces élèves rapporte toujours des bénéfices, tels que la collaboration et le respect mutuels chez les élèves, l acquisition de nouveaux savoirs et l amélioration de la pratique pédagogique des enseignants

Pedagogia Freinet :mediação para o social, o político e a formação de professores

Ce projet présente dans son premier chapitre une étude historique-bibliographique basée sur la Pédagogie Freinet en France, ainsi que sa formation républicaine, ses courants politiques et idéologiques qui ont moulés l organisation sociale et éducationnelle de ce pays. Ce travail montre le rôle des courants de gauche dans ce processus, cela se reflète aussi sur le jeune Freinet. Les changements opérés dans la décennie de 1950 dans le système scolaire, dans le propre Mouvement Freinet et les ruptures qui ont eues à l intérieur de ce mouvement. Cela se termine avec les directions prises dans les dernières décennies, son arrivée au Brésil et les perspectives actuelles. Le deuxième chapitre aborde la reconstitution historique du Brésil dont sa phase coloniale et impériale. Les événements historiques de la IIIe, IVe et Ve République sont mis en relief avec ceux du Mouvement Freinet. La phase militaire imposée au Brésil et les luttes pour la reconquête de la démocratie. Il se termine avec les considérations sur la LDBEN 9394/96 et l implantation du Curso Normal Superior; un bref historique de la Pédagogie Freinet au Brésil, des thèmes importants travaillés dans le troisième chapitre. Dans ce chapitre une recherche qualitative est décrite basée dans l Etnographie Critique et Multiréférentiellel et aussi dans la Recherche-Action. Elle est développée auprès d un groupe de cinq professeurs des premières classes de l école primaire au collège, inscrites dans le Curso Normal Superior. Les données ont été obtenues à partir de rencontres régulières avec le groupe la médiation didactique , des entretiens, des questionnaires, des observations dans les salles de classe, du travail final du cours, nommé Mémorial de Formation. À travers l ensemble des données, on recherche les apports et l actualité d une proposition pédagogique historiquement firmée pour le développement de la praxis éducative

O papel das interações no processo de inclusão de crianças com síndrome de Down

La inclusión actual está siendo orientada por diversos principios, tales como la cooperación, aceptación de las diferencias individuales, valoración de cada individuo y convivencia dentro de la diversidad. En esta perspectiva, se entiende la educación como un proceso, en que todos los alumnos con necesidades educativas especiales tienen el derecho de escolarización en el salón de clase general, visando el desarrollo máximo de su potencial. Es en la interacción con los otros que los niños desarrollan efectivamente sus capacidades, aprenden a descubrir al otro como portador de valores y, como consecuencia de esa relación, a tener más confianza en sí mismo. Es por lo tanto necesario que las influencias educativas sean recíprocas y que en la convivencia escolar, puedan ser constantes las relaciones interpersonales. Así, haciendo con que cada niño sea introducido a la vivencia de la ciudadanía, al aprendizaje que va más allá de los contenidos escolares y envolviendo también la construcción de valores, hábitos y actitudes. Con base en estos aspectos, nuestro trabajo tuvo como objetivo la interacción entre niños con síndrome de Down y sus compañeros, en dos clases regulares de una escuela pública em el nível de educación infantil, en la ciudad de Natal/RN. En este sentido, realizamos un estudio de caso con dos niños, envolviendo observación, aplicación de entrevistas y cuestionarios, además de la utilización de la sociometría. Los datos analizados apuntan la existencia de un espíritu de cooperación entre los niños, del respeto a la diversidad y también a sus limitaciones. Estos son valores que están siendo construidos y que son percibidos claramente en lo cotidiano de la escuela. De igual modo, de esta convivência resulta la construcción de vínculos afectivos y sociales entre los niños que presentan el síndrome de Down y sus compañeros, siendo estos similares a los desarrollados entre los niños en general. Sin embargo, se evidencia todavía, la necesidad de un incentivo mayor por parte de la comunidad escolar para que sean establecidos vínculos más significativos

Relações entre teorias da história e ensino de história: a compreensão de professores

This thesis has as an objective to think over the teachers` understanding of the school History of the Fundamental Teaching regarding the existent relations between the history theories and the teaching of the school History, as well as to think over how these teachers see the influence that their teaching practice gets from the history theories. The work is based on the postulates of the qualitative research and on the characteristics of the ethnography of the school practice. The main procedures of data gathering were the documental analysis, the semi-structured interviews, the field diary and the observations of classes. The scientific perspective of the multiple references is an important source in this research. The participants of this work are two teachers of the school district of Natal who work in the field of the school History in two schools on the North Side of the city. The accomplished analysis point to significant indications that didn't occur continuous and regular teaching situations in the initial and continuing education of these teachers that clearly showed the relations between the history theories and the teaching of the school History. They also suggest that their understanding about the influence that their teaching practice gets from the history theories, is not still explicit. We understand that the relations between the history theories and the teaching of the school History are important for the initial and continuing education of these teachers who belong in this knowledge field, even when these relations are not explicitly pointed by the teachers, because they will always influence the teaching practice that the teachers of the school History build

A aproximação entre educação escolar e trabalho: a experiência da Casa do Menor Trabalhador

It aims to consider the possible relationship between formal school education and work, from the experience of the State School House of the Minor Worker CMT of Natal-RN in this first decade of the 21st century. In this institution, children and adolescents are enrolled in the Fundamental Teaching sponsored by the State Public System studying the regular curriculum contents defined for this level of teaching, and in the opposite shift they take part in career workshops which are kept by members of a religious congregation. CMT has had as its object, since its foundation, to take children and adolescents from the streets and to provide them with a full time education associating basic education and training/qualification for the job market. In our research, we tried to learn a little bit of the expectations, concerns and knowledge of the young participants of two workshops: carpentry and bakery, so that we could gain sufficient understanding of the learning process of these youths, while still keeping an approximation with the reality of the aforementioned subjects. It was possible for us to conduct a description of the contexts and of characteristics of the subjects which make up CMT, capturing concrete aspects and aspects of the thoughts of students, teachers, instructors and coordinators. The main point of our research was: how does the approximation between formal school education and work take place in the House of the Minor Worker? To search for possible answers we have made use of basic techniques for the data construction - questionnaire, observation, conversation groups, assessment drills which allowed an approximation and a good dialogue with the participants. We also discussed the job world in the context of the capitalist exploration, from the contributions of Mèszáros (2005), Frigotto (1989); (1993); (1999); (2002); Ferretti (1994); (2004); Kuenzer (1989); (1997), in order to understand the skills demanded of the worker and the necessity of an education which allows the professional qualification of youths eager to enter the job market, through the first job. In this perspective, the study that we have systematized here aims to show the relevance of an education which manages to take a firm and conscientious stand in connection with the hegemonic capitalist project and to provide for a humane, ethical, responsible, critical and civic background

Interações comunicativas entre uma professora e um aluno com transtorno invasivo do desenvolvimento na escola regular

Inclusion of students with autism in regular education settings is a topic that has not been much explored by the national scientific literature. This matter is complex and, due to the extent of various aspects involved, it is essential to delimitate a focus of investigation. The direction taken by this study was to evaluate the effects of an intervention program in the communicative interactions between a student with autism and his teacher in a regular classroom. Data were collected in an elementary private school, located in the city of Natal, Rio Grande do Norte during the 2010 academic school year. The study included a teacher and a non-vocal, 10-year-old student diagnosed with autism. A quasi-experimental A-B research design was employed. During the intervention program the teacher was trained to use Naturalistic Teaching Strategies and Alternative and Augmentative Communication (AAC) resources to increase the frequency of interactions with the student during three classroom routines (entry time, snack and pedagogical activity). The results indicated qualitative and quantitative changes in the interactions of the dyad after the implementation of the intervention program. The student began to use pictograms to communicate with the teacher in two of the three routines investigated. The frequency of AAC use was also observed in the teacher‟s repertoire, especially when the student failed to understand gestures and words. The teacher positively evaluated the intervention program

O atendimento educacional especializado no processo de inclusão escolar, na rede municipal de ensino de Mossoró/RN

This dissertation aims to analyze the specialized educational services(AEE, Portuguese) implemented in four municipal schools of Mossoró/RN, with attention to the process of collaboration between regular classroom teachers and multifunctional resource classroom teachers. We use as theoretical reference the works of Vygotsky and others authors that write about education and collaboration. To accomplish the research we chose a qualitative approach, using as a methodological resources: study of cases, bibliographical, documental and field research. For the field research we make observations in regular and multifunctional classrooms. We produce group intervieus with regular and multifunctional teachers. From the analysis performed we identify that the concepts and the practices of teachers in regular classrooms changes, with integrationist predominance. The AEE s teachers had more inclusive conceptions and greater investment in continuing education than the regular classroom teachers. The practices of regular classroom teachers are more traditional, what makes the learning process more difficult for the students, even more for the students with disabilities and pervasive developmental disorders. Teachers of AEE was more interactive and creative, however, the attention to the students was more individual. In three of the four schools surveyed stand out the efforts of the teachers of specialist classroom to collaborate with regular school teachers, by notes, e-mails, phone calls and resource sharing. In one of the four was noted a good collaborative interactive between the AEE teachers and the regular school teachers. The school with the worst improvement was that in which the actions of the teachers of the AEE were limited to actions in multifunctional resource classroom. The resistance to these professionals was identified in the statements of the regular classroom teachers. Another issue raised was the lack of time for teachers to conduct AEE actions that contribute to the process of school students, because their working hours is restricted to the opposite turn in school. Transport difficulties for the students to attend the resource classroom multifunctional and the lack of dialogue with the health sector was challenges for the four schools. The families were with a practically constant interest to interact with the AEE teachers in the four schools. Thus, we believe that the presence of AEE school can make contributions to the educational process, however, it is necessary more attention to the collaborative process between teachers and the school community

Avaliação da qualidade da assistência aos portadores de úlceras venosas atendidos no ambulatório de um hospital universitário em Natal/RN

Study descriptive that was designed to assess the quality of care for people with venous ulcers (VUs) tended at the ambulatory of a university hospital in Natal / RN. The target population of the study was composed by 40 users bearers of venous ulcers served in the ambulatory of angiology of a university hospital in the level of tertiary education. The study received assent of the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol No. 169/06). The collect of data was performed using a form of interview and tour with collection of measures biophysiologic, for a team comprised by the researchers and an academic of nursing, in the period of three months. The data were analyzed in SPSS 14.0, using descriptive statistics and presented in the form of charts, tables and graphs. Identified a clientele of holders of VUs predominantly female, married, aged up to 59 years, low level of education and household income, from Natal, retirees or those exercising professions and occupations that require long periods standing or sitting. In relation to the characteristics of health, those surveyed had risk factors for venous disease and had UVs chronic, located in Zone 2, lost tissue in grade II and serous exudates on average quantity. The assistance to holders of UVs has been characterized by a lack of professional nurses and unavailability of products for the realization of the right curative in ambulatory and outside it; by the inadequacy of products used in VUs, for long periods of treatment without resolution, where the compressive therapy is not priority, by the lack of completeness in the levels of assistance; by monitoring the bearer of UVs only by doctors and the nurses, even with the other team of professionals in the health service; by the completion of guidelines by health professionals and the lack the standardization of conducting laboratory and specifics tests. The assistance was assessed as inadequate in aspects: reference and counter-reference (75.0%), number of consultations with angiologists last year (87.5%), documentation of the clinical findings (85.0%), use of compressive therapy in the past 30 days (77.5%), part of the team interdisciplinary (97.5%), completion of laboratory and specifics tests in the last year (100%), availability of products used in achieving the curative in ambulatory (80, 0%), and indication of products used in the conduct of dressing outside the clinic (70.0%) and appropriate in the guidelines made on the use of socks, lifting of the members and prescription of exercises regular (82.5%) and indication products used in achieving the curative in ambulatory (97.5%). We conclude that the assistance provided to holders of UV was inadequate in 80% of cases interviewed, becoming non-resolutive and assistematic

Qualidade de vida de pessoas com úlcera venosa: associação dos aspectos sociodemográficos, de saúde, assistência e clínicos da lesão

Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients´ quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients´ QOL. The study´s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universitário Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury

Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.