Estudos da relação entre fromaçãodocente e desenvolvimento do pensamento: redimensionando o olhares

Este trabajo trata de un estudio sobre la relación entre la formación continuada de los profesores y el desarrollo del pensamiento teórico. Es nuestro objetivo comprender la relación entre la formación profesional de los profesores de los años iniciales de la Enseñanza Primaria y el desarrollo de su pensamiento. En términos específicos pretendemos reconstruir los procesos formativos de las profesoras, identificando sus necesidades y los elementos que interfieren en su práctica pedagógica; diagnosticar la fase del desenvolvimiento del pensamiento y dar inicio al proceso formativo de desenvolvimiento del pensamiento; además de analizar la conexión entre ese proceso y la elaboración conceptual, tomando como referencia el concepto de pensamiento. La referencia empírica se constituye de profesoras de la Escuela Municipal Professor Arnaldo Monteiro Natal/RN, que actúan en los grados iniciales de la Enseñanza Primaria y da Educación Infantil. Para desencadenar el proceso investigativo utilizamos como referencial teórico el materialismo histórico-dialéctico como método para análisis de los fenómenos, por entender que a través de esa lógica es que podremos buscar los elementos que nos darán sustentación a una mediación pedagógica que puede posibilitar mayor eficacia en la comprensión de los fenómenos. Recorreremos a pesquisa colaborativa, una vez que es nuestra intención desenvolver una acción investigativa compartida, teniendo en vista buscar medios para resolver los problemas que la práctica pedagógica nos impone. La investigación colaborativa posibilita al sujeto partícipe reflexionar, ser investigador y co-constructor da su práctica. Así, algunos procedimientos metodológicos fueron considerados adecuados para que pudiésemos alcanzar los resultados deseados, como Reuniones, Sondeado Diagnóstica, Ciclos de Estudios Reflexivos, Sesiones Reflexivas y la Autobiografía de Formación. Ni todas las profesoras están en el nivel de elaboración conceptual, en función del proceso vivido a lo largo de nuestras vidas, aún así, toda a trayectoria de la pesquisa posibilitó la descubierta de aspectos significativa sobre nuestro objeto de investigación. Para hacer el análisis de ese proceso nos utilizamos de las teorías de Vigotski, Guetmanova, Kopnin, Rubinstein. Podemos decir que, en la perspectiva de la colaboración, la reflexión sobre la práctica puede desencadenar una nueva mirada del profesor sobre su proceso de formación, el desenvolvimiento de su pensamiento y la acción desarrollada con su alumno. No fue posible verificar, en la práctica, los resultados de nuestro trabajo, ya que, ese no era nuestro objetivo, mas nuestras fallas presentan mudanzas teóricas significativas. Entretanto, resaltamos que las conclusiones a que llegamos están lejos que se acaben , una vez que es un tema complejo, que puede posibilitar el surgimiento de nuevos estudios, de nuevas pesquisas, de nuevos conocimientos

Escola para os filhos dos outros: trajetória histórica da escola industrial de Natal (1942-1968)

This paper presents a reconstruction of the historical trajectory of the Escola Industrial de Natal (Industrial School of Natal), in the period 1942 to 1968, based on the analysis of its cultural, social and pedagogical characteristics in a process in which its educational practices and the individuals who constructed them were getting involved in their actions. In this sense, the concepts of memory and school culture occupied a central place to understand the elements that characterized its administrative and pedagogical organization such as, for example, its curriculum, aims, disciplinary rules, clientele, teachers, leaders and the configuration of the institutional power. Designed to meet the demands of an industrial process that has strengthened in the country, throughout its history, the Escola Industrial de Natal was becoming a space predominantly occupied by individuals, from economically disadvantaged social groups in society, in search of a professional training that would guarantee them the exercise of a profession. The time frame from 1942 to 1968 allowed us to verify the changes caused by the Organic Law of Industrial Education of 1942, and the Law number 3.552, from 1959, in the organizational structure of this school. In this context, a characteristic that was evident was the purpose of making it flow between the students the love for the country, the respect for civic values and the belief that industrial education would be able to boost the country's development, an aspect that reached a bigger dimension from the 1950 s. Marked the disciplinary character of this institution the control over the actions of individuals, developed through its multiple educational practices in specific areas and in the predetermined time, under the constant gaze of those who participated, in some from, in driving this process. On the other hand, the vocational and human training, provided to students, allowed new opportunities for social integration, not only in the state of Rio Grande do Norte, but also in other regions of Brazil. Conversely, during his career, the Escola Industrial de Natal has remained being seen as an organized institution, with good teachers, but intended for the children of others

Pensando e agindo: estudo da relação entre o dsenvolvimento do pensamento e prática pedagógica

Este trabajo, intitulado pensando y actuando: estudio da le relación entre el desarrollo del pensamiento y la práctica pedagógica del profesor, tiene como objetivo investigar la relación entre el desarrollo del pensamiento teórico y la práctica pedagógica de una profesora de la educación pre primaria que actúa en una escuela pública de Natal / RN, con niños de edades variables de cuatro a cinco años. En términos específicos, pretendemos propiciar la continuidad de un proceso de formación que le permita elaborar el significado de los conceptos que componen los conocimientos curriculares, específicamente, el concepto de familia; tener el dominio de los procesos y procedimientos lógicos inherentes al desarrollo del pensamiento y la formación del concepto; mediar de forma consciente y planeada las etapas necesarias para que se efectiven los procesos de elaboración conceptual propicios al desarrollo del pensamiento. Para desencadenar el proceso investigativo, utilizamos los principios del materialismo histórico-dialéctico mientras que para el método de análisis, porque comprendemos que, a través de esta lógica, es que podremos buscar los elementos que darán sustentación a una mediación pedagógica que permita mayor eficacia en la comprensión de los fenómenos. Recurriremos a la investigación colaborativa, una vez que era nuestra intención desarrollar una acción investigativa compartida, teniendo en vista buscar medios para resolver los problemas de la práctica pedagógica. La investigación colaborativa posibilita al sujeto participante reflexionar, ser investigador, coadjutor-constructor de su práctica. Así, algunos procedimientos metodológicos fueron considerados adecuados para que pudiéramos alcanzar los resultados deseados, como Reuniones, Planeamientos, Ciclos de Estudios Reflexivos, Observación Colaborativa, y Sesiones Reflexivas. Utilizamos la metodología conceptual de Ferreira (2009) como soporte para el análisis del concepto de familia elaborado. Para hacer el análisis de ese proceso nos utilizamos de las teorizaciones de Vigotski (2009, 1998), Rubinstein (, Liublinskaia, Ferreira, Freire, entre otros. Podemos decir que, en la perspectiva de la colaboración, la reflexión sobre la práctica puede desencadenar una nueva visión del profesor sobre su práctica pedagógica y el desarrollo del pensamiento de su alumno. Los resultados obtenidos nos muestran que este fue un trabajo bien sucedido en el sentido de que percibimos una relación estrecha entre lo que la profesora realizó y los aprendizajes adquiridos por los alumnos. El sentido que la participante da a su hacer posibilitó la abertura de caminos para el desarrollo del pensamiento, a partir del trabajo con la metodología conceptual, revelando la conciencia del significado de su acción, y dialogando con las necesidades del alumno y trabajando las. Destacamos la importancia de la colaboración y del proceso reflexivo para la formación y la práctica del profesional profesor y los aprendizajes adquiridos con relación al reflexionar crítico y colaborativamente, en la argumentación y en la reformulación de nuestras ideas. Afirmamos que lo que realizamos es apenas el comienzo de nuevos caminos que surgirán por la necesidad que tenemos de busca, de descubiertas, y por las ganas de desarrollar acciones productivas, propicias de condiciones para la expansión de la formación profesional y de la práctica pedagógica del profesor. Las conclusiones a que llegamos están lejos de que se acaben, ya que es un tema complejo, que puede posibilitar el surgimiento de nuevos estudios, de nuevas investigaciones, de nuevos conocimientos

Práticas etnomatemáticas no Liceu do Paracuri :a propósito dos ornamentos geométricos da cerâmica

The present study analyzes the ethnomatematics practices presents in the creation of the geometric ornaments of the icoaraciense ceramic, originated and still practiced in the neighborhood of Paracuri, District of Icoaraci, belonging to Belém, capital of the State of Pará/Brasil. The object of our study was centered at the workshops supplied by the artisans master of the School of Arts and Occupations, Master Raimundo Cardoso. Referred school provides to its students, formation at fundamental level as well professional formation, through vocational workshops that help to maintain alive the practice of the icoaraciense ceramic. Our interest of researching that cultural and vocational practice appeared when we got in touch with that School, during the development of activities of a discipline of the degree course of mathematics. In order to reach our objective, we accomplished, initially, a research about the icoaraciense ceramic historic, since the first works with the clay until to the main characteristics of that ceramic. Soon afterwards, we discussed on ethnomatematics, culture, knowledge, cognition and mathematical education. At the end, we analyzed the creation of the geometric ornaments of the icoaraciense ceramic, considering the proportion concepts, symmetry and some geometry notions, that are used by the artisans when they are ornamenting the pieces of that ceramic. We verified that, in spite of the artisans, usually, do not demonstrate to possess a bit of domain on the mathematical concepts that they are working with, for instance, the ones of translaction symmetry, rotation and reflection, they demonstrate full safety in the use of those concepts, as well as the capacity to recognize them, even if in a singular specific and very peculiar way, what opens the possibility of a partnership among mathematics teachers and master-artisans of the archeological ceramic and icoaraciense workshops

Em que contextos aprenderam a ensinar os professores que propiciam aprendizagens pertinente à alfabetização?

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Tornar-se professor formador pela experiência formadora: vivências e escritas de si

This thesis describes and analyzes the trajectory of education of an educator-teacher group to become tutor of memorials (final work of the course Normal Superior in Instituto de Educação superior President Kennedy IFESP-Natal-RN). The writing of memorials (self-biographical writing) propitiates to the pupil that writes a reflection on his/her student and professional life, and to whom guides an evolution in his/her professional education. From the methodological point of view, we adopt an etnomethodological perspective of qualitative approach which describes the reality of real citizens inserted in a real situation of education. It is constituted of participants of the research of 32 educator-teachers, deriving of three different areas of academic formation. The instruments of data collection consist of eight life histories, 32 contextualization applications of the participants of the research, interviews with two consultants of the project, as well as some documents. The results of the analyses put in evidence that the education of the educator-teacher goes for two parallel ways: the first deals with the experiences, interactions and elements of daily practice; the second with the academy experiences where the educator-teacher searches the post-graduation courses. The integration of these two ways defines the educator-teacher identity with foundation in knowings that constitute in the exercise of guidance of memorials. The teachers knowings are considered insufficient by the majority and others knowings are mobilized to the knowing to be educator-teacher, memorial tutor. The thesis concludes that the trajectory of the educator-teacher constitutes an educator experience, in the direction of that implies an articulation among the learnings, abilities and knowings, to support the pupil in self-discovery, and that these multiple experiences favor the education of these teachers

A aprendizagem na convivência:o estágio curricular em enfermagem

This is an analytic research of a qualitative nature whose purpose is to examine the learning process involving students of the Nursing Program of the Universidade Federal do Rio Grande do Norte UFRN who are attending the Supervised Clerkship in Nursing (SCN) in Family Health Strategy (FHS), based on learning through daily living. In order to do this, a historical overview of this academic activity in the teaching of nursing was presented, and the importance of FHS as the scene where professional health education takes place was discussed. For the empirical investigation, ten eighth-semester students involved in clerkship activities at family health units in the Western Sanitary District of Natal, Rio Grande do Norte, were interviewed. The theoretical approach relied, as epistemological presupposition, on the ideas of educator Humberto Maturana who showed that learning, both in nature and among human beings, takes place within dialogic living relationships wherein acceptance of the other, affectivity (love) and dialoguing are essential stimuli to learning. Students discourses gradually became part of the analytic categories that had been established beforehand. There has been verified that the students went through meaningful learning encouraged by all who shared the living environment, that is: nurse/instructor, teacher/supervisor, family health staff, and the community. Several feelings were involved in the process, such as joy, satisfaction, self-reliance, affectivity and, in the opposite direction, sadness, indignation, a feeling of impotence, and fear. The learning of interpersonal relationship was describe as the most relevant of the academic experiences and, therefore, thus emphasizing the relevance of affectivity to the learning process as Maturana points out. It is suggested that the teaching of nursing keep on giving priority to family health units as the Basic Care educational scene, with attention to the importance of placing the students in welcoming environments, in such a way as to encourage learning

Entre flores e espinhos: a atuação do técnico em enfermagem na estratégia saúde da família

It is about a study of an exploratory/descriptive type with a qualitative approach whose aim was to analyze the actuation of nursing technicians in Family Health Strategy (FHS), taking into consideration the defined attributions by the Ministry of Health (MH). Thus, it was sought to identify what activities they carry out, the difficulties encountered, what contributed to their professional performance, and what vision they have about FHS and about themselves in the context. Based on the assumption that the practice of Nursing Technician is not still geared to completeness and that the developed actions by this professional are predominantly individual and curative. We know that FHS proposes the work organization as a team, with territory definition, prioritization of promotion actions, protection and recovery of the individual/family/community health, choosing as a central point the establishment of entails between the professionals and the same ones. However, the team work pass through interdisciplinary, tying and competence, starting making the difference in the way of thinking and doing health. To the accomplishment of this study were interviewed twenty one Nursing Technicians of Family Health Units from Sanitário Oeste district in Natal-RN, using semistructured instrument. From the analysis, three empiric categories emerged: starting from the first, The reality of a dream: what FHS is for the Nursing Technician, we obtained two classifications: one inherent to the own conception they have about FHS, nominated The realization of a dream in the possible and another that corresponds to what they think about FHS, while project that doesn't take place fully, denominated of The beauty of a dream that doesn't take place. The second category was The FHS: a dream built in the daily of Nursing Technician treats of the day by day information of that professional; the activities they perform and how those are established. This created three other items, to know: The role of a Nursing Technician: a project that became routine; The pre-determined role of a Nursing Technician: the scale as factor of (non-)autonomy; and, Knowledge about the practice in FHS: challenges that are presented to the role of Nursing Technician. The third category, denominated of Charms and disenchantment in the beginning of a new practice, it is related to the facilities or difficulties in professional's actuation and how he sees himself in the context. From it emerged the "flowers" and the "thorns" found on the construction of a dream, which gave this study the title. The results indicate that, being considered the characteristics of researched professional category, it becomes fundamental the resizing of labor relations in FHS, being imperative that new glances is conducted, so that the way as those Nursing Technicians interacts with the families can become compatible, together with the team, as well as to return the attention for their possibilities and limits in face of the work process in FHS. Besides, it is necessary changes in the professional formation, so that it can guarantee the conceptual bases in the construction of new practices, seeking to answer to the model of current attention.

Corações e mentes desvendam o Sistema Único de Saúde : visões e vivências de estudantes de enfermagem

One of the Ministry of Health s attempts at contributing to making collective health more appealing to health students is the Experience and In-Service Training within the Reality of the Unified Health Service Project (VER-SUS). Hence, the object of this investigation is to survey learners views on the teaching of nursing based in the experiences they have lived through in the VER-SUS. Its purpose is to analyze the views and lived-through experiences of nursing students on how the VER-SUS contributed to their professional education. This is a study of the descriptiveexploratory type with a qualitative approach. Eighteen undergraduate students from the nursing program at the Federal University of Rio Grande do Norte (UFRN), former VER-SUS participants, took part in this study, from 2006 to 2009. Information was collected using focus group techniques guided by a set of questions and semistructured interview with open and closed questions. The information collected was analyzed using content analysis technique, of the thematic analysis type. The UFRN Research Ethics Committee approved of the survey pursuant to Report Opinion number 223/2010 and CAAE number 0105.0.051.000-10. Lived-through experiences and in-service training gathered from the VER-SUS have contributed meaningfully to health education, as they helped understand the role of the university and of a health and nursing education within the hegemonic model of education. According to the views and lived-through experiences of nursing students who took part in the SUS project it was extremely relevant to use active methodologies in the teaching-learning process and have the facilitators act as liaisons for the SUS. It follows from this study that the VER-SUS does contribute to a health-nursing education and brings the students close to the reality of the community

Estágio supervisionado em enfermagem: visão de preceptores

The present study aimed to analyze the vision of tutors from a university hospital about supervised internship in nursing. It is a descriptive nature research with qualitative approach, developed at the University Hospital Onofre Lopes (HUOL), located in Natal/RN. The population was composed of eleven assisting nurses engaged the precentorship of undergraduate course students in nursing, from the Federal University of Rio Grande do Norte (UFRN). For the empirical research, conducted in the period from September to November 2013, the semi-structured interview involving questions directed to the stage was used, as advocate the national curriculum guidelines, as regards this curricular component. With the consent of the institution where the study has been developed and approved by the Research Ethics Committee of UFRN, as n° 17800613.9.0000.5537, besides CAAE signing an informed consent by participants. The analysis of the information was held from the analysis of content, thematic mode. Thereby four categories were defined a priori, namely: the supervised internship in the vision of nurses; To be preceptor; The internship concerned: contributions and difficulties; Do the institutional actors communicate? The results indicate that in the view of the supervised internship preceptors is a sine qua non for the training of nurses, considering that it prepares for professional life. Besides being a moment conducive to the exercise of management and a greater rapprochement between theory and practice, stimulates the preceptor to upgrade to better exercise the function and also provides an exchange of knowledge between students and tutors, thus contributing to optimize the service. Nevertheless, the respondents indicate the existence of a distancing and little communication with the academic institution. In summary, it is realized that the nurses understand the importance of its function of tutors and supervised stage for vocational training. It is necessary, however, to reflect on the paths to be pinched in the confrontation of difficulties in this process, especially as regards the teaching/service relationship, which, while remaining at a distance, strengthens the existing dichotomy between theory and practice

Atuação dos profissionais de saúde no atendimento à criança vítima de violência

This study had the purpose of identifying the health professional performance during the care of children victimized by violence. Its objectives were the evaluation of how health professionals diagnose violence on the hospitalized child during the care process; the identification, according to the experience of each health professional, of the types of violence on the hospitalized child, the child's aggressors and the most frequent1y injured area in the body and the analysis of conducts adopted by health professionals upon the recognition of a violence case on a hospitalized child. The study was of the descriptive-exploratory type, using a quantitative approach, performed on Hospital da Criança Santo Antônio (HCSA) in Boa Vista - RR. The population consisted of 235 health professionals, with data collected from June to August 2006. The results show a clear predominance of the female gender, (76,17%); aged 31 to 35 (26,81%); married (45,96%). As for professional formation, 63,9% were nursing auxiliaries and technicians,16,2% physicians, 14,8% nurses, 3,9% social assistants and 2,1% psychologists; 45,96% had completed middle-level education, 51,06% of which coming from private education establishments and 48,94% from public education institutions.; 97,66 % have specialization or improvement courses on their area; 32,77% among 05 to 09 years of work time; 32,06(10 worked on pediatric infirmaries; 75,74% state they have experience with children victimized by violence; 96,22% consider themselves capable of identifying the types of violence suffered by children; 29,00% consider physical violence the most common kind; 91,57% sought to identify the aggressors; 27,72% consider the mother to be the child's main aggressor, 26,36% the father, and 22,28% the stepfather; 26,55% consider the limbs and pelvic waist to be the body region most affected by violence; 26,91% take the attitude of reporting to the nurse and 20,13% to the social service; 70,79% state that the conducts were performed as a team; 26,25% of the professionals consider that the social assistants helped the most on deciding which conduct to adopt; 76,40% state there was no one opposed to the performing of these conducts; but 23,60% that stated there was no one opposed to the performing of these conducts, 77,08% reveal that the family members were against the conducts taken by the team. We conclude that, the hea1th professionals who were part of the study, apparently are not adequate prepared to diagnose and report the violence on child. The results were more drastic when we related the physicians and the nurses' answers, considering that they give directed assistance to these victims social assistants and psychologists are the ones best prepared to conduct cases of child mistreatment. However, we are conscious of our responsibility with professional education not only in upper grade institution but also on the middle-level. We believe also, that a continued education program can help to improve the professional knowledge and improve the quality of care

Documentação oficial e o mito da educadora nata na educação infantil

O artigo descreve a trajetória, bem como apresenta as conclusões de pesquisa que resultou em dissertação de mestrado em educação, defendida em 1997, cujo objeto de estudo é o profissional que atua na educação infantil em nosso país. As análises levaram à conclusão de que, ao longo da história, tem-se reforçado a imagem do profissional dessa área como sendo a da mulher naturalmente educadora, passiva, paciente, amorosa, que sabe agir com bom senso, é guiada pelo coração, em detrimento da formação profissional. A não-valorização salarial, a inferioridade perante os demais docentes, a vinculação do seu trabalho com o doméstico e a deficiência articulam-se à difusão da figura mitificada, que não consegue desvincular-se das significações que interligam a mãe e a criança.

O trabalho como princípio educativo: algumas reflexões

Após algumas reflexões sobre o conceito de trabalho e formação, este artigo aborda algumas orientações, ou princípios, que podem contribuir para a organização de programas de formação de adultos. Ao trabalhar em programas de formação dessa natureza, devemos ter em mente que trabalhamos com indivíduos que já possuem conhecimentos elaborados, experiências práticas e vivências que devem ser consideradas como ponto de partida. Assim, devemos considerar que a aprendizagem acontece ao longo da vida, e que um curso é apenas parte do percurso de aprendizagem. Outro aspecto importante é que programas de formação para adultos, especialmente aqueles desenvolvidos em situação de trabalho, devem ter sentido para aqueles que irão participar. Os participantes devem, portanto, aderir voluntariamente à proposta; caso contrário, ela poderá ser entendida apenas como algo imposto, e não como um ganho profissional efetivo. Nas situações de formação em situações de trabalho, é também fundamental que os programas sejam elaborados a partir de um apurado conhecimento da realidade daqueles que irão participar. Avaliar e preservar a memória do que foi realizado evita que ocorram eternos recomeços. Por fim, é fundamental que os programas de formação contem também com um programa de apoio aos participantes, de tal forma que eles se sintam mais seguros no trilhar os caminhos das mudanças, quando retornarem aos seus respectivos espaços de trabalho.

Representações de professores de língua inglesa de Natal-RN: um estudo sistêmico-funcional

Teaching and learning representations have been more and more investigated in the Brazilian applied linguistics field, as it allows the understanding of the teachers representations and how they conceive the learning process. This practice facilitates the planning of actions to improve the educational system. This study aims at identifying, interpreting and discussing some representations related to the identity and professional view of English as a foreign language teachers in different school contexts of Natal-RN. The theoretical and methodological foundation for this research is Halliday s Systemic- Functional Linguistics (1994; HALLIDAY; MATHIESSEN, 2004; EGGINS, 1994, among others). Our goal was to reveal the teachers representations embedded in their language, mainly through the ideational metafunction, as language is the tool we use to express ourselves about the external world (events, qualities, things, etc) and the internal world (thoughts, beliefs, feelings, etc). The research corpus is made of 21 teacher narratives, generated from a questionnaire sent to the teachers, who were divided in two groups: Group 1 (public schools teachers) and Group 2 (private schools and English course teachers). Most of the participants seemed to be satisfied with their professional choice. Many of them see the job as a challenge and an opportunity to transmit knowledge. All of them affirmed that the English teacher is a professional, for different reasons; however, the low professional appreciation was a recurrent aspect among the studied narratives. When asked about where they work, the private school teachers seemed to be more satisfied with the teaching-learning process than the ones from the public schools. We believe that the data analyzed in this study is important to show how some English teachers from Natal-RN see their profession. The results might be used in continuing education courses as food-for-thought in group discussions, as it is extremely important to emphasize and stimulate this practice

Perspectivados cirurgiões-dentistas sobre a inserção da fisioterapia na atenção básica de saúde

This work aims at investigating the surgeons-dentists acceptability in the field of public health in the city of Natal, State of Rio Grande do Norte, about the possibility of medicinal plants insertion in basic attencion of health. Moreover, it searchs to know if during their professinal formation it had some theoretician-pratical basement on this subject, as well as investigating their confidence on the medicinal plants. The basic motivation for developing this study is the possibility of contributing to the insertion of a tradicional health pratical at public assistance scope, endorsed by popular use, but now scientifically proven. For in a such way, the medicinal plants use is emphasized as a way to be followed to increase basic pharmaceutical assistance, improving the acess to the medicine and diminish expenses. Following this logic, family health program constitutes the way through which this pratical will be available to the users of health services. The research was done over thirty surgeonsdentists, all ofthem pertaining to public service ofNatal, state ofRio Grande do Norte. It was used, as research instrument, semi-estructured interview associated with methodological analysis user s speeches. On this form, this work is inserted in a trend observed nowadays not only in Brazil, where the use of the medicinal plants has been stimulated and defended to be inserted at programs ofprimary attenction of health