Brazilian community health agents and qualitative primary healthcare information

The aim of this study was to explore female community health agents’ views about the value of recording qualitative information on contextual health issues they observe during home visits, data that are not officially required to be documented for the Brazilian System of Primary Healthcare Information. Background: The study was conducted in community primary healthcare centres located in the cities of Araçatuba and Coroados (state of São Paulo) and Rio de Janeiro (state of Rio de Janeiro), Brazil. Methods: The design was a qualitative, exploratory study. The purposeful sampling criteria were being female, with a minimum of three years of continuous service in the same location. Data collection with 62 participants was conducted via 11 focus groups (in 2007 and 2008). Audio files were transcribed and submitted to the method of thematic analysis. Four themes guided the analysis: working with qualitative information and undocumented observation; reflecting on qualitative information; integrating/analysing quantitative and qualitative information; and information-sharing with agents and family health teams. In 2010, 25 community health agents verified the final interpretation of the findings. Findings: Participants valued the recording of qualitative, contextual information to expand understanding of primary healthcare issues and as an indicator of clients’ improved health behaviour and health literacy. While participants initiated the recording of additional health information, they generally did not inform the family health team about these findings. They perceived that team members devalued this type of information by considering it a reflection of the clientele’s social conditions or problems beyond the scope of medical concerns. Documentation of qualitative evidence can account for the effectiveness of health education in two ways: by improving preventative care, and by amplifying the voices of underprivileged clients who live in poverty to ensure the most appropriate and best quality primary healthcare for them.

Por que aprender isso, professora? Sentido pessoal e atividade de estudo na psicologia histórico-cultural

This research investigated the process of personal sense attribution to the study activity of students in Elementary School. The theoretical reference is the Historical-Cultural Psychology. It was conducted with students from 4th grade in a public school. The methodological procedures were: observation the daily life of a classroom; learning oriented situations; focus groups; interviews. As a result, we sought to define the analysis unit: the relation between the study activity motives and the objectives of study actions. It is defended the thesis that for the scholar learning to happen, the study actions of the students must have a personal sense correspondent to the motives and to the social meanings of the study activity, towards the human development promotion.

Representações sociais de professores sobre inclusão e o projeto político pedagógico: a escola em movimento

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Ética, justiça e democracia em sala de aula: o desenvolvimento e a experiência de um novo método de discussão de dilemas morais para a educação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O enfermeiro e a estratégia saúde da família: desafios em coordenar a equipe multiprofissional

This study aimed at understanding the role played by nurses in managing a team in the Family Health Strategy (ESF) in relation to competences and skills practiced and developed in their everyday work and the difficulties found to perform their duties based on these professionals’ perceptions. Data were collected by means of focus groups with seven nurses in 2006 and then submitted to content analysis, which disclosed five themes: The context of the coordination of multidisciplinary teams in the Family Health Strategy, factors involved in the daily work in the ESF, conflicts experienced in the interface between teamwork and central coordination in the ESF, difficulties of the population towards the new model of care coordinated by the nurse, the perceived competence to exercise leadership in coordinating multidisciplinary teams. Results showed work overload, overlapping of tasks and lack of training. These professionals have been evaluated according to the logic of their work organization by productivity and not by the quality of their actions. Hence, they feel devalued professionally. They pointed out technical and scientific knowledge as an important competence attached to relational practices. There is a need to create formal opportunities to discuss the major difficulties found by the nurses managing multiprofessional teams when experiencing such management.

Interdependência entre os níveis de atenção do Sistema Único de Saúde (SUS): significado de integralidade apresentado por trabalhadores da Atenção Primária

Integrality constitutes an important principle of the SUS, achieved through the struggles of the Brazilian health movement. It represents an expansion of the concepts of health and illness, to include the social determinants of healthcare needs. Intending to investigate the meanings of integrality reported by primary care workers, a study was developed in a medium-sized municipality in the state of São Paulo, concerning distinct technological work organization models in primary healthcare units. Among the results, the dimension of system integrality appeared with greatest frequency, according to analysis on focus groups. The workers pointed out difficulties in integration and communication between the healthcare levels, determined by selective social policies and medium/high-technology services delegated to the private market. The theoretical-philosophical framework of this study was based on cultural-historical psychology, taking into consideration the categories of work/activity, consciousness, mediation and totality.

Gestão democrática da escola: possibilidades e dificuldades na percepção dos pais e dos gestores do Ensino Fundamental

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Projeto de Futuro na dimensão sócio afetiva: como se constroem as percepções de alunos(as) do Ensino Secundário em Portugal e do Ensino Médio no Brasil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Da dimensão humana à literatura de autoajuda: reflexões sobre a formação e o trabalho docente

Pós-graduação em Educação - IBRC

Is Competition Making a Comeback? Discovering Methods to Keep Female Adolescents Engaged in STEM: A Phenomenological Approach

The decreasing number of women who are graduating in the Science, Technology, Engineering and Mathematics (STEM) fields continues to be a major concern. Despite national support in the form of grants provided by National Science Foundation, National Center for Information and Technology and legislation passed such as the Deficit Reduction Act of 2005 that encourages women to enter the STEM fields, the number of women actually graduating in these fields is surprisingly low. This research study focuses on a robotics competition and its ability to engage female adolescents in STEM curricula. Data have been collected to help explain why young women are reticent to take technology or engineering type courses in high school and college. Factors that have been described include attitudes, parental support, social aspects, peer pressure, and lack of role models. Often these courses were thought to have masculine and “nerdy” overtones. The courses were usually majority male enrollments and appeared to be very competitive. With more female adolescents engaging in this type of competitive atmosphere, this study gathered information to discover what about the competition appealed to these young women. Focus groups were used to gather information from adolescent females who were participating in the First Lego League (FLL) and CEENBoT competitions. What enticed them to participate in a curriculum that data demonstrated many of their peers avoided? FLL and CEENBoT are robotics programs based on curricula that are taught in afterschool programs in non-formal environments. These programs culminate in a very large robotics competition. My research questions included: What are the factors that encouraged participants to participate in the robotics competition? What was the original enticement to the FLL and CEENBoT programs? What will make participants want to come back and what are the participants’ plans for the future? My research mirrored data of previous findings such as lack of role models, the need for parental support, social stigmatisms and peer pressure are still major factors that determine whether adolescent females seek out STEM activities. An interesting finding, which was an exception to previous findings, was these female adolescents enjoyed the challenge of the competition. The informal learning environments encouraged an atmosphere of social engagement and cooperative learning. Many volunteers that led the afterschool programs were women (role models) and a majority of parents showed support by accommodating an afterschool situation. The young women that were engaged in the competition noted it was a friendly competition, but they were all there to win. All who participated in the competition had a similar learning environment: competitive but cooperative. Further research is needed to determine if it is the learning environment that lures adolescent females to the program and entices them to continue in the STEM fields or if it is the competitive aspect of the culminating activity. Advisors: James King and Allen Steckelberg

Black Faculty Recruitment and Retention in the Voices of Black Faculty

“Black faculty focus groups explored major issues and concerns, examined awareness levels of Black faculty, and identified factors that have positive impact on recruitment and retention efforts.”

Family Health Strategy Professionals Facing Medical Social Needs: difficulties and coping strategies

Professionals of Family Health Strategy (FHS) work in communities where there are complex medical social problems. These contexts may lead them to psychological suffering, jeopardizing their care for the users, and creating yet another obstacle to the consolidation of FHS as the primary health care model in Brazil. The study investigated the difficulties and coping strategies reported by health professionals of the FHS teams when they face medical social needs of the communities where they work. Focus groups and semi-structured interviews were carried out with 68 professionals of three primary care units in the city of Sao Paulo (Southeastern Brazil). Drug dealing and abuse, alcoholism, depression and domestic violence are the most relevant problems mentioned by the study group. Professionals reported lack of adequate training, work overload, poor working conditions with feelings of professional impotence and frustration. To overcome these difficulties, professionals reported collective strategies, particularly experience sharing during team meetings and matrix support groups. The results indicate that the difficulties may put the professionals in a vulnerable state, similar to the patients they care for. The promotion of specialized and long term support should be reinforced, as well as the interaction with the local network of services and communities leaders. That may help professionals to deal with occupational stress related to medical and social needs present in their routine work; in the end, it may as well contribute to the strengthening of FHS.

What do medical students think about their quality of life? A qualitative study

Background: Medical education can affect medical students' physical and mental health as well as their quality of life. The aim of this study was to assess medical students' perceptions of their quality of life and its relationship with medical education. Methods: First-to sixth-year students from six Brazilian medical schools were interviewed using focus groups to explore what medical student's lives are like, factors related to increases and decreases of their quality of life during medical school, and how they deal with the difficulties in their training. Results: Students reported a variety of difficulties and crises during medical school. Factors that were reported to decrease their quality of life included competition, unprepared teachers, excessive activities, and medical school schedules that demanded exclusive dedication. Contact with pain, death and suffering and harsh social realities influence their quality of life, as well as frustrations with the program and insecurity regarding their professional future. The scarcity of time for studying, leisure activities, relationships, and rest was considered the main factor of influence. Among factors that increase quality of life are good teachers, classes with good didactic approaches, active learning methodologies, contact with patients, and efficient time management. Students also reported that meaningful relationships with family members, friends, or teachers increase their quality of life. Conclusion: Quality of teachers, curricula, healthy lifestyles related to eating habits, sleep, and physical activity modify medical students' quality of life. Lack of time due to medical school obligations was a major impact factor. Students affirm their quality of life is influenced by their medical school experiences, but they also reframe their difficulties, herein represented by their poor quality of life, understood as necessary and inherent to the process of becoming doctors.

Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability

Abstract Background Tobacco and cannabis use are strongly interrelated, but current national and international cessation programs typically focus on one substance, and address the other substance either only marginally or not at all. This study aimed to identify the demand for, and describe the development and content of, the first integrative group cessation program for co-smokers of cigarettes and cannabis. Methods First, a preliminary study using expert interviews, user focus groups with (ex-)smokers, and an online survey was conducted to investigate the demand for, and potential content of, an integrative smoking cessation program (ISCP) for tobacco and cannabis co-smokers. This study revealed that both experts and co-smokers considered an ISCP to be useful but expected only modest levels of readiness for participation.Based on the findings of the preliminary study, an interdisciplinary expert team developed a course concept and a recruitment strategy. The developed group cessation program is based on current treatment techniques (such as motivational interviewing, cognitive behavioural therapy, and self-control training) and structured into six course sessions.The program was evaluated regarding its acceptability among participants and course instructors. Results Both the participants and course instructors evaluated the course positively. Participants and instructors especially appreciated the group discussions and the modules that were aimed at developing personal strategies that could be applied during simultaneous cessation of tobacco and cannabis, such as dealing with craving, withdrawal, and high-risk situations. Conclusions There is a clear demand for a double cessation program for co-users of cigarettes and cannabis, and the first group cessation program tailored for these users has been developed and evaluated for acceptability. In the near future, the feasibility of the program will be evaluated. Trial registration Current Controlled Trials ISRCTN15248397