[Educational group practices in primary care: interaction between professionals, users and knowledge]. / Práticas educativas grupais na atenção básica: padrões de interação entre profissionais, usuários e conhecimento.

OBJECTIVE: To investigate the concept understood by Family Healthcare Strategy (ESF) professionals of knowledge, education and subjects participating in learning activities. METHOD: Qualitative study carried out with the ESF professionals with university degree, members of the healthcare staff who undertook educational health group activities at Basic Healthcare Units (UBS) in Belo Horizonte. The following triangulation techniques were used: participant observation, photos and field notes; interviews with professionals; and document analysis. RESULTS: We identified three interaction patterns that are different from each other. Firstly, the professional questions, listens and provides information to users, trusting in the transmission of knowledge; secondly, the professional questions and listens, trusting that users can learn from each other; thirdly, the professional questions, listens, discusses and produces knowledge with users, both teaching and learning from each other. CONCLUSION: There are educational practices that include unique methods capable of creating a militant space for citizenship engagement.

Impact of gender on the decision to participate in a clinical trial: a cross-sectional study.

BACKGROUND: In order for Informed Consent to be ethical and valid each clinical trial participant must be able to make a voluntary decision to participate, free from pressure or coercion. Nonetheless, many factors may influence the decision reached, and such influences may be different for male and female volunteers. Being aware of these differences may help researches develop better processes for obtaining consent that safeguard the right of autonomy for all participants. The goal of this study was to evaluate potential gender-based differences in the factors influencing clinical trial participation. METHODS: This cross-sectional study was conducted in the Northeast region of Minas Gerais, Brazil, in October 2011. A structured questionnaire was administered to 143 volunteers (48 male, 95 female) screened for participation in a clinical study of an investigational functional food with potential anthelminthic properties. Answers regarding their decision to participate in the study were compared, by gender, using chi-square and Mann Whitney tests. Odds ratios (OR) was used to measure association. RESULTS: A majority of subjects (58% of males, 59% of females) listed the desire to collaborate with the development of a product against parasitic worms as their main reason for participation. Females were significantly more likely to report a decision influenced by friends, family, or researchers (OR 3.14, 3.45, and 3.46 respectively, p < 0.005). Females were also significantly more likely to report a decision influenced by general altruistic considerations (OR 8.45, p < 0.005). There was no difference, by gender, in the report of decisions influenced by informational meetings, understanding of the disease, or the availability of medical treatments or exams. There was also no difference in knowledge of the rights of research participants. CONCLUSION: Study results indicate that there is a strong difference between male and female participants regarding social influences on the decision to participate in clinical research. Further research into the impact this may have on autonomy is warranted.

Identity Representations of People With Diabetes.

In this study, we aimed to investigate the construction of identity representations by primary health care patients with type 2 diabetes mellitus and their relationship to the required self-care actions. A free word association technique required clients from a basic health unit (N = 34) to suggest a word or expression and justify it in response to the question, "When talking about being a diabetic, what comes to your mind?" We performed, transcribed, and categorized the recordings, then interpreted them according to thematic content analysis, social representation, and social identity theories. Intentions mediated by identity processes-social comparison, social attribution, and categorization within the studied group-and also by objectification and anchoring, provided the following social constructions: normal, accepting of the disease, feeling unaccepting, and experiencing difficulties. The disease might alter patients' identity representation within a context permeated by individuals' subjective sense.

A randomized, controlled Phase 1b trial of the Sm-TSP-2 Vaccine for intestinal schistosomiasis in healthy Brazilian adults living in an endemic area.

BACKGROUND: Recombinant Schistosoma mansoni Tetraspanin-2 formulated on Alhydrogel (Sm-TSP-2/Alhydrogel) is being developed to prevent intestinal and hepatic disease caused by S. mansoni. The tegumentary Sm-TSP-2 antigen was selected based on its unique recognition by cytophilic antibodies in putatively immune individuals living in areas of ongoing S. mansoni transmission in Brazil, and preclinical studies in which vaccination with Sm-TSP-2 protected mice following infection challenge. METHODS: A randomized, observer-blind, controlled, Phase 1b clinical trial was conducted in 60 healthy adults living in a region of Brazil with ongoing S. mansoni transmission. In each cohort of 20 participants, 16 were randomized to receive one of two formulations of Sm-TSP-2 vaccine (adjuvanted with Alhydrogel only, or with Alhydrogel plus the Toll-like receptor-4 agonist, AP 10-701), and 4 to receive Euvax B hepatitis B vaccine. Successively higher doses of antigen (10 µg, 30 µg, and 100 µg) were administered in a dose-escalation fashion, with progression to the next dose cohort being dependent upon evaluation of 7-day safety data after all participants in the preceding cohort had received their first dose of vaccine. Each participant received 3 intramuscular injections of study product at intervals of 2 months and was followed for 12 months after the third vaccination. IgG and IgG subclass antibody responses to Sm-TSP-2 were measured by qualified indirect ELISAs at pre- and post-vaccination time points through the final study visit. RESULTS: Sm-TSP-2/Alhydrogel administered with or without AP 10-701 was well-tolerated in this population. The most common solicited adverse events were mild injection site tenderness and pain, and mild headache. No vaccine-related serious adverse events or adverse events of special interest were observed. Groups administered Sm-TSP-2/Alhydrogel with AP 10-701 had higher post-vaccination levels of antigen-specific IgG antibody. A significant dose-response relationship was seen in those administered Sm-TSP-2/Alhydrogel with AP 10-701. Peak anti-Sm-TSP-2 IgG levels were observed approximately 2 weeks following the third dose, regardless of Sm-TSP-2 formulation. IgG levels fell to low levels by Day 478 in all groups except the 100 µg with AP 10-701 group, in which 57% of subjects (4 of 7) still had IgG levels that were ≥4-fold higher than baseline. IgG subclass levels mirrored those of total IgG, with IgG1 being the predominant subclass response. CONCLUSIONS: Vaccination of adults with Sm-TSP-2/Alhydrogel in an area of ongoing S. mansoni transmission was safe, minimally reactogenic, and elicited significant IgG and IgG subclass responses against the vaccine antigen. These promising results have led to initiation of a Phase 2 clinical trial of this vaccine in an endemic region of Uganda. TRIAL REGISTRATION: NCT03110757.

[Health promotion education in the context of primary care]. / Educação para a promoção da saúde no contexto da atenção primária.

OBJECTIVE: To investigate whether the educational initiatives carried out in basic health units in Belo Horizonte, Minas Gerais, Brazil, follows the principles of health promotion. METHODS: This descriptive study examined 33 educational health promotion initiatives to determine whether they were guided by five principles, used as categories of analysis: multicausality of the health-disease process, intersectoriality, social engagement, sustainability, and use of dialogic teaching methods (active participation of subjects in the learning process, planning the activity to generate new knowledge, and use of various teaching strategies). Structured observation was used for data collection. The frequency of each category was evaluated in each initiative. RESULTS: Multicausality was the most frequent category observed (73.0%), and intersectoriality the least frequent (9.0%). Regarding the use of dialogic methods, 38.0% of the initiatives promoted the active engagement of subjects, 6.0% promoted knowledge generation, and 40.0% employed a variety of teaching strategies. CONCLUSIONS: Most educational initiatives were not actively oriented toward health promotion, understood as the strengthening of autonomy and self-management of health processes, social engagement, and employment of dialogic teaching approaches. However, some progress has been made moving away from hegemonic models of education in primary health care.

A history of hookworm vaccine development.

The human hookworms Necator americanus and Ancylostoma duodenale remain among the most common infections of humans in areas of rural poverty in the developing regions of the world, with an estimated 1 billion people infected with one or more of these parasites. Herein, we review the nearly 100 years of research, development, animal testing, and fieldwork that have led to our current progress in recombinant hookworm vaccines. We begin with the identification of hookworm at the start of the 20th century in Southern US, then discuss the progress in developed countries to eliminate human hookworm infection, and then the industrial development and field use in the 1970s a canine hookworm vaccine(Ancylostoma caninum), and finally our progress to date in the development and clinical testing of an array of recombinant antigens to prevent human hookworm disease from N. americanus infection. Special attention is given to the challenges faced in the development of a vaccine against a blood-feeding nematode, including the epidemiology of infection (high prevalence of infection), pathogenesis (chronic infection that increases with the age of the host), and a robust immune response that fails to confer the protection in the host and a concomitant absence of correlates of protection by a successful vaccine could be developed and tested. Finally, we provide the optimal and acceptable profiles of a human hookworm vaccine, including the proposed indication, target population, and route of administration, as developed by the Human Hookworm Vaccine Initiative, the only group currently working on vaccines targeting this parasite.

Correction: Safety and immunogenicity of the Na-GST-1 hookworm vaccine in Brazilian and American adults.

[This corrects the article DOI: 10.1371/journal.pntd.0005574.].

Hookworm, Ascaris lumbricoides infection and polyparasitism associated with poor cognitive performance in Brazilian schoolchildren.

OBJECTIVE: To investigate the relationship between hookworm and Ascaris lumbricoides infection and performance on three subsets of the Wechsler Intelligence Scale for Children - third edition (WISC-III) (Digit Span, Arithmetic and Coding) and Raven Colored Progressive Matrices. METHODS: Cross-sectional study of 210 children between the ages of 6 and 11 years in Americaninhas, Minas Gerais, Brazil. Separate proportional odds models were used to measure the association between the intensity of helminth infections and poor performance on each of the four cognitive tests. RESULTS: After adjusting for sex, age, socioeconomic status and other helminth infections, moderate-to-high-intensity hookworm infection was associated with poor performance on the WISC-III Coding subtest [OR = 3.20; 95% confidence interval (CI) = 1.43-7.17], low intensity of hookworm infection was associated with poor performance on the WISC-III Coding subtest [odds ratio (OR) = 3.71; 95% CI = 1.80-7.66] and moderate-to-high-intensity A. lumbricoides infection was associated with poor performance on the Raven test (OR = 2.03; 95% CI = 1.04-3.99), all in comparison with uninfected children. Children co-infected with A. lumbricoides infection and hookworm infection had greater odds of poor performance on some WISC-III subtests than children with only A. lumbricoides infection. CONCLUSIONS: These findings suggest that hookworm infection may be associated with poorer concentration and information processing skills, as measured on the WISC-III Coding subtest, and that A. lumbricoides infection may be associated with poorer general intelligence, as measured through the Raven Colored Progressive Matrices. This study also presents evidence that polyparasitized children experience worse cognitive outcomes than children with only one helminth infection.

A Comparison of the Quality of Informed Consent for Clinical Trials of an Experimental Hookworm Vaccine Conducted in Developed and Developing Countries.

Informed consent is one of the principal ethical requirements of conducting clinical research, regardless of the study setting. Breaches in the quality of the informed consent process are frequently described in reference to clinical trials conducted in developing countries, due to low levels of formal education, a lack of familiarity with biomedical research, and limited access to health services in these countries. However, few studies have directly compared the quality of the informed consent process in developed and developing countries using the same tool and in similar clinical trials. This study was conducted to compare the quality of the informed consent process of a series of clinical trials of an investigational hookworm vaccine that were performed in Brazil and the United States. A standardized questionnaire was used to assess the ethical quality of the informed consent process in a series of Phase 1 clinical trials of the Na-GST-1/Alhydrogel hookworm vaccine that were conducted in healthy adults in Brazil and the United States. In Brazil, the trial was conducted at two sites, one in the hookworm non-endemic urban area of Belo Horizonte, Minas, and one in the rural, resource-limited town of Americaninhas, both in the state of Minas Gerais; the American trial was conducted in Washington, DC. A 32-question survey was administered after the informed consent document was signed at each of the three trial sites; it assessed participants' understanding of information about the study presented in the document as well as the voluntariness of their decision to participate. 105 participants completed the questionnaire: 63 in Americaninhas, 18 in Belo Horizonte, and 24 in Washington, DC. Overall knowledge about the trial was suboptimal: the mean number of correct answers to questions about study objectives, methods, duration, rights, and potential risks and benefits, was 45.6% in Americaninhas, 65.2% in Belo Horizonte, and 59.1% in Washington, DC. Although there was no difference in the rate of correct answers between participants in Belo Horizonte and Washington, DC, there was a significant gap between participants at these two locations compared to Americaninhas (p = 0.0002 and p = 0.0001, respectively), which had a lower percentage of correct answers. Attitudes towards participating in the clinical trial also differed by site: while approximately 40% had doubts about participating in Washington, DC and Belo Horizonte, only 1.5% had concerns in Americaninhas. Finally, in Belo Horizonte and Washington, high percentages cited a desire to help others as motivation for participating, whereas in Americaninhas, the most common reason for participating was personal interest (p = 0.001). Understanding of information about a Phase 1 clinical trial of an experimental hookworm vaccine following informed consent was suboptimal, regardless of study site. Although overall there were no differences in knowledge between Brazil and the US, a lower level of understanding about the trial was seen in participants at the rural, resource-limited Brazilian site. These findings demonstrate the need for educational interventions directed at potential clinical trial participants, both in developing and developed countries, in order to improve understanding of the informed consent document.

The game as strategy for approach to sexuality with adolescents: theoretical-methodological reflections.

OBJECTIVE: To describe the Papo Reto [Straight Talk] game and reflect on its theoretical-methodological basis. METHOD: Analytical study on the process of elaboration of the Papo Reto online game, destined to adolescents aged 15-18 years, with access to the Game between 2014 and 2015. RESULTS: the interactions of 60 adolescents from Belo Horizonte and São Paulo constituted examples of the potentialities of the Game to favor the approach to sexuality with adolescents through simulation of reality, invention and interaction. Based on those potentialities, four thinking categories were discussed: the game as pedagogic device; the game as simulation of realities; the game as device for inventive learning; and the game empowering the interaction. CONCLUSION: By permitting that the adolescents take risks on new ways, the Game allows them to become creative and active in the production of senses, in the creation of their discourses and in the ways of thinking, feeling and acting in the sexuality field.

Safety and immunogenicity of the Na-GST-1 hookworm vaccine in Brazilian and American adults.

Necator americanus Glutathione-S-Transferase-1 (Na-GST-1) plays a role in the digestion of host hemoglobin by adult N. americanus hookworms. Vaccination of laboratory animals with recombinant Na-GST-1 is associated with significant protection from challenge infection. Recombinant Na-GST-1 was expressed in Pichia pastoris and adsorbed to aluminum hydroxide adjuvant (Alhydrogel) according to current Good Manufacturing Practice. Two Phase 1 trials were conducted in 142 healthy adult volunteers in the United States and Brazil, first in hookworm-naïve individuals and then in residents of a N. americanus endemic area in Brazil. Volunteers received one of three doses of recombinant Na-GST-1 (10, 30, or 100 µg) adjuvanted with Alhydrogel, adjuvanted with Alhydrogel and co-administered with an aqueous formulation of Glucopyranosyl Lipid A (GLA-AF), or the hepatitis B vaccine. Vaccinations were administered via intramuscular injection on days 0, 56, and 112. Na-GST-1/Alhydrogel was well tolerated in both hookworm-naïve and hookworm-exposed adults, with the most common adverse events being mild to moderate injection site pain and tenderness, and mild headache and nausea; no vaccine-related severe or serious adverse events were observed. Antigen-specific IgG antibodies were induced in a dose-dependent fashion, with increasing levels observed after each vaccination in both trials. The addition of GLA-AF to Na-GST-1/Alhydrogel did not result in significant increases in specific IgG responses. In both the US and Brazil studies, the predominant IgG subclass induced against Na-GST-1 was IgG1, with lesser amounts of IgG3. Vaccination of both hookworm-naïve and hookworm-exposed adults with recombinant Na-GST-1 was safe, well tolerated, and resulted in significant antigen-specific IgG responses. Based on these results, this vaccine will be advanced into clinical trials in children and eventual efficacy studies. TRIAL REGISTRATION: ClinicalTrials.gov (NCT01261130 for the Brazil trial and NCT01385189 for the US trial).

Health education and social representation: an experience with the control of tegumentary leishmaniasis in an endemic area in Minas Gerais, Brazil.

This study was developed in an endemic area of tegumentary leishmaniasis in Minas Gerais, Brazil, with the objective of analyzing a health education process based on the social representations theory. The educational model was developed in two phases with 34 local residents. In the first phase, social representations of leishmaniasis were identified and analyzed. The second phase was based on the interaction between social representations and scientific knowledge. The results showed that social representations were structured in a central core by the terms "wound" and "mosquito" and in the peripheral system by the terms "mountains", "standing water", and "injection" related respectively to place, transmission, and treatment of the disease. We concluded that tegumentary leishmaniasis is viewed as a wound caused by a mosquito, portrayed by metaphors. The results of the second phase showed that social representations are systems that favor adherence to scientific knowledge, at times more rigidly in the central core, other times more flexibly when linked to the peripheral systems.

Novos modos de subjetivação na formação do enfermeiro em Saúde Mental / New subjectivation modes in nurse education in the area of Mental Health / Nuevos modos de subjetivación en la formación del enfermero en Salud Mental

Trata-se de pesquisa cartográfica com o objetivo de analisar novos modos de subjetivação na formação do enfermeiro em Saúde Mental. A produção dos dados ocorreu por meio de entrevista semiestruturada e observação não participante, desenvolvidas durante uma disciplina de Saúde Mental de um curso de Enfermagem, no primeiro semestre de 2019. Os dados produzidos foram ancorados na Filosofia da Diferença de Deleuze e Guattari. Pela sala de aula observada, novos modos de ensinar Enfermagem em Saúde Mental puderam ser suscitados. Modos esses que refletem uma postura ético-estético-política expressiva em um território de formação não preocupado em reproduzir formas e modelos, todavia em inventar novos modos de resistir ao que está instituído. (AU)

This cartographic research aims to analyze new subjectivation modes in nurse education in the area of Mental Health. Data were collected by means of semi-structured interviews and non-participant observation, developed during a mental health discipline of a Nursing course that was offered in the first semester of 2019. The produced data were grounded on the Philosophy of Difference proposed by Deleuze and Guattari. Through the observed classroom, new ways of teaching about Nursing education in Mental Health emerged. These new ways reflect an expressive ethical-esthetic-political posture in an education territory that, instead of reproducing forms and models, invents new ways of resisting what is instituted. (AU)

Investigación cartográfica con el objetivo de analizar nuevos modos de subjetivación en la formación del enfermero en salud mental. La producción de los datos se realizó por medio de entrevista semiestructurada y observación no participante, desarrolladas durante una asignatura de salud mental de un curso de enfermería, en el primer semestre de 2019. Los datos producidos tenían como base la Filosofía de la Diferencia de Deleuze y Guattari. Llevando en consideración la sala de clase observada, fue posible suscitar nuevos modos de enseñanza sobre la formación en Enfermería en Salud Mental. Esos modos reflejan una postura ético-estética-política expresiva en un territorio de formación no preocupado en reproducir formas y modelos y sí en inventar nuevos modos de resistencia a lo instituido. (AU)

Improving the understanding of schistosomiasis among adolescents in endemic areas in Brazil: A comparison of educational methods.

OBJECTIVE: To evaluate the effectiveness of two teaching strategies, both guided by the concept of dialogicity, on adolescents' knowledge about schistosomiasis and adherence to diagnostic fecal testing. METHODS: Two teaching strategies related to schistosomiasis were developed, an educational video and group conversation, which were tested in two groups of students aged 10-15 years old. Before and after the intervention, a questionnaire was applied to assess participants' knowledge about schistosomiasis and, after the intervention, two fecal samples were requested from each participant. Comparisons were performed by paired t- and McNemar tests. RESULTS: Both strategies resulted in statistically significant improvements in knowledge between the pre- and post-tests. Students who watched the video had a higher return rate of fecal samples and percentage of correct questionnaire answers, mainly on questions about schistosomiasis infection. CONCLUSION: Teaching strategies based on dialogue favored the construction of concepts about schistosomiasis that can influence the adoption of positives attitudes related to health. PRACTICAL IMPLICATIONS: Using teaching strategies based on the concept of dialogicity can favor the increase of knowledge of school age children about schistosomiasis and can influence behavioral change related to health.

Estratégias de ensino utilizadas na formação do enfermeiro-educador: revisão integrativa / Teaching strategies used in the training of the nurse-educator: an integrative review

RESUMO Objetivo investigar as estratégias de ensino utilizadas na formação do enfermeiro-educador nos cursos de graduação em enfermagem em âmbito nacional e internacional. Métodos revisão integrativa realizada nas bases Literatura Latino-Americana e do Caribe em Ciências da Saúde, Current Index to Nursing and Allied Health Literature, National Center for Biotechnology Information, Web of Science, SCOPUS. Não foram determinados os limites temporais. Resultados com base nos sete artigos selecionados, identificaram-se diferentes estratégias de ensino utilizadas na formação de enfermeiros-educadores nos cursos de Enfermagem em países como o Brasil, Estados Unidos da América, Reino Unido, Espanha e Alemanha. As estratégias identificadas foram: Materiais Didáticos Digitais, Role Playing Game, Problematização, Poesia, Experiência Prática, Jogos Educativos e Formulação e Desenvolvimento de Ação Educativa. Conclusão as estratégias identificadas relacionam-se com os referenciais Moderno-Tradicional e Moderno-Dialógico, com pouca ou nenhuma abertura à experimentação sensível, ética-estética-política nos campos de ação que se relacionam com a Educação em Saúde.

ABSTRACT Objective to investigate which teaching strategies are used in the training of the nurse-educator in nursing undergraduate courses at a national and international level. Methods an integrative review carried out in the databases Latin American and Caribbean Health Sciences Literature, Current Index to Nursing and Allied Health Literature, National Center for Biotechnology Information, Web of Science, SCOPUS. No time limits were determined. Results Based on the seven selected articles, different teaching strategies used in the training of nurse-educators in Nursing courses were identified in countries such as Brazil, United States of America, United Kingdom, Spain and Germany. The strategies identified were: Digital Teaching Materials, Role Playing Game, Problematization, Poetry, Practical Experience, Educational Games and Educational Action Formulation and Development. Conclusion the strategies identified relate to the Modern-Traditional and Modern-Dialogical benchmarks, with little or no openness to sensitive, ethical-aesthetic-political experimentation in the fields of action that relate to Health Education.

[Health education: knowledge, social representation, and illness]. / Educação em saúde: conhecimentos, representações sociais e experiências da doença.

This article discusses the theory and practice of health and education, beginning with the notion of the hegemony (in health education practice) of strategies linked to the notion that to grasp established knowledge always leads to the acquisition of new behaviors and practices. Five different axioms have oriented education and health practices, either juxtaposed or at different moments: (1) the notion of overcoming the determination of knowledge over practices; (2) the determination of representations over practices; (3) the analysis of representations within the traditional framework of right and wrong; (4) reciprocity between representations and practices; and (5) the importance of considering practices amenable to re-elaboration through representations, thus situating experience in understanding subjects' illness processes, as well as the way subjects culturally construct illness. The article highlights the need for a link between social representations and illness-as-experience in health education practices.

Experimentações de educação e saúde: mapeando a produção de sentidos na pós-graduação em Enfermagem / Education and health experimentations: mapping the development of senses in Nursing graduate courses / Experimentaciones de educación y salud: mapeo de la producción de sentido en el postgrado en Enfermería

Trata-se de uma pesquisa-interferência cartográfica realizada com o objetivo de cartografar as possibilidades de experimentações desenvolvidas por estudantes de pós-graduação stricto sensu em Enfermagem produzirem novos sentidos no campo de interseções entre educação e saúde. As experimentações foram desenvolvidas durante a disciplina "Teorias do Conhecimento e da Educação nas Práticas Educativas em Saúde", ofertada na Universidade Federal de Minas Gerais. Neste artigo são apresentadas duas experimentações: uma inspirada nos conceitos de Dewey, com o tema internação psiquiátrica, e outra nos princípios de Paulo Freire, com a temática processo saúde-doença. As experimentações contribuíram para aproximar teoria e prática, ampliar as possibilidades de intervenção e problematizar a prática profissional. As contribuições produzidas pelas experimentações requerem um investimento diário para fazerem rachar os estratos que insistem em hierarquizar a circulação da vida e o modo de a subjetividade estar no mundo.(AU)

This cartographic intervention research was conducted to map the possibilities of experimentation developed by stricto sensu graduate Nursing students in the development of new senses in the intersecting field of education and health. Experimentations were developed in the discipline "Knowledge and Education Theories in Educational Health Practices" taught at Universidade Federal de Minas Gerais, Brazil. In this article, two experimentations are presented: one inspired by Dewey's concepts, on psychiatric hospitalization; and the other by Paulo Freire's principles, on the health-disease process. The experimentations contributed to bring theory and practice closer, expand the possibilities of intervention, and question the professional practice. The contributions provided by the experimentations require daily dedication to break the strata that insist on hierarchizing the circulation of life and the way subjectivity occurs in the world.(AU)

Se trata de una Investigación-Interferencia Cartográfica realizada con el objetivo de cartografiar las posibilidades de que experimentaciones desarrolladas por alumnos de postgrado stricto sensu en enfermería produjeran nuevos sentidos en el campo de intersecciones entre educación y salud. Las experimentaciones se desarrollaron durante la disciplina "Teorías del conocimiento y de la educación en las prácticas educativas en salud", dictada en la Universidad Federal de Minas Gerais. En este artículo se presentan dos experimentaciones: una inspirada en los conceptos de Deway, con el tema internación psiquiátrica y la otra en los principios de Paulo Freire, con la temática proceso salud-enfermedad. Las experimentaciones contribuyeron para aproximar teoría y práctica, ampliar las posibilidades de intervención y problematizar la práctica profesional. Las contribuciones producidas por las experimentaciones requieren una inversión diaria para resquebrajar los estratos que insisten en jerarquizar la circulación de la vida y el modo de estar en el mundo de la subjetividad.(AU)

Articulação teórico-prática em um currículo de um curso de Enfermagem / Articulación teórico-práctica en un currículo de un curso de Enfermería / Theoretical-practical articulation in a curriculum of a Nursing course

RESUMO Objetivo Compreender como a articulação teórico-prática se efetiva num currículo de um curso de graduação em Enfermagem. Método Trata-se de um estudo de caso único, com abordagem qualitativa, desenvolvido por meio de análise documental e por entrevistas individuais com roteiro semiestruturado com dez docentes e 14 discentes entrevistados no período de fevereiro a maio de 2015. A análise dos dados foi realizada segundo os pressupostos da Análise Crítica do Discurso. Resultados Os dados revelaram a existência de tensões e ambivalências entre duas formas de relação entre teoria e prática. A primeira, relacionada à teoria-prática como unidade indissolúvel e a segunda à visão da teoria e prática como instâncias dicotômicas e predomínio da teoria precedendo a prática. Conclusões e implicações para a prática Há fragilidades na efetivação da articulação teórico-prática no currículo do curso de Enfermagem investigado, evidenciando a supremacia do paradigma cartesiano no ensino superior de Enfermagem. Dessa forma, torna-se premente instituir estratégias que viabilizem a indissociabilidade teórico-prática no currículo.

RESUMEN Objetivo Comprender cómo la articulación teórico-práctica es efectiva en un plan de estudios de un curso de pregrado en Enfermería. Método Este es un estudio de caso único, con enfoque cualitativo, desarrollado a través del análisis de documentos y entrevistas individuales con guiones semiestructurados con diez maestros y 14 estudiantes entrevistados de febrero a mayo de 2015. El análisis de datos fue realizado de acuerdo con los supuestos del análisis crítico del discurso. Resultados Los datos revelaron la existencia de tensiones y ambivalencias entre dos formas de relación entre teoría y práctica. El primero, relacionado con la teoría-práctica como una unidad indisoluble y el segundo con la visión de la teoría y la práctica como instancias dicotómicas y el predominio de la teoría que precede a la práctica. Conclusiones e implicaciones para la práctica Existen debilidades en la implementación de la articulación teórica y práctica en el currículo del curso de Enfermería investigado, lo que demuestra la supremacía del paradigma cartesiano en la educación superior en Enfermería. Por lo tanto, es urgente establecer estrategias que permitan la inseparabilidad teórica y práctica en el currículo.

ABSTRACT Objective To understand how the theoretical-practical articulation is effective in a curriculum of an undergraduate Nursing course. Method This is a unique case study, with a qualitative approach, developed through document analysis and individual interviews with semi-structured script with 10 teachers and 14 students interviewed from February to May 2015. Data analysis was performed according to the assumptions of Critical Discourse Analysis. Results The data revealed the existence of tensions and ambivalences among two forms of relationship between theory and practice. The first, related to theory-practice as an indissoluble unit and the second, to the view of theory and practice as dichotomous instances and the predominance of theory preceding practice. Conclusions and implications for practice There are weaknesses in the implementation of theoretical and practical articulation in the curriculum of the Nursing course investigated, showing the supremacy of the cartesian paradigm in higher education in Nursing. Thus, it is urgent to institute strategies that enable the theoretical-practical inseparability in the curriculum.

[The interdiction of disease: a cultural construction of schistosomiasis in an endemic area in Minas Gerais, Brazil]. / A interdição da doença: uma construção cultural da esquistossomose em área endêmica, Minas Gerais, Brasil.

This study was conducted in a rural area endemic for schistosomiasis in Minas Gerais, Brazil. The objective was to determine the relationship between an environmental and health education program for schistosomiasis, implemented for teachers and students from the state secondary school in the village of Boa União, and the subsequent actions of its participants in regards to the environment and the illness. An important difference in this program is its perspective that it is not merely the implementation of instrumental and cognitive knowledge of the environment and illness, but an approach in which subjects are asked to question and investigate their perception of reality, the environment, and the illness. The study demonstrated that a change in attitude could occur from reflection on one's experience in relation to both the environment and diseases endemic it.

[Knowledge and willingness to participate in research: a descriptive study of volunteers in a clinical trial]. / Conhecimento e voluntariedade para participação em pesquisas: um estudo descritivo com participantes de um ensaio clínico.

The aim of this study was to evaluate volunteers' knowledge of the information on the free informed consent form and their willingness to participate in a clinical trial. This was a quantitative, descriptive, cross-sectional study conducted in November 2011 with subjects from a clinical trial in Americaninhas, northeast Minas Gerais State, Brazil. A convenience sample included 143 adults of both sexes, 18 to 45 years of age. A structured questionnaire was applied one week after signing the free informed consent form. Most participants signed the free informed consent without sufficient knowledge of the research information and were influenced in their decision to participate in the trial. The authors conclude that signing the free informed consent form fails to express all participants' autonomy in clinical trials.