Politícas públicas no Brasil: o desafio de garantir os direitos da infância

The article talks about the challenge of the construction of public policies for the child in the age group from 0 to 6 years old in Brazil, in the perspective of the right guarantees. One can presuppose that to comprehend the development of these policies, it is necessary to analyze the historical route of its assistance, possibilities and limits. It is also important to consider the contradictory relationships of power present in society, and its influence in the building of the conception of child and childhood that are very far to be neutral words, so they are policies. In this point of view, this work analyzes the arrangement of the current policies of assistance to children, making clear the shape as they were reorganized by the neo liberal policies and set of instructions of international organizations. The studies show that, instead of public and universal policies, programs and actions are introduced based on the focus in the fight against poverty, made with low costs and questionable quality.

Saberes e perspectivas dos docentes em torno do currículo de uma escola pública rural do RN

Este trabajo tiene como objetivo analizar los saberes y las perspectivas docentes en torno al currículum de una escuela pública rural de Enseñanza Fundamental del Río Grande do Norte considerando, sobre todo, los debates sobre la Educación en el Campo en Souza (2006, 2007), Arroyo, Caldart y Molina (2004) y Fernandes (2002, 2004). La propuesta surge como alternativa para la elaboración de proposiciones curriculares para mejorar la calidad de la enseñanza en esas escuelas, según las características específicas de la educación escolar en contexto rural, en la expectativa de que esta sea un elemento para el desarrollo local y global de las comunidades rurales. La fundamentación teórica para responder a la investigación, se respalda en las consideraciones sobre los saberes docentes teniendo en cuenta las lecturas de Gauthier (1998), Tardif (2011), Pimenta (2009), Paulo Freire (1996), Nóvoa (2007, 2008) y las referencias sobre el currículum crítico y postcrítico discutidas en Giroux (1997), Silva (1999), Moreira (2008), Moreira y Candau (2003, 2010), Sacristán (2000) e Sacristán e Gómez (1998). La referencia empírica se constituye de una escuela pública de una comunidad rural en el municipio de São José de Mipibu-RN. Los sujetos sociales de la investigación son cuatro profesores(as) que trabajan en los años iniciales de la Enseñanza Fundamental. Se recurrió a la investigación etnográfica fundamentada en los estudios de Lüdke y André (1986), Sandín Estebán (2010) y Gil (2007), una vez que el análisis del cotidiano escolar, bajo el mirar etnográfico, a través de los procedimientos de la observación participante y de la entrevista semiestructurada, permite el contacto directo del investigador con el ambiente en estudio, registra el no documentado, y percibe la institución escolar como espacio cultural, caracterizando varios grados de acomodación, contestación y resistencia inmersos en una pluralidad de lenguajes y objetivos conflictivos. Las observaciones hechas en la clase y las enseñanzas de los profesores y profesoras permiten comprender que los saberes y perspectivas docentes, a partir de las experiencias del profesorado, lanzan expectativas socioprofesionales sobre la docencia e intensifican el papel fundamental del docente en la construcción de los saberes, de las prácticas y concepciones del mundo rural, de la escuela rural y de la función social de esta. Los hallazgos de la investigación con los profesores sobre el contexto rural apuntan para la necesidad en problematizar verdades socialmente construidas, bajo la orientación de una racionalidad que reconozca el espacio rural como productor de la existencia. A partir de los análisis construidos, se pudo reconocer la necesidad de una política de formación conceptual específica para el profesorado de las escuelas rurales, anclada en el concepto históricocultural del rural. También se reitera la urgencia permanente y continuada en revisar los procesos de formación, vividos en la escuela, que contemplen las peculiaridades de la enseñanza rural, en una visión contrahegemónica del urbanocentrismo, a partir de un análisis crítico sobre el marco legal de la Educación del Campo.

Serviços-escola de psicologia do Rio Grande do Norte: formação profissional e política pública de saúde em debate

The Psychology University Services is stablished normatively as an indispensable equipment to the recognition of the graduation courses of psychologists by the Brazilian Education Ministery. The Public Healthcare Policies (Universal Health System/SUS) constitutes itself as a input field of the professional category, but shows huge challenges in the formation of these professionals. The objective of this work is to analyse the functioning of the Psychology University Services (SEP) and the Superior Educational Institutions from Natal, understood as important formation devices to attend the actual demands of the psychologist's work on SUS. For this, it sought a) characterize the psychological practices developed in the SEP; b) relate the National Curricular Lines of Direction of the psychology courses to the skills and competences developed in the SEP to the performance on the public healthcare policies; c) mapping ways of including the SEP in the network designed by the healthcare policy. Interviews were performed with 13 academic supervisors, 8 field supervisors and technicians of superior level (TNC), along with 9 managers, being for of the Psychology University Services and 5 of the graduation programs. Questionnaires were also applied to 57 interns and 24 graduates. Besides that, two conversation circles were performed with the faculty and technician members from two of the Educational Institutions that were participating of the research, as well as a workshop with students and psychologists, promoted by the CRP 17. We observed that most part of the faculty members and managers know the DCN and comprehend that the formation is in process of change in what concerns to the extension of the formation to the performance of the psychologists in various contexts. However, most part of the TNC don't know about them. Moreover, the results point to the predominance of the assisting model based on the traditional clinic psychology, although the articulation with the public healthcare and social assistance networks can already be timidly visualized. Different modalities of practices in theses Psychology University Services were also detected, such as conversation groups, thematic workshops, organizational consultancies, team meetings with the interns and TNS in a daily basis, matriciament in mental health, therapeutic monitoring, among others. Yet, the SEP in Rio Grande do Norte are still isolated from the other courses that perform in the healthcare area and also from the services that compose the public healthcare and public policies.

As múltiplas dimensões da garantia dos direitos do paciente idoso internado: o caso de uma instituição hospitalar pública no município de Natal/RN

In the context of current capitalist society, marked by the logic that restricts the human person their status as workforce, in order to generate profits, old age is often treated as an underprivileged life stage. This reality becomes more intense considering the sharp aging process that affects brazilian society is accompanied by the country's entry into a globalized world and tensioned by the dictates of capital. Thus, despite the increasing development of policies to strengthen the guarantee of elderly rights, it is necessary to establish effective strategies of these measures to ensure a higher quality of life to these subjects. Therefore, it is necessary to develop studies that problematize the issue of the elderly, which represent a growing portion of the population, and hence have more visible demands, including in health. With the increase in the elderly population in Brazil it is possible to realize the country is going through a demographic transition and epidemiological changes that contribute to change the landscape of health care of the elderly, especially the hospitalization. Thus, this study aimed to analyze the multiple aspects of ensuring the rights of elderly patients admitted to the State Hospital Dr. Ruy Pereira dos Santos (HRPS), located in Natal / RN, whose most patients are elderly. Specifically sought to understand the aging process, its social consequences and the vulnerability to which it is exposed, especially during the disease situation; understand the process of construction of the Brazilian public health and their actions for older people; learn the expressions of citizenship formation in Brazil with regard to policies for older people; and investigate the design of health professionals about the guarantee of the right of hospitalized elderly. Starting from an integrated coordinated theoretical and practical possibilities, a qualitative research and literature character, documentary and field was held. For this, there were four semi-structured interviews with health research locus Hospital professionals - namely, two social workers, a doctor and a nurse - as well as life stories with the hospitalized elderly patients, one in each deck the said Hospital, totaling three. The results pointed to the difficulty of health policy become effective as law and stressed one historical scenario violation of the rights of elderly hospitalized patients, which persists due to the precarious situation and the difficulty of effective implementation of the Unified Health System (SUS ) and other public policies to that end.

Perfis epidemiológicos de saúde bucal no Brasil e os modelos de vigilância

National surveys are important tools for public health surveillance and thus key elements in monitoring health conditions and system performance. In the field of oral health, such surveys began with the oral health survey in 1986 and later in 1996 and with the SBBrasil Project in 2003. The 2010 edition of SBBrasil is the principal oral health surveillance strategy for the production of primary data. In order to contribute to this discussion, this article proposes: (a) to present and discuss the Brazilian experience with nationwide oral health surveys and (b) to discuss the use of data in health surveillance models. One can conclude that oral health surveys in Brazil have great possibilities as a tool for health services and academia. Such surveys have shown evident potential for verifying trends in the oral health profile, as well as for producing valid indicators for use in health services.

Projeto SB Brasil 2010 - pesquisa nacional de saúde bucal revela importante redução da cárie dentária no país

O Projeto SB Brasil 2010, planejado e executado por órgãos do SUS, nos âmbitos federal, estadual e municipal, e de universidades brasileiras, por meio de Centros Colaboradores do Ministério da Saúde se constitui em recurso de valor estratégico para aprofundar os conhecimentos sobre os agravos bucais no país, e dá contribuição inestimável para orientar os rumos da PNSB e avançar na construção de um modelo de atenção pautado na Vigilância à Saúde

Projeto SB Brasil 2010 - pesquisa nacional de saúde bucal revela importante redução da cárie dentária no país

O Projeto SB Brasil 2010, planejado e executado por órgãos do SUS, nos âmbitos federal, estadual e municipal, e de universidades brasileiras, por meio de Centros Colaboradores do Ministério da Saúde se constitui em recurso de valor estratégico para aprofundar os conhecimentos sobre os agravos bucais no país, e dá contribuição inestimável para orientar os rumos da PNSB e avançar na construção de um modelo de atenção pautado na Vigilância à Saúde

Validade científica de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003

Indicators and analyses that used the database from SB Brazil 2003 (the most recent nationwide oral health survey) have been criticized as unreliable due to sampling problems. The current study countered that this critique was based solely on statistical concepts, unsupported by empirical evidence. The critique's essentially epistemic approach leads to peremptory reductionism that denies other forms of knowledge and fails to recognize the multidisciplinary nature of epidemiology. The current study retrieves information on the implementation of the oral health survey and its impact on knowledge output in the field. The article draws an analogy between science and art, demonstrating the multifaceted images obtained by both. Thus, recognition of validity requires a full grasp of the field and appropriate use of value criteria. The current article concludes that use of the SB Brazil 2003 database is a reliable and relevant application of epidemiology to oral health.

Validade científica de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003

Indicators and analyses that used the database from SB Brazil 2003 (the most recent nationwide oral health survey) have been criticized as unreliable due to sampling problems. The current study countered that this critique was based solely on statistical concepts, unsupported by empirical evidence. The critique's essentially epistemic approach leads to peremptory reductionism that denies other forms of knowledge and fails to recognize the multidisciplinary nature of epidemiology. The current study retrieves information on the implementation of the oral health survey and its impact on knowledge output in the field. The article draws an analogy between science and art, demonstrating the multifaceted images obtained by both. Thus, recognition of validity requires a full grasp of the field and appropriate use of value criteria. The current article concludes that use of the SB Brazil 2003 database is a reliable and relevant application of epidemiology to oral health.

Projeto SB Brasil 2010: elemento estratégico na construção de um modelo de vigilância em saúde bucal

O projeto começou a ser pensado no âmbito do Comitê Técnico Assessor (CTA) em Vigilância em Saúde Bucal do Ministério da Saúde desde abril de 2009. Foi submetido à consulta pública durante o mês de junho de 2009, resultando em uma participação significativa de diversos setores em seu processo de construção. Desde então, foi formado um Grupo Gestor que, por intermédio de oito Centros Colaboradores localizados nas diversas regiões do país, tem conduzido o projeto a partir de oficinas de trabalho nos estados e treinamento das equipes de campo.

Projeto SB Brasil 2010: elemento estratégico na construção de um modelo de vigilância em saúde bucal

O projeto começou a ser pensado no âmbito do Comitê Técnico Assessor (CTA) em Vigilância em Saúde Bucal do Ministério da Saúde desde abril de 2009. Foi submetido à consulta pública durante o mês de junho de 2009, resultando em uma participação significativa de diversos setores em seu processo de construção. Desde então, foi formado um Grupo Gestor que, por intermédio de oito Centros Colaboradores localizados nas diversas regiões do país, tem conduzido o projeto a partir de oficinas de trabalho nos estados e treinamento das equipes de campo.

A produção oral de inglês como LE em uma escola pública de Natal: uma experiência com a abordagem baseada em tarefas

The aim of this action research of mixed-methods was investigating the role of the tasks proposed by the Task-Based Learning, TBL (WILLIS, 1996) in the process of development of speech production in English as a foreign language (EFL) at the public school. Twenty-three students from a grade of secondary school from a state school in Rio Grande do Norte were exposed systematically to the implementation of the learning tasks focused in the speech production in EFL during two months. The instruments used at the data collection – pre and post-questionnaire; field notes; focal group; and pre and post-tests - generated two kinds of data: a) qualitative (the perception of the students about their speech production and the teaching of this ability at the public school; and, the usage of strategies of communication for these learners facing TBL); and, b) quantitative (the development of pronunciation; of accuracy in the proficiency tests (test KET – Cambridge, adapted); and, of Global Oral Proficiency (POG) of these learners after the accomplishment of the learning tasks). The quantitative results of the study indicate that there was a statistically significant development of pronunciation and accuracy at the proficiency tests, after the tasks experience. The qualitative findings, in turn, represented by the learners‟ reports and from the research teacher, show that there has been greater focus on the use of communicative strategies during the learners‟ oral production throughout the intervention with the tasks.

Currículo escolar e inclusão de estudantes com deficiência: diálogos com uma escola pública

This work of qualitative approach, has as its study object the school curriculum, resulting from the implementation of public policies for inclusion in the Brazilian educational field and of the teaching organization in State School Despertar. While we acknowledge advances in government discussions and proposals related to school inclusion in our country, it is still important to develop studies and interventions in the context of basic education focused on the curriculum. With methodological basis in collaborative-critical action research and contribution by Barbier, the survey was conducted in 2013, in a state school in the Natal - Rio Grande do Norte - school system, and aimed to analyze the curriculum of the State School Despertar, in particular issues related to the inclusion of students with disabilities in common teaching classes expressed in the school and in collective situations of continuing education with teachers and interpreter of Brazilian Sign Language (Libras). The school was previously chosen because it had already been locus of research in a study conducted by a professor at the Federal University of Rio Grande do Norte promoting the knowledge of their formative needs. The study subjects were 26 teachers in the early years and the end of elementary school and a Libras interpreter. The instruments were direct observation, semi-structured interviews, document analysis and a proposal for continuing education called Collaborative Group on School Inclusion (GCEI), established with the participating subjects and the other research collaborators. The analyzed data showed eight dialogues built with the State School Despertar, being basic the contributions of Goffman (1988) on stigma and of Forquin (1993) on school culture. As a theoretical framework, there were important contributions on School Curriculum (SACRISTÁN, 2000; 2007; APPLE, 2006; 2008), School Inclusion (BUENO, 2008), Continuing Education (NÓVOA, 2002; GATTI, 2003) and the existing studies on the dialogues between Curriculum and Special Education (MAGALHÃES, 2002; SILVA, 2008; 2010; OLIVEIRA, 2004; VIEIRA, 2012). The study highlighted the importance of extending the dialogue, the theoretical deepening of GCEI for the understanding of school curriculum and the specifics of any students, with or without disability. It will be necessary to revisit the school teaching practices that do not correspond to the students, for instance the formation of classes made in classrooms. It is also important to consider the organization of the school day and its interface with the pedagogical functions of each member of the school in building curriculum practices consistent with the diversity of modes and learning styles. Subliminal aspects of the curriculum should be reviewed, given its implications in the context of the classroom and management. However, significant changes identified in the practices of some teachers, such as the use of audio description, stimulus to the participation of students with disabilities and use of images, favored the development of other students, who benefit of more exciting and participatory classes. Based on the conducted research, we conclude on the importance of collectively discuss the conditions for / in schooling of different students and the (re)thinking of curriculum practices in the school as a whole, and therein lies a paradox because, on the one hand, it is not about minimizing the specific knowledge in dealing with the needs of students with disabilities, on the other, we are not interested in distancing these needs from those inherent in human nature, therefore peculiar to the other students. The questioning of our own practices is the challenge imposed, not to special education, or its target audience, but this is undoubtedly task of education.

Currículo escolar e inclusão de estudantes com deficiência: diálogos com uma escola pública

This work of qualitative approach, has as its study object the school curriculum, resulting from the implementation of public policies for inclusion in the Brazilian educational field and of the teaching organization in State School Despertar. While we acknowledge advances in government discussions and proposals related to school inclusion in our country, it is still important to develop studies and interventions in the context of basic education focused on the curriculum. With methodological basis in collaborative-critical action research and contribution by Barbier, the survey was conducted in 2013, in a state school in the Natal - Rio Grande do Norte - school system, and aimed to analyze the curriculum of the State School Despertar, in particular issues related to the inclusion of students with disabilities in common teaching classes expressed in the school and in collective situations of continuing education with teachers and interpreter of Brazilian Sign Language (Libras). The school was previously chosen because it had already been locus of research in a study conducted by a professor at the Federal University of Rio Grande do Norte promoting the knowledge of their formative needs. The study subjects were 26 teachers in the early years and the end of elementary school and a Libras interpreter. The instruments were direct observation, semi-structured interviews, document analysis and a proposal for continuing education called Collaborative Group on School Inclusion (GCEI), established with the participating subjects and the other research collaborators. The analyzed data showed eight dialogues built with the State School Despertar, being basic the contributions of Goffman (1988) on stigma and of Forquin (1993) on school culture. As a theoretical framework, there were important contributions on School Curriculum (SACRISTÁN, 2000; 2007; APPLE, 2006; 2008), School Inclusion (BUENO, 2008), Continuing Education (NÓVOA, 2002; GATTI, 2003) and the existing studies on the dialogues between Curriculum and Special Education (MAGALHÃES, 2002; SILVA, 2008; 2010; OLIVEIRA, 2004; VIEIRA, 2012). The study highlighted the importance of extending the dialogue, the theoretical deepening of GCEI for the understanding of school curriculum and the specifics of any students, with or without disability. It will be necessary to revisit the school teaching practices that do not correspond to the students, for instance the formation of classes made in classrooms. It is also important to consider the organization of the school day and its interface with the pedagogical functions of each member of the school in building curriculum practices consistent with the diversity of modes and learning styles. Subliminal aspects of the curriculum should be reviewed, given its implications in the context of the classroom and management. However, significant changes identified in the practices of some teachers, such as the use of audio description, stimulus to the participation of students with disabilities and use of images, favored the development of other students, who benefit of more exciting and participatory classes. Based on the conducted research, we conclude on the importance of collectively discuss the conditions for / in schooling of different students and the (re)thinking of curriculum practices in the school as a whole, and therein lies a paradox because, on the one hand, it is not about minimizing the specific knowledge in dealing with the needs of students with disabilities, on the other, we are not interested in distancing these needs from those inherent in human nature, therefore peculiar to the other students. The questioning of our own practices is the challenge imposed, not to special education, or its target audience, but this is undoubtedly task of education.

A prescrição de medicamentos por enfermeiros na atenção primária à saúde no Brasil: caracterização, normatização, formação e lições aprendidas.

O papel do enfermeiro como prescritor vem se ampliando em muitos países nos últimos anos, em diferentes situações e amplitudes de ação, se configurando como prática avançada na enfermagem. No Brasil, a prescrição de medicamentos por enfermeiros está prevista na Lei do Exercício Profissional desde 1986, e permite a esse profissional, a prescrição de medicamentos estabelecidos em programas de saúde pública. Esse estudo tem como objetivo geral analisar as determinações e perspectivas da prescrição de medicamentos por enfermeiros nos protocolos da Estratégia Saúde da Família. Os objetivos específicos são: apreender a atual situação internacional da prescrição de medicamentos por enfermeiros em comparação a essa prática no Brasil identificando semelhanças e diferenças; identificar os contornos legais e normativos da prescrição de medicamentos por enfermeiros no Brasil apontando sua história, tendências e desafios; caracterizar o modelo de prescrição de medicamentos por enfermeiros nos protocolos de Atenção Primária à Saúde no Brasil; investigar possíveis lacunas entre formação, capacitação, autoavaliação e prática da prescrição de medicamentos na Atenção Primária à Saúde na perspectiva do enfermeiro. Trata-se de Estudo de Caso Exemplar com abordagem qualitativa através de Revisão Bibliográfica, Análise Documental e Grupo Focal com enfermeiros. A análise dos dados deu-se por meio da Análise de Conteúdo e Análise Qualitativa de Conteúdo. Os resultados revelam que a categoria da enfermagem contribuiu para a legalização da prescrição, porém não para a sua legitimação; na Atenção Primária à Saúde, essa atribuição está consolidada por meio de protocolos e legislação, embora sem estratégia clara de acompanhamento pelo Ministério da Saúde; observa-se resistência em algumas normatizações dentro do setor saúde. Quanto aos protocolos, observou-se não há exigência de pré-requisitos na maioria deles; há possibilidade de diagnóstico pelo enfermeiro na gravidez, nutrição infantil e doenças sexualmente transmissíveis; observou-se variados graus de autonomia; amplo grupo de medicamentos prescritos por enfermeiros. Dos 37 participantes do Grupo Focal, 97,3% eram do sexo feminino; 54% formados há menos de 10 anos, 27% entre 10 e 20 anos, 16,2% há mais de 20 anos; 83,8% com especialização em Saúde Pública. Todos os enfermeiros relataram insuficiência da disciplina de farmacologia para instrumentalizar a prática prescritiva. Destacou-se a necessidade de pós-graduação; a importância da experiência clínica; falta de discussões e capacitação. Apenas alguns se autoavaliaram como competentes para prescrever, outros revelam medo de reação adversa a medicamentos. Conclui-se que há tendência da prescrição de medicamento por enfermeiros permanecer apenas na legalidade e o principal desafio é alcançar a legitimidade. Confirma-se uma prática prescritiva sem requisitos, diversidade de orientações induzindo a multiplicidade de ações que pode afetar a qualidade da prescrição. Há lacunas entre formação, capacitações e exigências cotidianas da prescrição de medicamentos por enfermeiros na Atenção Primária à Saúde. No Brasil se faz premente pesquisa para avaliar o impacto, a qualidade e a segurança da prescrição de medicamentos por enfermeiros. A experiência internacional sugere também que essa prescrição deve ser apoiada pelo coletivo de enfermeiros, com robusto plano de capacitação nacional, além de governança e apoio local.