A preceptoria na estratégia saúde da família: o olhar dos profissionais de saúde

The proposal of teaching-service integration from work experience brings a challenge to the professionals involved in health services: to combine their healthcare practice to the preparation of new professionals in accordance with the national health model. In Recife, the assistance network is known as school network, since it provides all its health equipment for Higher Education Institutions, in special for professionals who work as preceptors, making this activity an important component of the services network. The objective of the present study was to analyze preceptorship experience herein Multidisciplinary Residences in Health in the look of health professionals. This is a qualitative descriptive study, involving physicians, dentists, and nurses that have worked as preceptors for at least two years in multidisciplinary residency linked to two Higher Education Institutions. A semistructured interview was used as research instrument and data were processed by using the software Alceste 4.9. Results indicated four semantic classes which were divided into two axis. Axis 1, composed of class 4, and Axis 2, composed of classes 3, 2 and 1. Categorization considered the relation between classes. It was observed that in class 4 work overload is a dilemma for professional participation in preceptorship. This is noted by the words manage, time, patient, give, and complicated. However, it is also observed that the preceptorship involves positive learning and teaching actions, reinforced by the words say, explain, and discuss. Class 2 shows the preceptorship as an experience exchange, a positive moment that provides theoretical upgrade to the preceptor, associated to the professional practices performed by the binominal preceptor-student in health services and communities. In this perspective, everyone is benefited since preceptorship is structured according to dynamic aspects of knowledge, experienced in settings permeated by people´s health necessities. In class 3, potentialities of this practice are shown, and personal compromise is the main reason of acting as a preceptor in this network of education/attention, demonstrated in the words reason, formation, to like and professionals. Last, but not the least, class 1 suggests the importance of preceptorship and one of the strategies to create the National Politics of Humanization, from the teachingservice-community integration, observed in the words: arrives, university, fundamental, manner, partnership, service, and student. Besides, it rates perspectives and challenges for the improvement of the preceptorship in health services. Integrating teaching and service can enhance the proposals of changes concerning the healthcare model practiced in services, but this relation is still superficial. The preceptor is an actor in action, playing real life roles, and that is when he becomes essential to seek training with the profile defended in the proposed training of a professional who is capable of learning to learn

Aborto: um fenômeno sem lugar – uma experiência de plantão psicológico a mulheres em situação de abortamento

The present paper discusses the experience of a psychological emergency attendance in Maternidade Escola Januário Cicco (MEJC) in Natal and has as main objective to investigate the limits and possibilities of this practice in offering psychological care to women in abortion situation. The Ministry of Health considers the abortion a serious medical problem in Brazil and acknowledge the repercussions it causes in personal life and between the women’s family, most of all among the younger ones, in fully productive and reproductive age, that if not supported may suffer deep psychological and physical wounds. This research inserts itself in the field of psychological practices in institutions, by many ways, and aim to offer, by different approaches, among then the psychological emergency attendance, a psychological attention at the institutions. This attention refers to a care during the suffering at the time of crisis and in the many ways that the problem is present. The results were analyzed at a heideggerian hermeneutics optics, which search a determined aspect of reality that intends to know/understand, accompanied by the man’s own movement in existence. The cartography and the logbook were chosen in narrative form as a resource to allow the approximation of daily experience. The emergency psychological attendance was realized on curettage setor of MEJC between march of 2013 and february 2014 at tuesdays and Thursdays from 9h to 12h. The existential plot unveiled at this experience showed some possibilities and limits of emergency psychological attendance as studied. Among the possibilities, the emergency attendance helped the women that suffered an abortion to find new meanings, as: realize the need to self-care; see in the attendance a way to cope with the lost or other issues in their life’s; to enlarge the possibilities of her choice; to rethink her sex e reproductive life, and rethink her relationships and life projects. The attendance has proven itself as a health care mechanism showing the women the need to search for the necessary condition to self-care and to question what in that environment was saw as natural. The attendance showed itself as a suitable practice to the health care demand by creating/inventing ways of meet the woman needs. The attendance promoted an opening at the technical horizons of women’s, what was realized when the complaints moved past the physical health. As refered to the limits, some needs was beyond the emergency attendance service and demanded forwarding to regular psychological care or others specialized services. The service was not able to attend all of the demands of the sector. The attendance did not touched the medical staff to its need or made a change in posture to act beyond the technicality. The attendance, although has not made change in this context, was able to show the main difficulties, like the lack on prepare of the medical staff to deal with the abortion past beyond the technical procedure and the precariousness of the infrastructure of the services offered. At last, the attendance represented a shelter to the women in abortion situation, allowing the suffering to have a place.

Ensinar e aprender História na relação dialética entre interpretação e consciência histórica crítica

Teaching and learning History in dialectical relationship between interpretation and critical historical awareness has investigated the triggering of a theoretical-practical training process developed with a history teacher, her mediation in the teaching and learning of the discipline process, related to the appropriation of history text interpretation and the development of critical historical consciousness by public school 8 th-grade students of elementary level. It aims to analyze the relationship between mediation of teaching activity and ownership by the student on this level, the interpretation of history texts and development of this consciousness. It has been opted for collaborative research, as training and strategy, and was employed as procedures for the formation of knowledge: Meeting, Cycles of Reflexive Studies, Planning (with teachers), Observation performed in real life and portfolio (involving students). The teacher appropriated of contributions of the theory by P. Ya . Galperin and critical historical consciousness and developed a teaching process using a methodology grounded in theoretical constructs this author. The students appropriated the interpretation of history texts and demonstrated to be in a process of developing a critical historical consciousness. Performance of the students occurred more consistently in the interpretations implemented in groups, with teacher guidance and support of the activity map. Training processes, performed in and about teaching and student activities, revealed an improvement in teacher's professional development and the knowledge and expertise of the students. It has contributed to this, the critical reflection experienced in the investigative process. Given these findings, as needs of new thinking, research recommends the development of teaching and learning processes in other years of elementary school, involving the interpretation of history texts and the development of critical historical consciousness of students.

Capital social e desenvolvimento de territórios: estudo multicasos nos territórios da cidadania do Rio Grande do Norte

This study aims to systematize elements for territorial development analyzing attributes of social capital present in the territories of Rio Grande do Norte. Unlike other studies about the subject, it is not intended to measure the stock of social capital, but rather to reveal the phenomenon of social organization and its implications, considering territories examined are already made around social capital structures. Case study were used as strategy research because it is enables to understand holistic features and significant events within the context of real life. For this research were selected representatives of public and social institutions involved in territorial collegiate specifically those of the governing core, selected from the more effective involvement of discretion in structure, functioning and meetings. The three territories have similar realities, are products of a public policy that is based on common criteria and present interdependence between categories of analysis of social capital. The presence or absence of any relationship - link, bridge or connection - influences the performance of territorial policy, affecting the social organization and fostering processes of access to information. In the cases at hand, despite the similarity of the general conditions of structure and function, the Apodi has qualities superior to the other. The presence of Dom Helder Camara project that articulates, in parallel to the Territory of Citizenship, the same actors of public policy with social mobilization capacity and effectiveness of actions, is able to encourage different development processes at Apodi. This can be explanatory factor, the tangent construct social capital, so that the territory present living conditions and better levels of development than the other two addressed here.

Preceptoria em profissionais de saúde: viabilizando meios para uma formação pedagógica em hospitais públicos em Natal-RN

This study aimed to construct and carry out a distance course of pedagogical training for health professional performing preceptorship functions in public health institutions. The preceptorship in health is a pedagogical practice that occurs in workplace, led by assistance professionals with teaching position or not, where the vast majority of these acts intuitively, reproducing their own training, confusing transmitting information with education. These preceptors often do not dominate the pedagogical knowledge, necessary for the organization of training activities, such as the various teaching-learning processes and the different assessment types. Student supervision is essential in the training process of students in the health field, and on the occasion of supervised internships that the teaching-learning process is based on practical experience with participation in real life situations and professional work. It was realized an exploratory study, descriptive with qualitative approach, with the development of tutoring teaching course in health as final product. Applied semi structured research instrument from may to july 2014. It were evaluated 162 health professionals who perform the preceptorship, which made it possible define the preceptor's profile and identify the educational requirements related to the educational process, which justified the construction of the program content and the professionals’ perception analysis about preceptorship through identification of three categories: clinic knowledge valuation; valuation of professional orientation and valuation of professional future. The course was available on distance mode through Moodle platform with forty hours of work load from October to November 2014. With the aim of capacitate the health professionals to development of necessary abilities and skills to tutoring performance through thoughts about tutoring concepts, professional training within the curricular guidelines and SUS precepts, the role of health professionals as educators, application of active teaching methodologies, and evaluation methods. The applications were done online through the provided link; 300 vacancies offered, 243 professionals applied, chosen 134 that works on tutoring, where 49 represented professionals that works on the location of the study. The course lasted 45 days, and counted with tutors responsible to interact and evaluate the students. 28 professionals joined the course, 12 concluded. Opportunities were identified to stimulate the involvement, however the professionals’ satisfaction shows that, make an investment on tutors education, starting from the Permanent Education precepts, will provide a bigger appropriation of the knowledge to the education and therefore the awareness of their role as an educator on work ambit, proportioning essential tools to tutors act while enabler of integration between theory and practice and result better teaching-learning process.

Emoções, documentos e subjetivação na construção de transexualidades em João Pessoa/PB

This research aims to understand how the affective components involved in transgender relations with documents constitute specific ways in which these people recognize themselves and build their bodies and their paths, their life projects and their relationship with others. We understand that the documents, if the personal identification or those produced by social movements, legal actors and health and the State, are experienced by trans people beyond administrative functions that are initially thought, but also involve a series of emotional experiences mark their subjective processes, in how these people produce themselves and design in the world their sociality networks. We elected as research field two institutions located in the city of João Pessoa (Paraíba State), noting the intense institutional movement, political, social in favor of the rights of transexuals that have occurred in that city in recent years. Thus, the Rights Reference Centre for LGBT and Fight Against Homophobia (Espaço LGBT) and Health Clinic of Transvestites and Transexuals (Ambulatório de Saúde de Travestis e Transexuais) were the spaces where we find our interlocutors and analyze their experiences with the documents noting two key aspects: the search for first name change in the civil registry and the relationship of trans people with documents produced by the health policies and services such as protocols, records, receipts and psychiatric reports. We realized that although there is disagreement about the perception that our interlocutors have on the documentation that regulates health services, all reported experiencing embarrassment in social situations when you have those who make use of a document that is not consistent with the performance and “social face” taken. In addition to the reports of embarrassment, we saw that the discussion of social distress and trauma has grounded the platforms of social movements, public policy, legal processes and become “narratives of pains” that present strong potential micro-political on demand for rights to “trans people”.

“A gente casa porque nasce!”: um estudo sobre a concepção dos projetos de vida de três gerações de mulheres da Boa Vista dos Negros - Parelhas/RN

This research analyses the individual trajectories of quilombola women from Boa Vista dos Negros, next to the Parelhas city – in the region of Seridó-RN. To this study, our focus (youth and generation) is important to access the feminine universe, the intimacy of home, approaching issues related to the work and to understand family configurations. We aim to perceive the existence of individual projects based on the experiences of three black women generations from distinct family groups. In order to develop this research, the method used is routine and life history analyzes, semi-structured interviews, informal conversations and personal contact due to their participation in the PROEXT/SESU-MEC extension program. The feminine experiences of “hard work” in the agriculture or in the “street”, coping and struggles by the subaltern relationship in their routine as housecleaners create questions related to life experiences and social stigmatizations. The relevancy of this work is to reveal feminine universe into familiar and professional relationships, analyzing individual trajectories, evaluating the social status of women along their lives. In this sense, these narratives of feminine experiences allows the description of the quilombola routine, the life projects of these three women generations, as well as it allows to analyse the changes occurred since the end of the XX century, in particular related to the familiar arrangements.

“A gente casa porque nasce!”: um estudo sobre a concepção dos projetos de vida de três gerações de mulheres da Boa Vista dos Negros - Parelhas/RN

This research analyses the individual trajectories of quilombola women from Boa Vista dos Negros, next to the Parelhas city – in the region of Seridó-RN. To this study, our focus (youth and generation) is important to access the feminine universe, the intimacy of home, approaching issues related to the work and to understand family configurations. We aim to perceive the existence of individual projects based on the experiences of three black women generations from distinct family groups. In order to develop this research, the method used is routine and life history analyzes, semi-structured interviews, informal conversations and personal contact due to their participation in the PROEXT/SESU-MEC extension program. The feminine experiences of “hard work” in the agriculture or in the “street”, coping and struggles by the subaltern relationship in their routine as housecleaners create questions related to life experiences and social stigmatizations. The relevancy of this work is to reveal feminine universe into familiar and professional relationships, analyzing individual trajectories, evaluating the social status of women along their lives. In this sense, these narratives of feminine experiences allows the description of the quilombola routine, the life projects of these three women generations, as well as it allows to analyse the changes occurred since the end of the XX century, in particular related to the familiar arrangements.

“Oi, meu nome é Ana” - um estudo fenomenológico-existencial da experiência de mulheres com anorexia nervosa

This research deals with anorexia nervosa through the look of those who lived this experience. Eating Disorders have been presented as psychopathology increasingly recurrent in contemporary, being almost doubled incidence in the last 20 years, reaching mainly teenagers and bringing consequences and implications of various kinds. The literature points to the relevance of the current ideal of beauty, in which thinness is overvalued. In this case, the study’s objective was to understand, from an existential-phenomenological perspective, anorexia experience. Thus, when assessing the experience, seeking to understand the possible directions that the non-eating is for the person who lives such an experience. The study, of Heidegger's existential-phenomenological inspiration, used semi-structured interviews as a means of access to the experience. Female two people were interviewed, at the age of 17 and 30, began with a starter question ("How was, or how is, your anorexia experience?"), which allowed the interviewee to talk about their experience. For the selection of the study participant was publicized among health professionals, as well as in social networks and blogs, in which the research objectives and approaches have been made explicit. The field diary was also used as a methodological resource, seeking a greater approximation of the experiences of the interviewees and the researcher. The interviews were interpreted in the by Heidegger's hermeneutics. The meanings unveiled in the narratives revealed issues beyond the physical and pathological issue, being involved family, wishes, friends, experiences, life projects. The corporal, as thought by Martin Heidegger, became very present in the statements of the interviewees, as it is part of existence. Among the Heidegger´s ideas, emphasizes care, inhospitality, live, boredom, openness to possibilities and factuality, that might be discussed from interviewees' discourse, engendering reflections about their senses, in their lives.

“Oi, meu nome é Ana” - um estudo fenomenológico-existencial da experiência de mulheres com anorexia nervosa

This research deals with anorexia nervosa through the look of those who lived this experience. Eating Disorders have been presented as psychopathology increasingly recurrent in contemporary, being almost doubled incidence in the last 20 years, reaching mainly teenagers and bringing consequences and implications of various kinds. The literature points to the relevance of the current ideal of beauty, in which thinness is overvalued. In this case, the study’s objective was to understand, from an existential-phenomenological perspective, anorexia experience. Thus, when assessing the experience, seeking to understand the possible directions that the non-eating is for the person who lives such an experience. The study, of Heidegger's existential-phenomenological inspiration, used semi-structured interviews as a means of access to the experience. Female two people were interviewed, at the age of 17 and 30, began with a starter question ("How was, or how is, your anorexia experience?"), which allowed the interviewee to talk about their experience. For the selection of the study participant was publicized among health professionals, as well as in social networks and blogs, in which the research objectives and approaches have been made explicit. The field diary was also used as a methodological resource, seeking a greater approximation of the experiences of the interviewees and the researcher. The interviews were interpreted in the by Heidegger's hermeneutics. The meanings unveiled in the narratives revealed issues beyond the physical and pathological issue, being involved family, wishes, friends, experiences, life projects. The corporal, as thought by Martin Heidegger, became very present in the statements of the interviewees, as it is part of existence. Among the Heidegger´s ideas, emphasizes care, inhospitality, live, boredom, openness to possibilities and factuality, that might be discussed from interviewees' discourse, engendering reflections about their senses, in their lives.

UK prescribing practices as proxy markers of unmet need in allergic rhinitis : a retrospective observational study

Acknowledgements We thank Ruth B Murray for reviewing and editing this manuscript. We thank Joan B Soriano for his critical review and constructive comments. We thank Helga Mikkelsen and Alessandra Cifra for their assistance with manuscript editing and revision. Finally, we thank the Journal blind peer reviewers, whose suggestions and critical appraisal significantly improved our original submission. FUNDING This study was funded by Meda, Solna, Sweden. Data acquisition and analyses were funded by Meda. The study was conducted by Research in Real Life as an independent research organisation; Meda had no role in the conduct or reporting of the study.

Historical cohort study examining comparative effectiveness of albuterol inhalers with and without integrated dose counter for patients with asthma or chronic obstructive pulmonary disease

This study was supported financially by an unrestricted grant from Teva Pharmaceuticals, Frazer, PA, USA. The authors thank Jenny Fanstone of Fanstone Medical Communications Ltd., UK, and Elizabeth V Hillyer for medical writing support, funded by Research in Real-Life. We acknowledge with gratitude Dr Ruchir Parikh for his review of and contributions to the manuscript.

Metabolic Effects Associated with ICS in Patients with COPD and Comorbid Type 2 Diabetes : A Historical Matched Cohort Study

Funding: The analyses were funded by Boehringer Ingelheim. Access to data from the Optimum Patient Care Research Database was co-funded by Research in Real Life Ltd. The funder, Boehringer Ingelheim, had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Rafael Mares is employed by Research in Real Life Ltd., which provided support in the form of salary for author RM but did not have any additional role in the study design, decision to publish, or preparation of the manuscript. The specific role of this author is articulated in the ‘author contributions’ section.

Modulating membership grades to gain consensus for fuzzy set uncertainty values in a clinical decision support system

This paper deals with a very important issue in any knowledge engineering discipline: the accurate representation and modelling of real life data and its processing by human experts. The work is applied to the GRiST Mental Health Risk Screening Tool for assessing risks associated with mental-health problems. The complexity of risk data and the wide variations in clinicians' expert opinions make it difficult to elicit representations of uncertainty that are an accurate and meaningful consensus. It requires integrating each expert's estimation of a continuous distribution of uncertainty across a range of values. This paper describes an algorithm that generates a consensual distribution at the same time as measuring the consistency of inputs. Hence it provides a measure of the confidence in the particular data item's risk contribution at the input stage and can help give an indication of the quality of subsequent risk predictions. © 2010 IEEE.

'Catching them young':inspiring future engineers, an exploratory study

The requirement that primary school children appreciate fully the pivotal role played by engineering in the sustainable development of future society is reflected in the literature with much attention being paid to the need to spark childrens engineering imagination early-on in their school careers. Moreover, UK policy documents highlight the value of embedding engineering into the school curriculum, arguing that programmes aimed at inspiring children through a process of real-life learning experiences are vital pedagogical tools in promoting engineering to future generations. Despite such attention, engineering education at school-level remains sporadic, often reliant on individual engineering-entrepreneurs such as teachers who, through personal interest, get children involved in what are usually extra-curriculum, time-limited engineering focused programmes and competitions. This paper briefly discusses an exploratory study aimed at investigating the issues surrounding embedding engineering into the primary school curriculum. It gives some insight into the perceptions of various stakeholders in respect of the viability and value of introducing engineering education into the primary school curriculum from the age of 6 or 7. A conceptual framework of primary level engineering education, bringing together the theoretical, pedagogical and policy related phenomena influencing the development of engineering education is proposed. The paper concludes by arguing that in order to avert future societal disaster, childrens engineering imagination needs to be ignited from an early age and that to do this primary engineering education needs to be given far more educational, social and political attention. © 2009 Authors.