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

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

Interferência da palha de cana-de-açúcar (Saccharum spp.) na emergência de espécies de plantas daninhas da família convolvulaceae

Este trabalho foi conduzido na Faculdade de Ciências Agrárias e Veterinárias de Jaboticabal-UNESP, com o objetivo de estudar o efeito de diferentes quantidades de palha de cana-de-açúcar deixadas na superfície do solo sobre a emergência de algumas espécies de plantas daninhas pertencentes à família Convolvulaceae. Os tratamentos foram distribuídos no esquema de parcelas subsubdivididas, com a quantidade de palha nas parcelas de 0, 5, 10, 15 e 20 t ha-1, as variedades SP 79 2233 e RB 83 5486 nas subparcelas e as espécies de plantas daninhas nas subsubparcelas. Aos 45 dias após semeadura (DAS), a presença de 15 t ha-1 de palha reduziu em 46 e 62% o número de plantas de I. quamoclit e M. cissoides, respectivamente. Entretanto, a presença de 20 t ha-1 reduziu em 82, 65, 62, 70, 60 e 88% o número de plantas de I. quamoclit, I. purpurea, I. grandifolia, I. hederifolia, I. nil e M. cissoides, respectivamente, quando comparadas à ausência de palha.

Família e TV: mais que dominação e subordinação.

This work analises the social relationship between Television and the Family though the resignification of individuals about Television messages and the speeches that they make about Family. Firstly, the objective is to understand if the principles, values and beliefs constructed and communicated (repassed) inside the Family filter the messages from the Mass Media. Secondly, if there still exists a family culture able to forge identity against so many cultural exchanges. Thirdly, what the function of this identity in the production of senses is. In session 1 and 2, a general approach about the dissemination of Mass Media in Society and the pertinence of the work is presented. Session 3 is about the method used: a qualitative research, with thirteen families from Natal-RN, situated in the Middle Class. The theorical base is considered in the fourth session where the reference to the evolution of the Family is made, with enphasis on the Middle Class and some theories that analyze the pheomenom of the Mass Media , specially in the second half of twentieth century. In session 5 and 6, the research data is presented and analyzed. Finally, in the last session, as a conclusion it can be said that the value of the Family as emotional support is reforced by the speeches and practices that interfere in the signification procces, singular aspects, as well as the social repertoire constructed per si and by institutions (including the family) moreover, mediative message is assimilated by the receiver and becomes understood inside the learned speeches during the receiver‟s history of life, although these messsages are also components in the construction of these repertoire.

Aqui, todo mundo é da mesma família : parentesco e relações étnicas entre os ciganos na cidade alta, Limoeiro do Norte CE

This study aims to understand how facing a context of Constant interaction whit the local population, the gypsies family Alves dos Santos, neighborhood residentes in uptown, Limoeiro do Norte Ce, maintain a sense of ethnic belonging. To that end, I analyze both the social relations between Gypsies and non-gypsies community, as it is from the contact that the social boundaries are delineated, as the discourses and social representations that are used to qualify them from stigma. So, I found that grounded in the notion of family, gypsies are seen as a group, searching the history / past nomadic origing and blood common elements that underlie its condition, and the language a cultural trait that makes it possible to establish objective distinctions among gypsies and other community residentes, becoming thus a diacritical mark.

Mulher chefe de família, na cidade de Aracaju:dominação e poder

The research was focada in the feminine head of family, the City of Aracaju and its impacts in the nuclear familiar nucleus. Considering that, the papers of the men are in general, not valued and rewarded that the papers of the women in almost all the cultures. The women generally load the responsibility to take care of of the children and the domestic work, while the men traditionally are born with the responsibility to support the family. However, we find changes in this mainly north-eastern scene and, where through quantitative research, already one evidenced that they are majority as family support, therefore, we observe the construction of social identities of the women family heads and uncurling of the adaptativos aspects, the existing mechanism between domination and power, in the familiar nucleus. The impacts in the family if had change in the social relation for them to be family heads. One is about qualitative research that has left of the construction of a theoretical landmark, analyzing given of bibliographical sources and from interviews with women family heads, power to observe the forms of joints in the nuclear families, as they deal with the power to decide power, the financial power, the fragility, the domination and the influences of the traditional models. Analyzing the familiar relations between the woman, the children and the spouse, searching the excellent questions for the briefing of the thematic one, demystifying the dichotomy between the mother/wife and woman head of family in the residential environment

A política de humanização e a estratégia saúde da família: visões e vivências

This study approaches the topic of humanization in health that involves the set of policies implemented by the Ministry of Health in Brazil. Its aims are directed towards a reflection on the guiding theoretical and organizing axes of the National Humanization Policy (NHP) and their repercussions on municipal health policy of Natal, Brazil; an analysis of the results of the policy at the local level; knowledge of the views and experiences of the humanization agents in the daily work process and identification of the main challenges of the policy. The empirical field of investigation was the Family Health Strategy (FHS) of the city of Natal. The assumption of the study is that the FHS has produced local experiences with potentialities that must not be wasted, in which there are difficulties and discrepancies between the real and proposed model. The contradictions and challenges in the social and political context of Brazil in the early XXI century and their consequences in the field of health reflect anti-utilitarian aspects anchored strongly in the theoretical concepts of Boaventura de Sousa Santos about the sociology of privations and emergencies as well as of the work of translating. The predominantly qualitative approach collects some complementary quantitative data. The study procedures used were the following: bibliographic research; documental research; interviews; and direct observation. Interpretation of the information obtained was based on documental analysis and on the symbolic cartography of the social representations. Cartographic evidence suggests that practices still take place under dehumanizing conditions that compromise the quality of care given. However, there is a movement aimed at changing the work process that has been strengthening the link and widening the measures developed, incorporating new directions in diversity, integrality and solidarity. The map drawn shows a reality manifested by explicit intentions in a political agenda, by concrete solutions marked by an assortment of difficulties and expressed in the words of the agents and by latent clues identified in successful local experiences, posing many challenges for the consolidation of the proposed changes

Família e TV: mais que dominação e subordinação

This work analises the social relationship between Television and the Family though the resignification of individuals about Television messages and the speeches that they make about Family. Firstly, the objective is to understand if the principles, values and beliefs constructed and communicated (repassed) inside the Family filter the messages from the Mass Media. Secondly, if there still exists a family culture able to forge identity against so many cultural exchanges. Thirdly, what the function of this identity in the production of senses is. In session 1 and 2, a general approach about the dissemination of Mass Media in Society and the pertinence of the work is presented. Session 3 is about the method used: a qualitative research, with thirteen families from Natal-RN, situated in the Middle Class. The theorical base is considered in the fourth session where the reference to the evolution of the Family is made, with enphasis on the Middle Class and some theories that analyze the pheomenom of the Mass Media , specially in the second half of twentieth century. In session 5 and 6, the research data is presented and analyzed. Finally, in the last session, as a conclusion it can be said that the value of the Family as emotional support is reforced by the speeches and practices that interfere in the signification procces, singular aspects, as well as the social repertoire constructed per si and by institutions (including the family) moreover, mediative message is assimilated by the receiver and becomes understood inside the learned speeches during the receiver s history of life, although these messsages are also components in the construction of these repertoire

Avaliação do programa saúde da família no Rio Grande do Norte

The Family Health Program implemented in Brazilian municipalities from 1994 represents today the most promising proposal to promote important changes in municipality`s health systems, to allow universal access to health care, comprehensiveness, equity and to promote social control, achievements provided by the health reform process and incorporated to the Unified Health System principles. However, many are the challenges imposed to the Family Health Program so that it can cause these advances. In this study, we aimed to answer the following research question: what are the results of the Family Health Program in relation to beneficiaries at small, medium and large municipalities? The hypothesis that guided this work was that the variation in levels of achievement/results (strict, impacts and effects) of the Family Health Program is related to the size of the municipalities. Therefore, our general aim was to evaluate the results of the Family Health Program in municipalities at Rio Grande do Norte, Brazil. And as specific objectives, to measure strict results, effects and impacts of the Program, from the criteria of efficiency and effectiveness on the beneficiated population, and to measure the Program`s impact on the organization of municipality`s health system. This is an impact assessment research, developed from multiple case studies with quanti-qualitative approach. The study included small municipalities (Acari and Taipu), midsize (Canguaretama and Santa Cruz) and large (Natal and Mossoró). The individuals chosen to the research were users/beneficiaries of the Program and health professionals. Data analysis was performed using descriptive statistics and content analysis compared from the Program`s logical /theoretical model. The results obtained in relation to the principles evaluated (universality, comprehensiveness and community participation) presented that municipalities show different results, although not directly related to the size, but related with characteristics of the Program`s implementation form in each municipality and the arrangements made for its operationalization. The positive effect that generated significant change in people`s lives has been linked to the increase of access and to the decrease of geographic barriers. However, to the municipal health system, regarding the changes desired by the Program, it was not observed a positive impact, but a negative impact related to the increase of barriers for the user to access other levels of the health system

Família, aluno e professor: as forças tipológicas da educação básica na região metropolitana de Natal

This work was developed in the research line: "The habitus of study: builder of a new reality in the basic education of metropolitan area Natal" which is being developed with the support of CAPES by the Centre for Education. Acts, especially the problem of academic performance of students in basic education of the public in the Metropolitan Region of Natal (RMN). Thus, the aim of this paper is to construct a typology of students in the 9th year of basic education, attending the public schools (state or municipal) of MRN, 2009, and assess, according to these profiles, what personal characteristics student and their families: economic, social and cultural capital as well as teaching practices create environments capable of favoring a good educational development as measured by the performance obtained in the assessments in mathematics and English language. The data used were provided through the microdata Brazil Exam 2009 held by INEP. We used the methods Grade of Membership (GoM) for construction of profiles relevance of students according to the characteristics already mentioned. With these profiles was verified, which were effectively generating good performance in school curriculum components evaluated. The findings indicate that students belonging to the profile considered good environment, able to achieve better school performance both in Portuguese as in Mathematics, compared to the extreme profiles and adverse deficit

Efeitos do enriquecimento com nutrientes (N e P) em diferentes condições de luz sobre o crescimento do fitoplâncton em um reservatório eutrófico no semi-árido brasileiro

The increasing of pollution in aquatic ecosystems in the last decades has caused an expansion of eutrophication and loss of water quality for human consumption. The increase of frequency and intensity of cyanobacteria blooms have been recognized as a major problem connected to water quality and eutrophication. The knowledge of environmental factors controlling these blooms is a key step towards the management for recovering aquatic ecosystems from eutrophic conditions. Primary productivity in aquatic ecosystems is dependent on light and nutrients availability. In the present work we evaluated the relative importance of the concentration of major nutrients, such as phosphorus and nitrogen, and light for phytoplankton growth in the main water reservoir of Rio Grande do Norte State, named Engenheiro Armando Ribeiro Gonçalves (EARG), which is an eutrophic system, dominated by potentially toxic cyanobacteria populations. Limitation of phytoplankton growth was evaluated through bioassays using differential enrichment of nutrients (N and/or P) under two light conditions (low light and high light) and monthly monitoring of chlorophyll-a and nutrients (total nitrogen and phosphorus) concentrations, and water transparency (Secchi depth) at the pelagic region. Our results confirm that EARG reservoir is an eutrophic system with a low water quality. Results of bioassays on the growth of phytoplankton limitation (N or P) were conflicting with the results predicted by the TN:TP ratios, which indicates that these ratios were not a good indicator of algal growth limitation. Nitrogen was the limiting nutrient, considering both frequency and magnitude. Light and hidrology affected phytoplankton response to nutrient enrichment. The extreme eutrophic conditions of this reservoir, dominated by cyanobacteria blooms, demand urgent managing strategies in order to guarantee the multiple uses for this system, including water supply for human population. Although nitrogen is the limiting nutrient, an effective management program must focus on the reduction of both phosphorus and nitrogen input

A relação entre a família e a instituição de educação infantil: descrição reflexiva sobre uma experiência

The present paper is a doctorate thesis, in the area of Education, that has as a goal to describe and to reflect on the construction/systematization of a relation between family and institution of Childhood Education, in favor of sharing the care and education actions of children, in the context of creation of a County Center of Childhood Education, located in the city of Natal-RN. Our intension with this paper is to share some of the ideas and actions collectively constructed by this experience, with the intention of bringing a contribution for the thematic debates concerning Childhood Education - as modality of education, in a general way; and the relations between families and Institutions of Childhood Education, in a more specific way. The paper presented here is endorsed by the postulates of the qualitative research with characteristics of a research-action, having as main instruments of the data construction the open or half-structuralized interviews, the personal notebook of registers, the participant s index cards characterizing the children and comments. Authors as Aries (1981); Bassedas, Huguet and Solé (1999); Bhering and Blatchford (1999); Brasil (1998); Bujes (2001); Didonet (2002 - 2003); Formosinho (2007); Gómez (2000); Heywood (2004); Kramer (2005); Marchesi and Martín (2003); Marschal and Zohar (2006); Thiollent (2004); Tiriba (2006), amongst others, had theoretically based this paper. The experience described here points to the possibilities of sharing the care and education actions between family and Institution of Childhood Education, emphasizing the relevance of participative praxis in the interior of the institution, so that its job can propitiate this sharing with the families, throughout activities as meetings, lectures, workshops, participation in didactic projects, open expositions to the community, commemorative parties and valuation of the local culture, amongst other chances of dialogue and interaction between the educative institution and the families

Comparação de Meios de Enriquecimento e de Plaqueamento Utilizados na Pesquisa de Salmonella em Carcaças de Frango e Fezes de Aves

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Representações sociais e práticas discursivas de profissionais do programa saúde da família sobre o pré-natal

The present study had the objective to identify to the Social Representations of the professionals of medicine and nursing superior level of the Program Health of the Family concerning the assistance for the gestation. The research was qualitative under the optics of the Theory of the Social Representations of Serge Moscovici, of the Central Nucleus of Jean-Claude Abric and of the Analysis of Content of Laurence Bardin. We worked with the following instruments for the collection of data: Questionnaires, with social-demographic data; Free association of Words, with the inductive terms Pregnancy, Assistance for Gestation and Care; Production of mental image and half-structuralized Interview, with the following question: What does the assistance for the gestation represent for you? . We interviewed all the professionals of nursing and medicine of the Program Health of the Family in the city of Santa Cruz /RN (ten for each profession) in the period of February and March of 2007. From the analysis of the social-demographics data, we respectively identified the following percentages for nursing and medicine: the feminine sex for nursing predominated (90%); the age between 24 and 33 (70 and 60%); the religion catholic (80 and 50%) and 50% of the two groups has up to two years of formation and work in the score of the research. The analysis of the others instruments resulted in two categories: Institutionalized vision and Vision of the Common-sense. In the free association of words, the category institutionalized vision is configured as Central Nucleus and of the common sense one as nucleus Peripheral, demonstrating that the Social Representations of the assistance for the gestation attendance are in the universes consensual. In the mental images, we identified to this same construction. In the content of the interviews, the institutionalized vision is permeated by the responsibility of making and the availability of having - assistance for the gestation is recommended by the Health department and necessary genders - while the vision of the common-sense can be represented by the category sort, whose role of professionals of the assistance for the gestation is to strengthen the responsibility for the woman of a maternity socially constructed. In short, the analyzed speeches reflect that, to the knowledge acquired in the academy, are incorporated in the knowledge of the daily professional, and conducted by popular myths. Medicine and nursing recognize the importance of the attendance in such a way for the chance to educate the women for the maternity as for the possibility to prevent complications, but in its speeches they had excluded from this process the masculine figure. We conclude that the meaning of the inductive term take care, part of the common-sense and is incorporated the institutionalized speech to humanize the assistance. However, the pregnancy ceases from being seen in its natural biological direction and starts to be analyzed as a moment of fragility and predisposition the illnesses. Finally, the social nursing and the central nucleus representations for the assistance in gestation for medicine is anchored in the speeches institutionalized and of the common-sense, reflecting the concern in establishing a humanized assistance with quality

Dificuldades e/ou facilidades vivenciadas pelos profissionais que compõem a Estratégia de Saúde da Família

Descriptive and quantitative study, with the objective of review the positive and negative aspects experienced by professionals working in the Family Health Strategy (ESF) of Ceará-Mirim town, at Rio Grande do Norte state. The population included 190 healthcare professionals that integrate the family healthcare staff and the data-collection occurred in a meeting at their workplace, with the implementation of a questionnaire. Results were organized in Microsoft Excel spreadsheet software, with descriptive statistical analysis in tables, graphs and tables through frequencies, averages values and standard deviations. There is a predominance of females (n = 137) and higher rates in almost all professions, and higher average age (38.9%, SD = 7.8) and income wage (average = 10) in the medical category. Regarding the more developed activities, for physicians and nurses are the healthcare actions in the Unit, the oral hygiene for dentists, the immunization for auxiliary nurses (Aux-N), educational meeting for the dental office assistants (ACD), and home visitations to community-based health workers (ACS). About the easiness of work, 93.2% said to be presence of professionals with a personal profile in public healthcare; about the difficulties, 86.8% of professionals cited the unavailability of material, followed by salary range reported by nurses (80.9% ), dentists (80.0%), physicians (73.3%), ACS (83.1%), and Aux-N (90.5%). In relation to working conditions, the unavailability of materials was the most mentioned, with the exception of dentists who reported improvement in wages. We still identify among these difficulties: the drugs availability regarded as first grade obstacle by ACS and physicians, the type of contracts in second grade cited by the ACD and dentists and, in third grade, the salary range cited by dentists and auxiliary nurses. It is concluded that the difficulties and easiness faced by ESF professionals are divergent among themselves. For physicians and nurses, whose healthcare actions become directed to specific groups, the individual and the family, their difficulties relate to the unavailability of materials. For dentists, whose actions more quoted were topical application of fluoride and supervised toothbrush, their greatest difficulty is the salary range. As to the Aux-N, ACD and ACS, for all of them the unavailability of materials has hindered the implementation of their activities in ESF

Prática do enfermeiro do Programa Saúde da Família PSF na promoção da saúde do adolescente

Attention to the health of adolescents, based on paradigm flexneriano, needs to be overcome. Since the International Conference of Ottawa (1986), the literature is developing a discussion of the promotion of health, based on the paradigm of social production in health, suggests a design to overcome the health care traditional practices. Program Health of the Family PSF has this purpose to transmute the model of existing assistance, where the nurse is an essential element to the work done in the program. Around this context, it is our purpose to analyze the practice of nurse of the PSF for the promotion of health of adolescents, produced by a search of descriptive quantitative approach with the inclusion of qualitative data. Interviews were conducted with 9 nurses 3 units of health of the family USF, Mossoró-RN and applied questionnaires with 74 teenagers aged between 15 and 19 years old, with some nearby public schools where USF operate these nurses. The quantitative descriptions were transformed on tables, pictures and graphics using the program Excel (Microsoft) and the qualitative were worked through the technique of analyzing the content of Bardin (2004). The review was realized using the reference to promote health brought by the study. The results show that the most common problems that happen with teenagers are the drugs (33,8%), pregnancy (27,0%) and political problems-socio-economic-cultural issues (24,3%). Adolescents are spontaneous demand and rarely seek the USF. The actions presented by the nurses as, lectures and groups, are nothing comparing to the macro-problems presented by adolescents, and verticalized irregular. The nurses know the promotion of health generally, not explaining how operate it from its daily practice. Concluded that the practice of nurse of the PSF has not yet reach the promotion of health of the adolescent, being necessary to scheduling modules on the subject to continuous training of teams, professionals from USF, as well as teachers and other staff of schools, giving space to the participation of academic. The discussions should be socialized with the community to discuss possibilities of confrontation of the problems, which also require socio-structural changes. This research can contribute as work-diagnosis, which experienced the reality of care in nursing PSF to a specific group