Avaliação da qualidade da assistência a pessoas com úlceras venosas atendidas na estratégia saúde da família

A úlcera venosa constitui importante problema de saúde pública, gera repercussão social, econômica e mudanças nos hábitos de vida, dor, sofrimento, acarretando diminuição da qualidade de vida. O estudo objetivou avaliar a assistência prestada às pessoas com úlceras venosas atendidas pela Estratégia Saúde da Família. É um estudo analítico, transversal e quantitativo, realizado com 59 pessoas com úlceras venosas, atendidas em 36 unidades da Estratégia Saúde da Família. O estudo obteve aprovação do projeto de pesquisa pelo Comitê de Ética da Universidade Federal de Alagoas. Para a coleta dos dados utilizou-se instrumento testado, entrevista, exame físico e informações dos prontuários. Os dados foram organizados em planilha do Microsoft Excel 2007, exportados e analisados em software estatístico por meio de estatística descritiva e inferencial, considerando nível de significância estatística de ρ-valor < 0,05. As pessoas com úlcera venosa eram do sexo feminino (71,2%), ≥ 60 anos (67,8%) e estavam em tratamento > 1 ano (69,5%). Possuíam tempo de lesão > 6 meses (64,4%), dor na úlcera/membro (86,4%) e leito com ≤ 30% de granulação/epitelização (78,0%). A qualidade da assistência foi ruim (< 5 aspectos positivos) em 57,6% (ρ=0,000) e os aspectos que mais interferiram foram as seguintes inadequações: profissional que acompanha/realiza curativo (ρ=0,002, coeficiente de contingência (CC) =0,458, razão de chance (RC) =13,9), produtos nos últimos 30 dias (ρ=0,038, cc=0,334, RC=7,3) e acesso a consulta com angiologista (ρ=0,041, cc=0,305, RC=4,1). Os aspectos clínicos que contribuíram para o aumento do tempo de assistência foram: tempo de lesão >6 meses (ρ<0,001), dor (ρ=0,043), recidiva (ρ<0,001); nos aspectos assistenciais: inadequação dos produtos com 83,1% (ρ=0,036). Essas características dificultaram a cicatrização tecidual, prolongando o tempo de tratamento das lesões,que podem ter contribuído para a cronicidade das úlceras

A importância da atividade física regular como estratégia complementar na promoção de resiliência de idosas e sua importância para suas vidas

O conceito de saúde, na concepção mais abrangente, é uma condição multidimensional de bem-estar físico, psicológico e social e não apenas a inexistência de enfermidades. Os benefícios da atividade física são tão relevantes quanto os benefícios psicológicos, porque ambos contribuem para a saúde. A literatura aponta um conjunto de ligações diretas e indiretas entre a atividade física e a qualidade de vida. Apesar destes benefícios, o processo de envelhecimento é caracterizado por grandes perdas biopsicossociais, que geram várias situações de adversidades que causam preocupação e podem colocar em risco a saúde do idoso. Deste modo, surge a resiliência como um conjunto de processos sociais e intrapsíquicos, que possibilitam o desenvolvimento saudável do idoso, mesmo diante de experiências negativas. Nesta direção, observou-se a necessidade de executar uma pesquisa de conhecimento multidisciplinar conciliando a Educação Física com a Psicologia, a Medicina, a Terapia Ocupacional e a Gerontologia, com o objetivo de investigar o efeito da atividade física sobre os níveis de resiliência em mulheres idosas, bem como conhecer a importância desta atividade para suas vidas. Para tanto, realizou-se um estudo comparativo descritivo, de caráter transversal. Assim sendo, 230 mulheres idosas foram divididas em dois grupos: ativas (n=115; 65,8±5,8 anos de idade), constituído por idosas matriculadas em um programa de atividade física orientada para idosos com período de prática igual ou superior a dois anos, e sedentárias (n=115; 69,2±7,2 anos de idade). Em seguida, foram submetidas à avaliação do nível de resiliência psicológica e da aptidão física (resistência muscular de membros superiores e inferiores, flexibilidade e resistência aeróbia). As idosas ativas apresentaram valores significativamente (p=0,001) maiores do fator 3 da resiliência psicológica quando comparados àqueles do grupo de idosas sedentárias, o qual está relacionado à autoconfiança e à capacidade de adaptação a situações diversas. Não foram observadas diferenças significativas (p>0,05) entre os grupos para os demais fatores (1 e 2). Quando comparados os testes de aptidão física com o nível de resiliência psicológica moderada (n=28) e alta (n=202) do fator 3, observou- se que idosas com nível de resiliência psicológica alta apresentaram maior flexibilidade (p=0,004). E para a avaliação da percepção da importância da atividade física para as idosas foi aplicado um questionário semiestruturado. A partir da Análise de Conteúdo proposto por Bardin (2009) os resultados foram: saúde/prevenção (85%), interação (47%), autonomia (40%), alegria/felicidade (33%), resiliência (33%), lazer (15%). E para avaliar a resiliência utilizou-se a Escala de resiliência de Wagnild e Young (1993). Quanto aos níveis de resiliência os resultados demonstraram que todas idosas apresentaram alto nível. Considerando os achados do presente estudo, sugere-se o emprego da atividade física como método de intervenção para melhora da saúde mental e, por conseguinte, da resiliência psicológica na população em questão, uma vez que os resultados apontam que idosas fisicamente ativas apresentam escores de resiliência psicológica superiores àquelas estratificadas como sedentárias. O resultado desse estudo possibilitou também concluir que a importância da atividade física parece estar relacionada, na sua maioria, às características de saúde/prevenção, interação social, autonomia, resiliência, alegria/felicidade e lazer. Além disso, as mulheres do presente estudo apresentaram um alto nível de resiliência quando comparado à tabela normativa

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

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

Nutrição social no Brasil: [mais] uma estratégia biopolítica?

Inspirés par la « méthode » artisanat intellectuel propose par le sociologue Wright Mills, notre étude porte sur la formation du champ de pratiques discursives et non discursives (Michel Foucault) de la nutrition sociale dans le contexte de la société brésilienne dans lequel s insère le champ de la santé. Le travail empirique s épuise sur une source de documents normatifs de ce champ et s oriente à vérifier et à comprendre comment le praticien de la nutrition émerge dans le scènario des pratiques de la santé au Brésil à partir du milieux du 20ème siècle, tout en construisant son « regime de vérité » fondé dans des processus biopolitiques du champ de la médecine sociale. Nous avons relié deux phénomènes: a) l émergeance du champ biomédical de la nutrition comme une instance biopolitique, en approchant cette formation à l'histoire de la médecine sociale, depuis ses débuts européens jusqu'au contexte brésilien ; b) les pratiques discursives et non discursives du champ de la nutrition lequel est compris dans le Sistema Único de Saúde (SUS - Système Unique de Santé) brésilien. La démarche de recherche comprend l'élaboration et analyse d'une archive composée de publications qui contiennent l'Histoire du praticien de la nutrition au Brésil et des publications officielles disponibles dans le site web « Política Nacional de Alimentação e Nutrição » (Politique Nationale d'Alimentation et de Nutrition) lesquelles sont considérées comme des guides d actions des praticiens de la nutrition sociale dans le Sistema Único de Saúde (SUS). Le concept de biopouvoir, décrit par Michel Foucault entre 1974 et 1979, et la notion de biopolitique, dans son sens réinterprété et mis à jour par Giorgio Agamben, Antônio Negri et Michael Hardt, ont fourni le support théorique de cette recherche

A experiência humana como estratégia : a comunicação como jogo & o jogo como comunicação

En la interface de las Ciencias Sociales y de la Comunicación, la tesis expone una discusión sobre la Comunicación Social como área de conocimiento y discute las bases fenomenológicas de la producción de significado utilitario sobre el mundo. Para dar cuenta de esa reflexión se tiene como referencia la película Slumdog Millionaire? del director Danny Boyle. La experiencia vivida por el personaje principal llamado Jamal Malik sirve de apoyo a su éxito en un programa de TV cuyos desafíos consigue vencer uno a uno y transformarse en un millonario. El film, y en consecuencia la trayectoria de Jamal, es el operador cognitivo para que se presente la estrategia del personaje que transforma su conocimiento experimental en conocimiento pertinente, objetivo. La investigación sirve de base para ofrecer el argumento central de que solo existe conocimiento por medio de la experiencia vivida. A partir de esa concepción, la comunicación es vista en este ensayo como entrecruzamiento de caminos y nudos que se asemejan a un rizoma donde cada construcción de sentido, cada palabra que gana significación representa diversos enlaces de esos nudos sistémicos. Aseguramos que la comunicación es una condición sine qua non a los humanos y puede ser comprendida por la paradoja natural-artificial. Es de esta paradoja, que presentamos una contribución de la complejidad de la comunicación creyendo de forma dialógica que sí, hay una condición innata de la comunicación (y así mismo post humana) concomitantemente con la hipótesis de la artificialidad comunicacional. Corroboramos así, la idea de que el conocimiento fenomenológico de la comunicación es un juego de la construcción científica y, por lo tanto, un juego de la humanidad. En este mismo juego podemos comprender la comunicación por intermedio de algunos macro conceptos de la compleja actividad de comunicar (retroalimentación, recursividad y holograma) constelando así una estrategia de ligazón/estímulo/respuesta que nos permite conocer bien y saber organizar mejor el conocimiento adquirido en la práctica. La tesis tiene como interlocutores principales Claude Lévi-Strauss, Edgar Morin, Jean-Marie Pelt, Norval Baitello Junior y Vilém Flusser, entre otros

Limites e possibilidades do programa nacional de alimentação escolar enquanto estratégia de promoção da segurança alimentar e nutricional no municipio de Macaíba/RN

This dissertation aims to understand the importance of the National School Feeding as a strategy for ensuring the promotion of food and nutrition security in the municipality of Macaíba / RN, taking into account the implementation of the Law School Feeding, 11,947, 2009. The program was extended to all public basic education, youth and adults, in addition to ensuring that 30% of transfers from FNDE, were intended for the purchase of products from family farms. The survey was conducted with 160 students from public schools and farmers nesting Quilombo dos Palmares II, who produce on their land vegetables, fruits and cereals for their own consumption, for sale in local markets, in addition to providing for PNAE. The reciprocity between neighbors, such as mutual aid and sharing of common goods was noticeable in this group of farmers, since it was necessary to meet weekly deliveries of products to schools. As students, we applied a test of acceptability in two schools located in rural and in urban areas, to learn the opinion of ourselves in relation to school food consumed. It was concluded that to be most effective program in the region, there must be a better match in school menus, so that it can be attractive to students and to ensure greater use of fresh food, the main ingredient of same, practice of nutrition education in schools, to teach students the importance of food to health. In relation to local management, noted the need for adjustments bureaucratic as hiring staff for the departments, in order to be more agile in releasing payments to farmers, in addition to hiring assistants general services for schools, one Since the cooks exert dual role, the cooking while being responsible for cleaning the entire school environment. Government investments in the rural sector would be extremely valuable for farmers, since they need financial resources to purchase inputs, irrigation projects for gardens, availability of land for planting, transportation to facilitate the delivery of its products to schools and technical assistance more frequently

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

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

Professores em contexto formativo: um estudo do processo de mudanças de concepções sobre o ensino da matemática

El objetivo en esta tesis consistió en estudiar el proceso de los cambios de los conceptos de profesores de la educación infantil y de los años iníciales de la educación básica referente a la enseñanza de la matemática. La investigación se desenvolvió en la escuela Presidente Kennedy, en la ciudad de Natal, en Rio Grande do Norte, teniendo como participante 05 (cinco) profesores del curso normal superior a través de la educación superior del instituto relacionado. El trabajo asocia el programa a él Programa de Pós-Graduação em Educação da Universidade Federal do Rio Grande do Norte, en la base de pesquisa Formação e Profissionalização Docente coordinada de los doctores Betânia Leite Ramalho e Isauro Beltran Núñez. El referencial teórico-metodológico en quien si apoya el trabajo se inserta en la señal conceptual usada por Giordan y de Vecchi (1996), de Carrillo y Contreras (1994), Ramalho; Núñez y Gauthier (2003), Ponte (1998), Guimarães (1988), Ernest (1989). En esta investigación, los conceptos de los profesores habían sido estudiados en el contexto educativo de la formación del nivel superior, usándola reflexiva crítico práctico como estrategia formativa. Estos conceptos se entienden como estructuras subyacentes al pensamiento del profesor. Dado la naturaleza del objeto del estudio, la información, para las intenciones de esta investigación, habían sido cosechados a través de los instrumentos siguientes: cuestionario, plan de la lección, entrevista diaria y del campo. El cuestionario fue constituido de preguntas abiertas y de las entrevistas de la mitad-structuralized. La organización de los datos permitió a La inferencia de los conceptos, usando la técnica de la triangulación de datos. La investigación divulgó que los conceptos de los profesores, a través del proceso formativo, se habían desarrollado de una plataforma para otra, yéndose puesto que los modelos didácticos tradicionales para otros modelos dirigidos a una tendencia didáctica de espontaneísta/investigativa. La reflexión crítica era considerada como elemento catalítico de los cambios de los conceptos de los profesores en la educación de las matemáticas, sin embargo déjenos verifican que estos cambios son difíciles de ocurrir para la naturaleza compleja de estos conceptos. Como facilitadores de los factores de estos cambios, encontramos y el investigativo el trabajo, la dinámica y la naturaleza de las actividades se convirtió en el colaborativo de proceso formativo, entre otros. Como obstáculos a los cambios, identificamos el contexto del trabajo de los profesores, de la cultura de los individualistas prácticos de sus profesores de los colegas, del concepto linear, estático y de los mecánicos de los procesos para enseñar, el conocimiento profesional construído durante la formación inicial, alineación con los modelos didácticos de sus viejos profesores, entre otros

Prototexto, narrativa poética da ciência: uma estratégia de construção do conhecimento e religação de saberes no ensino de física

In this thesis I present the prototexto notion and to I base as a complex system while strategy of knowledge construction and reconexion of you know in physics teaching. Prototexto is a poetic narrative of the science, proposal and used initially as "instrument of creative" learning for students apprentice of science of the medium and technical teaching of the Vitória da Conquista's CEFET-BA, in the period of 1997-2004. Later become pregnant as a strategy of knowledge construction, in the Universidade Estadual da Bahia - UESB, the prototexto notion configures a complement to the mathematical formulation. The proposal of a poetic narrative of the science is that the apprentice of science starts to organize in an aesthetic-literary way your knowledge, dispersed in disciplines, starting from a theme of the physics. The prototexto emerges of my reflections concerning the classic science, identified for Edgar Morin as tends a thought excessively numeric, and that it has been reproduced in physics teaching, in most of the schools, limiting him/it to an order pattern with the mistake absence. They are operations of the prototexto: the poetic language, the pedagogic stamp, the unfinished of the argument, the system character and the apprentice's of science inclusion as subject implicated in the construction of the knowledge. the theoretical foundations are based Morin's proposition of the method as strategy, the beginning of the complementarity of Niels Bohr in conceiving excluding categories as face of a same phenomenon and the conception of creative time of Ilya Prigogine that enunciates the alliance among the nature and the man that it describes her

Praxiologia, representação social de menopausa e práticas educativas de enfermeiras na estratégia saúde da família

This research, whose theme is related to climacteric, aims to know the social representation of menopause developed by the nurses working for Estratégia Saúde da Família (Family Health Strategy) in João Pessoa PB, as well as identifying its structure and verifying the way it interferes with the assistance and educational practices to the climacterial user. In the theoretical level, it is based on a model that articulates the social representations theory, the central nucleus complementary theory and the central concepts of Pierre Bourdieu s praxiology: habitus, cultural capital, social field and symbolic power. A hundred and forty-seven female nurses who work for Estratégia Saúde da Família (Family Health Strategy) in João Pessoa (PB) took part in this research, and the data collection period was from February 2008 to March 2009. As to the methods and techniques, we used the method to determine the central nucleus based on the free association of words, a questionnaire to identify certain regularities that constitute the nurses habitus, and the semi-structured interview to explore opinions and attitudes when facing assistance situations and educational practices and to collect other relevant information. The data analysis was developed, when referring to the free associations, with the help of the EVOC software, which is a group of articulated programs which carry out the statistical analysis of the evocations and the identification of the possible elements of both the central nucleus and the peripheral system of the social representation. As to the questionnaire, we used the descriptive statistical analysis and the analysis of correlation between the variables. The interviews were submitted to a categorical analysis of the content. The EVOC result indicated that the cognition hormone was the only element of the central nucleus of the social representation of menopause. Due to its symbolic value and structuring power, this central nucleus ensures the strict and, at the same time, flexible character of the representational content. The analysis of the social advancement, of some fundamental features of the group habitus, as well as the analysis of its insertion in the health field and of the attitudinal opinions and dispositions concerning the assistance given to the climacterial user, and the analysis of the pedagogical dimension of this assistance, all these analyses lead to the conclusion that the nurses who took part in this research share a social representation of the menopause resulting from the association of different technical and scientific knowledge. These derive from the biomedical pattern as well as from hegemonic values which disqualify old age and overvalue youth, from pedagogical conceptions arising from patterns that are presently regarded as authoritative and old-fashioned and from cultural references (responsible for the semantic variations concerning the central nucleus) which are specific to the subgroups the nurses belong to. This research enables the creation of opportunities for discussion between active nurses working for Estratégia Saúde da Família, and the nurses who are teachers at institutions of higher education, aiming at linking theory to practice, so that they can find ways of thinking about the climacteric and working, in a more comprehensive way, with users who are experiencing this stage of life

Estratégia para erradicação de focos da Doença de Aujeszky em suínos no Estado de São Paulo

Este trabalho teve como objetivo a avaliação de duas estratégias para erradicação de focos da doença de Aujeszky (DA) em suínos criados comercialmente no estado de São Paulo. Foram identificados dois focos da enfermidade, no município de Cerqueira César, um apresentando somente animais sororreagentes (Foco 1) e outro, casos clínicos da doença (Foco 2). Foram avaliadas duas estratégias de erradicação, uma por eliminação dos sororreagentes e outra por despovoamento gradual, com acompanhamento durante 12 meses. A erradicação por eliminação dos sororreagentes foi aplicada no Foco 1 e compreendeu na identificação por exame sorológico, isolamento e abate dos positivos; vacinação dos negativos e reposição no plantel com animais provenientes de propriedade livre. No início dos trabalhos, 68% do plantel era positivo e ao final 51%. No Foco 2 utilizou-se o despovoamento gradual, onde todos os animais foram enviados ao abate sanitário, realizado vazio sanitário nas instalações, seguido pelo repovoamento com animais livres. Esta última estratégia, nas condições desse trabalho, mostrou-se a mais eficaz, pois erradicou a DA.

Dimensões didática, afetiva e formativa de docência que tecem as representações sociais entre licenciandos da UFPI

This study intends to analyze the social representation of teaching for students of first years of undergraduate courses in Education, Letters and Biology. The field of this research was the Federal University of Piaui - Campus of Picos in 2009. To reach the objective proposed above, was used the theory of social representations to the seizure of the elements which constitute such representations according to Moscovici and colleagues, considering the contribution of Abric with his Theory of Central Nucleus and Wagner with the Theory of Sociogenesis. Data were collected in two phases: first, through the Technique of Free Association of Words (TFAW) of which 100 subjects evoked representations of their teaching through the inductor terms 'to teach', 'student' and 'teacher'. For those data we used the EVOC software that promoted to detect the elements of the core and to conclude that the social representation of teaching is one of the work performed by a master / teacher who transmits, directed to an apprentice who learns, confined to the school involving the student with all his virtues to be smart, interested and dedicated, and teacher to be friend, wise bearer of knowledge and also intelligent. Then, using the Multiple Classification Procedure (MCP) only 10 subjects made ratings of 25 more evoked words in the first phase, for the analysis of data from the MPC with the use of the SPSS software we used Multidimensional Statistical Analysis (MSA) for the Free Classification we found three dimensions of Social Representation of Teaching: The Didactic, that focuses on teacher and student being superimposed, meaning the inseparability of these elements, the Affective, which presents the elements inherent in teachers with love as the strong point of this dimension, and the Formative, that is as ambiguous as ambivalent because it sees the teacher as a professional directed to help students get an education; for Directed Classification with Similarity Structure Analysis (SSA), we learn that teaching is a profession that materializes in the classroom, which is extremely true because the action happens in this teaching space, supposing a caring, loving, cheerful, capable, apt, patient, partner, responsible, dedicated, committed educator, who has wisdom and knows how to teach and help students through dialogue to there study and learning. All of it s necessary to occur the result of teaching, which is education in a disciplinary manner. The results point to a very traditional social representation of what is the role of teachers, the role of students and the role of the relationship itself between teaching and learning through the act of teaching. With this statement, we can confirm that the structure of Social Representation of Teaching for the investigated subjects reflects the sociogenetic conditions that engendered them, and that these conditions permeate their structural organization, in particular time-context in which social representation was captured

Quadrinhos nas aulas de ciências: narrando uma história de formação continuada

Located at the intersection of Science Education, Teacher Training and use of didactic Comics (HQ), the text aims to discuss the problem which thus sets: - What is the contribution of the incorporation of comics in the continuing education of teachers Natural Sciences of the early years of elementary school? - May be the comics for enabling science teaching? - How to contribute to a reflexive training of teachers of the early years? - In order to answer these questions, there was a collaborative action research in a school located in the city of Natal / RN, with three teachers who teach natural science in the early years of elementary school. The study involved the conduct of 13 meetings of in-service, under the focus on reflective practice, with the purpose of discussing topics underlying the teaching of science and the use of comics as a methodological strategy. All meetings were recorded on audio and transcripts. The teachers finally recorded the meetings by writing a portfolio. The teachers made use of 10 sessions with reading comics in science classes, which were video recorded and later watched by the educators in autoscopy sessions followed by individual interviews. From the collected data, several aspects that have emerged can be grouped into three categories: The difficult concept of science, teachers' work and the obstacles and possibilities of comics as a teaching strategy. In this sense, are woven assessments taking as its founding, look for the reflective and dialogic practices exercised in the classroom. In the analysis of the data, we can see the conceptual difficulties, methodological and pistemological questions of teachers for teaching science, but also the limitations of comic books for teaching. Learning more relevant appointed by the teachers is related to the importance of collective work to mitigate the training needs of teaching. Finally, signals that the HQ has a great potential for use in science classes, provided that the teacher conduct a careful planning for this, but that the meetings of continuing education promote moments of reflection on teaching practices that are capable of giving rise to new attitudes before the difficulties they depict

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

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

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

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