Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-07-02T00:12:08Z No. of bitstreams: 1 disserta??o Bianca.pdf: 1399857 bytes, checksum: 78bb18bfd92afdca24ea74936e870bf6 (MD5) / Made available in DSpace on 2016-07-02T00:12:08Z (GMT). No. of bitstreams: 1 disserta??o Bianca.pdf: 1399857 bytes, checksum: 78bb18bfd92afdca24ea74936e870bf6 (MD5) Previous issue date: 2015-03-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The development of educational activities to the health workers of Estrat?giaSa?de da Fam?lia ? ESF(Family Health Strategy program) is important to the achievement of an integral work. However it is necessary that such workers have their educational practices guided by the observance of Educa??o Permanente emSa?de ? EPS (Permanent Education in Health) to a major resolubility of the actions demanded by the population. This study aimed to analyze the practice of EPS developed in the Equipe de Sa?de da Fam?lia ? EqSF (Family THealth team) of the municipality of Cama?ari in the State of Bahia by seeking the resolubility of the production of the health care to the users of the ESF and to discuss the construction of knowledge and practices of the EPS to the EqSF by searching the resolubility of the production of health care. So as to this work could be possible we started a study with the discussion about the historicity of the formation of the health workers in Brazil and the main pedagogical conceptions which are present in the health field: Educa??oemServi?o (Education at Job), Educa??oContinuada (Continuing Education) and EPS practices. In the aftermath we discussed the resolubility and the wellness production. It is a matter of a qualitative study, of critical-analytical approach, in a perspective approximated to the dialectical method, having as background two Unidades de Sa?de da Fam?lia ? USF (Basic Health Care Unit), the Departamento de Aten??oB?sica ? DAB (Departament of Primary Health Care) and the Coordena??o de Educa??o Permanente emSa?de ? CEPS (Coordination of Permanent Education in Health) of the town of Cama?ari. The participants of the study constituted two groups: health workers of ESF (group I), DAB?s and CEPS?s managers (group II) summating 26 participants. We used as data collection techniques the semi-structured interview, the systematic observation and the document analysis, and as method of data analysis of content. From the confrontation of data emerged two categories: 1 ? The process of work of the ESF and the (dis)articulation of the EPS in the production of wellness; 2 ? Resolubility of the production of care in the ESF and the construction of knowledge and practices: the protagonism of the EPS. Concerning to the process of work of the EqSF the results foregrounded, there is the development of the group work of the ESF which were studied, notwithstanding the reference and counter-reference system of the municipality does not work out adequately. The comprehension about the EPS, in the vast majority of health workers is associated to knowledge qualification and updating; to the managers it is understood as a process of reflection of the practices to their transformation which is supposed to happen in a continuous and permanent way. We observed some aspects which damage the development of actions of the EPS such as: Professional turnover; lack of professionals with a suitable profile to work in the Primary Health Care; the need of more workers in the CEPS and with the necessary formation to perform such activities, lack of materials for holding such activities; and the fact related to the EPS not being considered as a priority by the management staff. We evinced also that the EPS influences both in the technical capability and EqSF team work and in the intersectoriality with other health services before the contributions of the educational activities to the empowerment of the work in the ESF what makes possible that the health workers develop actions of production of care with major resolubility. We consider that a comprehensive discussion about the EPS as a State policy is Paramount, giving to the health workers and the health managers a major comprehension. In the sense of giving resolubility to the needs of health of the population amidst a production of care to real health. / O desenvolvimento de atividades educativas para os trabalhadores de sa?de da Estrat?gia Sa?de da Fam?lia (ESF) ? importante para a realiza??o de um trabalho integral. Por?m, ? preciso que tais trabalhadores tenham suas pr?ticas educativas orientadas pela Educa??o Permanente em Sa?de (EPS) para a maior resolubilidade das a??es demandadas pela popula??o. Este estudo teve como objetivos analisar a pr?tica da EPS desenvolvida na EqSF do Munic?pio de Cama?ari-BA em busca da resolubilidade da produ??o do cuidado em sa?de aos usu?rios da ESF e discutir a constru??o de saberes e pr?ticas da EPS para a EqSF em busca da resolubilidade da produ??o do cuidado em sa?de. Para tanto iniciamos o estudo com a discuss?o sobre a historicidade da forma??o dos trabalhadores de sa?de no Brasil e as principais concep??es pedag?gicas presentes na sa?de: Educa??o em Servi?o, Educa??o Continuada e EPS. Posteriormente, discutimos a resolubilidade e a produ??o do cuidado. Trata-se de um estudo qualitativo, de abordagem cr?tico anal?tica, numa perspectiva aproximada do m?todo Dial?tico, tendo como cen?rios duas Unidades de Sa?de da Fam?lia (USF), o Departamento de Aten??o B?sica (DAB) e a Coordena??o de Educa??o Permanente em Sa?de de Cama?ari-BA. Os participantes do estudo foram constitu?dos de dois grupos: trabalhadores de sa?de da ESF (Grupo I), gestores do DAB e da CEPS (Grupo II), totalizando 26 participantes. Utilizamos como t?cnicas de coleta de dados a entrevista semi-estruturada, a observa??o sistem?tica e a an?lise de documentos, e como m?todo de an?lise de dados a an?lise de conte?do. A partir do confronto dos dados emergiram duas categorias: 1- PROCESSO DE TRABALHO DA ESF E A (DES) ARTICULA??O DA EPS NA PRODU??O DO CUIDADO: o pensar e o agir dos protagonistas; 2- RESOLUBILIDADE DA PRODU??O DO CUIDADO NA ESF E A CONSTRU??O DE SABERES E PR?TICAS: o protagonismo da EPS. Quanto ao processo de trabalho das EqSF os resultados evidenciaram que h? o desenvolvimento do trabalho em equipe nas USF estudadas, entretanto, ainda n?o flui adequadamente o sistema de refer?ncia e contrarrefer?ncia do munic?pio. A compreens?o sobre a EPS, na maioria dos trabalhadores de sa?de, est? associada ? capacita??o e atualiza??o dos conhecimentos; para os gestores ela ? entendida como um processo de reflex?o das pr?ticas para a sua transforma??o que deve acontecer de forma cont?nua e permanente. Observamos alguns aspectos que prejudicam o desenvolvimento das a??es de EPS como: rotatividade profissional; falta de profissionais com o perfil adequado para atuarem na Aten??o B?sica; necessidade de mais trabalhadores na CEPS e com a forma??o adequada para tal; falta de materiais para realiza??o das atividades; e a EPS n?o ser vista como prioridade pela gest?o. Evidenciamos tamb?m que a EPS influencia tanto na capacidade t?cnica e trabalho em equipe da EqSF quanto na intersetorialidade com os outros servi?os de sa?de, diante das contribui??es das atividades educativas para o desenvolvimento do trabalho na ESF, o que vem possibilitar a consolida??o da ESF, uma vez que permite que os trabalhadores de sa?de desenvolvam a??es de produ??o do cuidado com maior resolubilidade. Consideramos que ? necess?ria uma ampla discuss?o sobre a EPS enquanto uma pol?tica de Estado, oportunizando os trabalhadores de sa?de e gestores uma maior compreens?o, no sentido de dar resolubilidade ?s necessidades de sa?de da popula??o mediante uma produ??o do cuidado na sa?de efetiva.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-07-19T23:28:56Z No. of bitstreams: 1 DISSERTA??O ANDRESSA PRISCILA PIANC? S. LIMA.pdf: 1903052 bytes, checksum: 3d8a27256e27d81bbdd1cf3ad9eee48f (MD5) / Made available in DSpace on 2016-07-19T23:28:56Z (GMT). No. of bitstreams: 1 DISSERTA??O ANDRESSA PRISCILA PIANC? S. LIMA.pdf: 1903052 bytes, checksum: 3d8a27256e27d81bbdd1cf3ad9eee48f (MD5) Previous issue date: 2016-03-23 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Chapada Diamantina ? BA presents endemic especies with ornamental potential among which is Orthophytum mucugense, which occurs in the municipality Mucug?. This species is a target of extractivism and it is considered vulnerable, rendering studies of propagation and conservation of the species necessary. Therefore, the objective of this study was to establish protocols of micropropagation and in vitro conservation of O. mucugense. To that end, morphogenetic responses were evaluated in three types of explants, stem, root and leaf under the effect of different concentrations of the plant growth regulators NAA, 2,4-D and BAP. Sprouts formation in stem explants by direct organogenesis, in basal leaf explants by indirect organogenesis and callus formation in basal root and leaf explants were obtained. The rooting of the shoots was carried out with 1 coal g.L-1 activated for 30 days, and microplants acclimatized in a greenhouse with direct exposure to the environment. These results evince that tissue culture is a viable tool for in vitro propagation of O. mucugense. In in vitro conservation the effect of the medium salts reduction, of osmotic agents and of the retardant ancymidol in the minimum growth of the plants were tested; after 300 days of cultivation, analysis of the plant growth, of the chlorophyll content and of the regenerative capacity were carried out. On the basis of these assessments, the ancymidol, in the concentrations used, is not efficient in minimal growth induction, and the reduction of MS salts to ?3, with the combination of 45 g.L-1 of sucrose with 7.8 g.L-1 of mannitol is indicated for in vitro conservation of O. mucugense. / A Chapada Diamantina ? BA apresenta esp?cies end?micas com potencial ornamental dentre as quais est? a Orthophytum mucugense, que ocorre no munic?pio de Mucug?. Esta esp?cie ? alvo de extrativismo e considerada como vulner?vel, sendo necess?rios estudos de propaga??o e conserva??o da mesma. Portanto, objetivou-se neste trabalho estabelecer protocolos de micropropaga??o e conserva??o in vitro de O. mucugense. Para isto foram avaliadas as respostas morfog?nicas em tr?s tipos de explantes, caulinar, radicular e foliar, sob efeito de diferentes concentra??es dos reguladores vegetais ANA, 2,4-D e BAP. Foram obtidas forma??o de brotos em explante caulinar por organog?nese direta, em explante foliar basal por organog?nese indireta e forma??o de calo em explante foliar basal e radicular. O enraizamento dos brotos foi realizado com 1 g.L-1 de carv?o ativado por 30 dias, e as microplantas aclimatizadas em casa de vegeta??o com exposi??o direta ao ambiente. Estes dados demonstram que a cultura de tecidos ? uma ferramenta vi?vel para a propaga??o in vitro de O. mucugense. Na conserva??o in vitro foram testados o efeito da redu??o de sais do meio, de agentes osm?ticos e do retardante ancymidol no crescimento m?nimo das plantas; ap?s 300 dias de cultivo foram realizadas an?lises de crescimento das mesmas, do teor de clorofila e da capacidade regenerativa. Com base nestas avalia??es o ancymidol, nas concentra??es utilizadas, n?o ? eficiente na indu??o do crescimento m?nimo, e a redu??o de sais MS para ?3 com a combina??o de 45 g.L-1 de sacarose com 7,8 g.L-1 de manitol ? indicada para conserva??o in vitro de O. mucugense.

Indiana University-Purdue University Indianapolis (IUPUI) / The frequency and magnitude of floods in the midcontinental United States have increased in recent decades due to changing precipitation patterns as global temperatures rise. These trends pose major social and economic risks to the region, which is home to tens of millions of Americans and a global agricultural center. It is therefore critical to understand if current fluvial dynamics are within the scope of past fluvial-climate relationships, or if they represent a novel response to recent climate and land-use changes. Presented is a 1600-year-long flood frequency record for the moderately sized (~29,400 km2 watershed) White River, Indiana. Flood frequencies were determined using 14C-based sediment accumulation rates at Half Moon Pond, an oxbow lake on the lower White River’s floodplain. Comparison with regional paleoclimate data shows that White River flooding was frequent when atmospheric circulation resembled the negative mode of the Pacific-North American (PNA) teleconnection, particularly during the Medieval Climate Anomaly (950-1250 CE) and the Current Warm Period (last ~150 years). During these times, the regional climate was dominated by warm-season precipitation originating from the Gulf of Mexico. Conversely, White River flooding was less frequent during the Little Ice Age (1250-1800 CE) when cold-season precipitation from the North Pacific/Arctic dominated (+PNA-like conditions). The pre-1790 CE White River flood history was antiphased with reconstructed Ohio River flood frequencies from southern Illinois. This dynamic is consistent with discharge in small to moderate sized watersheds being sensitive to rainstorm runoff and large watersheds being sensitive to snowmelt runoff. After 1790 CE, flooding frequencies of both river systems increased to their highest levels, despite a shift to -PNA-like conditions. This change was likely due to extensive Euro-American land-clearance, which increased runoff/erosion by reducing evapotranspiration, interception, and infiltration. While the White River responded strongly to climatic conditions in the past that were similar to present conditions (-PNA-like conditions), recent land-use practices have amplified the effects of the current hydroclimate. Since a warming climate is expected to increase regional average precipitation and extreme rainfall events, and that landscape modifications have lowered surface resilience to hydroclimate events, flooding will likely become more frequent in the coming decades.

To diagnose patients suffering from blood clotting disorders latex immununoassays (LIA) can be used. A time consuming manual tangential flow filtration (TFF) process suggests the implementation of an automatic TFF system to improve the efficiency, profitability, and expandability of the production facility of LIA at Nordic Biomarker. Tests were made of the automatic TFF system's ability to perform the desired steps of concentration, dilution and diafiltration, both with purified water and mimicked product. The mimicked product of micro particles (MP) mixed with monoclonal antibodies (mAb) was also used to further test the system's pressure control, safety alarms and stops, and to determine a permeate flux by a critical flux experiment. The results imply a functional TFF system able to automatically concentrate the process fluid and maintain a stable volume during diafiltration, although an additional permeate pump was ordered to be able to attain a fully functional performance of the automatic TFF process. The final part of the implementation was to initiate a validation draft including a risk assessment, OQ plan and PQ plan that resulted in a plan of the main tests to be performed. To conclude, the essential part of the implementation of a high quality and efficient automatic TFF process was conducted to facilitate future expansion of the production of LIA.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-10-24T11:35:35Z No. of bitstreams: 1 DIS_CARLOS_DAVID_GODWARD_COMPLETO.pdf: 1317478 bytes, checksum: b5114678f308871a52be8844a408fe66 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-10-24T11:35:49Z (GMT) No. of bitstreams: 1 DIS_CARLOS_DAVID_GODWARD_COMPLETO.pdf: 1317478 bytes, checksum: b5114678f308871a52be8844a408fe66 (MD5) / Made available in DSpace on 2017-10-24T11:36:01Z (GMT). No. of bitstreams: 1 DIS_CARLOS_DAVID_GODWARD_COMPLETO.pdf: 1317478 bytes, checksum: b5114678f308871a52be8844a408fe66 (MD5) Previous issue date: 2017-08-11 / Conditional Income Transfer Programs, Bolsa Fam?lia Program in Brazil, became an innovative instrument for reducing social inequality in many countries, specifically, in Latin America, where they were widely adopted. These programs have proven effective in several aspects such as reducing poverty and inequality, improving schooling rates, etc. An aspect that has remained unmentioned of these programs was their potential to encourage targeted workers of the program to migrate to the informal labour market in order to remain "invisible" to program managers and, thus, receive the benefits even when they do not qualify according to program standards. This study applies VECM (Vector Error Corrector Model) to show this issue may be occurring in the six Brazilian state capitals, included in the IBGE Monthly Employment Survey, from the creation of the program, in 2004, until March 2016. / Os Programas de Transfer?ncia de Renda Condicionada, Programa Bolsa Fam?lia no Brasil, foram uma forma inovadora de reduzir a desigualdade social em muitos pa?ses, principalmente da Am?rica Latina. Estes programas se mostraram eficientes em v?rios aspectos, como reduzir a pobreza, a desigualdade, melhorar ?ndices de escolaridade, etc. Mas, um aspecto pouco mencionado destes programas, ? o potencial de incentivar os trabalhadores - alvo do programa - a migrar para o mercado laboral informal, com o objetivo de ficarem ?invis?veis? aos gestores do programa e, assim, receberem os benef?cios, ainda que n?o se qualifiquem a eles, pelos n?veis de renda definidos pelo programa. Este trabalho utiliza o VECM (modelo Vector Corretor de Erros) para mostrar que este fato pode estar ocorrendo nas seis capitais do Brasil, que conformaram a Pesquisa Mensal de Emprego do IBGE, desde a cria??o do programa at? mar?o de 2016.

Submitted by PPG Economia do desenvolvimento (economia-pg@pucrs.br) on 2018-01-19T12:58:13Z No. of bitstreams: 1 LUIZ_FELIPE_CAMPOS_FONTES_DIS.pdf: 1157438 bytes, checksum: 5c0dc0f464a309e26c0d2b33d1a2d147 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2018-01-29T12:05:27Z (GMT) No. of bitstreams: 1 LUIZ_FELIPE_CAMPOS_FONTES_DIS.pdf: 1157438 bytes, checksum: 5c0dc0f464a309e26c0d2b33d1a2d147 (MD5) / Made available in DSpace on 2018-01-29T12:10:30Z (GMT). No. of bitstreams: 1 LUIZ_FELIPE_CAMPOS_FONTES_DIS.pdf: 1157438 bytes, checksum: 5c0dc0f464a309e26c0d2b33d1a2d147 (MD5) Previous issue date: 2017-12-20 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The present dissertation consists of two independent essays in public policy evaluation, which estimates the causal effects of two major Brazilian policies, the Mais M?dicos Program (PMM) and the Bolsa Fam?lia Program (PBF). The first essay aims to evaluate the PMM in terms of the provision of physicians, presenting estimates of its impact on hospitalization for ambulatory care sensitive conditions (ACSH). The differences-in-differences method was used with propensity score matching (double difference matching), using three specifications, a falsification test and also a dynamic endogeneity test to confirm the robustness of the results. For the application of this methodology, a panel of municipal data was constructed covering several variables related to socioeconomic, demographic and public health infrastructure characteristics in the cities for the period from 2010 to 2016. First, it is shown that the program had an effect on increasing the density of physicians. Then, the main results show a significant reduction in hospital admissions in treated municipalities with an increasing and perceptible effect in the second year of the program. The second essay aims to analyze the impact of PBF in Brazilian intern migration. The Average Treatment Effect on Treated (ATT) was estimated through Propensity Score Matching (PSM) using microdata from Brazilian Census 2010. The results show that the program stimulates recipients? remigration to their home states and retain those already established in a locality. The estimates are robust in the possible presence of omitted variables and in different matching specifications. By exploring regional heterogeneity, we have shown that the impacts on return and retention are greater for the Northeast, the concentrating region of return migrations and Program beneficiaries. Through Dose Response Function it is also shown that the results are positively correlated with the monetary values transfer by the Bolsa Fam?lia, which may indicate a channel for the empirical results. / A presente disserta??o consiste em dois ensaios independentes em avalia??o de pol?ticas p?blicas, os quais estimam efeitos causais de duas pol?ticas brasileiras de grande apelo, o Programa Mais M?dicos (PMM) e o Programa Bolsa Fam?lia (PBF). O primeiro ensaio objetiva avaliar o PMM no que se refere ao provimento de m?dicos, apresentando estimativas de seu impacto nas interna??es por condi??es sens?veis ? aten??o prim?ria (ICSAP). Foi empregado o m?todo de diferen?as-em-diferen?as com pareamento por escore de propens?o (double difference matching). Para a aplica??o desta metodologia, foi constru?do um painel de dados municipais abrangendo diversas vari?veis relativas ?s caracter?sticas socioecon?micas, demogr?ficas e de infraestrutura p?blica de sa?de nas cidades para o per?odo de 2010 a 2016. Como um primeiro est?gio da an?lise, apresenta-se o impacto do programa sobre o n?mero de m?dicos nos munic?pios benefici?rios. As estimativas sugerem que houve aumento significativo na oferta de m?dicos por conta do PMM. Em um segundo est?gio mostra-se que o programa teve impacto na redu??o de interna??es hospitalares evit?veis nos munic?pios mais carentes em termos de oferta de sa?de, com um efeito crescente e percept?vel a partir do segundo ano da pol?tica. Al?m disso, algumas estrat?gias adotadas garantiram a robustez dos resultados como um teste de endogeneidade din?mica, estima??es para anos anteriores ao programa, e regress?es a partir de diferentes especifica??es. O segundo ensaio estima o impacto do PBF sobre a migra??o inter-estadual brasileira. A estima??o do efeito do tratamento m?dio sobre os tratados (Average Treatment Effect on Treated ? ATT) foi feita por meio do Propensity Score Matching (PSM) a partir dos microdados do Censo Demogr?fico de 2010, em que foi poss?vel analisar indiv?duos migrantes, migrantes retornados e n?o retornados. As estima??es apontam que o PBF estimula a remigra??o dos benefici?rios aos seus estados de origem, al?m de manter aqueles que j? est?o fixos em uma localidade, mesmo que essa n?o seja a sua de nascimento. Os resultados n?o se mostraram sens?veis ? poss?vel presen?a de vari?veis omitidas e as demais especifica??es utilizadas nas estima??es. Ao explorar a heterogeneidade regional, mostramos que os impactos sobre remigra??o e reten??o s?o maiores para regi?o Nordeste, a qual concentra grande parte dos remigrados e benefici?rios do PBF. Ainda, por meio da Fun??o Dose Resposta (FDR), mostra-se que os resultados s?o positivamente correlacionados com os valores monet?rios pagos pelo programa, o que pode indicar um mecanismo para os resultados.

Submitted by PPG Servi?o Social (servico-social-pg@pucrs.br) on 2018-01-17T17:29:09Z No. of bitstreams: 1 Disserta??o - Alexia Dorneles.pdf: 2217107 bytes, checksum: 1831a8335af11db921df01b16d3b2b86 (MD5) / Rejected by Caroline Xavier (caroline.xavier@pucrs.br), reason: Devolvido devido a falta dos anexos no arquivo PDF. on 2018-01-29T11:15:30Z (GMT) / Submitted by PPG Servi?o Social (servico-social-pg@pucrs.br) on 2018-01-30T10:31:30Z No. of bitstreams: 1 Disserta??o - Alexia Dorneles.pdf: 2214256 bytes, checksum: 9ee8a50d97b42e6297463c32cbf4b64c (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2018-02-05T13:20:37Z (GMT) No. of bitstreams: 1 Disserta??o - Alexia Dorneles.pdf: 2214256 bytes, checksum: 9ee8a50d97b42e6297463c32cbf4b64c (MD5) / Made available in DSpace on 2018-02-05T13:23:21Z (GMT). No. of bitstreams: 1 Disserta??o - Alexia Dorneles.pdf: 2214256 bytes, checksum: 9ee8a50d97b42e6297463c32cbf4b64c (MD5) Previous issue date: 2018-01-08 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The purpose of this dissertation is to analyze how the care of the families of children and adolescents hosted institutionally and assisted by the Social Assistance Policy in a municipality of the metropolitan region of Porto Alegre / RS has been constituted in the perspective of guarantee the right to family and community living, in order to contribute with subsidies in the qualification of this public policy. This is a qualitative research, developed through documentary research in ten (10) judicial processes, concerning the institutional reception of children and adolescents, which were in process in the Juiz de Inf?ncia e Juventude (JIJ), in the municipality of the metropolitan region of Porto Alegre, in the years 2016 and 2017, as well as in documents that give guidelines for institutional reception in Brazil, which deal with the right to family and community coexistence of children and adolescents: National Plan for the Promotion, Protection and Defense of the Right of Children and Adolescents to Family and Community Coexistence (2006a); Technical Guidelines for Reception Services for Children and Adolescents (2009) and Law No. 12.010, of August 3, 2009, which provides for Adoption (2009). Empirical research was also developed through interviews with seven (7) professionals who are included in the Social Assistance Policy and in the Tutelary Council of said municipality. In this way, through this study, it was observed that the reasons that contribute to the institutional reception of children and adolescents refer to the situation of social vulnerability, poor housing conditions, neglect and intra-family violence. In addition, some families were in a situation of unemployment and informal work, which also corroborated for the weakening of the bonds. In this way, it is understood that, in the present times, a journey back to the past is lived, since there is a regression in the realization of the rights of childhood and adolescence, because one advances in the legal context, however, through the advance of the neoliberal offensives and conservative, returns to the minorist logic in meeting the demands presented by children and adolescents. Also, it is understood that the legal argument has been constructed through perspectives of the moralization of the social question. In this way, a cycle is created, where the family suffers the impact of the capital dynamics, but is blamed, which corroborates for the institutional reception and the loss of family power. Thus, it has been observed that families that have their children institutionally are exposed to a context of (de) social protection. Among the challenges identified for the realization of the right to family and community coexistence of children and adolescents, the current context of precariousness of the Social Assistance Policy of the municipality under investigation is highlighted, since this public policy is surrounded by manifestations of the process of precariousness of the such as outsourcing and the high turnover of professionals, mid-level and higher. In addition, it was observed that there is a lack of investment in the service that offers basic social protection, which, together with the manifestations of the precarious work process, contributes to the discontinuity of care and follow-up of families. In addition, through this study, it was observed that the right to family and community coexistence of children and adolescents who are institutionally welcomed has been effected by violating the right to live with the family of origin. Regarding the possibilities, it is understood that, by means of a public tender, stability would be guaranteed to the professionals, for the development of intersectoral work. In addition, it is necessary to invest more in social policies - in this case in the Social Assistance Policy, with human and material resources, in order to develop a work based on integral protection, contributing with the families in facing the expressions of the social question; in the reduction of the chances of referral of children and adolescents to the institutional reception, as well as the length of stay of these subjects in the host institutions, with a view to the realization of the right to family and community coexistence. / O objetivo da presente disserta??o consiste em analisar como vem se constituindo o atendimento das fam?lias de crian?as e adolescentes acolhidas (os) institucionalmente e atendidas (os) pela Pol?tica de Assist?ncia Social em um munic?pio da regi?o metropolitana de Porto Alegre/RS, na perspectiva da garantia do direito ? conviv?ncia familiar e comunit?ria, a fim de contribuir com subs?dios na qualifica??o dessa pol?tica p?blica. Trata-se de uma pesquisa qualitativa, desenvolvida atrav?s de pesquisa documental em dez (10) processos judiciais, referentes ao acolhimento institucional de crian?as e adolescentes, que estavam em tramita??o no Juizado da Inf?ncia e Juventude (JIJ), no munic?pio da regi?o metropolitana de Porto Alegre, nos anos de 2016 e 2017, como tamb?m em documentos que d?o as diretrizes do acolhimento institucional no Brasil e que versam sobre o direito ? conviv?ncia familiar e comunit?ria de crian?as e adolescentes: Plano Nacional de Promo??o, Prote??o e Defesa do Direito de Crian?as e Adolescentes ? conviv?ncia Familiar e Comunit?ria (2006a); Orienta??es T?cnicas para os Servi?os de Acolhimento para Crian?as e Adolescentes (2009) e a Lei n? 12.010, de 3 de Agosto de 2009 que disp?e sobre a Ado??o (2009). Tamb?m se desenvolveu pesquisa emp?rica, por meio de entrevistas com sete (7) profissionais que est?o inseridos na Pol?tica de Assist?ncia Social e no Conselho Tutelar do referido munic?pio. Nesse caminho, atrav?s desse estudo, observou-se que as raz?es que contribuem para o acolhimento institucional de crian?as e adolescentes se referem ? situa??o de vulnerabilidade social, condi??es prec?rias de moradia, neglig?ncia e viol?ncia intrafamiliar. Ademais, algumas fam?lias se encontravam em situa??o de desemprego e trabalho informal, o que tamb?m corroborou para a fragiliza??o dos v?nculos. Dessa maneira, entende-se que, na contemporaneidade, vive-se uma viagem de volta ao passado, pois h? um retrocesso na efetiva??o dos direitos da inf?ncia e da adolesc?ncia, pois se avan?a no contexto legal, contudo, atrav?s do avan?o das ofensivas neoliberal e conservadora, retorna-se ? l?gica menorista no atendimento ?s demandas apresentadas pelas crian?as e adolescentes. Outrossim, compreende-se que o argumento jur?dico tem sido constru?do por meio de perspectivas da moraliza??o da quest?o social. Dessa forma, cria-se um ciclo, onde a fam?lia sofre o impacto da din?mica do capital, mas ? culpabilizada, o que corrobora para o acolhimento institucional e para a perda do poder familiar. Sendo assim, percebeu-se que as fam?lias que t?m os filhos acolhidos institucionalmente est?o expostas a um contexto de (des)prote??o social. Dentre os desafios identificados para a efetiva??o do direito ? conviv?ncia familiar e comunit?ria de crian?as e adolescentes, destaca-se o atual contexto de precariza??o da Pol?tica de Assist?ncia Social do munic?pio investigado, visto que essa pol?tica p?blica est? envolta por manifesta??es do processo de precariza??o do trabalho, tais como a terceiriza??o e a alta rotatividade de profissionais, de n?vel m?dio e superior. Al?m disso, observou-se que h? falta de investimento no servi?o que oferta prote??o social b?sica, que somada as manifesta??es do processo de precariza??o do trabalho contribui para a descontinuidade do atendimento e acompanhamento ?s fam?lias. Ademais, atrav?s desse estudo observou-se que o direito a conviv?ncia familiar e comunit?ria das crian?as e adolescentes que encontram-se acolhidas (os) institucionalmente vem sendo efetivado por meio da viola??o do direito a conviv?ncia com a fam?lia de origem. Quanto ?s possibilidades, entende-se que, por meio de concurso p?blico, se garantiria estabilidade aos profissionais, para o desenvolvimento de um trabalho intersetorial. Ademais, se faz necess?rio maior investimento nas pol?ticas sociais ? neste caso na Pol?tica de Assist?ncia Social, com recursos humanos e materiais, a fim de desenvolver um trabalho baseado na prote??o integral, contribuindo com as fam?lias no enfrentamento das express?es da quest?o social; na diminui??o das chances de encaminhamento das crian?as e adolescentes para o acolhimento institucional, bem como no tempo de perman?ncia desses sujeitos nas institui??es de acolhimento, na perspectiva da efetiva??o do direito ? conviv?ncia familiar e comunit?ria.

Submitted by Jadson Francisco de Jesus SILVA (jadson@uefs.br) on 2018-01-22T23:33:37Z No. of bitstreams: 1 DISSERTA??O PDF.pdf: 1421296 bytes, checksum: d0447d18981b9ca5dfeb2437db3a6a97 (MD5) / Made available in DSpace on 2018-01-22T23:33:37Z (GMT). No. of bitstreams: 1 DISSERTA??O PDF.pdf: 1421296 bytes, checksum: d0447d18981b9ca5dfeb2437db3a6a97 (MD5) Previous issue date: 2015-08-28 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Introduction: accountability is understood as a powerful tool in health work process, being able to provide remarkable changes in the organization of care model, aimed at solving the demands of people who enter the health services. However, the accountability assumed by the worker or health care team when hinged to the host, qualified listening and create bonds, is configured in a key agency and can provide closer relations between workers and users, promoting the recognition of the actual conditions and health needs of people and the community. Objectives: To discuss the different approaches on accountability and present them in an articulated wayunderstanding relational device associated with the definition of essential tool in the development of health work proposed for the Primary Health Care (ABS); analyze how the accountability of staff working in the Family Health Strategy in a city of Bahiahas been built in search of solving the demands of users. Methodology: qualitative and reflective approach was used in this study the. Therefore, we sought to identify texts through theoretical review, which addressed the different dimensions of health accountability, the Virtual Health Library (BVS) and Higher Education Personnel Improvement Coordination database(CAPES) from searching the word "accountability", identifying initially 348 studies, 38 of them were selected, relevant to the development to the study. Semi-structured interviews with users (13), health workers (22) and leaders (09), totalling 44 interviewed, and systematic observation of 07 (seven) Family Health Units in a municipality of Bahia were conducted. Data analysis was guided by the theme and reflective content analysis, and analytic flowchart. Results: accountability can be built from the user's first contact with the service, with potential to expand more responsive practices between workers and users. However, the organization of services in the Family Health Strategy (ESF) is driven by scheduled or induced demand focusing on users residing in the territory of social health unit, in certain lines of care, with directions agenda, attention occurring in the specific dayin the week and delimitation of quantitative spaces. The attention to spontaneous demand is organized based on the recognition of acute demand, based on illness and in need of immediate care; and non-acute demand, represented by situations that can wait for the service. It was identified lack of teamwork, reflecting a context in which every employee carries accountability for their practice in isolation, disjointed and directed almost exclusively induced demands. Concluding Remarks: The organization demands for ESF happens through the actions programming, directed to induced demand, based on individualism of the subject. The care to spontaneous demand has been driven by the logic of care to acute demand when there are urgent attention. The accountability for the development of health practices is taken individually, for each worker performs his function without promoting joint practices with the other team members. Finally, it is necessary to understand that accountability is underpinned in the actions of all subjects involved, associated with interconnected health services, making this way an articulated network of assurance continued care to users and families. / Introdu??o: a responsabiliza??o ? compreendida como uma potente ferramenta no processo de trabalho em sa?de, sendo capaz de proporcionar mudan?as significativas na organiza??o do modelo de aten??o, visando ? resolubilidade das demandas das pessoas que adentram os servi?os de sa?de. No entanto, a responsabiliza??o assumida pelo trabalhador ou equipe de sa?de, quando articulada ao acolhimento, escuta qualificada e cria??o de v?nculo, configura-se em um essencial agenciamento, podendo proporcionar estreitamento das rela??es entre trabalhadores e usu?rios, favorecendo o reconhecimento das reais condi??es e necessidades de sa?de das pessoas e da coletividade. Objetivos: discutir as diferentes abordagens sobre a responsabiliza??o e apresent?-las de maneira articulada a compreens?o de dispositivo relacional, associada ? defini??o de ferramenta essencial no desenvolvimento do trabalho em sa?de proposta para a Aten??o B?sica ? Sa?de (ABS); analisar como tem sido constru?da a responsabiliza??o das equipes que atuam na Estrat?gia Sa?de da Fam?lia em um munic?pio da Bahia, em busca da resolubilidade das demandas dos usu?rios. Metodologia: utilizou-se nesse estudo a abordagem qualitativa e reflexiva. Para tanto, buscou-se identificar textos por meio de revis?o te?rica, que abordavam as distintas dimens?es da responsabiliza??o em sa?de, na Biblioteca Virtual em Sa?de (BVS) e na base de dados da Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES), a partir do argumento de busca "responsabiliza??o", identificando-se inicialmente 348 estudos, sendo selecionados 38, considerados relevantes para o desenvolvimento para o estudo. Adotou-se tamb?m, entrevistas semiestruturadas com usu?rios (13), trabalhadores de sa?de (22) e dirigentes (09), totalizando 44 entrevistados, e a observa??o sistem?tica de 07 (sete) Unidades de Sa?de da Fam?lia em um munic?pio da Bahia. A an?lise de dados foi orientada pela an?lise de conte?do tem?tica e reflexiva, e fluxograma analisador. Resultados: a responsabiliza??o pode ser constru?da desde o primeiro contato do usu?rio com o servi?o, com potencial de ampliar as pr?ticas mais responsivas entre trabalhadores e usu?rios. No entanto, a organiza??o dos servi?os na Estrat?gia Sa?de da Fam?lia (ESF) ? orientada pela demanda programada ou induzida com foco em usu?rios que residem no territ?rio social da unidade de sa?de, em determinadas linhas de cuidado, com direcionamentos de agenda, aten??o em dia da semana espec?fico e delimita??o de quantitativo de vagas. A aten??o ? demanda espont?nea se organiza com base no reconhecimento da demanda aguda, baseada na enfermidade e na necessidade de atendimento imediato; e a demanda n?o?aguda, representadas por situa??es que podem aguardar o atendimento. Identificou-se aus?ncia de trabalho em equipe, reflexo de um contexto em que cada trabalhador exerce a responsabiliza??o em sua pr?tica de forma isolada, desarticulada e direcionada quase que exclusivamente, as demandas induzidas. Considera??es finais: A organiza??o das demandas na ESF acontece por meio da programa??o de a??es, direcionadas ? demanda induzida, embasada no individualismo do sujeito. A aten??o ? demanda espont?nea tem sido orientada pela l?gica do atendimento ? demanda aguda, quando h? urg?ncia de aten??o. A responsabiliza??o pelo desenvolvimento das pr?ticas em sa?de ? assumida individualmente, pois cada trabalhador desempenha sua fun??o sem promover articula??o das pr?ticas com os demais membros da equipe. Por fim, se faz necess?rio compreender que, a responsabiliza??o se concretiza nas a??es de todos os sujeitos envolvidos, associada a servi?os de sa?de interligados, compondo desta forma uma rede articulada com garantia do cuidado continuado aos usu?rios e fam?lias.

Submitted by Jadson Francisco de Jesus SILVA (jadson@uefs.br) on 2018-07-20T21:53:39Z No. of bitstreams: 1 DISSERTA??O PAULO ROBERTO finalz?o 09 03.pdf: 3626215 bytes, checksum: a916a4a7fbf307b65ccad4330d1dd18c (MD5) / Made available in DSpace on 2018-07-20T21:53:39Z (GMT). No. of bitstreams: 1 DISSERTA??O PAULO ROBERTO finalz?o 09 03.pdf: 3626215 bytes, checksum: a916a4a7fbf307b65ccad4330d1dd18c (MD5) Previous issue date: 2018-02-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Study qualitative, exploratory, with the objective of understanding the experiences of families of children with microcephaly by Zika virus. For the production of empirical data we explore the narratives of relatives contained in videos posted on the YouTube Internet platform published between 10/01/2015 and 07/31/2016, as well as narratives obtained from an in-depth interview, of the story-theme design applied in 11 family members of children with microcephaly attended at the Association of Parents and Friends of the Exceptional in Feira de Santana, as well as field diary material. The data collection took place between September and November 2017. For the treatment of the data we adopted the thematic content analysis and the iconographic analysis. The results are organized in: Article 1 - Bad news: experiences and feelings of families regarding the diagnosis of microcephaly by Zika virus; A session entitled: Understanding the family dynamics of study participants; Article 2 - "Well run, very fast ...": experiences of care of mothers of children with microcephaly by Zika; Article 3 - Family organization to take care of the child with microcephaly by z?ka virus. Microcephaly is revealed in the prenatal period, through imaging tests, or during the immediate or late postpartum. Relatives live with feelings of sadness, despair, pain, fright, commotion, disorientation and terror. After diagnosis, family members seek to understand microcephaly through internet resources, and question God's permission and the relevance of scientific knowledge. Mothers experience day-to-day organizing and cleaning the home environment, caring for their children and the specific care of the child with microcephaly, regarding lullaby, since children cry frequently, requiring the mother to spend hours with the child in the lap; Give a shower; change diapers; to feed; play; and, stimulate. They learn to differentiate cognitive, psychomotor, auditory, and visual impairments; recognize progress in the development and new needs of children; identify episodes of seizure; consider patience and attention relevant to care; and, seek to learn about new thematic and unknown terms such as calcifications. Family members build a network of solidarity and unity for the benefit of the child, family relationships are strengthened, bringing together previously conflicting relationships. Caregivers include mothers, fathers, grandparents, sisters, cousins, aunts, friends and neighbors, with the mother being the protagonist who also coordinates and defines the roles played by other people. Family members practice care that has been organized in four dimensions: "Take care"; Encourage; Access Resources and Services. We recommend that family members and health workers attend to the restriction of social interaction, weakening marital relationships, jealousy behaviors on the part of siblings, worsening of grandparents' health conditions, and financial difficulties that may affect the family of children with microcephaly. / Estudo qualitativo, do tipo explorat?rio, com objetivo de compreender as experi?ncias de fam?lias de crian?as com microcefalia por Zika v?rus. Para produ??o de dados emp?ricos exploramos as narrativas de familiares contidas em v?deos postados na plataforma virtual da internet YouTube publicados entre 01/10/2015 e 31/07/2016, e tamb?m narrativas obtidas de entrevista em profundidade, do desenho est?ria-tema aplicados em 11 familiares de crian?as com microcefalia atendidos na Associa??o de Pais e Amigos dos Excepcionais em Feira de Santana, al?m de material do di?rio de campo. A coleta de dados ocorreu entre setembro a novembro de 2017. Para tratamento dos dados adotamos a an?lise de conte?do tem?tica e a an?lise iconogr?fica. Os resultados encontram-se organizados em: Artigo 1 ? M?s not?cias: experi?ncias e sentimentos de fam?lias face o diagn?stico de microcefalia por Zika v?rus; Uma se??o intitulada: Compreendendo a din?mica familiar dos participantes do estudo; Artigo 2 ? ?Bem corrido, muito corrido...?: experi?ncias de cuidado de m?es de crian?as com microcefalia por Zika; Artigo 3 ? Organiza??o familiar para cuidar da crian?a com microcefalia por z?ka v?rus. A microcefalia ? revelada no per?odo pr?-natal, atrav?s de exames de imagens, ou durante o p?s-parto imediato ou tardio. Os familiares convivem com sentimentos de tristeza, desespero, dor, susto, como??o, desorienta??o e terror. Ap?s o diagn?stico, os familiares buscam compreender a microcefalia atrav?s dos recursos da internet, e questionam a permiss?o de Deus e a relev?ncia do conhecimento cient?fico. As m?es experienciam o dia a dia organizando e limpando o ambiente dom?stico, exercendo os cuidados aos filhos e o cuidado espec?fico ? crian?a com microcefalia, referentes a: ninar, pois as crian?as choram com frequ?ncia, necessitando que a m?e passe horas com a crian?a no colo; dar banho; trocar fralda; alimentar; brincar; e, estimular. Elas aprendem a diferenciar as defici?ncias cognitivas, psicomotoras, auditivas e visuais; reconhecem os avan?os no desenvolvimento e as novas necessidades das crian?as; identificam epis?dios de convuls?o; consideram a paci?ncia e a aten??o relevantes para o cuidado; e, buscam apreender sobre novas tem?ticas e termos desconhecidos como calcifica??es. Os familiares constroem uma rede de solidariedade e uni?o em prol da crian?a, as rela??es familiares s?o fortalecidas, aproximando rela??es antes conflituosas. Participam do cuidado as m?es, pais, av?s, irm?s (os), primos (as), tias (os), amigas e vizinhas, havendo protagonismo da m?e que tamb?m coordena e define os papeis desempenhados pelas outras pessoas. Os familiares exercem cuidados que foram organizados em quatro dimens?es: Cuidar Integralmente; ?Tomar Conta?; Estimular; Acessar Recursos e Servi?os. Recomendamos que os familiares e trabalhadores da sa?de atentem para a restri??o do conv?vio social, enfraquecimento das rela??es conjugais, comportamentos que indiquem ci?mes por parte dos irm?os, agravamento das condi??es de sa?de das av?s e dificuldades financeiras que podem repercutir na fam?lia de crian?as com microcefalia.

Submitted by Jadson Francisco de Jesus SILVA (jadson@uefs.br) on 2018-07-23T21:46:37Z No. of bitstreams: 1 DISSERTA??O MESTRADO NEUZA SANTOS DE JESUS - vers?o em PDF.pdf: 1783120 bytes, checksum: 82f09dd48cb5ef09234d960d913f8ea9 (MD5) / Made available in DSpace on 2018-07-23T21:46:37Z (GMT). No. of bitstreams: 1 DISSERTA??O MESTRADO NEUZA SANTOS DE JESUS - vers?o em PDF.pdf: 1783120 bytes, checksum: 82f09dd48cb5ef09234d960d913f8ea9 (MD5) Previous issue date: 2016-06-16 / The Family Health Strategy (FHS) in the context of the Unified Health System (SUS) is a tool to the reorganization of primary care in the country, covering the search for mechanisms to consolidate the work practices in meeting the demands social, contemplating the search for solving the individual and collective contexts. This aspect goes back to rethink health practices, for the purpose to serve as support available to users, to be able to serve you in full, respecting their economic, social and cultural reality. Thus, it is expected that such practices are summarize in search of a model of care that besides the biomedical aspects, articulate actions that integrate the habits, traditions and cultures of everyone and any old users, for example, of this population. For this reason, the bibliographical study of the research purpose to analyze the care production process in the FHS for the scope of solving the health care of indigenous peoples in Brazil based on a total of 14 (fourteen) scientific works published in the period from 2010 to 2014, on the basis of data from the Virtual Health Library and Portal CAPES. We used the method of content analysis for to explore these productions from nine units of meaning: Labor AIS Accessibility Work Process, Interculturalism, Home, Bonding, Completeness, Attention Model and Differentiated Attention. Once grouped, was made an empirical category ?Solvability Production and Care to the Indigenous in the FHS: the gap between official policy and practice. Because, despite the current National Health Policy of Indigenous Peoples in Brazil to be an important stimulus for development assistance practices to glimpse the importance of access and care production of integral to theses peoples, in practice still is imperceptible because the absence of services that enhance the indigenous culture, and consequently such qualified professionals to missing. Like this, does not exists dialogue and relationship between knowledges and practices academics and indigenous, showing the dislocation between the cultural diversity and the devaluation of exchange of experiences and knowledges between professionals and users, mainly because the difficulty in communication against of the diversity of the indigenous dialogues. For what the production of care provided to indigenous peoples has solvability depends on a maturing so much political how much operational in articulation of the health actions. This because professionals, users and families, and society itself, can be viewed as elements assets of the interactions established in the sense of favor the interaction between the users and the health services. Thus we will be promoted solvability of the demanded questions of the health care valuing the culture of indigenous peoples. This reality also requires the Health?s professionals a rethink about their training curricula in the sense of they can talk and learn the cultural diversity of the indigenous people. / A Estrat?gia de Sa?de da Fam?lia (ESF), no contexto do Sistema ?nico de Sa?de (SUS), constitui uma ferramenta que visa ? reorganiza??o da Aten??o B?sica no pa?s, contemplando a busca de mecanismos que possam consolidar as pr?ticas de trabalho no atendimento ?s demandas sociais, contemplando a busca pela resolubilidade no contexto individual e coletivo. Tal aspecto remonta a um repensar as pr?ticas de Sa?de, a fim de que sirva como suporte disponibilizado aos usu?rios, sendo capaz de atend?-lo de forma integral, respeitando-se sua realidade econ?mica, social e cultural. Desse modo, espera-se que tais pr?ticas busquem um modelo de Sa?de que, al?m dos aspectos biom?dicos, articule a??es que integrem os h?bitos, as tradi??es e culturas de todo e qualquer usu?rio, por exemplo, os povos ind?genas. Por essa raz?o, o estudo bibliogr?fico desta pesquisa cont?m uma abordagem qualitativa, cujo objetivo ? analisar o processo da produ??o do cuidado na ESF, quanto ao alcance da resolubilidade na aten??o ? Sa?de dos povos ind?genas no Brasil, a partir de 14 (quatorze) produ??es cient?ficas publicadas no per?odo de 2010 a 2014, nas bases de dados da Biblioteca Virtual em Sa?de e no Portal da CAPES. Utilizamos o m?todo da An?lise de Conte?do para explorar tais produ??es, a partir de nove n?cleos de sentido: Trabalho do AIS, Acessibilidade, Processo de Trabalho, Interculturalidade, Acolhimento, V?nculo, Integralidade, Modelo de Aten??o e Aten??o diferenciada. Agrupados, constru?mos a categoria emp?rica ?Resolubilidade na Produ??o do Cuidado ? Sa?de do Povo Ind?gena na ESF: o descompasso entre a pol?tica oficial e a pr?tica?. Pois, apesar da atual Pol?tica Nacional de Sa?de dos Povos Ind?genas no Brasil constituir um importante est?mulo ao desenvolvimento de pr?ticas de assist?ncia que vislumbrem a import?ncia do acesso e a integralidade da produ??o do cuidado a esses povos, na pr?tica, ainda ? impercept?vel, devido ? aus?ncia de servi?os que valorizem a cultura ind?gena e, consequentemente, faltam profissionais capacitados para tal. Assim, falta di?logo na articula??o entre os saberes e pr?ticas acad?micos e ind?genas, mostrando a desarticula??o entre a diversidade cultural e a desvaloriza??o da troca de experi?ncias e saberes entre profissionais e usu?rios, principalmente em fun??o da dificuldade de comunica??o diante da diversidade de dialetos ind?genas. Para que a produ??o do cuidado prestado aos povos ind?genas tenha resolubilidade, depende-se de um amadurecimento tanto pol?tico quanto operacional na articula??o das a??es em Sa?de. Isso porque, profissionais, usu?rios e familiares, e a pr?pria sociedade, devem ser visualizados como elementos ativos das intera??es estabelecidas, no sentido de se favorecer a intera??o entre os usu?rios e os servi?os de Sa?de. Dessa forma, promover-se-? a resolubilidade de quest?es demandadas do atendimento ? sa?de, valorizando-se a cultura dos povos ind?genas. Tal realidade tamb?m exige dos profissionais de Sa?de um repensar sobre os seus curr?culos formativos, no sentido de se dialogar e aprender a diversidade cultural do povo ind?gena.