982 resultados para Coesão e coerência


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Si les études sur les groupes noirs ruraux connaissent un essor dans l´Antropologie brésilienne contemporaine, au Nordeste, et spécialement au Rio Grande do Norte, ce genre de recherches restent rares. Ce travail a comme principal objectif de faire une description ethnographique des communautés du Pêga, do Arrojado e do Engenho Novo, dans la commune de Portalegre/RN, désignées comme des descendants africains et dont les membres se reconnaissent comme appartenant a une "grande famille". Ainsi, nous voulons analyser les processus d´élaboration d´une identité collective et comprendre le rôle des relations de parenté dans la vie cotidienne, festive et religieuse de Portalegre. En effet, nous pouvons observer que les "parents" développent des stratégies économiques et affirment leur alterité, reprennant des traits culturels et religieux qui leur sont propres pour se présenter comme un groupe doté d´une grande cohésion face a la société environnante. Nous utilisons la méthode ethnographique et la technique de l´observation participante, alliée à l´analyse des sources historiques primaires dans le but de décrire ces pratiques et stratégies. Nous pensons que la participation des membres du groupe à la production agricole, spécialement dans la confection de la farine de manioc, la construction des relations sociales au quotidien et l´organisation de la danse de São Gonçalo représentent autant d´occasions où la mémoire du groupe se fortifie, l´identité collective se cristallise et où la sociabilité se trouve consolidée. Nous analysons ces pratiques collectives et ces moments festifs comme des moyens de réaffirmation d´une identité locale centrée sur les relations de parenté

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This thesis is defined as a reflection on the mechanisms of expression and insertion of the homo situs in the participatory governance in Mozambique. For a better understanding of this social fact, it was settled a periodization which covered the decline of colonialism at the time of the independence, which was proclaimed in June 1975, the civil war that lasted over 16 years and the period of the democratic State, further established. Therefore, we sought to understand the mechanisms and failures of the participation of the homo situs in local development projects that absorbed the needs and problems of these peasants, not mobilizing the skills and social competences of these communities. It would be essential for the homo situs a genuine democratic practice involving a political culture based on the social construction of the territories of the traditional man which was characterized by being procedural and historical, finding in participation its higher base. In this context, it would be desirable that the community development in Mozambique could contemplate and respect the choices of the homo situs. For this purpose, it would be fundamental the consistency between theory and practice, which builds and rebuilds, continually the competence of the peasants, facilitating the possibility of realization of their primordial aspirations. In the research, it became apparent that there is not a continuous process of participation of the rural communities, which appear as participants, only at the time of the implementation of the activities. Therefore, even having the participation of the communities expected by the law, with predictable moments of discussion and necessary conditions for that, the State failed to establish an ongoing process of democratic dialogue with traditional populations, as well as it failed to organize, properly, accurate informational bases to help solve the problems of rural areas. These facts have led to obstacles to the process of conquest of the human and civil rights of the traditional communities

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The present work aims to analyze the several proportional electoral systems from the contemporaries democracies in order to, in the end, purpose a system that better fits to the constitutional Brazilian order. In this direction, we pursued to indicate the main virtues and imperfections in proportional electoral systems in use in more than two hundred countries, especially relating to the positive and negative effects that these systems inject in the party systems, in the governability and in the representativity. In order to collect elements, and also before getting to the work s main point, other issues were approached, even in a shortened way. Nevertheless, in a position taking, we conclude the work opting for a proportional electoral system that potencializes the constitutional principles of representativity and governability as well as prints a party system strong and strict, once these are the depositaries of a democracy compromised with the Brazilian society

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This work analyses the ability of National States and regions have to formulations development strategies. Redeeming the initial development concept as a conflictual process, the hypothesis is that it presents internal and external constraints, as the latter have a higher preponderance, revealed the role played by money. In this case, one can point to as sub-hypothesis that the growth models with external constraint, mainly through the balance of payments, may illustrate the fact that countries are subject to international economic interactions that limit the possibility of bringing acylating strategies well successful in overcoming backwardness. For the specific case of regions, indicates that the external constraint remains an element of embarrassment for regional development, but redeems itself the center-periphery relations in this context to discuss the role of monetary and financial system as an explanation for the disparities regional income. On the domestic front, we highlight the importance of social structures of accumulation as an element of internal cohesion necessary to achieve successful development trajectories. It points also to the importance of the State in the process rescuing some of the main theoretical contributions of the political economy of development, incorporating the concept of globalization on theoretical frameworks presented. This construction where development depends on the actions of external and internal conditions, where money plays a key role as a guideline for reflections on regional development. The attempt was to transplant our considerations on the general development to address the case of regions. Finally, we conclude by greater confidence in the hypothesis and sub-hypotheses of departure, which led to propositions of economic policies

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This work focalize the institutional and educational evaluation, aiming to investigate the Municipal System Institutional Evaluation Performance of Teresina City Piauí (2001-2005), and to reflect about Institutional System Performance and its contribution to compose a new learning evaluation practice. In this sense, classifies elements about the evaluation practice in two Elementary Education municipal public schools, involving Education Municipal Bureau technicians as managers, pedagogues, teachers and students. Based on the ethnographic studies principles in the educational area, the work employs investigative procedures like document analysis, interviews with groups and individuals and also participator s comments. Intending to comprehend the complexity produced by the institutional and education evaluation processes, the wok reveals the Institutional Evaluation legal and educational political basis and the several positions assumed by the Learning Evaluation, as a classification tool or as a learning enhancement. This work points, as results, to a evaluation culture bipolarity carried out by the Municipal Education System as a explicit control and regulation toll, related to the classification and learning in a interaction process that operates both in the pressure and the reflection, as a culture practice established between excellence of logic and learning. The evaluation history has been construct on the evaluation actions dialectics, joint simultaneously between the Institutional Evaluation Performance and the learning evaluation. The senses, meanings and actions bipolarity is a interaction process product sustained between the institutional evaluation, under the scholar ranking application, and the learning evaluation. In this relativity, the teacher evaluation practice is found, ruled by interesting, thoughts and actions on the school evaluation, allowing a higher security and support to the learning results. Grounded in the researched reality, its possible to say that the teacher s evaluation practice is diversified, with different characteristics, when it is done in the learning search and in the learning intention. In the first case, reflects, rearranges and constructs new actions that lead the student to produce learning. In the second, shows the will, the wish of learning, but is a weak action, producing a not really significant learning and development; as a result, remains the mark approach as a determinant in the student future. The work s hope is to contribute not just to rethink these two evaluations dimensions the institutional and the learning ones but also to organize the school and to improve the pedagogic process

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Les récits sur les expériences de vie se constituent en apprentissages signifiants dans le processus d´ auto-formation des éducateurs. La formation est un phenomène qui extrapôle l ambiance scolaire, incluant les expériences qui servent de matrice pour la construction de la connaissance au long de la vie. Dans cette perspective, «la connaissance de soi», telle quelle proposée par SOUZA, NOVOA et JOSSO, est la notion centrale au tour de laquelle se développe cette dissertation. La recherche a comme idée principale transposer pour la realité des professeurs l´exercice reflexif de son enseignement, médiant la redécouverte de ses expériences de vie, a travers des histoires de soi que, potentialisés, peuvent transformer ses pratiques dans la classe scolaire. Je prends comme point de départ mes propres expériences comme éducatrice assumant la conviction de la indissociation entre sujet et objet de la connaissance, comme propose Édgar Morin pour parler de la science de la complexité. Je fais aussi l´usage des récits de six professeurs du réseau publique de l enseigment, révélateurs de la construction de la connaissance appuyée dans la cohérence de la praxis pédagogique avec son mode de comprendre et sentir le monde. Les oeuvres «Mes Démons» d Édgar Morin, «O Tempo e Eu» de Luis da Câmara Cascudo et «O Banquete dos Deuses» de Daniel Munduruku, ont élargit le champs des récits d expériences que se constituent en matrices des processus de formation. Le travail avec les récits de formation démontrent qu´à partir de la réflection du sujet sur sa propre expérience, il est possible de se projéter des nouvelles configurations de la connaissance tenant comme base, la reliaison entre vie, idées, et pratiques pédagogiques. À partir de la métaphore du bûcher il est possible de se comprendre la force de combustion des expériences de vie dans la formation des enseignants

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La musique, plus qu`um mot et le texte écrit, a le pouvoir de produire le déplacement du sujet en relation aux contingences du temps e de l´espace. Entendre de la musique est plus que de l´amusement. Comme un artifice cognitif qui ultrapasse l´expérience analytique e métonymique, les formes tonales doublent la réalité, expandent les sens, actionent l´imagination, retotalisent les sentiments, amplient les expériences, permettent la rencontre du sujet avec les éssences des phénomènes qui ne sont pas traductibles par les mots. Nous écoutons de la musique pour restituer notre dignité e conférer à la vie plus de vérité, plus de concrétion (Santiago Kovadloff). La mélodie permet l´expérimentation des états de cohésion, de conéction pleine entre sens et intention, entre commencement et fin, de la finitude de la vie (Schopenhauer). Le phénomène musical provoque l´expréssion de la douleur, de la souffrance et, au même temps, du jubile et de la joie, réliant nature et homme (Nietzsche). Tenant comme base cette compréhension, la dissertation tient dans la musique une importante métaphore pour comprendre la complexité humaine, une fois qu´elle propicie une écoute sensible du monde et mobilise dans le sujet l´expérimentation de divers états de l´être. Nous pouvons dire que la musique est un opérateur de la conaissence parce qu´elle fait affleurer l´écoute intérieure, la rencontre du sujet avec lui même. Cet opérateur cognitif actione les pôles de l´ésprit qui font dialoguer sensibilité, éthique et esthétique, ordre et chaos, silence et bruit, mouvement et pause, repétition et inovation. Par l´expérience musicale, nous habitons des formes hibrides de sensibilité et raison. L´inachèvement, notre principal caractéristique comme humains, a, dans la musique, une image impair, parce que la musique est l´expression du dévir. Pour tisser ces arguments, la dissertation part des études de Schopenhauer et Nietzsche sur la musique, esthétique et métaphysique; Expose des fragments de la biographie de trois grands penseurs contemporains (Werner Heinsenberg, Ilya Prigogine et Edgar Morin) accentuant la présence de la musique en ses vies; et, par fin, présente ce que nous appelons biographies sonores de quatre artistes-musiciens brésiliens (Benedito Juarez et Gil Jardim, de São Paulo, et Ronaldo Ferreira de Lima et, Cleudo Freire, du Rio Grande do Norte)

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The dissertation is developed in the Research Base of Teacher Training and Professionalization of Universidade Federal do Rio Grande do Norte as a way to discuss the professionalization of High School teachers in Natal. It is a study linked to the research The context of teaching practice and professionalism: the case of high school teachers and sponsored by CNPq, with the objective of characterizing working conditions and job satisfaction as dimensions to the teacher professionalism in high schools. In this study we prioritized the focus on professionalization in national and international discussions, which combines the aspects of teaching in its historical, social, political and economical path, in order to reflect about its evolutional elements in the hierarchy of professions and establish a relation to high school teaching. To develop this relation we elaborated some questions that are considered relevant, such as: How does the high school teacher evaluate his/her working conditions to his/her professional practice? What level of satisfaction does the high school teacher have regarding his/her professional practice? What expectations does the high school teacher have in relation to his/her professional development? The answers to those questions were according to the high school teachers considerations shown in the questionnaire, which was structured with open and closed questions. These questions gave better adequacy to the teachers evaluations about their working place and the situations they experience in their working conditions, provoking job satisfaction and expectations for professional growth. The description of the teachers perception about working conditions, job satisfaction and expectation of professional development can explain the distinct factors that characterize these categories in the working context, although the conclusive results, in general, do not show a direct relationship between the categories studied. Some factors that teachers attribute as causes of bigger difficulties in working conditions and work activity itself are: working time, salary, professional status, school s infrastructure, and school s social context. These factors are similarly related to the degree of job satisfaction, without showing interference in the professional expectations

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In the passage of life, the labyrinth of songs and corners are propitious ways for a better comprehension, perception and incorporation of learnings that emerge from our subjectiveness in a magic caught by senses. Eyesight, taste, hearing, touch and smell in communication with the world, put us in front of cultural diversities. The ludicity accumulated by experiences promote the flow of hilarious and concrete discoveries that express themselves in work and leisure demonstrations. Such reflections emerge indicators to the problematic construction centralized in the incorporation of cultural experience knowledge to the formation process and professional interventions in this rule and area. From this significant problematic, aiming to deepen studies, we favored leisure as field of investigative production in full expansion. This, for sure, was an exercise of qualification that guided us through meander of education and made us dip into studies about the corporeity. A research in which the scenery was painted and constructed with the complicity of the culture lived with shine, colors, rhythm and drummings of one of the most present cultural cycles: carnival. Recognized as a stimulant for beauty, participation, socialization, and helped us to enter in the essence of gestures and expressions of corporeity, to think, elaborate and socialize a critic-scientific knowledge which, appropriating from the rhythm of colors, of sounds, of tonalities, of senses and of meanings impregnated in the web of life. All these things seduced the researcher, making imagination flow amid ludic-creative dialogues with the imaginary of researchers creation and production in the rule and area of leisure, education and corporeity. Option that made us outline as objective to investigate and interpret how leisure teachers-researchers, from their studies, researches and interventions, locate and incorporate the knowledge from cultural experience to the formation process and intervention of professionals in this rule and in this area, emphasizing the contributions from this knowledge to fence and qualify this praxis. So, as living each cultural scenery, each epistemological contribution was feeding the production with images of the different versions of the Brazilian breedings, creating and raising expectations and new discoveries and newcomers. With the seriousness of a scientific study, we lived an xxiii academic experience with complex intensity, rigor and coherence, eliminating, step by step, the risks and limitations always present in a work of this magnitude. However, we weren t, even for one moment, alone. Our epistemic regard always maintained mediated by the principles of a methodological approach - the Etnomethodology, that while central guide provided us clues to unveil the lived world by our people-playful , in a universe of 15 members, that allowed themselves to comprehend, comment, analyze. This way, grasping the object in interactions arised and provoked by narrative interview, it was systematically dialected by (re) interpretation of images and formulations of people-playful, enriched by their beliefs, myths, conceptions and rituals inherent to knowledge from cultural experience, which each one attuned with Brazilian and international history, in a mixture of senses echoed from songs and tales. Inspired in drummings and percussions, clothing and choreographies of gestures and expressions, in mixtures produced in unit interactions in the multiplicity shown as necessary requests to the totality of life, with ludicity the rescue of the past, the conquest of present and the construction of future was the axle guide. This rich process of scientific creation made us realize that is possible qualify and empower the praxis in the rule and area of leisure incorporating the knowledge from cultural experience. What also becomes possible is the recuperation of objective revolutionaries and changing conditions of praxis itself with the view of strengthening and triggerment of vital elements in the rule and area of leisure. We also reaffirm that from this praxis emerge elements necessary to human formation in plenitude, by the appropriation of knowledge that guide the facing of challenges of a complex and plural world that valorize education, corporeity and leisure

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In this research, we invite to reflection by a phenomenological gaze on the body, through the description of some works of contemporary Brazilian dance company Grupo Corpo. This Company was chosen intentionally to give us elements in their creations to interrogate the understanding of the body and sensitive. Thus, as we launch issues in this dissertation: that body dance in Grupo Corpo? And as we can see, a phenomenological approach, an understanding of the body and sensitive works in that company? Building on this, the works are to be questioned Benguelê (1998/2003), Lecuona (2004) and Onqotô (2005). It is intended, through these works, coreological approaching the discourse of philosophical discourse and give movement to phenomenological thought of Maurice Merleau-Ponty, in special the sensitive, flesh of the body, the investment in the sensory world as a merger, calling the know body and its power to take chances, to incorporate the world, language, culture, create and choose. Thus, these openings is where thought enters this research. This consistency, we used the phenomenological attitude of Maurice Merleau-Ponty as a methodological approach, since in their study the philosopher takes a look expressive on the body, forming a sensitive language that is expressed in the movements, which deepens the arguments of the Phenomenology a new arrangement for knowledge as a result of our experience in the lived world. The reflections presented here aim to take us to the amazement, the unthinking, whom many still impose epistemological challenges, including understanding the body of knowledge and sensitive

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Foram estudados tumores de mama em cadelas, comparando o seu padrão citológico, obtido através da Citologia Aspirativa por Agulha Fina (CAAF), com os resultados da histopatologia. Num período de um ano, as cadelas trazidas ao Hospital Veterinário -- UNESP -- Câmpus de Jaboticabal foram submetidas a exérese cirúrgica dos tumores mamários. As amostras foram avaliadas de acordo com parâmetros estruturais utilizados nos tumores mamários humanos, como grau de atipia, critérios nucleares, padrão de cromatina e nucléolos, alta celularidade e pouca coesão intercelular. Utilizaram-se estes critérios para diferenciar tumores mamários benignos de malignos com 63% de diagnósticos concordantes, sensibilidade de 73% e especificidade de 83%. Nossos dados mostraram ter uma correlação positiva com o prognóstico, demonstrando que é possível reconhecer variáveis estruturais de malignidade na citopatologia para obter um diagnóstico precoce e um prognóstico seguro.

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It is a descriptive study with a qualitative approach, and an action-research type, which aimed to analyze the changes of knowledge about contraceptive methods invested to a teenager group attended in Igapó Family Healthcare Unit, in the city of Natal/RN, after consent and institutional assent of Ethics Committee of Rio Grande do Norte Federal University (Protocol No. 131/07). It were researched 16 teenagers of both sexes, with age ranging from 11 to 16 years. We used two structured questionnaires, one in the initial diagnosis and another during the seven meetings of the focus group, in addition to the field notes and the meetings discussions transcriptions. The data-collection was performed in the period of two months by a team composed by a nurse the research coordinator, a dentist, a nursing assistant, a community-based healthcare worker and a nursing academic. The quantitative and qualitative data were organized, tagged and categorized into spreadsheet in Microsoft Excel, being held a thematic analysis of speeches performed by the study participants. The results were presented as tables, graphics, photos, drawings and word clippings. The educational strategy developed in focus group allowed adolescents to discuss, exchange ideas and opinions on several contraceptive methods, providing expansion in knowledge of all contraceptives discussed, especially those natural and surgical, which were less mentioned at the beginning of the study. Among the advantages of the contraceptive methods listed by teenagers, was highlighted avoiding pregnancy and STDs in use of the barrier method of condom. As for the disadvantages more frequently noted by the survey with the misuse of barrier methods, was highlighted get pregnant, acquire STD's and do not prevent STD's in hormonal, natural and surgical methods. Adolescents showed consistency between the advantages and disadvantages and types of contraceptive methods, showing a widening in knowledge among them. It may be said that, in general, those surveyed had a good understanding about the use of the various contraceptive methods. Thus, the study participants had positively evaluated all the criteria used to qualify the meetings in the focus group. The action strategy of the focus group should be encouraged by professionals who work with teenagers, since they prefer to live in groups, one characteristic of adolescence.

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It is an exploratory and descriptive study made by a quantitative approach, developed among February and May 2010, aiming to assess the pain of patients underwent abdominal surgeries in a University Hospital, in Natal/RN; to identify the local and intensity of the pain based on Numerical Estimative Scale; to analyze the pain related to the sensorial-discriminative, motivational-affective and cognitive-assessment dimensions, using the McGill Questionnaire pain; to establish a relation between the pain process and age, gender, religion, and king of surgery; to identify the medicines efficiency used to control postoperative pain. The sample was composed by 253 patients underwent abdominal surgeries. The results showed a total of 63.63% females between 38 and 47 years of age (21.34%); illiterates (21.73%); married (64.03%), living in Natal and surroundings (67.97%) and Catholics (74.30%). In their first assessment, 84.19% showed postoperative pain; the pain was considered light in 18.97% of them, moderate in 21.74% and severe in 43.48%. The mean number of descriptors chosen through the McGill Questionnaire Pain was 10.78 (DP= 6.09) and pain rating 23.65 (DP= 15.93). The descriptors selected with higher frequency were: sickening pain (69.01%), tired (65.25%), thin (62.44%), bored (58.69%), ardor (46.48%), pointed (38.50%) and colic (35.21%). In their second assessment, 57.71% of patients didn t relate any postoperative pain and 42.29% were still complaining about the pain. After taking analgesic medication, just 41.90% of patients who had complete pain relief. The Pharmacological groups most used were: simple analgesic (37.86%), weak opioids (32.98%), AINES (19.85%) and strong opioid (9.31%). It was not found a significant postoperative pain variation related to the sexes, religion and kind of surgery. It was concluded there were a high level in the number of patients with postoperative pain, mainly in a severe scale. Less than half of patients had the pain relief. Then, it was observed there was not coherence between the pain intensity and the analgesic it was used. To solve or relieve this kind of problems is necessary a permanent education to the health professionals who works in this area

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The environment of Intensive Care Unit (ICU) is commonly referred to as a place where caring is inextricably linked to high technology. The care in ICU often changes the patient into a taxpayer being left apart from its complexity and sometimes seen through a reductionist perspective. Thus, studies circa the care process are needed oriented from a historical ransom, raising the prospect of a more centralized human care. Hence, this study aimed to analyze the care process in a nursing intensive care unit from the perspective of the professional, family and patients. The study is characterized from a qualitative, descriptive and exploratory methodological approach. The actors were participating nursing professionals, patients and family members of an intensive care unit of Mossoró / RN. Data were collected in the period of May-June 2011, through interviews and observation of activities performed by nursing professionals, and their records in the chart. Data analysis was divided into topics and subtopics representing the phases and shapes that formed the collection. The analysis and discussion of the interviews were based on Bardin's proposal, when we created categories from a process of sorting and grouping criteria adequately defined. The observation of nursing records intended to observe the emphasis which is described in those notes as well as their consistency with practice of FCN and resolution 358/2009. The analysis showed that the nursing staff also performs work focused on mechanized activities and technical-bureaucratic institution that seem to override the needs of patients. In an overview, the care provided by professionals occurs either fragmented or insipient, however there is a service that involves other aspects beyond technical-curative practice, considering that major attention is given to the family and patient, focused on the concern of Nursing guiding their actions in not only the performance of procedures. However, the process of humanizing not always ends with an engagement between professional and patient, which mischaracterizes the true meaning of human care. The records also showed a tendency to focus on caring in a positivist line, where, in most cases, the factors of the disease and the obligation to meet the productivity have overshadowed other relevant aspects to a holistic understanding of caring. Regarding FCN Resolution No. 358/2009, which guides a systematization of nursing care, it is confirmed a technical view, a fragmented and superficial view of the patient, as well as a weakness of care, caused by ignorance and unpreparedness of the entire team. The perspective of caring demonstrates a reality with dialectic between what is proposed in a humane nursing and what happens in this performance space. Besides, it was shown a daily full of important considerations that arise in professional practice, in their views and also those people who were participants in the process

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The Nursing Process (NP) is considered as the dynamics of the systemized and inter-related actions of human care. We believe that the nursing manager, as the representative of all the nursing care provided in the hospital setting, is an important agent for the implementation of institutional policies, such as the NP, in the service. However, there is little information in the literature about the NP in the perspective of the nurse manager. The objective of this study was to analyze the viability of the Nursing Process in the hospital context based on the attitudes of the nurse managers toward the Process. We conducted a descriptive-exploratory research study, of quantitative approach, with a population of 45 nurse managers that worked in the state hospitals located in Natal, RN and in the university hospitals of the UFRN. Two instruments were used for the collection of data: a nursing process questionnaire, constructed for use in this study, and the scale for the measurement of the attitudes titled Positions on the Nursing Process. The population is predominantly feminine (91,0%) and have relative nursing practice experience (Mean=17,6 years). However, they have little experience in management (Mean=8,6 years). They express little knowledge of the PE nursing terms and little experience with the Process. They have a positive atitude toward the NP (Mean = 110,9); are favorable to its developement in the service (86,7%); 48,9% indicated little possibility of institutionalization in the service and 37,8% indicated large possibility. The Spearman test for association between the variables of attitude about the NP and the possibility of its institutionalization demonstrated a weak negative association in the total individual scores of the attitudes (-,316) as in the 20 itens of the instrument, with coefficients varying from 0,014 to 0,464. Factorial analysis of the instrument identified three underlying factors to the attitudes of the managers in this study: relevance, operationalization and collaboration, with Cronbach Alpha coeficients of 0,955, 0,844 and 0,807, respectively, and 0,956 for the whole instrument, indicating that the scale and its factorial subscales have internal consistency. We conclude that there is a weak tendency for the managers with a favorable attitude to have a negative perception about the possibility of institutionalization of the NP in the service. The favorable position does not appear to be sufficient for the viability of this methodology in the hospital sector, results that is worrisome for nursing. This situation suggests that the difficulties with the institution of the NP in the hospitals may be related to other factors, including the organizational conditions. We believe that the institucionalization of the NP in a servisse where it is not known and not practiced, constitutes the introduction of an innovative work technology that involves many demands, among them the adherence of the persons to the proposed innovation. This demands time and the institutional adjustments and the human resources necessary. In this process, the involvement of the health professional of the institution is necessary. This situation brings to light the discussions of professional autonomy, the action limits and perspectives, the redefinition of roles, delimiation (or consensus) of the objects of study and of the work processes, among others.