A humanização no parto e no nascimento: os saberes e as práticas no contexto de uma maternidade pública brasileira

The practice of medicine related to the gestational processes tend to be organized according to the context and the place of work, being thus dependent of the conditions both social and economical, and of the physical structure and the functionality of the services. The high mortality rate in this process has diminished, since 1986, the study made by the World Health Organization (WHO) as to the technical aspects and the social inequalities that influence this situation in different geographical contexts. This culminated recommendations that proposed the reorientation of the dynamical practice of medicine, with a focus on the safety of maternities. Brazil adopted, in the year 2000, the suggestions of the OMS, emphasizing the humanization as the main reason for these actions. However, this discussion tends to not consider the problems caused by the social inequalities and the epidemiological and social conditionings that define the actions of the Unified Health System (Sistema Único de Saúde SUS). In this area, this research seeks to analyze the practices, cares taken, and the universal symbol that promotes and rewards the assistance to the birth of children by the SUS. Besides the analysis of the public documents that deal with this subject, an ethnographic study was developed in a maternity in Natal/RN, considered a model of humanization after receiving the Galba de Araújo prize in 2002. In this stage, the methodological strategies were observed, and the focus of the individual interviews with workers and users of this service. In the analysis of the data, it became evident that the different professional workers and women who gave birth, tend to show concern of the standards the delimit production and reproduction of the practice of medicine, as they favor the absence of a critical posture of the actions destined to the population. Besides this, if became evident that the institutional difficulties associated to the economical, cultural, and political problems also difficult the involvement and the reflection of the workers in favor of assisting changes of the process. There is also a utilization of a perspective prescriptive of humanization in the everyday life of the social workers, without reflection of its meaning. Some workers present, in their statements, a preoccupation with the social and economical aspects that affect the practice of medicine, and with the limitations of the humanization discourse that disarticulates the necessities of those involved in the process of formation, and soon tend to return to the discussion of humanization while a kind practice characterized by the minimization of the interventionist actions. Now the users of the system show themselves before the dynamic of the services, submitting themselves to what is offered while assistance, without questioning and/or reflecting about their usual shortages. Therefore, to think of changes in the know and do of the practice of medicine destined to the birth of children implies reflection on the quotidian production of these practices and of the social contexts that influence the process of assistance in the practice of medicine. Herein it would be possible to predict the appropriation, by different workers concerning their exasperations and necessities, making them active in the pursuit of their rights as citizens

Práticas educativas e integralidade na saúde da família: um estudo etnográfico

Primary Health Care, especially in the family health strategy, it is expected that the joint assistance and actions of health promotion. The Ministry of health (BRAZIL, 2007) defines health education as an eyeshadow strategy of prevention and health promotion, based on reflective practices, which allow the user to their condition of historical, social and political subject, under the vision of an expanded clinic on the part of health professionals. In this sense, there are guidelines for it professionals to develop educational activities and that they can interfere in the health/disease process of the population, with a view to the development of autonomy of the subject. This research had as objective to understand in the light of the integrality of the care, as is the production of health education practices, within the framework of the family health strategy from ethnographic study in a family health unit (USF). The location of the research was the unit of USF Felipe Camarão II in West Health District, in the city of Natal, RN, Brazil, selected from preliminary mapping of educational practices deployed in units of health of the family of this municipality, based on criteria such as time-to-deployment of USF and sustainability of existing actions. Immersion in the field consisted of participant observation with journaling, held during the period of August 2012 to January 2013, in which she accompanied team work processes in clinical-welfare actions on the USF, in households and in educational activities of group character. The results presented in ethnographic description were analyzed based on the axes proposed by Ayres (2009) for identification of integrality in health practices:the axis of the needs; the axis of the purposes; the joint axis; and the axis of the interactionsThe evidence described from observation point the presence of each axle up health education practices developed by the teams, even incipient form, namely: articulation and appreciation of knowledge and practices of popular culture with local initiatives (Pastoril do Peixe Boi Encantado, Auto de Natal e Grupo Terapia e Arte); Clinical integration with health promotion actions and coordination of multidisciplinary knowledge, with professional-user link (course for pregnant women). However, a few challenges were identified to be faced in order to move forward in these practices in integral care: the need to break with the fragmentation of actions; strengthening teamwork; need for greater sustainability policy of collective actions; intersectoral work aimed at a better role of the State in the face of the health-disease process, adding to the action of individuals.The analysis produced from observation of the processes experienced indicates the need for a better recognition of local managers that actions similar to those that occur in the USF Felipe Camarão II enable advances in completeness as allows inclusion of actors involved in the processes of health work, and stimulate participation and shared responsibility in the fight for health-disease situations

Saúde do trabalhador: entre os dispositivos legais e as práticas efetivas

The health worker is seized in this research beyond the mere applicability of legal devices concerning the legislation of Labor, in order to be established correlations with activities alluding to the public power in the ambit of State of Rio Grande do Norte (RN). This dissertation is an cutting of analysis circumscribed in the research, "Accidents at work: law, citizenship and justice," of the Grupo de Estudos Seguridade Social e Trabalho (GESTO) of Universidade Federal do Rio Grande do Norte (UFRN). The overall goal turned to apprehend and relate contradictory elements inherent compliance of Occupational Health and Safety (OHS) in the supermarket which showed the highest occurrence of legal violations recognized by the Labor Justice of RN in the period between 2006 and 2008 . The specific objectives turned to identify, from the condemnatory sentences, violations inherent in the protective direction of the OH & S legislation; analyze the relationship of health damages to workers at the supposed recognition of rights claimed in condemnatory sentences and correlate violations inherent in the legislation OSH impacts on the health of workers, from data contained in expert reports. The justification for perform the research backed up, among other factors, in the fact that class of activity has been presented as the most recurrent in condemnatory sentences, since it chose to focus the analysis on documentary evidence from the supermarket which showed greater expression in relation to violations of the OSH legislation. From a qualitative perspective, the methodological approach was based on content analysis of thirteen condemnatory sentences, handed down by the potiguar labor justice, and three expert reports from a large supermarket in the city of Natal/RN. Aftermaths are evidenced relating to the cyclical processes of reorganization of capital, demanding requirements for labor organizations whose strategies for survival include identifying mechanisms to extract as much of the work force. Structural determination and ideological context that puts into question the historical achievements of workers, for example the legal devices aimed at preventing workplace accidents, expressed in this research as relativized, showing limitations of reach, as was inferred the indemnities, by material and moral damages, arising from Work-Related Musculoskeletal Diseases (MSDs'S), recognized by the laborite judiciary

Concepções e práticas dos profissionais que atuam na educação infantil diante da violência doméstica contra crianças de zero a cinco anos

El estudio presenta el problema de la violencia doméstica contra los niños de hasta cinco años en el contexto de los centros municipales de Educación Infantil (CMEI) en la ciudad de Natal-RN. Constituye un análisis bajo el enfoque teórico y metodológico de carácter cualitativo, en vista de la totalidad, con la asunción de la violencia doméstica contra los niños en su guía sociales, legales, históricos y culturales con el tema. Tiene como objetivo investigar si los profesionales que trabajan en Educación Infantil son capaces de identificar las posibles situaciones de violencia doméstica contra los niños que están bajo su responsabilidad, e incluso si, en los casos de los casos sospechosos o reales de la identidad de saber que las referencias deben ser adoptadas. La ruta entre el conocimiento y el método establecido implica el análisis conceptual de la infancia, la educación infantil y violencia doméstica contra los niños, además de la realización de grupos focales con los participantes de la encuesta con sus registros en un diario de campo. Perciben a sí mismos para el estudio de las contradicciones en la lucha contra la violencia doméstica contra los niños. Incluso con los conocimientos teóricos sobre el tema, los profesionales no pueden dar referencias adecuadas para proteger a los niños y detener la violencia. Nos encontramos con que las condiciones objetivas del trabajo de los profesionales que trabajan en CMEI, asociados con poco conocimiento sobre el tema, no contribuyen a las referencias. Llegamos a la conclusión de que es necesario la participación de la Secretaría Municipal de Educación, sin olvidar que todas las acciones tienen limitaciones como la violencia doméstica contra los niños también se relaciona con problemas estructurales de la sociabilidad capitalista.

As contribuições relativas ao uso de eventos/fóruns para constituição de comunidades de práticas e expressão da inteligência coletiva: o caso do Bibliocontas

Reflete sobre as Comunidades de Prática (CoPs), na perspectiva do conceito de Inteligência Coletiva de Pierre Lèvy. Descreve o ponto de vista de Lèvy, procurando estabelecer um diálogo como conceito de CoPs, criado por Etienne Wenger. Aponta os elementos encontrados nos fóruns virtuais e presenciais realizados pelo do Grupo Bibliocontas, (grupo formado por profissionais da informação que atuam nos Tribunais de Contas brasileiros), que podem contribuir para constituição de uma comunidade de prática. Verifica que os eventos/fóruns são canais integradores para efetivação de uma comunidade de prática, cujo resultado propicia a transformação das pessoas, a formação de identidades e a negociação de significados do fazer profissional. Observa que a construção coletiva de conhecimentos tem sido materializada na forma de diretrizes e ações, que foram ou estão para serem concretizadas pelas instituições dos participantes do grupo em questão, além do resultado da análise dos dados quantitativos, que indica um crescimento constante de troca de mensagens em ambiente virtual e aumento do número de participantes no grupo.

Construir com os professores do 2º ciclo práticas letivas inovadoras: um projeto de pesquisa sobre o ensino do tema curricular 'alimentação humana'

O propósito neste texto é divulgar um projeto de investigação que foi desenvolvido com professores do 2º ciclo, no qual se utilizou uma metodologia do tipo investigação-ação. Por intermédio deste projeto foi possível avaliar o impacto do uso de estratégias do Ensino por Pesquisa (EPP), com vista ao desenvolvimento de novas competências científico-didáticas (atitudes e saberes). Tais estratégias foram desenvolvidas com base em preceitos da Nova Didática e no âmbito de um programa de formação. Os dados levantados e analisados mostraram que esse tipo de metodologia contribui para a superação de dificuldades de aprendizagem inerentes a processos de formação profissional (inicial e continuada), como a de aprender por meio do trabalho cooperativo na Escola.

GESTÃO AMBIENTAL E COMPETITIVIDADE EM DESTINOS TURÍSTICOS: percepção dos gestores de pequenos meios de hospedagem de Natal/RN sobre o uso de práticas ambientais como fator de competitividade

The present work aimed at investigating the small hotel managers perceptions from Natal/RN concerning the environmental practice uses as a competitive factor. This study is characterized as a descriptive exploratory research that used an aleatory probabilistic sample followed by the application of collect data instrument (questionnaire). The small hotels located in Natal/RN were the study participants and the specific location where 35 questionnaires were answered. Based on the data and on the mangers point of view, it is possible to comprehend that, among the presented indicators, the development of environmental programs in the hotel enterprise is showed as the least important for the client s choice. As the main conclusion it is relevant to argue that, according to the small hotel managers, the guests do not still search for hotels that implement environmental practices. On the other side, the interviewed managers believe that the use of these practices can generate a great competitive advantage in relation to their competitors. The information obtained by this present research will be able to contribute to establish a contemporary panorama in relation to the importance attributed by the managers concerning the use of environmental practices in small hotel enterprises in Natal/RN. In addition the correct use of this information can generate possibilities of major competitiveness in this segment

Corpo, doença e biomedicina: uma análise antropológica de práticas corporais e de tratamento entre pessoas com HIV/AIDS

A epidemia do HIV/AIDS tem desafiado tanto a biomedicina como a ciência de modo geral. Tecnologias vêm sendo exploradas a fim de criar uma base terapêutica consistente às pessoas infectadas. Se os tratamentos exigem o consumo diário de medicamentos, os exames laboratoriais contemplam uma rotina a ser sempre mantida. Levam a um processo de mudança e adaptação pessoal junto de uma reorganização intensiva das formas de cuidado do corpo. As práticas clínico-terapêuticas devem ser entendidas, porém, como elementos particulares de processos culturais de grande alcance. Partindo de pesquisa etnográfica no Rio de Janeiro, discuto os efeitos sociais da biomedicina como um saber e uma cultura global sobre práticas sociais locais.

Conhecimentos, atitudes e práticas dos médicos pediatras quanto ao desenvolvimento da comunicação oral

OBJETIVO: investigar os conhecimentos e as atitudes práticas de pediatras em relação à comunicação oral de crianças. MÉTODOS: foram entrevistados 79 pediatras por meio de questionário específico. O conteúdo do questionário buscava informações sobre o profissional, conhecimento das etapas do desenvolvimento da comunicação infantil, sua conduta frente a alguma queixa de suspeita de alterações da comunicação, encaminhamentos profissionais e o método utilizado como avaliação destas crianças. Os questionários foram entregues pessoalmente e respondidos manualmente pelos médicos. RESULTADOS: a maioria dos pediatras entrevistados tem conhecimento, embora básico, das alterações da comunicação infantil e o desenvolvimento da linguagem. Porém, muitos pediatras desconhecem a real atuação do fonoaudiólogo. Além disso, embora haja uma preocupação com a idade da criança falar corretamente, os médicos não realizam o encaminhamento no período adequado. CONCLUSÃO: este estudo mostra a importância da divulgação do trabalho fonoaudiológico em outros meios que não os restritos a ambientes acadêmico, científico ou clínico apenas frequentado por fonoaudiólogos, mas também por profissionais da área médica.

Nossos Ancestrais moravam ali

A presente comunicação relata experiências com estudos em populações tradicionais no interior do Rio Grande do Norte e chama atenção para as vantagens de uma abordagem pluridisciplinar para futuros estudos etnográficos Ao longo de nossas pesquisas com comunidades de pesca e uma de quilombolas, deparamo-nos com vestígios arqueológicos (cacos de cerâmica, conchais e uma canoa ubá, entre outros materiais). Foram registrados relatos de indivíduos pertencentes a essas populações que apontam que esses objetos remontam seus antepassados. Em Patané/Camocim, no município de Ares, observamos práticas nativas que remontam antepassados indígenas, inclusive a formação de “sambaquis” individuais associados às moradias atuais. Na população quilombola de Capoeiras no município de Macaíba, vários moradores comentaram acerca de uns cacos de “panela” encontrados nos seus roçados, que dizem ser dos Tapuias, sendo este etnônimo utilizado como pertencente dos seus ancestrais

A fábrica de professores e a padronização do conhecimento

This paper concern the general subject of teacher career construction, since the period of the initial formation in the teaching course of pedagogy crossing the first effectives experiences of professional performance, until the reflections about the results of the continuous formation propositions. The specifics subject is the formative quotidian in the teacher s life beyond of the traditional stereotypes about individuals and institutions bring up for discussion a micro sociological approach about the professionals uncertainty and the personal hopes, the teacher displeasures and the pedagogical satisfactions. The epistemological reflection about the different formatives experiences, taking as example the Programa de Formação de Alfabetizadores PROFA (Alphabetizers Formation Program) developed by the Secretaria Municipal de Educação of Natal City, consider the ambiguous tension between the knowledge that the teachers acquire in their formation and the concrete teachers practical since those experiences. The study methodology is based in the qualitative comprehensive research, sustained by observations, impressive reflective accounts, and also in the theoretic analyses with contemporary references to the critical pedagogical through and education sociology. I used the autobiographic reflective account by the writer-researcher in her owner academic and professional way. I propose an image of a teacher s factory in such a way for its conformist aspects to the continuity stands as much the internal contradictions of the system. Gears, pieces and manual instructions are the educational components of this factory as ideological, institutional and technical structures to aim at to limit the critics and the changes. However the teachers thinking and acting with their owner creativity to adapted uncontexted professional knowledge s to their pedagogical lives. Under those analogies I propose the problem of this research the teacher s formation and theirs pedagogical practices- and also examine briefly its theoretic-philosophical and methodological basis. From the analysis and interpretation of my owner experiential life as teacher s educator I put the necessity of re-thinking the teacher s formation in terms to rebound more meaningfully in their pedagogical actuation. I believe an important part of the teacher s formation process is the personal wish to learn more about the office, explicitly connected to human convictions and values such as to a positive professional identity. Thus, the teacher able to reflect about your owner educator life can find the best way to help the students to think critically about their culture and history, valorizing creative exits by themselves to face the conformist social stands connected with school education

Controlador adaptativo backstepping a estrutura variável

Neste trabalho, um controlador adaptativo backstepping a estrutura variável (Variable Structure Adaptive Backstepping Controller, VS-ABC) é apresentado para plantas monovariáveis, lineares e invariantes no tempo com grau relativo unitário. Ao invés das tradicionais leis integrais para estimação dos parâmetros da planta, leis chaveadas são utilizadas com o objetivo de aumentar a robustez em relação a incertezas paramétricas e distúrbios externos, bem como melhorar o desempenho transitório do sistema. Adicionalmente, o projeto do novo controlador é mais intuitivo quando comparado ao controlador backstepping original, uma vez que os relés introduzidos apresentam amplitudes diretamente relacionadas com os parâmetros nominais da planta. Esta nova abordagem, com uso de estrutura variável, também reduz a complexidade das implementações práticas, motivando a utilização de componentes industriais, tais como, FPGAs (Field Programmable Gate Arrays ), MCUs (Microcontrollers) e DSPs (Digital Signal Processors). Simulações preliminares para um sistema instável de primeira e segunda ordem são apresentadas de modo a corroborar os estudos. Um dos exemplos de Rohrs é ainda abordado através de simulações, para os dois cenários adaptativos: o controlador backstepping adaptativo original e o VS-ABC

A CRONIFICAÇÃO NOS SERVIÇOS SUBSTITUTIVOS NA REDE DE SAÚDE MENTAL DE NATAL/RN

Brazilian Psychiatry Reform, through Psychosocial Care Strategy, has intended to build insane people care practices from community care services which contemplates the subjects complete lives. However, to change the traditional care ways demands the facing of a series of epistemological, political and cultural obstacles. One of the current challenges deals with patients aggravation processes, with management ways, with devices and with professionals, as well as with the assistance network. The purpose of this thesis was to investigate how these aggravation processes has been constituted in Natal mental healthcare network, understanding its effects in the work teams and patients. Theoretical and methodological perspective used was Institutional analysis was, subsidizing the usage of concept-tools as the implication analysis, selfmanagement and self-analysis, and restitution. The research was carried out at the Natal East Sanitary District Mental Healthcare Clinic, with the participation of technicians and patients. The research procedures were: literature and document research on the attendance and the analyzed theme; attendance registers analysis; participating observation of the institutional routine for three months and field log entries; talking groups, one with the team and one with the patients. Two main discussion points are shown: 1. The mental healthcare clinic organization logic and the intersector politics; 2. The work and management processes developed at the mental healthcare clinic. The analysis show diversity in the attended demands in the service, which has favored the patients aggravation, this device and the substitute network processes. The work processes are apart from the political sphere and from the managements processes. In this sense, we show the need to reevaluate the clinic device as well as the management models adopted in the Brazilian Psychiatry Reform context

Práticas agroecológicas para o cultivo do gergelim (Sesamum indicum L.)

The exceeded use of the natural resources required by the modern agriculture has been caused soil impoverishment, soil salinization and soil compaction. The unreasonable use of chemical fertilizers and pesticides causes chemical imbalances in the plant tissues, nutritional losses, taste chances and human health problems. The monocrops are more vulnerable to the pest and disease attacks. The aim of this work were to indicate the better relative planting time of the cowpea bean for the sesame/cowpea bean intercropping based on the evaluation of agronomic, economic, ecological and physiological parameters and to evaluate the viability of the cow urine and cassava wastewater use as alternative fertilizers on the sesame cultivation. In a field essay, when the sesame/cowpea bean was evaluate, the mainly treatments were the single planting of the two cultures and the multiple cropping, with the cowpea bean being planted on the same time, 7, 14 and 21 days after the sesame. The mainly treatments of the second essay were the combined doses of the cow urine (0 and 50 ml) and cassava wastewater (0, 500 and 1000 mL). In the intercrop evaluation significant differences were found between the treatments for the most of the parameters. It was verified that as the sowing of the cowpea bean was retarded in relation to the sesame sowing, the sesame performance increased when the cowpea bean performance decreased. The treatment 7 days balanced the competition relations that occurred between the two crops in the intercrop. The sesame presented little pronounced responses to the different doses of cassava wastewater. The cow urine affected the sesame growth and the growth rates increased with the increasing of the application of the product. The responses of the sesame growth to the cow urine application must be related both the nutritional richness of the product and the presence of growth stimulating substances. The obtained results indicated that in the sesame/cowpea bean intercropping, when the sesame is planted 7 days after the sesame, there is a higher possibility of the net gains to the farmer. Cow urine and cassava wastewater may be used as additional organic fertilizers

Concepções dos agentes comunitários de saúde sobre suas práticas assistenciais

O presente estudo objetivou identificar as representações elaboradas por agentes comunitários de saúde (ACS) acerca de suas práticas assistenciais. Utilizamos a metodologia qualitativa de pesquisa, adotando, como instrumento de coleta de dados, a entrevista semiestruturada e, para a interpretação dos dados, recorremos à Análise Temática. Foram ouvidos 12 ACS das Equipes do Programa de Agentes Comunitários de Saúde (PACS) de um município do interior paulista. O material obtido permitiu verificar como temas: o vínculo como instrumento de trabalho e a prática pautada na promoção da saúde e na prevenção das doenças. Os relatos demonstram a importância do vínculo na prática diária, enfatizam os princípios humanitários que embasam as ações de solidariedade, destacam o sentimento de gratificação quando o trabalho executado é reconhecido pelas famílias e revelam que os sujeitos ouvidos têm dificuldades para discernir o alcance de seus limites. Embora estes profissionais apresentem um bom suporte técnico para o cumprimento de suas ações, também demonstram carência na instrumentalização para o exercício profissional. Concluímos que as diretrizes e normas estabelecidas para o PACS funcionam como norteadoras do processo de assistência, mas ainda não respondem a questões mais subjetivas encontradas na assistência ao indivíduo-famíliacomunidade. Além disso, os ACS parecem estar vulneráveis às flutuações de gestão dos municípios, estados e Governo Federal, apresentam inconsistência na ideologia do desempenho do próprio papel e não conseguem inverter o modelo assistencial pautado na doença e na intervenção médica individual.