Atividade de formação interprofissional em urgência pré-hospitalar

To acting in emergencies it is important that health professionals develop specific and differentiated skills, which shows us the importance of training in emergency planning. So undergraduate courses in medicine and nursing should encourage the development of these skills and evaluate them through various instruments targeted to the different fields. The aim of this study was to implement an optional and interprofessional curricular component, focusing on interprofessional education in pre-hospital emergency for medical and nursing courses Federal University of Rio Grande do Norte (UFRN). This is an exploratory descriptive study, with 24 medical and nursing graduates of last year undergraduate of supervised training, who underwent theoretical and practical training in the care of pre-hospital emergency services. There were theoretical and practical lessons per week for one school semester, taught by doctors and nurses of the Emergency Medical Service (EMS), where the topics discussed were: basic and advanced life support, safe transport in clinical emergencies, trauma, gynecological, obstetric, pediatric and psychiatric diseases, and have been carried out practical activities in ambulances. The students were evaluated by pre-test, post-test and practical stations made through the Objective Structured Clinical Evaluation (OSCE), in the skills laboratory of the Health Sciences Center. During the activities the students were encouraged to critical and reflective thinking, highlighting the importance of integration between the various health care professionals. It was observed that 88% of the students had a score increase over the pre-test. In the evaluation process carried out by medical students and nursing UFRN have similar expectations regarding the essential skills acquired during the training activity. The results of this study will form the basis for the organization of interprofessional education activity in pre-hospital emergency medical students and nursing, as well as helped to organize practices stations, identifying basic clinical skills, and implementing student assessment tools UFRN.

Estratégia de capacitação pedagógica do residente: uma perspectiva para melhoria do ensino na Universidade Federal do Rio Grande do Norte

Studies have shown that resident informally plays the role of teacher. It is estimated that up to 25% of the residents of the time is devoted to teaching, mainly contributing as a facilitator, however, almost the entire medical residency programs in Brazil did not offer teacher training during residency education. This paper aims to introduce educational content initiation to teaching as part of the training of resident physician inserted in residency program of the University Hospital Onofre Lopes (HUOL). It is an exploratory, descriptive and prospective study in HUOL the Federal University of Rio Grande do Norte. Three steps were developed: preparation and planning of a pedagogic course, associated with a motivating technical content (basic and advanced life support); second stage, testing of pedagogical model for medical students; and finally, replication to residents. The interventions were made two practice stations life support with performance evaluation in practical activity through OSPE (Objective Structured Practical Examination). The techniques presented teachings were one-minute preceptor and feedback. Data collection was conducted through a structured evaluation form during the life support stations and at the end of the course, and analyzed using descriptive statistics. The results showed that the feedback and one minute preceptor were considered important for teaching and learning for more than 85% of participants. The feedback from evaluators practices stations added information about the performance and were held appreciatively way, according to 100% of the participants. Positive aspects highlighted by the participants were related to educational content, especially the participants of the first intervention. The time of the lectures of motivating technical content was the most repeated negative. Based on the good acceptance of pedagogical contents, this pioneer teacher training strategy was included in the formal residency program in Cardiology of our institution. It is considered therefore that the educational training model with motivating technical content was feasible and had a good evaluation and acceptance by most participants in both interventions. Thus, we believe that the educational content can be inserted in the formal curriculum of medical residency of other programs at HUOL through the training model developed in this study.

Estratégia de capacitação pedagógica do residente: uma perspectiva para melhoria do ensino na Universidade Federal do Rio Grande do Norte

Studies have shown that resident informally plays the role of teacher. It is estimated that up to 25% of the residents of the time is devoted to teaching, mainly contributing as a facilitator, however, almost the entire medical residency programs in Brazil did not offer teacher training during residency education. This paper aims to introduce educational content initiation to teaching as part of the training of resident physician inserted in residency program of the University Hospital Onofre Lopes (HUOL). It is an exploratory, descriptive and prospective study in HUOL the Federal University of Rio Grande do Norte. Three steps were developed: preparation and planning of a pedagogic course, associated with a motivating technical content (basic and advanced life support); second stage, testing of pedagogical model for medical students; and finally, replication to residents. The interventions were made two practice stations life support with performance evaluation in practical activity through OSPE (Objective Structured Practical Examination). The techniques presented teachings were one-minute preceptor and feedback. Data collection was conducted through a structured evaluation form during the life support stations and at the end of the course, and analyzed using descriptive statistics. The results showed that the feedback and one minute preceptor were considered important for teaching and learning for more than 85% of participants. The feedback from evaluators practices stations added information about the performance and were held appreciatively way, according to 100% of the participants. Positive aspects highlighted by the participants were related to educational content, especially the participants of the first intervention. The time of the lectures of motivating technical content was the most repeated negative. Based on the good acceptance of pedagogical contents, this pioneer teacher training strategy was included in the formal residency program in Cardiology of our institution. It is considered therefore that the educational training model with motivating technical content was feasible and had a good evaluation and acceptance by most participants in both interventions. Thus, we believe that the educational content can be inserted in the formal curriculum of medical residency of other programs at HUOL through the training model developed in this study.

Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events

Entre cartas e contos na sala de aula: diálogos e afetos em textos de Mário de Andrade e Câmara Cascudo

Specific educational material production for a group of level IV – 8th and 9th years of Youth and Adults Education, having as starting point the reading of a series of letter of correspondence between Câmara Cascudo and Mário de Andrade in the 1920s, and the verification of the way the dialog between the two authors reveals elements that transpire themselves in the tale entitled “Piá não sofre? Sofre”, from the book Os contos de Belazarte, de Mário de Andrade. The educational material production was preceded by the analysis of the selected tale, which will be studied along with some of the letters, in an analysis of the textual, discursive and semantic features of the text in representation of these both genres: letter and tale. The selected tale was written between 1923 and 1926, dates close to the years when the author came by Rio Grande do Norte state, in the years from 1927 to 1929, accompanied by Câmara Cascudo, being also this period that there are records of letters in the set of correspondence between them. To the reading of the selected material, it was used theoretical references from literature and literary historiography, especially the history of Brazilian modernist movement. To the production of the educational material, it was chosen as theoretical reference the accumulated knowledge in the area of literature teaching, literacy and the recommendations of the Brazilian National Curriculum Parameters. The methodology in this study was constructed from the theoretical references and had as basic support the study of didactic sequences from which a specific thematic unit got its shape from, required by the analyzed material and tested in a classroom.

Entre cartas e contos na sala de aula: diálogos e afetos em textos de Mário de Andrade e Câmara Cascudo

Specific educational material production for a group of level IV – 8th and 9th years of Youth and Adults Education, having as starting point the reading of a series of letter of correspondence between Câmara Cascudo and Mário de Andrade in the 1920s, and the verification of the way the dialog between the two authors reveals elements that transpire themselves in the tale entitled “Piá não sofre? Sofre”, from the book Os contos de Belazarte, de Mário de Andrade. The educational material production was preceded by the analysis of the selected tale, which will be studied along with some of the letters, in an analysis of the textual, discursive and semantic features of the text in representation of these both genres: letter and tale. The selected tale was written between 1923 and 1926, dates close to the years when the author came by Rio Grande do Norte state, in the years from 1927 to 1929, accompanied by Câmara Cascudo, being also this period that there are records of letters in the set of correspondence between them. To the reading of the selected material, it was used theoretical references from literature and literary historiography, especially the history of Brazilian modernist movement. To the production of the educational material, it was chosen as theoretical reference the accumulated knowledge in the area of literature teaching, literacy and the recommendations of the Brazilian National Curriculum Parameters. The methodology in this study was constructed from the theoretical references and had as basic support the study of didactic sequences from which a specific thematic unit got its shape from, required by the analyzed material and tested in a classroom.

Natureza morta...edifício com vida: uma arquitetura sustentável para o Serviço de Verificação de Óbitos

Sustainability in buildings, while reducing the impact on the environment, contributes to the promotion of social welfare, to increase the health and productivity of occupants. The search for a way of build that meets the aspirations and development of humanity without, however, represent degradation of the environment, has become the great challenge of contemporary architecture. It is considered that the incorporation of principles that provide a sustainable building with careful choices of design solutions contribute to a better economic and thermal performance of the building, as well as functional and psychological comfort to its users. Based on this general understanding, this paper presents an architecture project aimed to health care whose the solutions adopted follow carefully the relevant legislation and sets his sights on the theme of sustainability. The methodology began with studies on the themes of verification service of deaths, sustainability and those application in construction developed through research in academic studies and analysis of architectural projects, using them like reference for the solutions adopted. Within the project analysis was performed a visit to the verification service of deaths in the city of Palmas in Tocantins, subsidizing information that, plus the relevant legislation, led to functional programming and pre-dimensional of the building to be designed. The result of this programming environments were individual records with information from environmental restrictions, space required for the development of activities, desirable flow and sustainability strategies, that can be considered as the first product of relevance of the professional master's degree. Finally we have outlined the basic design architecture of a Verification Service of Death SVO/RN (in portuguese), whose process of projecting defined as a guiding line of work four points: the use of bioclimatic architecture as the main feature projectual, the use of resources would provide minimal harm to the environment, the use of modulation and structure to the building as a form of rationalization and finally the search for solutions that ensure environmental and psychological comfort to users. Importantly to highlight that, besides owning a rare theme in literature that refers to architectural projects, the whole project was drawn up with foundations in projective criteria that contribute to environmental sustainability, with emphasis on thermal performance, energy efficiency and reuse of rainwater

Avaliação da autopercepção estética e qualidade de vida em pessoas vivendo com HIV/AIDS com síndrome lipodistrófica (SLD) em uso de antirretrovirais

Em 1996 com a introdução no Brasil da Highly Active Antiretroviral Therapy (HAART) melhorando a sobrevida e diminuindo o número de óbitos entre os portadores do HIV/Aids, surgem relatos de alterações metabólicas e morfológicas - Síndrome Lipodistrófica (SLD). Portanto, este estudo busca avaliar a partir da autopercepção estética de pessoas que vivem com HIV/AIDS (PVHA) em uso de terapia antirretroviral (TARV) o impacto da SLD na qualidade de vida. Pesquisa exploratória observacional com dados quantitativos e qualitativos, que contou com a multidisciplinaridade, a partir dos critérios de inclusão os voluntários eram captados pelo médico infectologista assistente. Foi realizada com base nos princípios da Resolução 196/96-CNP. A amostra foi composta por 48 PVHA, com idade entre 32 a 66 anos. 89,6% demonstraram interesse em mudar partes do corpo que perceberam enquanto alteradas ou comprometidas pela SLD, dado reforçado quando estes afirmam que se percebem (35,4%) e sentem (35,4%) que as outras pessoas os vêem de forma diferente. Quanto a qualidade de vida o domínio da espiritualidade, religião e crenças pessoais alcançou maior média (14,7) com DP 4,0 neste estudo. A pesquisa permitiu uma publicação internacional (Journal of Public Health and Epidemiology-JPHE) e várias participações com publicação em eventos (nacionais e internacionais). O estudo sugere que a infecção por HIV e a presença da SLD a partir da autopercepção dos sujeitos entrevistados pode afetar a qualidade de vida. E destaca a importância de ações que ressaltem o suporte social como motivador para o autocuidado

Qualidade de vida do servidor da Universidade Federal do Rio Grande do Norte em condição crônica de saúde

The study aimed to analyze the influence of chronic health conditions (CHC) on quality of life (QOL) of UFRN servers assaulted by CHC. It is a descriptive and cross-sectional study with prospective data and quantitative approach, accomplished in the ambulatory clinic of the Department of Server Assistance (DSA) of the Pro-Rectory of Human Resources, during three months. The sample was composed by accessibility, totaling 215 people, being 153 active and 62 inactive servers, in chronic health condition. The data were collected through the application of the sociodemographic characterization, health, environmental and laboral form, the Medical Outcome Study 36-Item Short Form (SF-36). The study was evaluated by the HUOL Ethics Committee (CAAE no. 0046.0.294.000.10), obtaining assent. The results were analyzed in the SPSS 15.0 program through the descriptive and inferential statistics. It was identified servants predominantly male (59,1%), under 60 years old, married or in stable union, Catholics, brown color, living in the capital and residents in own home. Regarding labor issues, there was a predominance of active servers technical-administrative with intermediate and medium level positions and small proportion of docents. Among the CHC, the non-communicable diseases - NCDs (95.8%) had a higher frequency, followed by persistent mental disorders - PMDs (18.6%) and, finally, the continuous and structural physical deficiency - CSPD (16.9 %). The QOL of servers was considered good, with a mean score of 72.5 points in the total score, with the most affected domains: physical (59.1), general health (66.2), bodily pain (66.3) and functional aspects (72.0). The mental health dimension (76.5) had a better average than the physical dimension (68.0 points). It was found that the decrease in QOL scores is significant statistically related to higher number of CHC (ρ <0.001), with no statistical significance regarding the functional situation (p = 0.259). The administrative technicians of elementary, primary, secondary levels and docents had the worst QOL scores. After the correlation analysis of CHC with the domains and dimensions of the SF-36, there was statistically significant, negative and weak correlation of the domains: functional aspect (ρ = 0.002, r = -0.207), physical aspects (ρ = 0.007; r = -0.183), vitality (ρ = 0.002, r = -0.213), social function (ρ = 0.000, r = -0.313), emotional aspects (ρ = 0.000, r = -0.293), mental health (ρ = 0.000 , r = -0.238), physical health dimension (ρ = 0.002, r = -0.210) and mental health dimension (ρ = 0.000, r = -0.298). The presence of PMD isolated or together, contributed to a lower SF-36 scores, being the domains variation of mean significant, except for bodily pain, general health and physical aspects. By correlating the categories of CHC and QOL, there was a weak correlation (r ≤ -0.376) and significant (ρ ≤ 0.011), mainly related to the NCD, PMDs and NCD + PMD, affecting the mental health, social function, emotional aspects, vitality and functional aspect domains. Front of the results, it was concludes that the servers quality of life is influenced by the CHC. Thus, it was inferred that the presence of CHC causes a negative effect on quality of life, leading the active and inactive servers to exposure their overall life activities and work over the years, due to the morbidity affected, mainly related to NCDs and PMDs. Descriptors: Quality of life. Chronic disease. Occupational Health. Nursing

A encruzilhada da vida política em assentamentos de reforma agrária no Rio Grande do Norte

The rural settlements represent a mark in the expensive historical process of fight by the land in Brazil. At first offer basic terms of survival, through the access the land and of the fundamental supports for exploration. At the same time, have stimulated organization forms politicizes of the families who manage to work with the new challenges of the everyday. The moment that follows the land conquest, and therefore, the settlements construction while life and work project, it is crossed for objective and subjective demands, with highlight for options of agricultural production and strategies of collective action. Originally formed as representation instance legitimates of the families - front to the government and social actors - the settlers associations are private spaces for political sociability, that guided by principles participative, can lead the settlers the new conquests through indeed democratic experiences. The goal of this work is to comprehend the participation forms in the scope of these associations and the way as that translates in life best terms for the group, from the settlements experiences located in the Territories of the Citizenship Mato Grande and Açu-Mossoró, in Rio Grande do Norte's State. The theoretical conceptions that guide this analysis are concentrate on discussions about democracy and participation (Patermam, Putnam, Bodernave) and in the reflections about the rural world (Medeiros, Martins, Woodman e Woodman and Bergamansco). About methodological, different point of view strategies were developed: The direct observation, the application in locate of questionnaires to the families settlers and interviews semi-structured with the internal leaderships. With that could verify that the participation forms in the associations operate in two heartfelt: Of a side, they promote assimilation opportunities of democratic abilities accompanied of notions of social rights and redefinition of political standards; Of another, it offers indeed the possibility of the settlers lead, with relative autonomy, the political organization and her changes in direction to a way of life that wish to have in the settling

Beco da lama: formas e cores de uma plástica da vida

Our research goes a remarkable setting of Natal-RN. This is a place where we find art practices and artworks territorialities building the margin of museums, art galleries and institutional galleries. Its geography includes an area popularly known as Mud Alley. Along geography that we critically about how some processes of sociability, which formed the margins of institutional fields, can, and its progeny, compose new possibilities to relate to art and artistic practices. Thinking about the dialogues and clashes that positioning the margins can offer, we investigated the role of bookstores, bars and other spaces of the Alley in the promotion and dissemination of artistic practices, focusing on how these spaces handle the work, the artists and the patrons Beco da Lama. Our integration into the search field resulted in collecting testimonials, pictures and watching expressions which, together with sensations obtained during the years of integration in that setting, help make our empirical material. To follow us methodologically this investigation, we looked at a higher frequency, a theoretical support of authors: Gilles Deleuze, Félix Guattari and Giorgio Agamben. With them compose an investigative diagram to think about the art of Alley, noting the relationship of the Alley with the established field of art, as well as towards the rest of the city. The results point to the view of a singular event that shows artistic practices writing in the margins of institutional spaces, new territoriality for contact with art. The term territoriality points to situations formed by practices, feelings, wishes, expressions, and poetic subjectivity that can tell us we are confronted with an event comprising it as the moment of realization of potentialities, desires, subjectivities and spatialities training, flocks, movements. In our case, the event while the Mud Alley Alley Arts forced us to rethink the role and the place of art and artist in Natal-RN

Sistema inteligente para diagnóstico de patologias na laringe utilizando máquinas de vetor de suporte

The human voice is an important communication tool and any disorder of the voice can have profound implications for social and professional life of an individual. Techniques of digital signal processing have been used by acoustic analysis of vocal disorders caused by pathologies in the larynx, due to its simplicity and noninvasive nature. This work deals with the acoustic analysis of voice signals affected by pathologies in the larynx, specifically, edema, and nodules on the vocal folds. The purpose of this work is to develop a classification system of voices to help pre-diagnosis of pathologies in the larynx, as well as monitoring pharmacological treatments and after surgery. Linear Prediction Coefficients (LPC), Mel Frequency cepstral coefficients (MFCC) and the coefficients obtained through the Wavelet Packet Transform (WPT) are applied to extract relevant characteristics of the voice signal. For the classification task is used the Support Vector Machine (SVM), which aims to build optimal hyperplanes that maximize the margin of separation between the classes involved. The hyperplane generated is determined by the support vectors, which are subsets of points in these classes. According to the database used in this work, the results showed a good performance, with a hit rate of 98.46% for classification of normal and pathological voices in general, and 98.75% in the classification of diseases together: edema and nodules

Qualidade de vida, eficiência mastigatória e presença de disfunção temporomandibular em usuários de prótese parcial removível com arco dental curto inferior

Even nowadays there is in Brasil a large number of edentulous and a precarious financial condition of most of the population. In addition, World Health Organization aims for oral health, which consists on the maintenance of a natural dentition, functional and aesthetic composed of at least 20 teeth, without need of prosthetic intervention throughout life. From this and considering the lack of researches about the permanence of edentulous spaces in the oral cavity, and also avoiding overtreatment, this research has been proposed. Thus, the aim was to evaluate the effect of different lengths of the shortened lower dental arch in the presence or absence of a removable partial denture (RPD) on masticatory function, quality of life and occurrence of temporomandibular dysfunction. To achieve this goal, we compared the masticatory efficiency (colorimetric test), the oral comfort through the analysis of the impact of oral health in quality of life (OHIP-14), the presence of temporomandibular dysfunction (RDC/TMD) and the general quality of life (WHOQOL) of patients with shortened dental arches (SDA) (n=60), which is an arch with a reduction of teeth starting posteriorly, and patients with complete dental arch (Complete DA) (n = 34). The group of patients whit SDA was divided among PPR wears (PPD + SDA) (n = 17) and non-wears (n = 43). The population of this study consisted on patients who received or looked for treatment at the clinics of the Department of Dentistry of UFRN, from clinical analysis and records. The sample was chosen by convenience. For statistical analysis, it was a database in SPSS 17.0, followed by descriptive analysis with frequencies, absolute values, tests of central tendency and variability. The statistical tests used were chi-squared and analysis of variance as well as Tukey s post test, when applicable, all with a 95% confidence level. The results shown a prevalence of TMD of 47,1% among patients using PRP and 69,8% among those who didn t, but this result wasn t statistically significant. The mean of the results of masticatory efficiency, WHOQOL and OHIP didn t show association to the presence or absence of PPR and to the lower number of occlusal units of the patients (0, 1, 2 or more occlusal). The association only occurred among the different groups of SDA and the patients with complete dental arch. Taking into account the results, it could be observed that studied patients with low posterior support using lower PRP didn t have better masticatory efficiency, general quality of life, less impacts of their oral conditions in quality of life or not even less temporomandibular dysfunction or better masticatory efficiency when compared to those who didn t use the prosthesis

Adolescentes e jovens e suas bases de apoio :relações de amizade como suporte social no enfrentamento à violência

The purpose of this work is to map the family and community social supports for adolescents and young students from Bom Pastor Distric, West Zone of Natal/RN, as well as to describe how such resources are used by these individuaIs in that community. Social support refers not only to formal activities or organizations, but also to spontaneous or informal forms of support - friendship and solidarity nets available in the community, affective relations that are meaningful in the lives of children and young people. Our discussion is based on a research performed with 382 adolescents and young students from Jean Mermoz Public School (students from 5th to 11th grades, aged 13 to 14). We emphasized the situations of violence derived from family or community spheres faced by these students. In relation to this specific aspect, we observed the participants more frequently look for help from the informal social supports, mostly from their friends, which indicates that the formal ones are not considered to be effective instruments for social assistance. The search for informal social supports shows the relations informally established in the streets (for instance when they look for help from friends, rei atives or neighbors) have more effect and play an important role in which there are values and affections exchange. Thinking the strengthening of these social links is of extreme importance and leads to the weakening of the hegemonic logics focused on the production of subjects as private identities, and to the amplification of an ethics committed to the disassembly of a sociability anchored to fear, impotence, intolerance, discrimination, and reduction of spaces for circulating and confronting mechanisms of social exclusion. It is crucial that we concentrate our attention to building friendship as a system of reciprocity and affective exchanges, as a space for political actions and production of forms of lives that are potent against social anesthesia

Suporte ao uso de álcool e drogas na atenção primária: um estudo com equipes de Natal/RN

National surveys indicate that 6.8 % of the brazilian population is dependent on alcohol and 1 % dependent on illicit drugs, representing a significant portion of the population affected by this issue . Primary Care becomes instrumental in expanding the coverage of this demand and in reducing unnecessary referrals for specialized care. This study aimed to investigate the responsiveness and institutional support of Primary Care Teams in relation to the demands of alcohol and drugs users. The research was conducted in a Family Health Unit in West Sanitary District of Natal City. With quantitative and qualitative nature, our study consisted of two stages. At first, we performed a mapping of alcohol and other drugs abusive use in a sample of the population assisted by Family Heath Teams, using sociodemographic questionnaire and ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). 406 questionnaires were completed. Of these questionnaires, 27.8% are men and 72.2% women, of which 56% are between 20 and 39 years-old, they are housewives, have a stable relationship and are consumers of tobacco (37.6%), marijuana (13%) and especially alcohol (57%). In second stage, two Conversation Circles with Family Health Teams and the referential Family Health Support Center were formed to discuss the data of the mapping realized in the previous phase. The circles, which had participation of 20 of the 37 professional teams from Family Health and 2 from Family Health Support Center, showed a lack of professional training in the subject; inability of the healthcare network in the user embracement; belief of professionals that nothing can be done when matter is alcohol and drugs; and referencing as the only care action performed by teams. Thus we point out the need to support an approach on issues of alcohol and drugs which consider gender issues, investing in Harm Reduction Policy as a possibility of working in this context for recognizing each user in their uniqueness and strategizing with them to promote health in a broad and contextualized way