Programa de Pós-Graduação em Saúde Coletiva - FACISA
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Master Thesis O ensino em saúde coletiva à luz do modelo de ação e raciocínio pedagógico de Lee Shulman(Universidade Federal do Rio Grande do Norte, 2025-09-29) Oliveira, Samara Barreto de; Telles, Mauricio Wiering Pinto; Almeida Júnior, José Jailson de; https://orcid.org/0000-0001-7448-0703; http://lattes.cnpq.br/8768677759534396; https://orcid.org/0000-0002-5568-6877; http://lattes.cnpq.br/3146268167204989; https://orcid.org/0000-0001-6238-5928; http://lattes.cnpq.br/6726953502848560; Severo, Ana Kalliny de Sousa; https://orcid.org/0000-0002-9548-6394; http://lattes.cnpq.br/5170430928839162; Lima, Bárbara Patrícia da SilvaTeaching Public Health in higher education constitutes a strategic field for training critical, reflective health professionals capable of responding to the complex demands of the Brazilian Unified Health System (SUS). However, teaching in this area still faces weaknesses related to pedagogical training, institutional conditions, and curricular integration. In light of this scenario, this research aimed to understand the nature of the faculty working in public health at a public higher education institution in Rio Grande do Norte, as well as to analyze their pedagogical practices, strengths, and challenges, using Lee Shulman's Pedagogical Reasoning and Action Model as a theoretical framework. This is a descriptive qualitative investigation conducted with faculty members affiliated with the Trairi School of Health Sciences (FACISA) through document analysis and semi-structured interviews. The results revealed a predominantly female faculty, with multidisciplinary training and temporary positions, revealing a heterogeneous profile that brings together different perspectives on public health, but also expresses instability and precarious work. Content selection and organization were described as guided by the curriculum's structuring elements and core competencies, but also influenced by the student profile and the professor's domain knowledge. A growing appreciation for active methodologies was noted, associated with student leadership, practical involvement in practical scenarios, and the use of digital technologies. However, traditional practices still persist in certain contexts, denoting connections between innovation and the reproduction of pedagogical models. Among the strengths, collective planning, interdisciplinarity, and the use of diverse resources in the knowledge representation stage stood out, which fosters meaningful learning. Challenges, however, were related to structural and territorial limitations, insufficient workload, low student participation, and the lack of institutional pedagogical support. Faculty reported difficulties in sharing teaching control, work overload, and training gaps in didactics and pedagogy, factors that weaken the consolidation of more critical and reflective practices. The conclusion is that Public Health teaching at the institution under study is intentionally organized and aligns with Shulman's premises, but faces structural, pedagogical, and institutional barriers that compromise its effectiveness. This reinforces the urgent need for investment in teacher training, strengthening working conditions, and encouraging scientific debates to improve teaching skills and enhance the development of professionals capable of transformative work in the field of public health.Master Thesis Análise das falas de familiares e usuários do CAPS diante das camadas distais do modelo de Dahlgren e Whitehead sobre determinantes sociais em saúde(Universidade Federal do Rio Grande do Norte, 2024-12-20) Santos, Flávia Arichelle Cavalcante dos; Távora, Rafaela Carolini de Oliveira; https://orcid.org/0000-0003-0644-668X; http://lattes.cnpq.br/4017906740512071; http://lattes.cnpq.br/0777338531393229; Valença, Cecilia Nogueira; https://orcid.org/0000-0003-3998-3983; http://lattes.cnpq.br/2788316719185705; Lucena, Silvia Kalyma PaivaIntroduction: Mental well-being encompasses intrinsic and extrinsic factors of human beings, including biological, psychological, emotional, and sociocultural factors inherent to each society. Psychosocial Care Centers function as specialized care facilities for individuals with severe mental disorders and distress, integrating the network of outpatient care. Objective: To analyze the statements of family members and users of the Psychosocial Care Center regarding the layers Living and working conditions and General socioeconomic, cultural, and environmental conditions, according to the Dahlgren and Whitehead model. Method: This is a cross-sectional, descriptive, and exploratory study with a qualitative approach. Data collection took place at the Chiquita Bacana Psychosocial Care Center II, located in the municipality of Santa Cruz, Rio Grande do Norte, in the Trairi region. The inclusion criteria considered all users aged 18 and over who sought care at the Psychosocial Care Center during the data collection period and were accompanied by a person they identified as family. Structured interviews were conducted and divided into thematic categories. The findings were analyzed using the Social Determinants of Health model by Dahlgren and Whitehead. Results: Statements from 12 users and 12 family members were analyzed and are presented in thematic categories. Users and family members were unemployed or engaged in informal activities; those working expressed satisfaction with their roles. The primary source of income cited was social assistance programs and pension benefits. Most respondents lived in their own homes. The majority lived with others, with an average of three to four people per household. Regarding water supply, participants reported difficulties in access. Basic sanitation conditions included mentions of septic tanks and drainage systems; for waste collection, burning waste and collection vehicles were cited. Users and family members reported consuming three to four meals per day. The most frequently mentioned healthcare services were Basic Health Units and regional reference hospitals; the most commonly cited public services were health posts and educational institutions. Participants showed little interest in participating in cultural activities or those related to public policies. Most participants stated they lived in areas with adequate public lighting. Reports on urban paving included mentions of both unpaved and paved streets, with the greatest dissatisfaction related to public safety. Conclusion: The analysis of the collected statements suggests that living and working conditions, along with socioeconomic, cultural, and environmental factors, play a determining role as protective or vulnerability factors affecting the mental health of the studied population. These effects are directly linked to the quality, access, and effectiveness of available services and resources.Master Thesis Repercussões do ensino remoto emergencial na formação em saúde coletiva de nutricionistas de uma universidade pública do Rio Grande do Norte(Universidade Federal do Rio Grande do Norte, 2024-08-30) Carvalho, Giovanna Melo de; Telles, Mauricio Wiering Pinto; https://orcid.org/0000-0002-5568-6877; http://lattes.cnpq.br/3146268167204989; http://lattes.cnpq.br/1126015072163601; Medeiros, Anna Cecilia Queiroz de; Gomes, Sávio MarcelinoThe Emergency Remote Learning (ERL) model adopted by Higher Education Institutions (HEIs) during the COVID-19 pandemic presented various challenges for health-related degree programs, considering the essential in-person nature of many activities conducted during the educational process. This includes training aligned with the principles of the Unified Health System (SUS), with an emphasis on Public Health, according to the National Curriculum Guidelines (DCNs). The consequences of ERT further exposed the pre-existing challenges in the training of health professionals, particularly nutritionists. Nutrition education in Brazil has long been marked by deficiencies in integrating biological and social knowledge, especially concerning Public Health (PH), which also suffers from the lack of a clear profile of the necessary competencies and skills for nutritionists working in the field. There is a gap in the literature on how nutritionists were trained in the PH field during ERL. This issue becomes even more significant within public universities, institutions with social responsibility to the community, integration of teaching-service-community, and alignment with training for the SUS. In light of this, this qualitative and exploratory case study aimed to investigate PH training within a Nutrition course at an HEI in Rio Grande do Norte during emergency remote teaching, using students, graduates, and faculty members in the field as references. The study sought to gather their perceptions, concerns, challenges, and hopes to contribute to the body of knowledge regarding nutritionists’ training in PH. The research subjects are faculty, graduates, and students from the Nutrition undergraduate program at the Federal University of Rio Grande do Norte (central campus) and the Faculty of Health Sciences of Trairi (FACISA campus). Data was collected through semi-structured interviews specific to each group, and document analysis of the Pedagogical Projects of the Nutrition course at both HEIs, as well as the syllabi of curricular components related to PH during ERL. The obtained data were analyzed using Thematic Content Analysis. ERL had negative impacts on the training of nutritionists at UFRN, with the severity depending on the student's profile, the characteristics of the curricular component, and the faculty's methodology. Regarding PH, the most significant impact was the inability to carry out practical activities and develop the teaching-service-community connection. Weaknesses in PH education were revealed at both campuses, predating the pandemic. Faculty expressed great dissatisfaction with ERL, particularly regarding the use of communication and information technologies (CITs), increased workload, and lack of student interaction. Despite the challenges reported by both groups, the innovations and adaptations made were also considered positive as tools to enhance in-person teaching. Thus, we can observe the impact of remote learning on nutrition professionals' training in PH in the state, contributing to the reflection on the role of PH within the Nutrition degree program, seeking increasingly DCN-oriented health training and SUS-focused practice, with a more assertive use of communication and information technologies to enhance in-person education.Master Thesis Enfrentamento a violência de gênero na atenção primária à saúde a luz da integralidade(Universidade Federal do Rio Grande do Norte, 2024-05-24) Silva, Rayara Cibelle Ribeiro da; Rolim, Ana Carine Arruda; Fernandes, Marcelo Costa; https://orcid.org/0000-0002-0447-9683; http://lattes.cnpq.br/9471678445935347; http://lattes.cnpq.br/1148466010754863; Bezerra, Juliana da Fonseca; Távora, Rafaela Carolini de OliveiraAmong the different types and characteristics of violence, gender-based violence stands out, one of the biggest health problems today. Gender violence is linked to various acts and behaviors, such as physical, sexual and psychological abuse, in addition to moral and intellectual oppression. Gender issues were gradually and predominantly established so that violence against women found forms that adapted to the characteristics of time and modern society. In this sense, Primary Health Care (PHC) is the privileged locus of care, being an ally in the prevention, combat and monitoring of gender-based violence. The valorization of PHC is part of its connection in the operating scenario, enabling greater connection and understanding of subjects and their local relationships. This study aims to analyze, based on the speeches of health professionals, actions to combat gender-based violence in PHC in the light of comprehensiveness. This is a descriptive study, with a qualitative approach, methodologically systematized by the Collective Subject Discourse (DSC) and based on the Theory of Social Representations. It was developed in two Basic Health Units (UBS). One in the municipality of Caicó in the state of Rio Grande do Norte and the other in the municipality of Sousa in the state of Paraíba. The participants were all health professionals who make up the team working at the UBS involved in the research and who wished to participate after presenting the RCLE. Data were collected through a semi-structured interview in October 2023, upon release and approval from the Ethics Committee to which the study was submitted. The empirical material was analyzed using the DSC technique. The study considered the ethical aspects of research involving human beings considered in Resolution No. 510/2016, of the National Health Council/CNS. From the speeches it was possible to construct four themes: professionals' knowledge of the care network for victims of violence; the prevention of cases of gender-based violence in PHC; comprehensiveness in the management of gender-based violence; and the actions of professionals in the face of gender-based violence in PHC. The effectiveness of interventions in PHC proved to be a fundamental element in mitigating this phenomenon. Strategies that promote reception, awareness among health professionals and coordination with other sectors are crucial for adequate support and prevention of gender-based violence. Thus, APS plays a central role in the integrated response to this social challenge. However, corporatist work, the disease-centered model and the disarticulation of services are points that stand out in the meanings expressed by the study participants. Within these obstacles, the service does not meet the complex demands that permeate cases of gender-based violence, consequently, victims often do not receive the necessary support, which can result in a culture of underreporting of cases and the perpetuation of the cycle of violence.Master Thesis Direito humano à alimentação: delineando o acesso de mulheres no interior do Estado do Rio Grande do Norte(Universidade Federal do Rio Grande do Norte, 2023-07-19) Moura, Laedja Driely Silva de; Severo, Ana Kalliny de Sousa; Silva, Catarine Santos da; https://orcid.org/0000-0002-2120-9730; http://lattes.cnpq.br/5420075210935645; https://orcid.org/0000-0002-9548-6394; http://lattes.cnpq.br/5170430928839162; http://lattes.cnpq.br/4176529936759214; Nagashima, Alynne Mendonça Saraiva; Oliveira, Juliana SouzaFood is a basic fundamental right to life recognized by the International Covenant on human, economic, social and cultural rights in several countries, including Brazil, as provided for in the Federal Constitution of 1988. However, it is not recent that this right has been violated , mainly affecting more vulnerable populations, due to the lack of adequate conditions for decent food for their survival. The objective of this research is to know the access to the right to adequate food of a group of women users of the Social Assistance Reference Centers (CRAS) in the municipality of Santa Cruz-RN. This is a quantitative and qualitative study of the interventionresearch type, having Institutional Analysis as a methodological theoretical perspective. The meetings took place between October and December 2022, with a maximum participation of 17 women aged between 21 and 59 years. The data were constructed through the application of a socioeconomic questionnaire, the Brazilian Food Insecurity Scale (EBIA), in addition to conversation circles and a research diary. Three conversation circles were held about the experience of women in relation to the right to food and the research diary served as a contribution throughout the collection of material. In the meetings, the women did not know a priori that food was a social right, just as they did not know that the State was responsible for guaranteeing this right to the population. The participation of some support networks did not guarantee access to food, given that most were in some degree of food insecurity and did not recognize this fact. It is necessary to develop and improve programs and projects in order to strengthen the support networks in guaranteeing the right to food, as well as the development of activities at CRAS that take information about education and citizenship, in order to better inform and assist these subjects. about their rights and guarantees in society.Master Thesis Avaliação do efeito de palmilhas adaptadas em chinelos no tratamento da fasciopatia plantar: um estudo com moradores do semiárido potiguar(2019-11-29) Costa, Ana Rafaella Araújo; Souza, Marcelo Cardoso de; Lins, Caio Alano de Almeida; ; ; ; Nogueira, Matheus Figueiredo; ; Câmara, Saionara Maria Aires da;Introduction: Plantar fasciitis (PF) is a subcalcaneal painful syndrome, which was firstly described in 1812. It is the most common cause of pain in the plantar heel region. Estimates highlight that one out of every 10 people will have pain in the lower calcaneal region at some point in life. Most patients report poor quality of life, since pain prevents the accomplishment of activities of daily living (ADL) and the performance of physical activities. Conservative treatments account for 90% of hindfoot pain resolutions and are associated with therapies including joint mobilization, stretching, insoles, shock wave therapy and laser therapy. Nevertheless, the use of insoles is restricted to the application in closed footwear such as shoes and sneakers, and this can be an obstacle to the treatment in cities with hot weather. Objective: To assess the effectiveness of insoles adapted for slippers in pain and function in individuals with PF. Method: Randomized, double-blind, controlled and clinical study involving 66 pa-tients diagnosed with PF, who were randomized into two groups: insole slipper (IS) group (n=34), which received a custom-made slipper (flip-flop) with foot devices and smooth beige synthetic leather cover. The flat slipper group (FS) (n=34) received a slipper (flip-flop) cov-ered with smooth beige synthetic leather, identical to the one used by the intervention group, but without the foot devices. Patients were instructed to wear the slipper at least 4 hours a day for 12 weeks. We held two assessments: one before the intervention protocol (T0) and the second after the 12 weeks of intervention (T12). As the primary outcome, we considered the pain measured through the Visual Analogue Scale (VAS). The secondary outcomes were: foot function by FFI questionnaire Foot Function Index; foot and ankle functionality by FAAM questionnaire Foot and Ankle Ability Measure (FAAM); functional capacity by 6-minute walking test (6MWT); patient’s expectation and satisfaction with treatment by Likert scale; the blinding questionnaire to ascertain patients’ blinding, besides a daily diary to note the hours they wore the slipper every day. Results: The IS group significantly improved morning pain through the morning VAS variable (p=0,016); without differences between groups for end-of-day VAS (p = 0,31), 6MWT (p = 0,45) and FAAM (p = 0,062). Another statistically significant value obtained was from FFI variable, where the IS group unveiled results (p=0,023), thereby showing improvements in foot func-tion after wearing the slipper. Conclusion: Insoles adapted for flip-flops as a 12-week treat-ment for PF-related pain were effective in improving morning pain and foot function.Master Thesis “Ou eu luto, ou eu morro": ativismo em HIV/aids e processos de subjetivação na experiência da Coletiva Loka de Efavirenz(2019-04-26) Cortez, Lumena Cristina de Assunção; Melo, Lucas Pereira de; Silva, Merces de Fátima dos Santos; ; ; ; Fontes, Flávio Fernandes; ; Gutiérrez, Mônica Lourdes Franch;Introduction: The Acquired Immunodeficiency Syndrome (aids) pandemic caused by human immunodeficiency virus (HIV) has overwhelmingly broken geographic barriers in the world and has raised discussions about sexual identities and practices that were considered as morally promiscuous and divergent. This condition, which is permeated by social markers of difference, has repercussions on the life experience of those living or dealing with HIV/aids, and on the agenda of their demands, personal engagement and collective mobilizations. In the current scenario, recent political and institutional demands have been based on the optimism of considering the advances in antiretroviral therapies as the only measure of treatment and as a definitive answer in the field of prevention, leaving aside issues such as human rights, social inequalities, among others. Objectives: To understand the relationship between HIV/aids activism in networks and social media and the production of the "person living with HIV/aids" (processes of subjectivation) from the Coletiva Loka of Efavirenz. Methodology: This is a research anchored in the theoretical-methodological framework of Ethnography. Data were collected through individual interviews, socioeconomic questionnaire, insider participant observation on the social network Facebook. Fieldwork took place from March 2017 to July 2018. The interlocutors were six activists, mostly blacks and browns, from the outskirts and/or countryside, with dissident sexual orientations and gender identities, and that were university students. The analysis took place through thematic categorization. Results: The performance of the Loka de Efavirenz is decentralized and horizontal. The objectives of the interlocutors in the social network included reporting life experiences with illness, making it public and available, disseminating the material they produced, and enabling an intersectional discussion of the epidemic through claims that included local and global demands such as therapeutic management, adherence to treatment and institutional racism. The main mobilization strategies were: elaboration of virtual content, production and presentation of artistic performances, actions with posters in universities, participation in national and international events, seminars, debates, acts and public demonstrations. Through mediation between different worlds and realities, activists see the existence of two "aids": AIDS related to biomedical and epidemiological aspects, and Aid$ resulting from historical oppressions, subordination and economic interests that perpetuate social inequalities, inserted under the new effects of biopolitics or of a necropolitics. In addition, participants gathered key information on HIV/aids activism, such as social achievements in health and politics, coupled with the social, biological, and political impacts of the epidemic in the 1980s and 1990s. Conclusion: The current scenario presents itself as a political and social challenge to confront the HIV/aids epidemic and to strengthen activism. Thus, the results of this research can support intersectoral professional practices based on human rights and health needs of activists and people living with HIV/aids, in addition to increasing the political visibility of the topic and those involved, reinforcing the strategic and mediation between civil society and the state in the claim and maintenance of social rights.Master Thesis Percepção da gestante sobre sua família e gestação por meio do modelo Calgary e da Hermenêutica(2018-07-06) Silva, José Lenartte da; Tavora, Rafaela Carolini de Oliveira; ; ; Valença, Cecilia Nogueira; ; Jorge, Herla Maria Furtado;Introduction: The gestational period involves changes in different aspects, showing that antenatal care must exceed the biological dimension. Objective: To understand the perception of the pregnant woman about her family and pregnancy through the Calgary model and Hermeneutics. Method: It is a descriptive, exploratory, qualitative study, carried out with pregnant women and their families in a Basic Health Unit, in the city of Santa Cruz / RN, whose sample was defined by the method of data saturation. Three thematic workshops were carried out, applying the techniques of the genogram and ecomap, group dynamics to understand the interpersonal relationships between pregnant women and their families. The semi-structured interviews underwent an analysis using Habermas's dialectical-hermeneutics, with a synthesis of the critical and understanding processes. Results: The categories "My family", "Positive feelings" and "Negative feelings" emerged. The graphic representations (genogram) of each family were constructed, as well as identifying the support and / or conflict (ecomapa) relationships. Discussion: There are family relationships of support and conflict. The genogram allowed to visualize the compositions of the families and the ecomapa allowed to analyze the diverse relations contained in the supra-systems and systems, through the feedebacks, of the process of self-regulation. The statements of the pregnant women were analyzed through the concepts of the Calgary Model of Family Assessment and hermeneutic-dialectic. It was noticed that the pregnant women belonged same family nucleus, but live the world of living different systems and subsystems. The process of communication, faced with the topics covered, was permeated by disturbed languages, however, being possible to understand and discuss them. Final considerations: Family support improved the gait of pregnancy emotionally. Those who did not receive it immediately experienced the balance of relationships with the passing of days. In this way, pregnant women could feel more confident, certainly in this process, dialogue was fundamental to success. Studies are still needed that point out ways to address the conflicts and challenges that arise from pregnancy.