Fenótipo neuropsicológico de adolescentes com síndrome de Down

This research aimed to contribute to the characterization of a neuropsychological phenotype of adolescents with Down Syndrome (DS). A multicases study of six adolescents (three males and three females, aged 13 to 14 years) diagnosed with DS and treated at two institutions in the city of Natal (Brazil), was conducted. Participants were assessed using the methodological approach developed by Luria, which is composed by four complementary stages. The first one aimed to investigate the qualitative impact of DS in school life and social development of the adolescents; dimensions of behavior and social-affective aspects of the members of the study were investigated. In the second stage participants performed a battery of neuropsychological tests in order to identify strengths and weaknesses in their cognitive functioning. The third stage was incorporated into the second in order to analyze the quality of the activity of the participants along the quantitative evaluation, highlighting strategies used, errors produced among other indicators. Lastly, the fourth stage refers to the intervention with the participants. Although this is not a specific objective of the study, it is argued that the outcome of this research will subsidize the practice of different professionals working with this clinical group. The results of the first stage emphasized the presence of difficulties in social relationships and in school life of observed adolescents. In turn, the second and third stages pointed out to the presence of difficulties in tasks involving logical and abstract thinking, as well as difficulties in expressive language. In relation to visual memory, we observed a better performance in activities of lower complexity, ie, with less interference of executive functioning, particularly in terms of the functions of planning and initiative. Finally, it was found motor and mental retardation, affecting significantly the performance related to different cognitive areas. The results highlighted here can be considered as subsidies for future interventions, suggesting the need for developping projects that take into account different aspects constituents of the human subject, involving not only the individual with developmental changes, as well as their families, teachers, schools and society in general

A relação juventude-trabalho no projovem integrado do município de Natal/RN

The National Program for Youth Inclusion (ProJovem) has been created in 2005 in order to break the reproductive cycle of social inequality, through the improvement of the basic education and the professional qualification. Therefore, our objective is to discuss how the categories youth-work are inserted and implemented on ProJovem Integrado , which could be translated as Integrated , in Natal/RN. In 2008, ProJovem is has started to be executed based in four modalities: (1) Teenagers Socio-Educational Service, (2) Urban, (3) Worker and (4) Countryside Land Knowledge, aiming to serve a population from 15 to 29 years old who were seldom helped by specifics policies so far. In order to implement this research, three semi-structured interviews have been made, as well as observations at the program units and analysis of the official documents. In Natal, the operating modalities are: ProJovem Urban, which three units, divided in two districts of the city; the ProJovem Teenagers , which has ten units on Natal s four administrative regions; and ProJovem Worker , which were still structuring its courses until the beginning of the data collection. The data has been qualitatively analyzed through the Marxian Theory, tied to the Constant Comparative Method. The referred approach, based on the Grounded Theory, enables the understanding of the phenomenon s meanings through the perspective of the participants. The neighborhoods in which ProJovem s units are inserted has been characterized as well the Program s target. The results have been presented in three blocks: a) the modality s structure, which includes the implementation, functioning and operationalization of the activities; b) management of the modality s management, concerned to the main difficulties, expectations and functions; and c) the relation youth-work at the modalities. About the objectives and qualification and insertion goals, there is incongruence at the offer of occupational arches. We have observed that offered occupations are historically subservient and precarious. Hence they do not promote significant changes on the students career paths by usually inserting them into informal jobs or underemployments. Besides that, the professional qualification is very incipient. For that reason, it does not go with the necessary requirements to enable the youngster to enter the work world. It is considered that other researches are necessary to for better understanding of the remaining aspects of the relation youth-work

Políticas públicas para a juventude: uma análise do Projovem Adolescente sob a perspectiva dos participantes

A partir dos diagnósticos das vulnerabilidades da condição juvenil contemporânea, as Políticas Públicas de Juventude tem ganhado maior força e um lugar mais definido nas pautas das demandas e conquistas sociais. Faz-se necessário, então, direcionar atenção para estas Políticas Públicas, a fim de promover uma reflexão sobre como ocorre a execução destas junto ao seu público alvo. Esta dissertação centraliza sua análise no Projovem Adolescente (PJA), uma das modalidades Programa Nacional de Inclusão de Jovens PROJOVEM que se destina ao atendimento de jovens com específica faixa etária entre 15 a 17 anos, com caráter assistencial e socioeducativo. Desta forma, o objetivo geral deste estudo foi discutir as ações do Projovem Adolescente no que diz respeito ao processo socioeducativo, a partir da perspectiva dos adolescentes participantes da cidade de Natal/RN. E, especificamente, objetivou-se: investigar de que maneira os adolescentes avaliam as atividades das quais participam, considerando se suas expectativas coincidem com as propostas do serviço; averiguar a participação dos adolescentes na elaboração, execução e avaliação das ações socioeducativas do serviço; bem como compreender as motivações que contribuem para a inserção e permanência ou evasão dos adolescentes no PJA. Para tanto foram realizados três grupos focais com adolescentes participantes do Projovem Adolescente, em diferentes núcleos do serviço, no município de Natal/RN. Cada grupo focal contou com dois encontros, em que primeiramente foram debatidos aspectos da participação nas ações socioeducativas e, num segundo encontro foram realizadas oficinas de produção de fanzines. A análise qualitativa dos dados foi realizada a partir da perspectiva teórica do materialismo histórico-dialético, utilizando-se como método de análise o Método Comparativo Constante, baseado na Teoria Fundamentada, que busca compreender o significado do fenômeno sob a perspectiva dos participantes. Os resultados foram apresentados divididos em eixos de análise os quais versaram sobre: as concepções dos jovens sobre adolescência e juventude; e a participação nas ações socioeducativas do PJA, destacando-se as características positivas e negativas apontadas pelos participantes, a relação dos jovens com o trabalho e as possibilidades e contribuições do PJA em seus contextos de vida. Em vista da análise empreendida, é possível constatar que a concepção dos participantes sobre a própria vivência da adolescência e juventude se encontra marcada pela absorção de determinadas imagens socialmente atribuídas aos jovens, como a que considera a juventude enquanto etapa de preparação para o mundo adulto. A participação nas ações socioeducativas, por sua vez, foi, de uma maneira geral, avaliada positivamente pelos participantes, não obstante esta avaliação, os jovens apresentaram uma visão muito crítica sobre a execução do serviço no município de Natal, relatando conhecer bem as dificuldades de ordem da gestão, bem como as contradições e limitações nas ações do serviço. Compreende-se a perspectiva da inclusão social no contexto neoliberal em que são implementadas as políticas sociais, contudo acredita-se que dar voz aos jovens participantes contribuiu para proporcionar uma reflexão sobre o modo como as políticas sociais, através do Projovem Adolescente tem atingido seu público, considerando as questões e perspectivas apresentadas pelos jovens como ferramentas a serviço das juventudes na construção de políticas democráticas e efetivas

A redução de danos no atendimento especializado em álcool e outras drogas

The harm reduction HR is the official policy of Ministry of Public Health to deal with problem derived from alcohol consumption and other drugs AD. The HR refers to policies and support programs whose purpose is to reduce the risks related to the use of AD, without necessarily decrease individual consumption. This research aim was to analyze the HR conceptions and practices at two specialized institutions for AD users: 1) Psychosocial Care Center Alcohol and Drugs III (CAPSad III); 2) Therapeutic Community Fazenda da Esperança (FE) Dom Bosco. This is a qualitative research that used the following methodological tools: semi-structured interview with 21 professionals; socio demographic file and rounds of conversation with 63 participants users; participant observation and field journal. The interviews with professionals have characterized HR as a less complex and cheap treatment. At FE the HR proposal does not make part of their actions, being considered ―against the human being dignity‖. At CAPSad III is understood as an ―inevitable‖ guideline to service, once users do not remain abstinent. The users understand RD as an improvement in healthy conditions, social relations and work that occurs with the decreasing consumption of AD. They use the HR when they avoid situations that facilitate AD consumption, share relapse prevention strategies and, exclusively at CAPSad III, decrease psychotropic consumption. Stands out as an analyzer the HR comprehension as a less efficient treatment that opposes to the objective of both institutions, which is abstinence. The HR is not operationalize in daily routine by professionals and users as a healthy promotion strategy, however, the users are more affected to HR and produce strategies to face the difficulties arising from the AD consumption

A percepção de suporte organizacional dos novos servidores da Universidade Federal do Rio Grande do Norte

This work deals with organizational support perception-OSP. This is done considering staff global beliefs, value of their contributions, care and well being related of individuals in an organization. These issues has been have been present in many researches since the 80s. It is important to analyze this matter considering all the changes that occurred nationally and internationally in the academic environment, characterized as being diversified in academic and managerial level. This occurs especially in Brazil since Federal Universities and their agents have suffered impact and restructuring. The research has emphasized the technical-managerial as well as professor staff level at Universidade Federal do Rio Grande do Norte aiming to deal with their unsatisfaction upon social political support. Thus, there was participation of 259 staff that were admitted from 2003 to 2005 in many sectors and units of the university. These subjects were submitted to a social and demographical query through an application of a scale of organizational support perception-OSP. Descriptive and multivariate analysis was done considering factors (management style of higher command), material support, wages, work overload, social support at work and ascending levels). Results show that there a hierarchy of the analyzed factors, the factor social support at work as being the first one with 3,31%, the factor management style of the higher command in second with 3,30%, then followed by the factor social support at work with 2,92%, in a sequence the factor material support, factor overload with 2,49% in the fourth position, and in the fifth place, the factor ascending with an average of 2,33% and in last the factor wages with 2,20%. It is concluded that the factors related to the more positive attributions of the OSP (social support at work), in a sequence material support opposing from the most negative factors of the OSP (wages, overload, ascending) reveal a reality that points out that the OSP is very much related to the individualized actions of the members of the organization (leader-member-group) rather than on structure and institutionalized actions carried out at UFRN

Violência sob o olhar do adolescente autor de Ato Infracional: reflexões fenomenologicas

O envolvimento de jovens com a violência nos últimos anos, no Brasil, tem aumentado significativamente, bem como o número de adolescentes cumprindo medidas socioeducativas com restrição de liberdade. Entretanto, a literatura mostra a produção incipiente de estudos que abordam o jovem infrator a partir da sua própria experiência. Com base nessas evidências, esta pesquisa teve como objetivo compreender como adolescentes autores de atos infracionais experienciam a violência, sejam como agentes, espectadores ou vítimas, sob a ótica da Analítica Existencial, de Martin Heidegger. Trata-se de uma pesquisa qualitativa, de inspiração fenomenológico-hermenêutica, tendo sido utilizada a narrativa como recurso metodológico. Foram realizadas entrevistas semiestruturadas, com dois adolescentes de 16 e 17 anos, egressos de medida socioeducativa de restrição de liberdade. A interpretação das narrativas foi feita a partir dos sentidos que emergiram na experiência relatada e do diálogo entre algumas noções heideggerianas como ser-no-mundo, cuidado e impessoalidade. Os relatos mostraram que a violência está presente desde a infância desses adolescentes, tendo sido presenciada na própria família. Para eles, o comportamento violento representa uma forma de impor respeito e admiração. As experiências podem ser interpretadas como uma expressão das relações entre o ser adolescente e o mundo que caracteriza o seu contexto de vida. Assim, as noções de cuidado, no modo de ocupação, e impessoalidade, são vistas como presentes nas experiências narradas. Por hora, o que apresentamos foi nossa compreensão dessas experiências únicas de ser adolescentes num contexto de violência, mostrando peculiaridades de duas crianças que não queriam ser um problema social, mas lançados num mundo inóspito e cruel, na qual nos absorve para as tramas mais sutis de ser, misturando significações e sentidos num espectro fluido que é o viver. Por fim, esperamos que esta pesquisa possa acrescentar não só aos estudos sobre a violência de jovens, mas também ressaltar a importância de se compreender a violência pelo olhar daqueles que a vivenciam

O psicólogo e os serviços de acolhimento institucional para crianças e adolescentes

The Shelters are responsible for caring for children and adolescents whose families or guardians are temporarily unable to fulfill his role as care and protection. The activities to be developed by psychologists in these services are greatly important for the elaboration and development of political- pedagogical project of the same, and for reasons pertaining to the present and future of children and adolescents received judgments. The psychologist puts up the challenge of contributing to a better care of children, also cooperating with the implementation of the new care standards of childcare. The aim of this study was to investigate the role of the professional psychologist in assistance to children and adolescents in 13 Shelters in the Metropolitan Region of Natal/RN. For both set out to make visits to the institutions to know how it is organized the field work of the psychologist, his routine work and activities developed. Nine psychologists interviewed according to a semi-structured interview script. The data analysis is supported by the theoretical aspects of dialectical materialism historical and theme content analysis was used. Results were presented from three angles: psychologists and institutional framework; activities, resources and methods of work; psychologists and legal frameworks of the Institutional Hospitality. The study points out the recent entry of the psychologist in Shelters, combined with considerable turnover of these professionals. This work has been organized through the Individualized Service Plan, prioritizing the return to family of origin. Moreover, in general, perform joints with the service network, reporting, individual consultations and follow-adoption processes . Staff members, however, feel a lack of specific and continuing training on special protection, including due to the distance between the proposed theory and practice. It was thus observed a movement of psychologists distance themselves from welfare or repressive practices, however the structural difficulties of services and lack of continuing education appear to limit the development of a performance focused on the transformation of the reality of children and adolescents treated and their families

Gênero, trabalho e saúde mental entre trabalhadoras rurais assentadas na região do Mato Grande Potiguar

The lack of studies aimed at the mental health of the rural population, the social, economic, familial and emotional impact that mental disorders produce and the vulnerability that women have in this context, lead us to believe in the need to investigate the mental health demands of female rural workers, in order to subsidize the development of more effective and culturally sensitive public health programs and policies that take into account the specificities of this population. The present study aims to investigate the prevalence of common mental disorders (CMD) and the possible factors associated with the emergence of such disorders among women living in a rural settlement in Rio Grande do Norte. This survey has a quantitative and qualitative character with an ethnographic approach. As methodological strategies, we made use of an adapted version of the socio-demographic and environmental questionnaire prepared by The Department of Geology/UFRN s Strategic Analysis Laboratory to evaluate the quality of life of the families from the rural settlement and the mental health screening test Self-Reporting Questionnaire (SRQ-20) to identify the prevalence of CMD in adult women from the community. Complementing the role of methodological tools, we use the participant observation and semi-structured interviews with women who presented positive hypothesis of CMD attempting to comprehend the crossings that build the subjective experience of being a woman in this context. The results point to the high prevalence of CMD (43.6%) and suggest the link between poverty, lack of social support, unequal gender relations and the occurrence of CMD. We also verified that the settled women do not access the health network to address issues relating to mental health and that the only recourse of care offered by primary health care is the prescription of anxiolytic medication. In this context, the religiosity and the work are the most important strategies for mental health support among women

O acolhimento como promoção da saúde entre pacientes com câncer

Cancer has been affecting people all around the world; disregard sex, ethnicity or social class. Despite the fact it is not always deadly, to be diagnosed and treated of cancer brings a lot of physical, emotional and social suffering, specially for those with less economic resources. Considering the complexity of the problem, there has been perceived that medical treatment is not enough to support cancer patients. There is an increasing understanding about their necessity of integral care, supposed to be given by a multidisciplinary health care equip that can consider all the different aspects involved in the illness process. Everyone has a particular way of been ill or healthy, and gives different meanings to the experienced events. The starting point of the research was the contact with a called work `group of shelter', developed with cancer patients by a multidisciplinary health care equip working on the LIGA Norte Riograndense Contra o Câncer. The research goal is to identify meanings people give to the shelter they receive in the group and to understand the way they experience the disease. Considering it singularity of this process, one worked with individually half-structuralized interviews, carried through with nine patients of the chemotherapy clinics and suck, that they had passed for the experience of the group of shelter, having approached getting ill, the treatment, the shelter and the recreation of the psychosocial processes (or not) after all this process. It was chosen as focus of analysis the creation of psychosocial processes and production of felt of these social actors through its discourse analysis perspective, boarded in accordance with the following thematic axles: the experience of the cancer, the shelter and recreation of the psychosocial processes the life. It was found that shelter has an extensive meaning going beyond the the group and involving others besides the multidisciplinary health care equip, and being important to give each patient the best possible benefit. It was also identified the importance of other social actors, such as relatives, friends and neighbors; added of religious faith, mentioned by all interviewees. It is to be considered the recovering capacity shown by eight interviewees, demonstrated by changing the way of interacting with others, getting new values and behaviors, and demonstrating more wisdom. We can consider the possibility of making this strategy to become part of the everyday practices of others health services working with cancer patients, what we think can help to minimize their suffering

Significados de família para adolescentes em liberdade assistida

Guided by the social-historical perspective, this research aimed to understand how the adolescents in Assisted Freedom measure have meaning the family institution. The Pastoral Minor, located in the city of Natal, was chosen as space of investigation, whose social-educative program is the source of our concerns about the attendance of adolescents in conflict with law. The corpus was accomplished, mainly, through the individual semi- structured interview with four adolescents and seven of their relatives that participated of the research. We use another instruments to constitute the corpus, like the documental research of the technical reports on the participants of program files, and the registered notes in the field diary. As resource to data treatment, we use the Thematic Content Analysis. The data discussion was focused on the three thematic units that emerged: Family, Social-Educational Measure, Family and Social-Educational Measure. On the adolescents perspective, the family configures as a group based on the existence of affective bonds. Despite of the vulnerability of their familiar reality and their wish for freedom with their peers, the affective bonds revealed it as being important in their lives. This study, glimpse possibilities to contribute for the construction of public politics and attendance programs, that can be closer of the social-familiar reality of the adolescents who are in conflict with the law and, in this case, to promote their access to the statute of subjects of rights

Adolescentes preocupadas em conquistar um corpo magro: Um estudo sobre discursos produzidos em diários eletrônicos

The concern about a good physical condition is heavily present nowadays, in documentary films about health and in the media, and it is also expressed through the outstanding growth of physical academies, beauty institutes and aesthetic medicine and all kind of aesthetic surgeries. In the western world the body wave is a significant trend, characterized by the great investments in body image. However, what is overlooked is the fact that in parallel trend grows the number of teenagers, especially females, with all kind of problems related to their body image. As adolescence is a moment of transformations, teenagers tend to be more aware of their body image and often neglect food ingestion and try to build their bodies following the images they have from top models and movie stars. The low self-esteem accompanying this sort of experience is an additional problem. Therefore the research aim to analyze discourses regarding the body image produced in world wide web diaries (blogs). The blogs selection was made through the site www.blogs.com.br, which is considered the widest guide of electronic diaries in Brazil. We looked after blogs including the keyword body and from adolescents aged 10 to 19, who showed concern about a slim body. Three blogs were chosen, considering the example criteria. Discourse analysis shows that these teenagers feel unsatisfied with their bodies, searching by all means the thinness presented as a aesthetic paradigm in western societies which often implies neglecting their own health, using appetite inhibitor drugs, restricting or totally abstaining food ingestion for long periods of time, or provoking themselves vomits after ingesting food. These behaviors, together with intense fear of gaining weight, can be characterized as alimentary disorders, related to the body image. As they usually hide this sort of behaviors from family and friends who do not share this concern, the blogs seem to be an easy tool for adolescents to find peers with whom to share common values and ideas and reaffirm their identities and virtual sense of community

Faz-de-conta que eu brinco : o comparecimento da brincadeira na educação infantil da rede pública de Vitória da Conquista-Bahia

This research aimed to understand the place that the child s play in the childish education of Vitoria da Conquista s public system. We understand the childish education institution like a space that should respect the child as a person in a peculiar condition of development. We adopted the social-historical approach understood from Vygotsky and Leontiev, with the social theory of construction of knowledge and its dialogue with authors like Piaget e Brougère. The child s play was seen like result of social relations with great influence in the childish development. The research was accomplished in 04 public day care centers, amongst 18 existent ones in the city. While subjects of investigation participated 09 educators that works with children with ages between 03 and 04 years old and the children of their respective class-room. The procedures used were the participative observation and the interview with the educators, as a procedure of composition of research corpus, focusing the child s play activity, particularly in the way that it is expressed in the childish education. From of corpus constitution we used the thematic content analysis. We clustered the appearance of child s play in the childish education in three thematic nucleuses to detailed analysis: 1. mediated by the educator; 2. proposed by the educator; and 3. started by the children. The results show that, despite of the limitations that configure the day care centers routine, the child s play appears in the childish education. We hope, through the comprehension of the place occupied by the child s play in the childish education, contributes to the execution of the public politics, above all in the educational scope, to children with ages between zero and six years old, fomenting the discussion of the educator practice, its limitations and possibilities

A motivação e o significado do trabalho de bancários: estudo comparativo entre dois momentos do processo de reestruturação produtiva

This master s dissertation deals with motivation and the meaning of work amongst bank employees. This is done considering a cognitive perception. Work is understood here under a social and subjective comprehension, once it deals with significance attribution. Motivation is the process that rules choice of the different possibilities of individual behavior, all of which according to the Expectation Theory. This study aims to analyze the implications of the productive restructure, since it is related to technological innovation, organizational changes and management, in motivation and work significance. Thus, the objective of the research is to verify motivational differences and the meaning of work amongst bank employees. This is done in two distinct moments of the productive restructure of bank employees in Natal-RN. The research is divided in two parts. In the first one, changes that occurred in banks between 1999 until 2005 were identified by the means of interviews with 7 bank managers. The analyzed perspective was training intensifying, quality emphasis of customer attendance, the use of automation/technology, staff stabilization, change in staff profile, work intensification, etc. In the second study the Inventory of Motivation and Work Meaning was applied. Thus, questions related to work focus, social demographic data, in 187 bank employees were dealt with. The collected data was compared to data from previous work. It was observed that productive restructure has a reflection in the meaning of work increasing self-expression, economical reward, and responsibility in work conditions. All of the item mention beforehand maintain the level of inhumanness and consummation and respond as being the characteristics of the real work environment. On the other hand, bank employees value less justice, self-expression and more the survival perspective, implying instrumental values to work. As for motivation, it is increased among bank employees. These employees have greater expectations that their work produce results since they believe in their interference in work results

O trabalho docente em psicólogo e o enfrentamento da violência contra crianças e adolescentes: uma experiência teresinense

In this thesis I discuss the role of the psychologist as a university professor and as intellectual from a specific context and also from a specific query. The context is the city of Teresina, capital city of Piauí state, which is peripheral in Brazil s northeast region. The defiance here is to build a critical psychological tradition that will deal with the challenges imposed by the reality of poverty and socio-economic backwardness of the region. The greatest difficulty is the lack of a public institution of learning that carries out instruction, research and extension with commitment to social transformation, and with the production of a psychological knowledge that is able to understand local reality. I take it that the undergraduate course in Psychology at UESPI [State University of Piauí] is the only one in Teresina that can take over such mission. The query is confronting violence against children and adolescents that defies us to ethically and politically commit to solidarity toward fragile human beings in need of adult involvement in order to survive this daily inhumanity. The involvement of psychologists from Teresina in this must result from a social commitment and a technical competence to deal with prevention and therapeutic consideration toward the victims. This dissertation is divided into three parts: the first is a study on the curriculum and the performance of psychologists, which revises the academic output in Brazil and envisages new queries to the theme, such as the role of teaching inside the curriculum, and presents social security (including Medicare) as the privileged field in which Brazilian psychologists perform. The second part contains a study on the concepts of childhood, adolescence and violence, which presents a consideration on the strategies to confront violence against children and adolescents. In the last part I discuss the role of the psychologist as teacher and intellectual in the context undergraduate course in Psychology at UESPI [State University of Piauí] from the commitment to the protection of children and adolescents

Entre a hegemonia e a polissemia: a Política de Educação e Desenvolvimento para o SUS no contexto do Brasil contemporâneo

The proposal of the Unified Health System Policy (SUS) has been considered one of the most democratic public policies in Brazil. In spite of this, its implementation in a context of social inequalities has demanded significant efforts. From a socio-constructionist perspective on social psychology, the study focused on the National Policy for Permanent Education in Health for the Unified Health System (SUS), launched by the Brazilian government in 2004, as an additional effort to improve practices and accomplish the effective implementation of the principles and guidelines of the Policy. Considering the process of permanent interdependencies between these propositions and the socio-political and cultural context, the study aimed to identify the discursive constructions articulated in the National Policy for Permanent Education in Health for the Unified Health System (SUS) and how they fit into the existing power relations of ongoing Brazilian socio-political context. Subject positionings and action orientation offered to different social actors by these discursive constructions and the kind of practices allowed were also explored, as well as the implementation of the proposal in Rio Grande do Norte state and how this process was perceived by the people involved. The information produced by documental analyses, participant observation and interviews was analyzed as proposed by Institutional Ethnography. It evidenced the inter-relations between the practices of different social actors, the conditions available for those practices and the interests and power relations involved. Discontinuities on public policies in Brazil and the tendency to prioritize institutional and personal interests, in detriment of collective processes of social transformation, were some of obstacles highlighted by participants. The hegemony of the medical model and the individualistic and curative intervention practices that the model elicits were also emphasized as one of the drawbacks of the ongoing system. Facing these challenges, reflexivity and dialogism appear as strategies for a transformative action, making possible the denaturalization of ongoing practices, as well as the values and tenets supporting them