27 resultados para Retention in care

em Universidade Federal do Rio Grande do Norte(UFRN)


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DAVIM, Rejane Marie Barbosa;ENDERS, Bertha Cruz; DANTAS, Janmilli da Costa; SILVA, Richardson Augusto Rosendo da; NÓBREGA, Edualeide Jeane Pereira Bulhões da. Método mãe-canguru: vivência de mães no alojamento conjunto. Revista da Rede de Enfermagem do Nordeste, Fortaleza, v. 10, n. 1, p. 37-44, jan./mar.2009.

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The current paper aims at analyzing customer retention in Internet provider services. For this study, we sought to understand what are the client's expectations regarding the services available and compare them with management perception in relation to the use of those services. Identifying the coherence level between the two points of view, management and client, it is possible to pinpoint how service is assessed in real conditions. Then, from this point on, a new vision can be implemented on available services, and new customer service strategies aiming at best serving to their expectation and need, can be rethought. The exploratory research was utilized. It was based on case study, and quantitative and qualitative methods were used. The quantitative method was done by applying the cluster technique with six variables of control derived from the six main services, whose definition was done through qualitative survey of the internal management team. Then, an structured interview with 443 clients, from a probabilistic sample of 800 costumers. The total number of active clients of the internet provider is of 10.677. Client perception in relation to services varied, if compared with the four services that were under the managerial metric method, this comparison showed a more positive evaluation than the real use of the service. Thus, it was observed that the value of each service available for the client depends on his/her perception of it, regardless of using or not the offered service. As a result, it is possible to understand which services offered by the company under study effectively contribute to a good client-company relationship, and the upkeep of those clients

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Lightweight oilwell cement slurries have been recently studied as a mean to improve zonal isolation and sheath-porous formation adherence. Foamed slurries consisting of Portland cement and air-entraining admixtures have become an interesting option for this application. The loss in hydrostatic pressure as a consequence of cement hydration results in the expansion of the air bubbles entrapped in the cement matrix, thus improving the sheath-porous formation contact. Consequently, slurries are able to better retain their water to complete the hydration process. The main objective of the present study was to evaluate the effect of the addition of an air-entraining admixture on the density, stability and permeability of composite slurries containing Portland cement and diatomite as light mineral load. Successful formulations are potential cementing materials for low fracture gradient oilwells. The experimental procedures used for slurry preparation and characterization were based on the American Petroleum Institute and ABNT guidelines Slurries containing a pre-established concentration of the air-entraining admixture and different contents of diatomite were prepared aiming at final densities of 13 to 15 lb/gal. The results revealed that the reduction of 15 to 25% of the density of the slurries did not significantly affect their strength. The addition of both diatomite and the air-entraining admixture increased the viscosity of the slurry providing better air-bubble retention in the volume of the slurry. Stable slurries depicted bottom to top density variation of less than 1.0 lb/gal and length reduction of the stability sample of 5.86 mm. Finally, permeability coefficient values between 0.617 and 0.406 mD were obtained. Therefore, lightweight oilwell cement slurries depicting a satisfactory set of physicochemical and mechanical properties can be formulated using a combination of diatomite and air-entraining admixtures for low fracture gradient oilwells

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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

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With the trajectory that the problems related to child health are taking in our society, particularly with regard to infant mortality, beyond the process of decentralization of health and the implementation of the Family Health Strategy in the cities, where it has increased considerably performance of nursing staff in Primary Health Care, they can be considered essential factors for reflections on the care of nurse dispenses the health of these children. In order to check how it is organized the working process of the nurse in caring for these children in USFs as well as the difficulties found in the dynamics of this work, this research aimed to analyze the work processes of nurses in care Child Health in USFs, with emphasis on technologies used in producing care. This is a research exploratory and descriptive with qualitative approach, based on the theoretical reference in about Work Process and Composition Technique of Work. The data were collected through semi-structured interviews of 11 nurses who, at the moment, perform their functions for more than 01 year at USF. The guiding questions were based at theoretical reference. To analyze the results, was used the referential of content analysis, and was refer to thematic analysis. In situations that were involved closed questions of the interview, was used the aid of SPSS 15.0 program for Windows. The results indicated that the process of nurse work in health care of children, focuses on the preventive character, whose focus of the actions are healthy children, following the routines and protocols established by the Ministry of Health with a view to maintaining health them. When analyzing the data through theoretical references of Composition Technique of Work found that the core technologies of daily tasks of the nurse are directed for the use of technology soft-hard and hard, and the reason established between the Dead Working and Alive Working, there is prevalence of the first against the second in the production of this care. These situations contribute to the explanation of the emergence problems related to adhesion of mothers / caregivers to monitoring the CD, due to character prescriptive and normalizer of actions. The results also suggested the presence of "vanishing lines" in the make of nurses, confirming the self-governance of health professionals in daily work. These "vanishing lines" express the own execution of the Work Live in action, guided by the use of soft technologies, however, was not characterized as a process of technology transition. So, to get a better resolution to the problems related to child health, the nurse has reorganize your work process by focusing on the execution of work live in action.

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The objective of analyze the shift of the working process of the ESF team in care of children with disabilities, from awareness-raising actions. It is a qualitative study, with the action-research method. Thirteen health professionals were involved from two teams of ESF unit area of the Unidade de Saúde da Família Dr. Chico Porto (UBSFCP) in Mossoró, from March to August 2011. Data were analyzed following the direction of freirean s thematic analysis. In the situational diagnosis of the current reality of CwD assistance in that UBSFCP, through participant observation and application of semi-structured interviews with professionals, we realize that despite these actions carry some assistance to the CwD, in practice few are used for inclusion and accessibility. The monitoring of the CwD is done through individual consultations by each team professional, home visits when possible, both ruled on the complaints and problems, with little solving in the used actions. Since the need for a change in the treatment model and training requirements as pointed out by professionals in the interview, then we decided to build the proposed of training suggested by the multidisciplinary team and put together collectively the achievement of this moment in all its phases. In the step of implementation (action), aspects related to the current situation in Brazil and Mossoró (Laws, policies and health care) for the CwD and CwD Assistance and their family in the ESF in the first two moments of the first training (action) were contemplate. On the second day we discussed the specialized care to CwD, contribution of the Handicapped Parents and Friends Association of Mossoró and in a second moment a workshop was held in which awareness for inclusion of CwD and actions of ESF were discussed. All these moments were discussed and collectively constructed. In the evaluation, we found that implementation (action) allowed to the professional the comprehension of new understandings about people with disabilities, on ways to include, guiding, caring, watching, and mainly to have a new vision on health assistance of the CwD, expanding assistance beyond clinical aspects and recognizing the educational aspects of the rights and duties of citizens and the inclusion of these children in the social spaces area. As difficulties, we face the need for some professionals to be absent to attend another job, solve personal problems, and little or no participation. Thus, during this action-research, the subjects were able to realize the importance of carrying out their practice to the quality of life for him and to the one they care

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According to demographic estimates, by the year 2025 Brazil will be the sixth country in the world in number of elderly. For this reason, it is a purpose of public policies to help people to reach that age being healthier. The current health care model of health surveillance through the Family Health Strategy (EFS, in portuguese) is configured as a gateway into the care of the elderly in the Unified Health System (SUS, in portuguese). It is also an area of development of practices to promote health, prevention and control of chronic nondegenerative diseases. The aim of this study was to analyze the health care of the elderly provided by ESF professionals for the achievement of a full care. The study is descriptive case study with a quantitative approach, performed in the city of Santo Antônio/RN. The population included all health professionals, who are FHS members of the city that agreed to participate of the survey, a total of 80 professionals. Data were collected using a structured questionnaire, having mostly closed questions and divided into two parts: one containing sociodemographic information of health professionals and vocational training and the other, the activities carried on by the professionals in senior care, being analyzed from a database tabulated in a spreadsheet and discussed according to the descriptive statistics in tables, graphs and charts using frequencies, medians and values of central tendency. It was verified a predominance of professionals who finished highschool, mostly female, aged from 30 to 34 years old, with training completed in the last 10 years, without being graduated in the field of geriatrics or gerontology and mostly without training in gerontology. Family members and caregivers were the components of the social support network most identified by the professionals (66.3%).The elderly access to the Family Health Basic Unit was considered by83.8% of professionals as the most important factor that interferes in the activities of health care of the elderly. Considering the inclusion of the family in care: 98.8% of professionals consider the family as one of the goals of care, but 82.5% assist the family to know their role and participate in the care of the elderly, emphasizing that no professional makes use of tools for evaluating the functionality of the family. Regarding the actions taken to assist the elderly, 91.25% have home visits program to the elderly, 88.75% use the host program; 77.5% know the habits of life, cultural, ethical and religious values of the elderly, their families and their community ;51.25% complement the activities through intersectoral actions, 50%participate in groups of living with the elderly; 33.75% keeps track and maintain updated the health information of the elderly; 11.25% of the professionals perform the Single Therapy Planning (PTS, in portuguese) and few implement the actions to promote health according to PTS; there is a deficit in the number of professional categories in the identification and monitoring of the frail older people in their households. It is concluded that the health care of the elderly developed by ESF professionals differs among the professional categories. It was identified weaknesses in the promotion of an active and healthy aging and also in the establishment of an integrated and full care of the elderly. It is recommended the adoption of permanent educational activities by the City Management, initially for ESF professionals in the the perspective of the guidelines of the National Policy of Health Care for the Elderly and later to the other professionals that are part of the health care network of the elderly, at all levels of care in the city for the development of strategies and practices that promote the improvement of the quality of healthcare for the elderly, expecting concrete and effective results in terms of promoting health within Brazilian reality

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The nurses assistance in monitoring the growth and development of children has been characterized mostly a service based on the biological dimension of illness, when in reality, the actions should be combined in the reorientation of care model of the Family Health Strategy. Thus, the research aimed to examine the role of nurses in the growth and development of children. This is an exploratory and descriptive, qualitative approach. The project was approved by the Ethics Committee of the Universidade Federal do Rio Grande do Norte under Opinion No. 191/2012. Data collection was developed in the Health Units from the city of Natal, RN, Brazil. Survey participants were nurses who worked in the Family Health Strategy for at least two years and who performed the monitoring of child growth and development in the health unit selected. Data were collected through an in-depth interview, and seized material from speeches was treated as categorical thematic analysis proposed by Bardin. This process revealed three themes, which were analyzed in the light of Relief Models and Process Work in Health and Nursing and discussed based on the findings literary. The results elucidated that nurses consider their performance satisfactory as it has favored the accession of mothers of children under one year nursing visits, contributing to the reduction of morbidity and mortality due to prevalent diseases, as well as the establishment of a connection between the professionals and mothers. It was shown that despite having a promotion and prevention with the use of lightweight technologies, the nurses also emphasized the care of mothers in complaints and signs and symptoms of children, followed by referrals to professionals in the unit or to other sectors. Furthermore, we found that the process of working nurses face challenges regarding the organizational structure of services and social situation of the family. Given these statements, it is observed that despite the strong interference from hegemonic health model in the performance of nurses, it is found that these professionals have been investing in promotion and prevention to injuries to children in care, with a focus on family context. Thus, nurses are embarking on making the reorientation of health care through the use of relational technologies, which has contributed to solving the integral care to the pediatric population

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Drying of fruit pulps in spouted beds of inert particles has been indicated as a viable technique to produce fruit powders. Most of the processes employed to produce dried fruit pulps and juices, such as Foam Mat, encapsulation by co-crystallization and spray drying utilize adjuvant and additives (such as thickeners, coating materials, emulsifiers, acidulants, flavors and dyes), which is not always desirable. The fruit pulp composition exerts an important effect on the fruit powder production using a spouted bed. In the study by Medeiros (2001) it was concluded that lipids, starch and pectin contents play an important role on the process performance, enhancing the powder production; however, the drying of fruit pulps containing high content of reducing sugars (glucose and fructose) is practically unviable. This work has the objective of expanding the studies on drying of fruit pulps in spouted bed with aid of adjuvant (lipids, starch and pectin) aiming to enhance the dryer performance without jeopardizing the sensorial quality of the product. The optimum composition obtained by Medeiros (2001) was the basis for preparing the mixtures of pulps. The mixture formulations included pulps of mango (Mangifera indica), umbu (Spondias tuberosa) and red mombin (Spondia purpurea) with addition of cornstarch, pectin and lipids. Different products were used as lipids source: olive and Brazil nut oils, coconut milk, heavy milk, powder of palm fat and palm olein. First of all, experiments were conducted to define the best formulation of the fruit pulps mixture. This definition was based on the drying performance obtained for each mixture and on the sensorial characteristics of the dry powder. The mixture formulations were submitted to drying at fixed operating conditions of drying and atomizing air flow rate, load of inert particles, temperature and flow rate of the mixture. The best results were obtained with the compositions having powder of palm fat and palm olein in terms of the drying performance and sensorial analysis. Physical and physicochemical characteristics were determined for the dry powders obtained from the mixtures formulations. Solubility and reconstitution time as well as the properties of the product after reconstitution were also evaluated. According to these analyses, the powder from the mixtures formulations presented similar characteristics and compatible quality to those produced in other types of dryers. Considering that the palm olein is produced in Brazil and that it has been used in the food industry substituting the palm fat powder, further studies on drying performance were conducted with the composition that included the palm olein. A complete factorial design of experiments 23, with three repetitions at the central point was conducted to evaluate the effects of the air temperature, feeding flow rate and intermittence time on the responses related to the process performance (powder collection efficiency, material retained in the bed and angle of repose of the inert particles after the process) and to the product quality (mean moisture content, loss of vitamin C and solubility). Powder production was uniform for the majority of the experiments and the higher efficiency with lower retention in the bed (59.2% and 1.8g, respectively) were obtained for the air temperature of 80°C, mixture feed rate of 5ml/min in intervals of 10 min. The statistical analysis of the results showed that the process variables had individual or combined significant influences on the powder collection efficiency, material retention in the bed, powder moisture content and loss of vitamin C. At the experimental ranges of this work, the angle of repose and solubility were not influenced by the operating variables. From the results of the experimental design, statistical models were obtained for the powder moisture content and loss of vitamin C

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Nowadays, Brazil has both the greatest goat herd and the greatest goat milk production of South America. The state of Rio Grande do Norte, located in northeast of Brazil, has an average year production of three thousand cubic meters of goat milk in natura. Part of this milk production is homemade and it comes from small farms, which unite in rural cooperatives created to encourage the production and implementation of industrial processes for preservation and processing of milk. Results presented by literature and obtained from preliminary essays in this thesis show that non conventional dryer of spouted bed with inert particles is able to produce powder milk from in natura milk (cattle or goat), with the same quality of spray dryer, however, operating at low cost. The method of drying in spouted bed consists of injecting milk emulsion on the bed of inert particles gushed by hot air. This emulsion covers the particles with a thin film, which dries and is reduced to powder during the circulation of inerts inside the bed. The powder is dragged by exhaustion air and separated in the cyclone. The friction among particles resulted from the particles circulation, encourages high taxes of shear in the thin film of emulsion, breaking the cohesive forces and making this process possible. Studying the drying process and the powder goat milk production in one unit of spouted bed with inert particles, seeing the development of a low cost technological route for powder milk production is the aim of this thesis. The powder milk produced by this route must attend the local demand of food industries which need an intermediate product to be used as a food ingredient (ice-cream, milk candy). In order to reach this aim, this thesis approaches the aspects related to physical, thermodynamics and physic-chemicals characteristics of goat milk, whose complete data are still inexistent in the literature. The properties of materials are of great importance to the project of any process which involves the operations of transportation of movement, heat and mass quantity, such as the dryers which operate in fluid dynamically active regime, like the spouted bed. It was obtained new data related to the goat milk properties in function of concentration of solids and temperature. It is also important to mention the study developed about the kinetic of solids retention in the bed of inert particles during the drying of goat milk. It was found more adequate processes conditions to the proposed technological route to be implemented in small and micro-industries, with simplifications in the system of milk injection as well as in the form of operation of the dryer. Important data were obtained for a posterior stage of this research which involves the v modeling, simulation, control and optimization of the process. The results obtained in this thesis, in relation to process performance as well as to the quality of produced powder milk validate the proposal of using the spouted bed dryer in the production of powder goat milk

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The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems

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The Callitrichidae family presents cooperative breeding, where breeders and non breeders take care of the offspring. The aspects of care analyzed in this study were infant carrying, supervision, proximity and food transfer. Three sets of infants from two wild groups of Callithrix jacchus were studied in the environments of Caatinga (Assu group) and Atlantic Forest (Jundiaí group). The methods used in the study were instantaneous focal sampling (infant carrying, supervision and proximity) and continuous focal sampling (food transfer). In the two sets observed in Assu group, the father carried and transferred food to infants more than the rest of the group. The biggest contribution in supervision was from the father and from another adult male. The members that remained in proximity to the infants in both groups were the younger in the groups (juveniles and sub-adults). In the Jundiaí group, the father and the adult male helper of the group were the main caregivers; one of the sub-adult females was responsible for supervision of the infants. With the disappearance of the reproductive male and one of the sub-adults females in 3º month of infants life, the care was redistributed and the only adult male left in the group was the animal that contributed more in provisioning of the infant. In the Assu group, there were adult females in its composition which were involved in agonistic interactions with breeders and adult males, and seemed to influence their low participation in care. Food transfer initiates early in the development of the infants, as a way to encourage nutritional independence. Different types of food transfer (active food transfer, food steal, food steal attempt, passive food transfer and food handling) were observed in the study and frequency of each one varied with developmental phase and tolerance by the members. One relevant data of the study was the presence of active food transfer in Assu group, since in literature there are very few registers of this type of transfer for this species. It is important that groups from distinct environments and composition be studied for a better understanding of the dynamics of infants development

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Drying of fruit pulps in spouted beds of inert particles has been indicated as a viable technique to produce fruit powders. Most of the processes employed to produce dried fruit pulps and juices, such as Foam Mat, encapsulation by co-crystallization and spray drying utilize adjuvant and additives (such as thickeners, coating materials, emulsifiers, acidulants, flavors and dyes), which is not always desirable. The fruit pulp composition exerts an important effect on the fruit powder production using a spouted bed. In the study by Medeiros (2001) it was concluded that lipids, starch and pectin contents play an important role on the process performance, enhancing the powder production; however, the drying of fruit pulps containing high content of reducing sugars (glucose and fructose) is practically unviable. This work has the objective of expanding the studies on drying of fruit pulps in spouted bed with aid of adjuvant (lipids, starch and pectin) aiming to enhance the dryer performance without jeopardizing the sensorial quality of the product. The optimum composition obtained by Medeiros (2001) was the basis for preparing the mixtures of pulps. The mixture formulations included pulps of mango (Mangifera indica), umbu (Spondias tuberosa) and red mombin (Spondia purpurea) with addition of cornstarch, pectin and lipids. Different products were used as lipids source: olive and Brazil nut oils, coconut milk, heavy milk, powder of palm fat and palm olein. First of all, experiments were conducted to define the best formulation of the fruit pulps mixture. This definition was based on the drying performance obtained for each mixture and on the sensorial characteristics of the dry powder. The mixture formulations were submitted to drying at fixed operating conditions of drying and atomizing air flow rate, load of inert particles, temperature and flow rate of the mixture. The best results were obtained with the compositions having powder of palm fat and palm olein in terms of the drying performance and sensorial analysis. Physical and physicochemical characteristics were determined for the dry powders obtained from the mixtures formulations. Solubility and reconstitution time as well as the properties of the product after reconstitution were also evaluated. According to these analyses, the powder from the mixtures formulations presented similar characteristics and compatible quality to those produced in other types of dryers. Considering that the palm olein is produced in Brazil and that it has been used in the food industry substituting the palm fat powder, further studies on drying performance were conducted with the composition that included the palm olein. A complete factorial design of experiments 23, with three repetitions at the central point was conducted to evaluate the effects of the air temperature, feeding flow rate and intermittence time on the responses related to the process performance (powder collection efficiency, material retained in the bed and angle of repose of the inert particles after the process) and to the product quality (mean moisture content, loss of vitamin C and solubility). Powder production was uniform for the majority of the experiments and the higher efficiency with lower retention in the bed (59.2% and 1.8g, respectively) were obtained for the air temperature of 80°C, mixture feed rate of 5ml/min in intervals of 10 min. The statistical analysis of the results showed that the process variables had individual or combined significant influences on the powder collection efficiency, material retention in the bed, powder moisture content and loss of vitamin C. At the experimental ranges of this work, the angle of repose and solubility were not influenced by the operating variables. From the results of the experimental design, statistical models were obtained for the powder moisture content and loss of vitamin C

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The objective was to understand the process of care in the perception of hospitalized children with cancer. This is a descriptive study of qualitative approach. Data were collected between the months of October 2013 and January 2014, through photographic records and semi-structured interview consisting of questions relating to the identification of age, sex, diagnosis and length of stay and a script of questions related to the recorded pictures. Eight children were included aged between six and twelve who were admitted to a pediatric oncology sector, located in the city of Natal / RN. The criteria used in the sample were: being hospitalized for cancer treatment; and present favorable physical conditions for carrying out the data collection. For the treatment of collected material was used content analysis, thematic modality. The study followed the ethical and legal principles governing scientific research with human beings and took place with the approval of the project by the Ethics and Research Committee of the Northern League Riograndense against Cancer, with opinion registered under number 329 015 and CAAE 16097613.9.0000.5293. According to the results it was found that, for the child, the care happens through technical activities, such as making procedures and the use of personal protective equipment, as well as through the dialogic relationship, which favors the establishment of confidence in care professional. Caring also means developing activities that promote well-being, the fun and the social and cognitive development, highlighting thus the playful, during hospitalization, as an auxiliary tool in the care process. During hospitalization, the child identifies two individuals responsible for their care, accompanying family and professional, and nursing professionals the most cited in moments of care. , Also of note, the promotion of care, in the perception of the child related to the infrastructure of the institution, environmental cleaning, personal hygiene, the medicalization and the food. It is concluded that care understood by the child, whilst still maintaining relations with the biomedical model, points to a new perspective that should consider the biological, social and psychological of acquiring cancer without unlink them of the development child. 9 Moreover, we see the child as an active social actor in this process, and therefore needs to be heard and answered their needs

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In the Brazilian network of psychosocial care, health professionals are important actors in the process of transformation of mental health public policies among various services. In the reality of psychiatric hospitals, one should understand the need to expand the debate about the current context of practices developed. This study aimed at analyzing the process of psychiatric reform and the mental health policy in the State of Rio Grande do Norte (RN) from the profiles and practices of higher-level professionals in two psychiatric hospitals. This is a cross-sectional and descriptive research, with quantitative and qualitative data, conducted in two psychiatric hospitals of RN. The universe of the target population was 95 professionals, taking into account the margin of error of 8%, non-response rate and the inclusion criteria: holding effective link with the institution by means of approval in public examination for, at least, six months, being state or municipal servant; having a minimum weekly workload of 20 hours in service; participating in care and/or activities with patients and families in a direct way. The final sample consisted of 60 professionals. The tool for data collection was a questionnaire with closed and semi-open questions about socioeconomic profile, and mental health policies, practices and training. Quantitative data were tabulated in the statistical software SPSS, and simple and bivariate statistics, chi-square type, was used for analysis by adopting the significance level with the value p<0,05. In order to analyze data, the content analysis of Bardin was used. The qualitative findings obtained with the semi-open questions in Analyse Lexicale par Context d'un Ensemble de Segments de Texte (ALCESTE) were grouped into four thematic axes: Professional action in mental health; Mental health training; Scenarios of psychiatric reform and psychiatric hospitals; Mental health policies and practices: challenges for professionals in hospitals. The profile of professionals has revealed the majority of women (89,7%), nurses (36,7%), aged 50-59 years (42,9%), weekly workload of 40 hours (52,4% ), time of completion of graduation from six to 15 years (57%), and 21,4% reported to have specialization in mental health. Regarding the practices developed in individual care, it was found an association between those who do not build or partially conducts the therapeutic project and those who conduct care related to observation and annotation. In family care, it was obtained care consultation during crisis; and, in group care, recreational activities. In the analysis of thematic axes, it was noted that, despite changes identified in the profiles and practices of higher-level professionals in care services for mental health, with the implementation of new public policies for this field, the findings indicate the confluence of asymmetries and divergences in the actions of the teams in psychiatric hospitals, difficulties in managing services, frequent readmissions, reduced quantitative of available services and equipment, high demand of users, disarticulation of the network of psychosocial care, and the very shortage of skilled human resources to compose these services. Accordingly, the evidenced scenarios partially outline the current political and ideological mismatch of the national process of psychiatric reform that denies the role of care actions conducted within hospitals, although it has not gone far enough with the creation of new services that justify the total extinction of this institution