Avaliação de um teste imunoenzimático competitivo no diagnóstico sorológico da brucelose em búfalos (Bubalus bubalis)

O trabalho teve por objetivo avaliar o teste imunoenzimático competitivo (CEIA) para uso no diagnóstico sorológico da brucelose em búfalos (Bubalus bubalis), comparando seus resultados com aqueles obtidos na reação de fixação de complemento (CFT) e no teste rosa Bengala (RBT). Foram examinados 477 soros por meio do CEIA e do RBT e 465, desses mesmos soros, por meio da CFT. Na CFT e no CEIA, soros com títulos maiores ou iguais a 1/4 foram considerados positivos. Para a determinação da sensibibilidade e da especificidade relativas do CEIA, foram considerados como doentes os animais com resultados positivos no RBT e na CFT e sãos os animais com resultados negativos nesses dois testes. Soros com resultados discordantes nesses duas provas foram eliminados da análise. Os resultados apontaram uma concordância de 97,42% entre o CEIA e a CFT e uma concordância de 95,39% entre o CEIA e o RBT. A sensibilidade relativa do CEIA foi de 100% e a especificidade relativa do teste foi de 98,55%. Esses dados mostram que o desempenho do CEIA diferiu pouco do desempenho dos outros dois testes, sugerindo que o mesmo pode constituir um recurso útil para o diagnóstico sorológico da brucelose em búfalos.

Inquérito epidemiológico sobre teníase em população do programa saúde da família no município de Uberaba, MG

Foi realizado inquérito para avaliar alguns aspectos epidemiológicos da teníase em 100.144 indivíduos do Programa Saúde da Família. Foram identificados 185 (0,2%) indivíduos com antecedentes de teníase. Destes, 112 (60,5%) receberam tratamento com praziquantel. em 97 (86,6%) dos casos, houve eliminação de proglotes que corresponderam a Taenia saginata e Taenia solium em 36 (37,1%) e 4 (4,1%), respectivamente.

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

Habitus, representações sociais e construção identitária dos profesores de Maracanaú

In the last three decades, the subject of the teacher's social identity has been discussed under various theoretical focuses, not only in Brazil, but also beyond our borders. In this thesis, the theme is approached starting from the theoretical proposal that has been developed by Domingos Sobrinho (1994), which is strongly based in the epistemological approach between Pierre Bourdieu s praxiology and the Theory of the Social Representations formulated by Serge Moscovici. It presupposes that this would make it easier to apprehend the process of construction of social identity of the investigated social group. The universe of the research is constituted by teachers of the fundamental teaching of the municipal district of Maracanaú, state of Ceará, that were active in class-room work there during at least three years, and were registered or had concluded the Course of Educational Formation promoted by UECE in that municipal district. Taking into account that the teacher's social identity is a process in permanent construction, resulting of their daily experiences and of the interferences originated from of the social context, the investigative tasks were implemented in two different stages, although they complement each other. Initially, with the objective of putting in evidence the genesis of the formation of that group s habitus, an analysis of the family and school lives of eleven teachers who participated in the course was made, using as main sources of data: thematic memorials, semi-structured interviews and observations - inside and out of the class-room during four school semesters. In the second stage a test of free association of words was applied to 426 teachers, seeking to apprehend the structure of the social representations of family and school a methodological strategy considered necessary to enhance and identify certain outlines of the habitus in study, besides being in agreement with the theoretical model followed. It became evident from the results that the identity of Maracanaú s teachers is molded and transformed into a multifaceted dynamic unit that shows successes and mistakes, certainties and doubts. For instance, besides an innovative speech seeking to reassure that teaching is a profession and not a simple vocation or mission, some discourse and attitudes are identified that point to the opposite direction, extolling the school as extension of the family, defending a parental relationship with the students, and looking at certain aspects of daily school life as sacramental . However, in the light of science such ambiguities and incoherences are inherent to common sense discourse, where the influences of the patterns and cultural references are present in the process of identity construction of the group, which was confirmed by the research of their social representations of family and school

Os jogos com regras na perspectiva do desenho universal: contribuições à educação matemática inclusiva

To think about a school that is for everyone has been a challenge for many people connected to education worldwide demanding from researchers of each level of knowledge an association to such effort. The study presented on this paper unites itself to the voices, movements and researches of these scholars, seeking to contribute on building possibilities on which mathematics can be thought and worked on schools in order for every student to learn, whether they have some sort of deficiency, disorders, syndromes or not. This essay has the goal to investigate the possibilities of inclusive pedagogical practices mediated by math games with rules, developed and used throughout the Universal Design perspective; a qualitative research took place with a collaborative methodology that involved managers, teachers and students from a public school situated on the city of Natal/Brazil. On the investigation math games with rules were developed and made according to the Universal Design concept, starting from initial studies which articulated theoretical groundings to the reality of school and the teacher s conceptions. After that, classes using these tools were planned collectively which oriented inclusive pedagogical practices of classes from the 1st to the 4th year of elementary school. Throughout the process many instruments such as: tape recording, video footages, notes from the researcher; the teachers and the students were used for constant work evaluation and also to record the research data. In the end, the data indicated effective contributions of the mediated pedagogical practices by games with rules under the perspective of Universal Design for Inclusive Mathematics Education

A Escola sob o olhar da família: relações que se compreendem e se praticam no cotidiano

This study approaches the relations of family and school, from the perspective of the family. It aims to analyze the meanings attributed by family to the school as a space for plural relationships, and understand the relations that these mothers constitute culturally with schools and their everyday pedagogical practices. When we seek to understand this problematic, it was established as guiding principles of the search in/from/with everyday life. Accordingly, we focused on, as main interlocutors, mothers and authors such as Certeau (1994), Morin (2000) and Freire (1978), among others, on the understanding that cultural diversity is an essential element of the complex relationship between family and public school, because they come from different cultural contexts. In the course of the research it was made the use of the procedure of dialogic conversation as a production process and information analysis. The current analysis highlights that families observe the difference between cultural and report that they are from different socio-political context set by the school, they came from rural areas and their lives were marked by the struggle for survival, and the work activity has been present since their childhood. For the families that participated in this research the school is/was not part of the cultural repertoire significance in their lives and it feels that they attribute to them, are in negotiations with their symbolic universe. The mothers hold a speech of a schoolar binding and pertencing, but the school has the time as possible in their daily lives. Thus, the dynamics of family and school relationships, is configured as complex, and the ambiguity in maternal speech marks a thinking/doing about the school in which they demonstrate ways of making the common man, involving the art of duplicity of the saying and doing, gimmnicks and antidiscipline

A relação entre a família e a instituição de educação infantil: descrição reflexiva sobre uma experiência

The present paper is a doctorate thesis, in the area of Education, that has as a goal to describe and to reflect on the construction/systematization of a relation between family and institution of Childhood Education, in favor of sharing the care and education actions of children, in the context of creation of a County Center of Childhood Education, located in the city of Natal-RN. Our intension with this paper is to share some of the ideas and actions collectively constructed by this experience, with the intention of bringing a contribution for the thematic debates concerning Childhood Education - as modality of education, in a general way; and the relations between families and Institutions of Childhood Education, in a more specific way. The paper presented here is endorsed by the postulates of the qualitative research with characteristics of a research-action, having as main instruments of the data construction the open or half-structuralized interviews, the personal notebook of registers, the participant s index cards characterizing the children and comments. Authors as Aries (1981); Bassedas, Huguet and Solé (1999); Bhering and Blatchford (1999); Brasil (1998); Bujes (2001); Didonet (2002 - 2003); Formosinho (2007); Gómez (2000); Heywood (2004); Kramer (2005); Marchesi and Martín (2003); Marschal and Zohar (2006); Thiollent (2004); Tiriba (2006), amongst others, had theoretically based this paper. The experience described here points to the possibilities of sharing the care and education actions between family and Institution of Childhood Education, emphasizing the relevance of participative praxis in the interior of the institution, so that its job can propitiate this sharing with the families, throughout activities as meetings, lectures, workshops, participation in didactic projects, open expositions to the community, commemorative parties and valuation of the local culture, amongst other chances of dialogue and interaction between the educative institution and the families

A dimensão social do desenho: um estudo sobre as interações no processo de (re) construção imagética da criança no Ensino Fundamental

In the historical-cultural perspective, the drawing is processed by means of a shared and complex way, under diverse relations with the other and with the immersed signs of the culture. That is, something constituted by the social interactions and that can modify the structure of the psychological functions, therefore as socialized sign, propitiates the incorporation of the functions socially. In this way, the figuration carrier sensitive and established meanings historically disclosing the shared experiences and the ways of the subject to think and perceive the world. Such reflections gave shape to the main problem of this research: how to think over about the drawing at the school to incide in the reconstruction of the childs imaginative language? Under such perspective, this work deals with the interactions in the production process of the drawing of the children in a context of teach-Iearning of the elementary school having as goal to analyze the interactions established in the cIassroom in the process of production of the drawings; to propose situations of learnings that favor the advance graphical expression of the students; and to identify in the interactive games some relations between body expression and drawing. For its accomplishment, it was opted for the construction process based in the collaborative investigation by the fact to propitiate negotiations, sharing and confrontation of ideas, becoming possible a joint construction of the knowledge. For this research, the researcher and the collaborating teacher, as well as the involved children, become themselves into co-authors of the context studied. As locus of the research, it was chosen a first cycle class, with 30 students, from Municipal School Profª. Emília Ramos (Natal/RN - Brazil), whose election took in account the fact of this school to constitute in a promotional space of reflections and professional development of teachers in service and, at the same time, for presentinglimitations theoretic- methodological in the field of teaching for Arts. In the process of the research, it was perceived that the children with the support of the verbal language formulates meanings on the seen and imagined object, printing lines and forms that if overlap to the physiological aspects of the visual perception. That is, the drawing discloses a reality appraised, enriched for the picked up vision of the image, but the meanings established for the author, or observer who becomes it perceivable and identified. In the systemizing situations, it was observed that the teaching-Iearning process of the drawing, implies a co-construction between teachers and learners. And, moreover, the necessity to interlace emotion and cognition by means of plastic-corporal interactions that foment drawing experiences, whose process concurs for the imagenative reconstruct of the apprentices

Representações sociais e práticas discursivas de profissionais do programa saúde da família sobre o pré-natal

The present study had the objective to identify to the Social Representations of the professionals of medicine and nursing superior level of the Program Health of the Family concerning the assistance for the gestation. The research was qualitative under the optics of the Theory of the Social Representations of Serge Moscovici, of the Central Nucleus of Jean-Claude Abric and of the Analysis of Content of Laurence Bardin. We worked with the following instruments for the collection of data: Questionnaires, with social-demographic data; Free association of Words, with the inductive terms Pregnancy, Assistance for Gestation and Care; Production of mental image and half-structuralized Interview, with the following question: What does the assistance for the gestation represent for you? . We interviewed all the professionals of nursing and medicine of the Program Health of the Family in the city of Santa Cruz /RN (ten for each profession) in the period of February and March of 2007. From the analysis of the social-demographics data, we respectively identified the following percentages for nursing and medicine: the feminine sex for nursing predominated (90%); the age between 24 and 33 (70 and 60%); the religion catholic (80 and 50%) and 50% of the two groups has up to two years of formation and work in the score of the research. The analysis of the others instruments resulted in two categories: Institutionalized vision and Vision of the Common-sense. In the free association of words, the category institutionalized vision is configured as Central Nucleus and of the common sense one as nucleus Peripheral, demonstrating that the Social Representations of the assistance for the gestation attendance are in the universes consensual. In the mental images, we identified to this same construction. In the content of the interviews, the institutionalized vision is permeated by the responsibility of making and the availability of having - assistance for the gestation is recommended by the Health department and necessary genders - while the vision of the common-sense can be represented by the category sort, whose role of professionals of the assistance for the gestation is to strengthen the responsibility for the woman of a maternity socially constructed. In short, the analyzed speeches reflect that, to the knowledge acquired in the academy, are incorporated in the knowledge of the daily professional, and conducted by popular myths. Medicine and nursing recognize the importance of the attendance in such a way for the chance to educate the women for the maternity as for the possibility to prevent complications, but in its speeches they had excluded from this process the masculine figure. We conclude that the meaning of the inductive term take care, part of the common-sense and is incorporated the institutionalized speech to humanize the assistance. However, the pregnancy ceases from being seen in its natural biological direction and starts to be analyzed as a moment of fragility and predisposition the illnesses. Finally, the social nursing and the central nucleus representations for the assistance in gestation for medicine is anchored in the speeches institutionalized and of the common-sense, reflecting the concern in establishing a humanized assistance with quality

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

Prática do enfermeiro do Programa Saúde da Família PSF na promoção da saúde do adolescente

Attention to the health of adolescents, based on paradigm flexneriano, needs to be overcome. Since the International Conference of Ottawa (1986), the literature is developing a discussion of the promotion of health, based on the paradigm of social production in health, suggests a design to overcome the health care traditional practices. Program Health of the Family PSF has this purpose to transmute the model of existing assistance, where the nurse is an essential element to the work done in the program. Around this context, it is our purpose to analyze the practice of nurse of the PSF for the promotion of health of adolescents, produced by a search of descriptive quantitative approach with the inclusion of qualitative data. Interviews were conducted with 9 nurses 3 units of health of the family USF, Mossoró-RN and applied questionnaires with 74 teenagers aged between 15 and 19 years old, with some nearby public schools where USF operate these nurses. The quantitative descriptions were transformed on tables, pictures and graphics using the program Excel (Microsoft) and the qualitative were worked through the technique of analyzing the content of Bardin (2004). The review was realized using the reference to promote health brought by the study. The results show that the most common problems that happen with teenagers are the drugs (33,8%), pregnancy (27,0%) and political problems-socio-economic-cultural issues (24,3%). Adolescents are spontaneous demand and rarely seek the USF. The actions presented by the nurses as, lectures and groups, are nothing comparing to the macro-problems presented by adolescents, and verticalized irregular. The nurses know the promotion of health generally, not explaining how operate it from its daily practice. Concluded that the practice of nurse of the PSF has not yet reach the promotion of health of the adolescent, being necessary to scheduling modules on the subject to continuous training of teams, professionals from USF, as well as teachers and other staff of schools, giving space to the participation of academic. The discussions should be socialized with the community to discuss possibilities of confrontation of the problems, which also require socio-structural changes. This research can contribute as work-diagnosis, which experienced the reality of care in nursing PSF to a specific group

Conhecimento dos adolescentes sobre métodos contraceptivos: pesquisa-ação em uma unidade do programa saúde da família de Natal

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

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

Acurácia do teste de labirinto no rastreamento de déficits cognitivos em idosos

This study intended to evaluate the maze test accuracy in cognitive deficit screening in elderly with or without neuropsychological pathology. The sample included 40 healthy young (18-25 years old; mean- 21 ± 1.6), 40 healthy old (60-77 years old; mean- 67 ± 5.1) and 18 patients with probable diagnosis of Alzheimer s disease initial stage (52-90 years old; mean- 78 ± 9.2). Data analysis was made using Anova with Tukey s post hoc, multiple linear regression analysis and ROC curve analysis. According to Tukey s test Alzheimer patients spent more time (46843 ± 37926 ms) to execute the test than healthy young (5482 ± 2873 ms; p= 0.0001) and elderly (17978 ± 13700; p= 0.0001); healthy young executed test n lower time (p= 0.035). According to the regression analysis of age, education level and cognitive performance of the three groups, the cognitive performance was the predictor of the execution time. When analyzing young and elderly only age was the predictor and the cognitive performance was the only factor to influence the test of old aged healthy and patients. The ROC curve analysis indicated 72% accuracy for young and elderly and 36% for healthy and elderly patients. The maze execution time represented a better balance between sensibility (75%) and the specificity (61%) was near 13575 ms, indicating that those subjects that execute the maze in a time higher to this value may show cognitive deficit related to the executive function. According to the results it is suggested that the maze test used in this study shows a good accuracy in the cognitive deficit tracking and may discriminate age changes

Saúde da família: uma estratégia de mudança no processo de produção dos serviços de saúde

The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caicó, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors