A representação social do cuidado no Programa Saúde da Família na cidade do Natal

The aim of this study was to learn about the social representations of the care provided by the Family Health Program (FHP) in the city of Natal, Brazil and determine how these representations guide the daily actions of doctors, dentists, nurses, nurse s assistants and oral health assistants during the work process. In this sense, we used the theoreticalmethodological approach to the Theory of Social Representations. For data collection, we used the following instruments: a two-part questionnaire, where the first part recorded sociodemographic data and the second part was adapted to the free word association technique (FWAT), which was applied to 90 professionals belonging to 18 FHP units. Interviews were also used as collection instruments. These were based on inductive stimuli and on direct observations of 30 of these professionals. After a superficial reading of the material, we constructed a corpus from which ten categories emerged. To analyze FWAT we used lexicographic analysis, combining frequency and the mean order of responses. The interviews and sociodemographic variables were analyzed using content analysis and descriptive statistical analysis, respectively. The study showed that the central nucleus of the social representation in question is composed of the elements attention, receptivity and love, revealing that the subjects have different understandings of the FHP care process and that the knowledge accumulated in this respect is supported by an approximate vision of the meaning of care. However, traditional elements with trivializing connotations about care predominate, which compromises the development of strategies to overcome traditional practices. In the set of analyses, we were able to capture the invariance of a contradiction: on one hand, professionals know and affirm the importance of providing care for FHP patients; on the other, the experience of daily practice translates into the negation of this concept. In this contradictory context, professionals build gradual and successive syntheses that allow them to act and affirm themselves by associating information from their academic formation, structured knowledge acquired in other experiences, values and symbols of their daily routine. Thus, they shape and reshape themselves, according to what is concretely and specifically required, at the same time both plural and multiple. The composition of the central nucleus indicates that any measure that intends to modify attitudes that is, the daily actions of FHP professionals with respect to care must take into account and give priority to the debate about the redefining of the semantic fields of the central nucleus (love/attention/receptivity and humanization), especially those of love and attention

Avaliação da atenção à saúde de portadores de HIV no centro de referência para o tratamento da Aids em Natal/RN por profissionais e usuários do serviço

Objective: The aim of this study was to evaluate the health care of HIV/AIDS Reference Center for treatment of AIDS in Natal/RN for professionals and service users. Methods: This is an evaluative study with a quantitative approach, performed in the outpatient Giselda Trigueiro Hospital, in Natal (RN). The target population consisted of 313 patients with HIV and 34 professionals of the center. Data collection occurred from august 2007 to july 2008, with a structured form of interview, validated through a pilot study. The data were analyzed by descriptive and inferential statistics. Results: The evaluation of the service was considered unsatisfactory by 85.6% users. However, 58.8% of professionals considered it satisfactory. There was difference in the evaluation of the following indicators: the relationship professional users, offering support, timeliness of professional guidelines on the treatment. There was similarity in the following indicators: physical structure, respect for privacy, opportunity to make complaints, hospitality, convenience of schedules, availability of ARVs and laboratory tests, and ease of access. Conclusion: The results point to dissatisfaction of the users and professional satisfaction with the health care of people with HIV / AIDS in the service searched. It was found that the indicators used in this study may be considered relevant to evaluate the service in question, as well as monitoringparameters provide acceptable quality of health care by the National STD/AIDS

Significados e percepções do homem diante da gravidez de sua companheira com síndromes hipertensivas

The general aim of the research was to comprehend the Social Representations constructed by the man in the face of his companion s risk pregnancy caused by hypertensive syndromes. The study is of exploratory and descriptive character in a qualitative approach developed at two public maternity hospitals, both located in Natal-RN, with 65 men whose wives had undergone high-risk pregnancy. The project was submitted to the Ethics on Research Committee of the Federal University of Rio Grande do Norte, Brazil (CEP-UFRN), with favorable report no. 81/07. For data collection, the following multimethods were employed: a word free association test; a projective test for registering mental images; and a semistructured interview schedule. The speech contents were analyzed in accordance with the Theory of Social Representations and complemented by the Central Nucleus Theory. The discussion of the results was grounded on literary findings of the companion s participation in pregnancy as well as in risk pregnancy associated with hypertensive syndromes. The data showed fear as representation s central nucleus, while recollections of that feeling referred to death of both companion and child in addition to fear of the unknown. The categories preoccupation and carefulness, other feelings, and clinical picture of the disease represented components of the peripheral nucleus. The results concerning mental images followed the same category criteria of the word free association test fear, other feelings, preoccupation, carefulness, and clinical picture of the disease. After being processed in accordance with the principles of content analysis, the statements originated three thematic unities: fear and insecurity in the presence of the companion s risk pregnancy; attitudes of carefulness to the risk pregnancy of the partner; and humanized assistance during the companion s risk pregnancy. Considering the results, the conclusion is that the partner s risk pregnancy caused by hypertensive syndromes represents, for the man, feelings of fear, preoccupation, insecurity, lack of acceptance and information, as well as attitudes of carefulness. The results reveal necessity of reorganizing the obstetric assistance with an eye to including the man as participant in the reproductive process. That demands extension of humanized carefulness to the companion with a view to make him an active coadjutor in the assistance of high-risk pregnant

Representações sociais dos trabalhadores de saúde da atenção básica sobre envelhecimento e o atendimento ao idoso

This study aims to identify the social representations built on senior care health workers of Primary Care. This is an exploratory research within the subsidized social representations held in 100 Basic Health Units in the city of João Pessoa-PB, with a sample of n= 204 workers of both sexes, who agreed to participate. To collect the data used to set an interview in two parts: the first looked at the Test of Free Association of Words using the inductive stimulus "senior care". The interviews were analyzed with the help of a software for quantitative analysis of textual data ALCESTE (version 2010). The results were interpreted from the theoretical framework of social representations. The study included 178 women (87.25%) and 26 men (12.75%), working in Family Health Units in the city of João Pessoa, the majority are aged between 40-49 years of age ( 28.92%), and have higher education with 81.86%. The results of Alceste link to the term inducer six (6) where the hierarchical classes representing senior care workers as synonymous with care and attention, showing situations neglect of the elderly, for that patience is required to promote the increase of disease prevention and living with the elderly to generate humanization in health services. It is considered that the social representations of health workers on assistance to the elderly may support modeling of strategic actions in health services with health promotion programs for large groups, able to modify practices and behavior in elder care and strengthening the policy was directed at the elderly

Avaliação da terapia comunitária na atenção primária à saúde

A busca por um modelo democrático de saúde despertou a atenção do governo brasileiro para o estabelecimento de prioridades e estratégias, que impulsionaram a implantação do Programa de Saúde da Família (PSF), atualmente denominada Estratégia Saúde da Família (ESF), a fim de aproximar a equipe de saúde da comunidade e, assim, implementar ações de promoção da saúde e de prevenção do adoecimento. Nessa perspectiva a Terapia Comunitária (TC) emerge como uma tecnologia de cuidado voltada à saúde mental na Atenção Básica de Saúde. Desde 2007, a TC vem sendo desenvolvida no município de João Pessoa/PB por profissionais da ESF: enfermeiras, agentes comunitários de saúde, médicos, odontólogos, fisioterapeutas, nutricionistas, psicólogos, entre outros. O estudo teve como objetivos: avaliar a satisfação dos usuários em relação à TC na Atenção Básica no município de João Pessoa/PB; medir o nível de satisfação dos participantes da TC em relação a essa ferramenta do cuidado; identificar elementos importantes para a satisfação em relação à TC por parte dos usuários. Trata-se de um estudo avaliativo, transversal e observacional, realizado no período de maio a agosto de 2009. Utilizou-se como instrumento de coleta de dados a Escala de Avaliação da Satisfação dos Usuários com os Serviços de Saúde Mental Satis-BR, bem como um instrumento de perguntas complementares utilizado pelos terapeutas comunitários. Os resultados revelaram que dos 198 (100%) entrevistados, 105 (53%) verbalizaram satisfação e 93 (47%) muita satisfação nos encontros de TC, o que evidencia que a totalidade da amostra está satisfeita com a terapia. Os elementos importantes que concorreram para a satisfação dos usuários da TC foram: respeito, dignidade, escuta, compreensão, acolhimento, apoio nas necessidades e boas instalações dos locais onde ocorre a terapia. A TC vem fortalecendo o cuidado à saúde mental, por se constituir como uma tecnologia de prevenção e fortalecendo a porta de entrada para a rede de saúde mental e de apoio psicossocial. Conclui-se, portanto, que a TC vem se destacando como instrumento de inclusão da saúde mental na Atenção Básica no atendimento aos usuários do Sistema Único de Saúde

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

Natal como destino turístico : um estudo das imagens (re)veladas pela mídia, pelos turistas e suas implicações educacionais e culturais

This thesis is a result of a research on Natal/RN as a tourist destination. We understand that cities are chosen as tourist destinations beyond its cartographic localization, from other dimensions of meanings that, in its set, constitute images. These images are, probably, very different of the images constructed by native and resident populations, who possess relations of identity with the place. The knowledge of the meanings that others attribute to this city as tourist destination, bring us near to the symbolic bonds established by individuals or social groups on the act of their choices, as well as bring us near to the interaction process city-tourists where the expectations are confirmed or not. The images divulgated by the media also participate of the complex formation of the tourist image that is being constructed and available for the different public, in different social contexts. The tourism constitutes a symbolic asset of the modern society, being considered by the studious, as one of the most expressive phenomena of the modernity, for involving each year displacement and the interaction of thousand of people of different cultures in the entire world. All this people s mobilization points to practical social related to personal motivations, to the entailed desired to the idea to travel and to exceed borders. It is already consensus that tourism is a phenomenon of economic growth, generating jobs, income, professional, qualification, bringing improvements for the host cities. Since 1995, in Brazil, the tourism as a sector of the economy, passed to be considered one of the national priorities, and in this perspective, the national politics of the tourism invested in infrastructure of Brazilian cities with high tourist potential, objecting to increase the flows of Brazilian and foreign tourists. Owing to this fact, the country still invests in programs of tourist marketing, mainly divulging the images of the natural beauties of Brazil abroad. And for Brazilians, the campaigns appeal to rescue the feeling to be Brazilian, associating the idea to travel and know its country. Natal city possesses an excellent positioning in the tourist marketing, being predominantly divulgated in national and international level, for its naturalistic singularity, where the images of its natural enchantments as warm water beaches, white dunes, warm weather, constant breeze and an always blue sky are shown as the favorite scene on this city. From what was viewed above that the choice of a tourist destination articulates from a determined imaginary of a place, already constructed or in process of construction, we consider the knowledge of this imaginary a basic learning for the population of the city and especially, for educators, in the formation of professionals in this area and for tourism managers, elaborators of public politics. Based on this estimative, we developed this research that had as a general objective to identify the images that illustrate Natal city as a tourist destination - our objective of study, particularly the meanings and senses attributed by the tourist marketing (hotel s folders) and by the tourists that visited the city during this study. The discussions and reflections that had guided this research had been given from the theoretical link between imaginary and social representation, also considering some interfaces between the fields of communication and symbol. From the studied authors, Baczko (1985) clarifies that the study of social imaginary is directed for the mechanisms and structures of the social life, especially for the intervention accomplishes and efficient of the representations and symbols in the practical collectives, as well as in its direction and orientation . Following this same thought, Moscovici (1978) says that the social representation are produced in communicational and symbolic contexts, and these representations once that already constituted circulate socially as almost tangible entities. Based on this fundament and on the analyze of Barthes (1990), particularly in the approach given to the reading of photographic image, we could observe on hotel s folders that each page evidences senses and meanings of functionality of internal and external spaces, pointing to the way of leisure offered by the keepers of city which is the hotels. About, the leisure that they offer, it is directed to young public, giving meaning to the young myth of personalized leisure tourism on children, young and adults images. The image about security that hotels offer and the singular image of Natal city as a paradise place, provide an idealization of pleasure through the sun, dunes, and beaches and also due to the hospitability of the natives who are assigned as educated . For the tourist that participated on this research, Natal city is tied only by the imaginary of leisure and nature which constitute the emotional link of the relation media-city-tourist. And with such force and fullness of directions the city discloses without tensions and contradictions as a place protected by a mythical and sacred aura. The study also demonstrates us that the potiguar culture remains (almost) forgotten, due to the silenced in this imaginary. In this perspective, we highlight that this culture silence is very close related to the disvalue of education in its general meaning. We defend that the imaginary apprehended constitutes a new reading and a new looking and understanding the tourist reality that comes historically consolidating in this city. In this direction, we glimpse that this study and its future dismemberments can collaborate with the process of rescue the cultural values of the potiguar people, in the way that the meaning of tourist may be redefined, and the tourist image of the city can be also disclosed for its identities particularities of its culture

O pedagogo como agente de transformação social para além dos muros escolares

This thesis concerns the problem about the pedagogue actuation in the social education into no scholars places. It search to understand the context and the social pedagogue role to his praxis and formation that enlarger the possibilities of the social educative practices into no scholars places. In this direction, we developed an investigation about the actuation of the pedagogues-educators in Natal city, in the 2007-2010 periods, into Municipal Secretary of the Labor and Social Assistance (SEMTAS). Considering that pedagogues are regularly attached in social educators profession as municipals public employees, we re the objective to evaluate their role into the social executed in the no scholars places, with the focus in the environmental dimensions of theirs work s places, pedagogical organization, institutional management and the professional formation. It privileged in this research the Specialized Reference Center of Social Assistance II (CREAS II), the Passages Houses I, II and III, the Social-Educative Measures in Open Environment Execution Program of Natal city (PENSEMA) and the Pitimbú Educational Center (CEDUC-Pitimbú). To realize this study it developed a research with qualitative nature by critic ethnography approach privileging those information collected with the social pedagogue-educators of the mentioned places. Through the methodological procedures adopted; beyond the bibliographical review we remarked the documental research, the semi-structured interview, the questionnaires-routes and the field observations. The analytical results revealed that the politics to the social education in Brazil historically came been dimensioned by the fight of social movements demanding the fundamental rights to the excluded people; that the SEMTAS politics of social education present a relative basic social protection to the excluded children and young people specially into law view; that the politics of social education in Natal city it s close of the logic of sanitarian attention about the disadvantaged groups; that the conceptual, methodological and formatives fragilities needs to the social pedagogues-educators praxis into non scholars places made difficult the operation capacity of a educative proposition anchored in a institutional action guided by the idea of emancipator education; that the SEMTAS take face several difficulties to developed a web assistance as preview in the reception proposition elaborated by the social pedagogues-educators. However in despite the tensions we remarked the value of this potentiality to the non scholar social education in her attempt to constitute herself in a legitimate space to the pedagogue professional actuation. In despite the obstacles to work and formation quotidian, across those non scholar spaces in the municipalities institutes to the social politics, it demonstrated personal sensibility and professional creativity in learning mediations and educative action to the children and younger derived from exclusion process and the social iniquities

Literatura e educação: um caso/uma casa de inclusão

O estudo investiga as contribuições da literatura para a inclusão social na escola, explorando o potencial inclusivo do texto literário. Sua relevância consiste em fornecer ao professor subsídios para ampliar suas competências no ensino de literatura a partir do (re)conhecimento da função inclusiva do texto literário e da construção de uma comunidade de leitores que atenda à diversidade de interesses, necessidades e sentimentos dos aprendizes. Entende-se que a literatura é inclusiva em sua natureza pois, inclui o leitor no texto e permite práticas socializadoras de leitura. O estudo alinha-se à vertente qualitativa caracterizando-se como pesquisa-ação participante. Adotaram-se como procedimentos metodológicos a observação participante e a intervenção pedagógica. O estudo realizou-se em uma turma de 4º ano do ensino fundamental com 43 alunos, de faixa etária entre 8 e 13 anos, matriculados na Casa do Menor Trabalhador CMT, escola pública do município de Natal-RN (Brasil). Os instrumentos utilizados foram: gravação em áudio; diário de campo; entrevistas. Na intervenção pedagógica, realizaram-se 20 aulas de leitura de literatura de contos, fábulas, poemas e adivinhas com diferentes estratégias didáticas. As sessões de leitura foram desenvolvidas conforme os moldes da andaimagem (scaffolding) descritos por Graves e Graves (1995). Tomou-se como referencial teórico os estudos de Aiscow, Porter e Wang (1997), Amarilha (1997; 2006), Aquino (1998), Eco (2003), Caldin (2004; 2003), Cazden (1991), Chartier (1994), Culler (1999), Iser (1996), Manguel (1997), Paulino (2001), Perrenoud (2001), Petit (2008), Sartre (2006), Stainback e Stainback (1999), Stierle (1979) e Zilberman (2005). A análise aponta a relevância do diálogo entre literatura e inclusão social para democratizar a leitura literária e tornar o ambiente escolar mais inclusivo. Confirma a natureza inclusiva do texto literário, no modo como promove a entrada cooperativa do leitor no texto literário em prática socializadora de aprendizado, de compartilhamento de sentimentos, sensações, subjetividades e de acolhimento das diferenças. O estudo revela e consolida a leitura de literatura como uma atividade intelectual significativa, prazerosa e democrática, na qual o leitor, ao colaborar com a construção de sentidos e ao estabelecer relações interativas, passa por transformações que favorecem a inclusão. Ressalta-se a importância do mediador de leitura na seleção de estratégias que viabilizem a democratização da literatura e pela literatura, no pequeno universo da sala de aula, que atendam às necessidades dos educandos, desenvolvendo habilidades leitoras, incentivando o gosto pelo texto literário que educa e convida à inclusão

Uma odisséia em busca de Héstia: do turismo à hospitalidade pelos caminhos das representações sociais

This thesis is the result of a piece of research on hospitality social representations between tourism professionals and academics in the city of Natal. The reasearch s corner stone is the point of the view that the notion of hospitality, with all its theoretical and practical implications, is essential to the success of any tourist destination. Is there any relevance in the growing use of the word, almost as a synonym for tourism? How is this notion, first learned in the domestic context and then exercised in the contact with the city and especially with visitors, represented in the learning process for professional practice and in the exercise of professional tourist reception itself? In order to answer this question, initially we chose to study the concept of hospitality in their current academic view, with reference to the French school, which binds hospitality to the maussian perspective of donation, and other scholars of the current theme, with emphasis on the research performed in the program of Master of Hospitality at the Anhembi Morumbi University, whose philosophy imprints in the hospitality concept the same sense we want to give this study. Then we chose to analyze the notion of hospitality, by the Social Representations Theory, in light of Moscovici s methodology, as well as the analysis of the core of this concept among tourism professionals and students. It was found that hospitality is still a very diffuse reference to representations of these two groups and that academic education, if accepted both theoretical and practical implications of this research s starting point, will still have a long way to go. Cities such as Natal, "naturally" hospitable, according to its dwellers, where tourism is relevant to their economies, need (re)thinking and (re)organizing, continuously, their actions towards quality and performance of their professional training especially those concerned with receptive structure

Um estudante cego no curso de licenciatura em musica da ufrn: questões de acessibilidade curricular e física

This work aims to discuss and analyze the process of school inclusion of a blind person in the Bachelor's Degree in Music, at the School of Music at the Federal University of Rio Grande do Norte, as well as reflect on the importance of establishing systems of support and to ensure university inclusive process of people with visual impairments. In pursuit to achieve these objectives, this research chose a qualitative methodological approach, the case study, using as procedures for data construction an interview, observation, analysis of documents and photographs. Joined the group of participants in this study, a blind student in the class of 2009.1of the EMUFRN Bachelor's Degree in Music, teachers from two disciplines complied by the student, two classmates, a monitor support in music theory, the course coordinator and school principal, and two other individuals who contributed to the inclusion process in actions not formalized institutionally. The results indicate UFRN proposed initiatives that contribute to inclusion of students with disabilities in this institution, the main one is the creation of the Standing Committee of Support for Students with Special Educational Needs (CAENE), a group that guides administrative sectors, teachers, principals, coordinators and students on the measures needed to enter and remain in quality education for all. Physical accessibility is still under construction at UFRN, and many access and sectors see it being adapted for students with physical or visual disabilities, and those with mobility impairments, have access to various parts of the university, however, as shown in this study, some points need to be reconsidered, as there are several places where the installation of tactile floor does not fully follow the guidelines proposed in the legislation. The proposals for access to the curriculum, mediated by EMUFRN, are actions that propose the inclusion of the blind student, as the existence of an educational monitor to help in the study of music theory, however, we need to rethink these proposals to not became actions of reactive intervention. Assuming a more proactive posture, the EMUFRN will be prepared to receive the diversity of students that expects. The study also points out that the blind student is part of a group of students that are practical musicians, who must work in events and evening shows, and who have little knowledge in music theory, leading, respectively, in low frequency classes and learning difficulties in certain curricular components, which may cause the closing of such components. In this case, the challenge of EMUFRN, considering the inclusive perspective, it is not specifically fit for the academic host a blind student, but to develop an accessibility project curriculum to consider effectively the diversity of all its students, taking into account mainly the economic and cultural conditions. This implies a process of resizing academic practices that be guided for collaborative and coordinated actions involving the various educational actors at EMUFRN and UFRN

Interação entre a equipe de enfermagem e a gestante com diagnóstico de pré-eclâmpsia

The objective of this exploratory descriptive study with a qualitative approach was to analyze the perception of the nursing team and the pregnant women hospitalized with pre-eclampsia regarding the interactive process occurring in the care relationship. Data were collected by semi-structured interview with twenty nursing professionals that work in the high-risk ward and ten pregnant women with the diagnosis of pre-eclampsia. The discourses were analyzed using the content analysis method, in the modality of thematic identification. Three categories were identified that describe the perception of the interaction by the nursing professionals: recognizing the needs of the hospitalized pregnant woman, understanding the woman with pre-eclampsia, and presenting difficulties in the interactive process. With regards to the pregnant women, four categories emerged: recognizing the clinical care, feeling the lack of information, experiencing feelings during the hospitalization, and envisioning the interaction process. The meaning of the discourses was analyzed according to the principles of symbolic interactionism. The results indicate that both, the nursing professionals and the pregnant women, have a limited perception of their interaction, suggesting a need for further reflection about this reality in the health service units and in the nursing education environment

Condutas de profissionais que realizam a consulta pré-natal na Estratégia Saúde da Família quanto à detecção, tratamento e acompanhamento da gestante com sífilis

The objective of this exploratory descriptive quantitative study was to analyze the behaviors in the detection, treatment and followup of the pregnant woman with syphilis, by health professionals that conduct the pre-natal consultation in the Family Health Strategy, as to the adherence to the recommendations of the Ministry of Health. The study was conducted in nine municipalites of the Trairi region in the state of Rio Grande do Norte. Data were collected during the months of July through September 2007, by means of a questionnaire with a population of 53 health professionals, 30 nurses and 23 physicians. Data were analyzed by descriptive statistics. The results were organized in three major items: knowledge of the health professionals about the symptomatology of syphilis and their actions in the detection of the disease; actions in the treatment of the pregnant woman with syphilis; and the actions of followup of the desease. We identified that 81,2% of the professionals have knowledge about the symptomatology of syphilis in the pregnant woman;79,2% request the VDRL exam in the adequate intervals and approximately 50% conduct the treatment in conformity with the recommendations of the Ministry of Health. For the followup care of the infected woman, 79,2% request a monthly VDRL examination, 69,8% explain the disease to the pregnant woman, and 20,7% affirm that they conduct a proper reception to the woman.We conclude that the majority of the health professionals have knowledge of the detection, treatment and followup of the pregnant woman with syphilis. However, the actions of some professionals diverge from the conduct procedures recommended by the Ministry of Health, as to the requesting of the examinations, medication prescription and notification of the iesease. This indicates the need for improved

Saúde da família: uma estratégia de mudança no processo de produção dos serviços de saúde

The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caicó, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors

Análise de qualidade da atenção à criança na estratégia saúde da família: o óbito infantil evitável como referência

Alma-Ata declaration bring the Primary Attention to the Health (PAH) as first level of health attention for individuals, family and community, which considers infant group as priority. Several initiatives that gave bases to integral attention to the children health formalized in the principles of Unique Health System. Family Health Strategy (FHS) comes to strengthen this attention, instituting new ways of work organization and professional practices that gave impact in their quality indicators. One of them is children mortality, showing decline in their values. Though, studies indicates persistence of avoidable infant deaths. In Natal RN, this reality is also perceptible leading to inquietudes, mainly at the space of services production, it means, which motivated the accomplishment of the present study intending to analyse the way that the organizational and structural processes as long as the professional practices in FHS interfered in the quality of children s health attention who died by avoidable death in the year of 2007 in municipal district of Natal-RN. It treats, therefore, to an exploratory and descriptive survey of cases study type, thar had as primary sources the oficial documents of MH, the family prontuary, pregnant card, child card and testimony obt ined from instrument of research elaborated based in investigation form of infant death by MH, applied to 10 mothers of children who had avoidable death. In analysis it was appealed silmultaneous triangulation of methods and sources, allowing a bigger aproximation from obtained informations. To elucidate the cases, the aspects studied were analyzed to the light of explicative model of Social Determinants of Health. Among individual and family aspects were highlighted the related to age, schooling, family habits and customs and mother s economic condition, besides of pregnancy age, newborn weight and associated diseases, which don t differ from literature about the theme. Reffering to the factors organizational and structural processes and professionals practice, highlihgted, the treatment given by the professionals, the territorialization and adscription of areas, the difficulty of having access to the services or sleepers and the reference and counterreference. But also, the ausence or few greet, the lack of communication, few assiduity and ponctuality by professionals in service, among others. In a general way mothers considers the attendance received in the hospital good and very good , opnions that in the Basic Attention weren t so favorable, in spite of many of predictible actions in this level have been performed in the studied cases. It is observed, therefore, that the social determinants of health has a strong influence in ocurrence of infant deaths, what implicates in a large actuation by Infant Mortality Committee from municipal district. This way, it becomes fundamental the reflection and evaluation about the effectiveness and execution by the processes of vigilance to health in FHUs; the rethink about the social determinants of health in a wide and articulate way to the services quality, to permanent education, to management in service, to the given attention and to the way how it is installed the popular participation and social control. To the professionals it is presented the great challenge to review their daily practice, their values, behaviors and commitment, which ones must be guided by logical of sharing, work in team, humanescence and alterity, not only by the accomplishment of a professional duty