Information, control and health promotion in the Brazilian context of the pandemic.

This article discusses how preventive and promotional discourses have been incorporated by the Brazilian population in the context of the coronavirus pandemic. It analyzes materials posted on the internet and social after the first case of COVID 19-related death in Brazil that are related health promotion and COVID-19 aimed at orienting society's response to the pandemic. The analysis considers two key factors: the mismanagement of the pandemic by the Brazilian government and infodemic. There is complex use of scientific information with recommendations that focus on what people should do (intervention) and in transforming individuals' behaviors, based on an ideal model of healthy behaviors. Narratives aimed to delegate to the population and specific groups the task of taking care of themselves have been reinforced, removing from the State the responsibility to offer conditions for the population to address the situation. There is a sophistication of strategies that blame individual practices, personal organization and that are disconnected from the collective, especially for those who live in situation of extreme vulnerability. Concomitantly, there are also discourses based on notions of solidarity and renewed social connections, which are empowering and consistent with the practice of health promotion as it attributes meanings to the subjects and their ways of life. We conclude that greatest advocacy in the field of health promotion at this moment is political and could be directed toward reaffirming health promotion principles, supporting permanent mobilization against setbacks in the public sphere and defending a new, democratic, inclusive and collective vision of society.

Reclaiming the social in community movements: perspectives from the USA and Brazil/South America: 25 years after Ottawa.

Since the Ottawa Charter 25 years ago, community participation has been adopted worldwide by nation states and communities as a core health promotion strategy. Rising inequities since that time, however, have been largely unchecked in the Americas and globally, and have presented us with an acutely paradoxical time for community participation and action. On the one hand, transnational globalized markets and accompanying economic and environmental devastation have challenged the effectiveness of community action to create health. On the other hand, hopeful signs of local through national and international activism and of new mechanisms for community engagement continue to surface as meaningful and effective democratic acts. This article presents a dialogue on these issues between colleagues in the United States and Brazil, and considers the broader applicability to Latin America and worldwide. We begin by discussing how community participation and community organizing grew out of our respective histories. We consider the catalytic role of the Ottawa Charter in spurring a reorientation of health promotion and the genesis of healthy city and community initiatives, as well as other current community organizing strategies and the growth of participatory research/CBPR. We unpack the potential for co-optation of both community and social participation and end with recommendations for what we can do to maintain our integrity of belief in democratic social participation to promote improved health and health equity.

A roda de conversas à luz da práxis freireana e seus impactos na percepção da diminuição do bullying escolar / Conversation circles through the lens of Freirean praxis and their impact on the perception of declining school bullying / La rueda de conversaciones a la luz de la praxis freireana y sus impactos en la percepción de la disminución del bullying escolar

O objetivo deste artigo é analisar e avaliar a roda de conversas como instrumento participativo e educativo capaz de impactar na percepção de diminuição do bullying entre adolescentes no contexto escolar. Trata-se de um estudo de abordagem qualitativa, realizado por meio de entrevistas semiestruturadas com 18 adolescentes de uma escola do ensino fundamental do Estado de São Paulo. Os resultados foram analisados à luz da práxis freireana e demonstraram que esse instrumento contribuiu para ampliar o entendimento sobre esse tipo de comportamento agressivo, favoreceu a quebra do silenciamento das agressões até então não verbalizadas, e impactou a percepção de diminuição do bullying. Ressalta-se que não se trata de conceber a roda como instrumento resolutivo e estanque em si, mas como participativo, complementar, apoiador e potencialmente capaz de contribuir para desnaturalizar a violência no cenário escolar e promover a emancipação dos envolvidos.(AU)

The aim of this study was to analyze and assess conversation circles as a participatory and educational tool capable of having an impact on the perception of declining school bullying among adolescents. Using semi-structured interviews, we conducted a qualitative study with 18 middle school students in the state of São Paulo. The results were analyzed through the lens of Freirean praxis and demonstrated that the tool fostered a broaden understanding of this type of aggressive behavior, helped break the silence on hitherto non-verbalized bullying and had an impact on the perception of declining bullying. It is highlighted that conversation circles are not conceived as a tool for resolving and stemming bullying, but rather a complementary participatory method of support that can help denormalize school violence and promote the emancipation of the individuals involved.(AU)

El objetivo de este artículo es analizar la rueda de conversaciones como instrumento participativo y educativo capaz de impactar la percepción de la disminución del bullying entre adolescentes en el contexto escolar. Se trata de un estudio de abordaje cualitativo, realizado por medio de entrevistas semiestructuradas con 18 adolescentes de una escuela de la enseñanza fundamental del Estado de São Paulo. Los resultados se analizaron a la luz de la praxis freireana y demostraron que este instrumento contribuyó para ampliar el entendimiento sobre este tipo de comportamiento agresivo, favoreció la ruptura del silencio sobre las agresiones que hasta aquel entonces no eran verbalizadas e impactó la percepción de disminución del bullying. Se subraya que no se trata de concebir la rueda como instrumento de resolución y estanque en sí mismo, sino como participativo, complementario, apoyador y potencialmente capaz de contribuir para la desnaturalización de la violencia en el escenario escolar y promover la emancipación de los envueltos.(AU)

Motuca healthy municipality project: building together a better future.

The Brazilian Ministry of Health in collaboration with the Municipality of Motuca and the School of Public Health at the University of São Paulo set up in 2002 the Motuca Healthy Municipality project with the aim of improving the population's health and quality of life. The project used a participatory and holistic approach, which addressed the social determinants and structural inequities, and called for strategies of community empowerment, social participation, intersectoral networking and good governance. All local and public actors from rural and urban areas were consulted and participated in the project to collect information on the living conditions and challenges to better wellbeing. This participatory methodology allowed in turn developing cultural and socially appropriate initiatives to improve local governance and standards of living on a long-term basis. Although there is still the challenge to maintain the momentum and reenergize the efforts, the project serves as a model for further efforts to evaluate the effectiveness of participatory intervention and research methodologies to promote health and well-being in communities.

Theory and practice in the context of health promotion program evaluation.

Evaluation of health promotion (HP) actions is a major challenge, generating inquiries and reflections that can contribute on the effectiveness of the actions themselves. With the aim on fostering exchange on monitoring and evaluation experiences related to the implementation of healthy settings, the 1 st Brazilian Seminar on Health Promotion Effectiveness was launched in 2005. The program included round table and workshops known as Working Groups (WG) in Brazil. The criteria used to constitute the workshops focused settings as spaces of circulation and living as an intrinsic connection to lifestyles and conditions, as well as to social and/or environmental risk factors associated with groups living in these settings day after day. Focusing on evaluation as an activity that generates knowledge, this article highlights and stimulates the discussion about some major issues arising from the theoretical-methodological approach and the discussions developed in the workshops. The debates carried out during the Seminar illustrated the different perceptions and views of the social players involved in implementation and evaluation of H P practices, disclosing a multiplicity of meanings. It became clear that procedures are needed to document a future maturation of concepts and methods, in combination with further in-depth theoretical discussion.

Articulação entre Práticas Integrativas e Promoção da Saúde: ações coletivas com acupuntura na Estratégia Saúde da Família / Articulation between Integrative Practices and Health Promotion: collective actions with acupuncture in the Family Health Strategy

As Práticas Integrativas e Complementares em Saúde (PICS) são reconhecidas pela Organização Mundial de Saúde e englobam várias terapêuticas corporais e comportamentais, sendo uma delas a acupuntura. Esta pesquisa teve como objetivo analisar uma experiência que articulou ações coletivas de acupuntura com a promoção da saúde em uma Unidade de Saúde da Família. Foi realizado um estudo descritivo e analítico, de natureza qualitativa, que utilizou rodas de conversas e registros em diário de pesquisa como estratégias para produção de dados. Este estudo possibilitou uma ampliação no acolhimento das demandas dos usuários, com estreitamento de vínculo entre a equipe de saúde e a comunidade, contribuindo para a desmedicalização do cuidado. Pôde-se perceber a ampliação da clínica,o aumento do conhecimento sobre as PICS, com incentivo à desmedicalização, autocuidado, participação de práticas coletivas, troca de saberes e inserção de estratégias capazes de colaborar com o processo de reconstrução de modos de viver a vida de pessoas que buscam o serviço de saúde.

Integrative and Complementary Practices in Health (PICS, in Portuguese) are recognizedby the World Health Organization and encompass several bodily and behavioral therapies, one of which is acupuncture. This research aimed to analyze and reflect on an experience that articulated collective actions using acupuncture practices with health promotion in a Family Health Unit. A descriptive and analytical study of qualitative nature was carried out, which used conversation circles and research diary records as strategies for data production. This study enabled an expansion in the understanding ofthe users' needs, with a closer bond between the health team and the community, contributing to the demedicalization of care. It was possible to perceive the expansion of the clinic's offer, the increase in knowledge of PICS, encouraging demedicalization,self-care, participation in collective practices, exchange of knowledge, and insertion of strategies capable of collaborating with the process of reconstructing the life habits of those who seek health care.

Direito humano à alimentação adequada e objetivos do desenvolvimento sustentável: interferências coletivas com crianças em periferias vulnerabilizadas / The human right to adequate food and sustainable development goals: collective interferences with children in vulnerable urban peripheries

Resumo Este artigo teve como objetivo analisar as relações entre o Direito Humano à Alimentação Adequada (DHAA) e os Objetivos do Desenvolvimento Sustentável (ODS) que emergem de ações dialógicas com crianças e adolescentes em periferias urbanas vulnerabilizadas de São Vicente, São Paulo. Utilizando referencial metodológico das pesquisas participativas, a observação e registros de assembleias comunitárias e da parceria entre universidade pública e movimento social apontam para espaços de acolhimento às crianças e adolescentes que viabilizam leituras diagnósticas coletivas sobre a alimentação. Esses processos dialógicos permitem problematizar as dimensões do DHAA a partir da cadeia de produção, comercialização e consumo de alimentos, além da instabilidade a que essas crianças e adolescentes estão submetidos, em uma complexa rede de determinantes que produzem má-nutrição nos territórios onde vivem. Os resultados apontam que estas dimensões dialogam com todos os ODS, na medida em que demandam a sustentabilidade cultural, econômica, social e ambiental da alimentação. A parceria e a integração entre universidade e sociedade fortalece e potencializa os espaços de controle social e formação dos atores para a luta pelo DHAA, e pode também produzir efeitos de transformação nas desigualdades nos territórios e reconhecer a criança como sujeito de direitos com profundo rigor ético na construção de escutas inclusivas e de práticas qualificadas.

Abstract This study aimed to analyze the relation between the Human Right to Adequate Food (HRAF) and Sustainable Development Goals (SDG) resulting from a dialogic experience with children and adolescents in the periphery of São Vicente, São Paulo. Using the methodological framework of participatory research, community assemblies observation, and the partnership between the university and social movements point to a caring place for children/adolescents that enable collective diagnostic readings on food. Dialogical processes enable us to problematize HRAF dimensions based on the chain of food production, trading and consumption, and the instability to which those children/adolescents are subjected in a complex network of determinants that produce hunger and malnutrition in the territories in which they live. Results show that these dimensions dialogue with all the SDGs, as they demand cultural, economic, social, and environmental sustainability of food. The partnership and integration between university and society strengthens and enhances the spaces of social control and training of actors to advocate for the HRAF. It can also change inequalities in the territories and acknowledge children as subjects of rights with deep ethical commitment in the construction of inclusive listening and qualified practices.

Shared Participatory Research Principles and Methodologies: Perspectives from the USA and Brazil-45 Years after Paulo Freire's "Pedagogy of the Oppressed".

The trajectory of participation in health research by community social actors worldwide has been built on a history of community participation from the Ottawa Charter Health Promotion call for community mobilization, to the emancipatory educational philosophy of Paulo Freire, to social movements and organizing for health and social justice. This paper builds on this history to expand our global knowledge about community participation in research through a dialogue between experiences and contexts in two prominent countries in this approach; the United States and Brazil. We first focus on differences in political and scientific contexts, financing, and academic perspectives and then present how, despite these differences, similarities exist in values and collaborative methodologies aimed at engaging community partners in democratizing science and knowledge construction. We present three case studies, one from the U.S. and two from Brazil, which illustrate similar multi-level processes using participatory research tools and Freirian dialogue to contribute to social mobilization, community empowerment, and the transformation of inequitable societal conditions. Despite different processes of evolution, we observed a convergence of participatory health research strategies and values that can transform science in our commitment to reduce health and social inequities and improve community wellbeing.

Sustainability and power in health promotion: community-based participatory research in a reproductive health policy case study in New Mexico.

Health promotion programs are commonly viewed as value-free initiatives which seek to improve health, often through behavior change. An opposing view has begun to emerge that health promotion efforts, especially ones seeking to impact health policy and social determinants of health, are vulnerable to political contexts and may depend on who is in power at the time. This community-based participatory research study attempts to understand these interactions by applying a conceptual model focused on the power context, diverse stakeholder roles within this context, and the relationship of political levers and other change strategies to the sustainability of health promotion interventions aimed at health policy change. We present a case study of a health promotion coalition, New Mexico for Responsible Sex Education (NMRSE), as an example of power dynamics and change processes. Formed in 2005 in response to federal policies mandating abstinence-only education, NMRSE includes community activists, health promotion staff from the New Mexico Department of Health, and policy-maker allies. Applying an adapted Mayer's 'power analysis' instrument, we conducted semi-structured stakeholder interviews and triangulated political-context analyses from the perspective of the stakeholders.We identified multiple understandings of sustainability and health promotion policy change, including: the importance of diverse stakeholders working together in coalition and social networks; their distinct positions of power within their political contexts; the role of science versus advocacy in change processes; the particular challenges for public sector health promotion professionals; and other facilitators versus barriers to action. One problem that emerged consisted of the challenges for state employees to engage in health promotion advocacy due to limitations imposed on their activities by state and federal policies. This investigation's results include a refined conceptual model, a power-analysis instrument, and new understandings of the intersection of power and stakeholder strategies in the sustainability of health promotion and health in all policies.

Supervisão acadêmica e apoio pedagógico do Programa Mais Médicos em áreas indígenas e remotas da Amazônia Legal: vivências, desafios e perspectivas / Academic supervision and pedagogical support of the More Doctors Program in indigenous and remote areas of the Legal Amazon: experiences, challenges and perspectives

Este artigo busca analisar a supervisão acadêmica do Grupo Especial de Supervisão (GES) do Programa Mais Médicos (PMM) em áreas remotas e territórios indígenas da Amazônia Legal, com foco na realidade dos profissionais dessas localidades e nas possibilidades de suporte pedagógico para regiões de difícil acesso. O trabalho foi desenvolvido a partir de entrevistas semiestruturadas com médicos do PMM e da narrativa autobiográfica da pesquisadora. Os dados foram submetidos à análise de conteúdo textual, que resultou em três categorias: o "ser médico" do PMM (trajetórias, expectativas e perspectivas de trabalho); a contextualização do trabalho médico nas áreas indígenas e remotas da Amazônia Legal; e as características de funcionamento da supervisão acadêmica do GES/PMM que a tornam "especial" e fundamental para o país. A pesquisa, com isso, ajudou na compreensão da realidade da região, dos desafios enfrentados pelos profissionais e supervisores edas possibilidades de aprimoramento do suporte pedagógico para o PMM e outros programas de provimento médico. Por fim, discute-se o imperativo das questões estruturais de trabalho e vida nesses locais sobre o alcance real da supervisão, o que exige dela uma postura crítica e engajada por melhorias para a região.

The article seeks to analyze the academic supervision of the Special Supervision Group (GES, in Portuguese) from the More Doctors Program (PMMin Portuguese) in remote areas and indigenous territories of the Legal Amazon, focusing on the reality of professionals in these locations and the possibilities of pedagogical support for regions of difficult access. The work was developed from semi-structured interviews with PMM doctors and the autobiographical narrative of the researcher. The data were subjected to textual content analysis, which yielded three categories: the PMM's "being a doctor" (trajectories, expectations, and work perspectives); the contextualization of medical work in indigenous and remote areas of the Legal Amazon; and the characteristics of the GES/PMM's academic supervision functioning that distinguish it as "special" and fundamental to the country.The research thereby helped in understanding the reality of the region, the challenges faced by practitioners and supervisors, and the possibilities for improving pedagogical support for the PMM and other medical provider programs. Finally, it discusses the imperative of the structural issues of work and life in these places on the actual scope of supervision, which requires it to take a critical and engaged stance for improvements in the region.

Formação médica na atenção primária à saúde: percepção de estudantes / Medical training in primary health care: the students' perspective

Resumo: Introdução: A implantação das Diretrizes Curriculares Nacionais da graduação em Medicina de 2001 e 2014 provocou movimentos de mudanças na formação médica proporcionadas pela integração ensino-serviço na atenção primária à saúde (APS) desde os anos iniciais do curso e colocou em análise uma formação que se propõe ser generalista, crítica e reflexiva. Objetivo: Este estudo teve como objetivo identificar as contribuições que a interação ensino-serviço pode oferecer para a produção de um espaço de aprendizagem significativa, tendo como cenário uma unidade de saúde da família. Método: Trata-se de estudo de abordagem qualitativa com realização de rodas de conversas, nas quais participaram estudantes do primeiro, terceiro e quinto períodos do curso de Medicina, a fim de analisar as impressões deles do início, meio e término da disciplina. Foi utilizada a análise de conteúdo para a sistematização e avaliação dos dados obtidos. Resultado: Os ciclos pedagógicos foram considerados como oportunidades de aprendizagem, os portfólios reflexivos não atenderam aos objetivos de avaliação formativa, e a inserção nas práticas possibilitou conhecer as especificidades e a complementaridade das profissões, além da importância do trabalho em equipe. A visita domiciliar (VD) foi valorizada, no entanto carece de objetivos claros a fim de que cumpra seu papel de desenvolver a habilidade comunicacional, o acolhimento das demandas e a responsabilização do cuidado. Conclusão: A inserção precoce de estudantes da graduação em Medicina na atenção primária oportuniza experiências de aprendizagem significativa e potencializa o uso articulado e processual de ferramentas como a VD e o portfólio. Embora as políticas favoreçam a integração ensino-serviço-comunidade, provocar movimentos instituintes nos modelos hegemonicamente consolidados, colocando a APS na centralidade do processo, ainda é um grande desafio a ser enfrentado.

Abstract: Introduction: The implementation of the National Curriculum Guidelines for medicine in 2001 and 2014 brought about changes in undergraduate medical training provided by teaching-service integration in Primary Health Care (PHC) since the initial years of the course, and proposed a training that is generalist, critical and reflective. Objective: Identify the contributions that teaching-service interaction can offer for the production of a meaningful learning space, in the setting of a Family Health Unit. Method: A qualitative approach study with Conversation Wheels with students from the 1st, 3rd and 5th periods of the medical course in order to analyze their impressions at the start, midway through and at the end of the subject. Content Analysis was used to systematize and analyze the data obtained. Results: Pedagogical cycles were considered learning opportunities; the reflective portfolios did not meet the objectives of formative assessment and insertion into practice enabled an understanding of the specific and complementary characteristics of the professions in addition to the importance of teamwork. The value of the Home Visit was highlighted, however, a lack of clear objectives hinder its role of developing communication skills, accepting demands and making care responsible. Conclusions: The early insertion of undergraduate medical students into primary care settings provides meaningful learning experiences and enhances the articulated and procedural use of tools such as the HV and the portfolio. Although policies favor teaching-service-community integration, instigating inaugural movements within the hegemonically consolidated models, placing PHC at the center of the process, remains a major challenge.

La contribución de los Centros Colaboradores de la OMS/OPS en los avances de la promoción de la salud en América Latina.

Los "Centros Colaboradores" de la Organización Mundial de la Salud (OMS) son instituciones designadas para prestar apoyo estratégico en el desarrollo de los objetivos y la ejecución de las actividades de la OMS, y para generar capacidad institucional en países y regiones. En las Américas existen ocho Centros Colaboradores directamente relacionados a la promoción de la salud. Cuatro centros se ubican en Norteamérica y los otros cuatro en América Latina. El propósito de este artículo es describir los Centros Colaboradores de la Región de América Latina. Los centros han sido importantes en el desarrollo de la agenda de promoción de la salud de la región, la consolidación de la estrategia de entornos saludables y el fortalecimiento de las redes académicas y profesionales de promoción de la salud.

Educação Permanente em Saúde: experiências inovadoras em saúde mental na Atenção Básica à Saúde / Permanent Education in Health: innovative experiences in mental health in Primary Health Care

RESUMO O processo de articulação da Rede de Atenção Psicossocial é um desafio diário vinculado à assistência integral à saúde e a estigmas sobre transtornos mentais, sendo necessário repensar estratégias que intensifiquem a articulação de maneira inclusiva, garantindo acesso a toda a população. Este artigo descreve uma pesquisa de intervenção de abordagem qualitativa, utilizando Oficinas como método de Educação Permanente em Saúde, apresentando os agentes comunitários de saúde como público-alvo. O objetivo deste estudo foi possibilitar a intervenção, a implementação e a análise dessa metodologia, com o intuito de promover um espaço de troca, criação coletiva e transformação da prática na produção diária de saúde entre profissionais e usuários com transtornos mentais, pensando sobre o fortalecimento do papel na Rede de Atenção Psicossocial segundo a Reforma Psiquiátrica. Esta pesquisa promoveu encontros com atividades reflexivas e aprendizagem inventiva que permitiram a 'construção conjunta', partindo de problemas identificados no cotidiano e construindo juntos a solução comum. Ao construir a solução, este estudo fortaleceu o relacionamento entre as equipes de atendimento da Rede de Atenção Psicossocial, incentivando esses profissionais a serem uma extensão do Centro de Atenção Psicossocial no território.

ABSTRACT The articulation process of the Psychosocial Care Network is a daily challenge linked to comprehensive health care and stigmas about mental disorders, and it is necessary to rethink strategies that intensify the articulation in an inclusive way, guaranteeing access for all the population. This article describes a qualitative approach intervention research, using workshops as a method of Permanent Education in Health, presenting the community health agents as a target audience. The purpose of this study is to enable the intervention, implementation and analysis of this methodology, aiming to promote a space of exchange, collective creation and transformation of the practice in the daily production of health among professionals and users with mental disorders, thinking the strengthening of the protagonism in the Psychosocial Care Network, according to the Psychiatric Reform. This research promoted meetings with reflective activities and inventive learning that allowed 'joint construction', starting with problems identified in daily life and building together the common solution. While building the solution, this study strengthened the relationship between the teams within those services of the Psychosocial Care Network, encouraging these professionals to be an extension of the Psychosocial Care Center in the territory.

[Health promotion evaluation: focus on "healthy cities"]. / Avaliação em promoção da saúde: foco no "município saudável".

Since the Healthy City movement is a health promotion strategy, an update study was carried out to put into context the health promotion evaluation debate stressing the principles to be considered in an evaluation initiative and in the problematic of Health Cities projects. A literature review of "Healthy Cities" was conducted. A typology based on of Healthy Cities papers found in MEDLINE, LILACS and published in the "Health Promotion International" between 1985 and 2000 was proposed taking into consideration the main focus of each paper. Articles on evaluation were analyzed in more details according to stressing methods, research tools, indicators, study results, and critical appraisal of their models. Finally, it is highlighted initiatives that would come close to the principles of "Health Promotion" and adopt evaluation as a tool for building up capabilities and the empowerment of community groups involved with Healthy Cities initiatives.

Pesquisa qualitativa em saúde e a perspectiva da Cartografia em Deligny e Deleuze/Guattari / Qualitative research in healthcare and deligny's and Deleuze/Guattari's Cartographic perspective / Investigacion cualitativa en salud y la perspectiva de la cartografia de deligny y Deleuze/Guatarri

Este artigo tem como objetivo apresentar os delineamentos teórico-metodológicos da investigação Atenção Básica e a Produção do cuidado em Rede, Santos - São Paulo, que teve como cenário de estudo Unidades da Atenção Básica e buscou identificar experiências de cuidado de saúde em rede. A investigação qualitativa e participativa orientou-se pela perspectiva cartográfica de Deligny e Deleuze/Guattari, por meio da utilização dos instrumentos Diários de Pesquisa e Mapa dos Trajetos dos Pesquisadores. Os resultados apontaram que o percurso metodológico permitiu instalar um território de pesquisa no qual todos os participantes produziam juntos os dados e os modos de perceber as redes de cuidado. O acompanhamento da implicação dos pesquisadores e de seus embates por não estarem no controle da investigação, aceitando entrar em contato com aquilo que não se sabe ou não se espera encontrar, mostrou que o conhecimento produzido em uma pesquisa provoca boas surpresas.

This article aims to present the theoretical-methodological outlines of the investigation Basic Attention and the Production of Care Network, Santos - São Paulo whose scenario of studies were the Basic Attention Units and which tried to identify experiences of healthcare network. The qualitative and participatory investigation was oriented by Deligny's and Deleuze/ Guattari's cartographic perspective through the use research diaries and a map of the researchers' course. The results pointed that the methodological path allowed to install a research territory in which all the participants produced together the data and the ways of perceiving the nets of cared. The follow-up of the implication of the researchers and their conflicts for not being in control of the investigation, accepting to get in touch with what is not known or expected to be found, showed that the knowledge produced in a research provokes good surprises

Este artículo presenta las líneas metodológicas de investigación "Atención Básica y la producción de cuidado en red, Santos, São Paulo, teniendo como escenario del estudio Unidades de Atención Básica y buscó identificar experiencias de cuidado de salud en red. La investigación cualitativa y participativa se orientó por la perspectiva cartográfica de Deligny/Deleuze Gattari, mediante el uso de los instrumentos: Diarios de Investigación, y mapas de los trayectos de los investigadores. Los resultados indicaron que las apuestas metodológicas realizadas permitieron instalar un territorio de investigación en el cual todos los participantes producen juntos los datos y los modos de percibir las redes de cuidado. El acompañamiento de la implicación de los investigadores y sus choques en no estar en el controle de la investigación aceptando entrar en contacto con lo que no se sabe o no se espera encontrar, mostró que el conocimiento producido en una investigación provoca buenas sorpresas.

Capacitação de agentes comunitários de saúde para a detecção da demência na fase leve / Capacitating community health workers to detect dementia at the mild stage / Capacitación de agentes comunitarios de salud para detección de las demencias en la fase leve

Objetivo: avaliar o processo de educação permanente na capacitação de agentes comunitários de saúde (ACS) para a detecção de pessoas com demência na fase leve. Método: descritivo, comparando o desempenho dos sujeitos antes e após a oficina de aprendizagem. Após a aprovação pelo Comitê de Ética em Pesquisa, foi realizada oficina de capacitação com oito ACS de uma unidade básica de saúde, da cidade de Santos, em 2018. Antes e após a oficina foram aplicados questionários semiestruturados. Os dados foram tratados a partir da análise temática. Resultados: a falta de conhecimento sobre a demência aponta para a necessidade de investimento em educação permanente dos ACS como uma importante ferramenta a ser utilizada na detecção de casos iniciais. Conclusão: a educação permanente pode contribuir para o maior número de casos identificados nas fases iniciais da demência na atenção básica de forma que os encaminhamentos necessários e tratamentos possíveis sejam iniciados precocemente de forma a beneficiar pessoas e/ou suas famílias.

Objective: to evaluate the continuing professional development (CPD) process in capacitation of community health workers (CHWs) to detect early dementias. Method: this descriptive study compared the performance of eight CHWs from a Basic Health Unit in Santos, by applying semi-structured questionnaires before and after a CPD workshop held in 2018, after approval by the research ethics committee. The data were processed using thematic analysis. Results: the CHWs' lack of knowledge about dementia points to the need to invest in continuing professional development as an important tool to be used to detect early cases. Conclusion: continued professional development can contribute to identification of more cases in the early stages of dementia in primary care, so that necessary referrals and possible treatment are initiated early to benefit individuals and/or their families.

Objetivo: evaluar el proceso de educación permanente en la capacitación de agentes comunitarios de salud (ACS) para detección de personas con demencia en la fase leve. Método: estudio descriptivo, comparado el desempeño de las personas antes y después del taller de aprendizaje. Tras la aprobación del Comité de Ética en Investigación, se realizó un taller de capacitación con ocho ACS de una Unidad Básica de Salud de la ciudad de Santos, en 2018. Antes y después del taller, se aplicaron cuestionarios semiestructurados. Los datos fueron procesados desde el análisis temático. Resultados: la falta de conocimiento sobre la demencia apunta hacia la necesidad de inversión en educación permanente, por parte de los ACS, como una importante herramienta a ser utilizada en la detección de casos iniciales. Conclusión: la educación permanente puede contribuir a la identificación en la atención básica de mayor número de casos en las fases iniciales de la demencia de forma a que las derivaciones aplicables y los posibles tratamientos se inicien precozmente para poder beneficiar a las personas y/o a sus familias.

Interdisciplinaridade e as múltiplas dimensões do trabalho em saúde / Interdisciplinarity and the multiple dimensions of health work / Interdisciplinaridad y las múltiples dimensiones del trabajo sanitario

Este artigo tem como objetivo analisar criticamente a interdisciplinaridade e a forma como é compreendida e implementada no trabalho em saúde. A coleta de dados se deu através de pesquisa bibliográfica e revisão integrativa de artigos científicos na área de saúde em periódicos indexados nas bases de dados SCIELO, BVS, LILACS, PUBMED, publicados no período entre janeiro de 2007 a dezembro de 2020. Identificou-se a ausência de consenso sobre o conceito e verificou-se que a temática perpassa diferentes áreas do saber. Os resultados foram organizados em dois núcleos: a interdisciplinaridade na formação acadêmica e na atuação profissional. Dentre as evidências constatou-se que embora o trabalho em saúde tenha como princípio norteador o cuidado integral, e as Diretrizes Curriculares Nacionais primem por uma formação interdisciplinar, ainda é preponderante nos cursos de graduação relacionados à saúde os currículos pautados em disciplinas, o que reflete em práticas desarticuladas e isoladas. Conclui-se que práticas interdisciplinares em consonância com o princípio da integralidade das ações em saúde se tornam cada vez mais necessárias, tanto para manutenção do diálogo entre os diferentes campos do conhecimento e o fortalecimento das relações profissionais, quanto para melhor responder às necessidades de saúde. (AU)

his article aims to critically analyse interdisciplinarity and the way it is understood and implemented in health work. The production of data data collection took place through bibliographical research and integrative review of scientific articles in the health field in journals indexed in the databases SCIELO, BVS, LILACS, PUBMED, published between January 2007 and December 2020. It was identified the lack of consensus on the concept and it was found that the theme spans different areas of knowledge. The results were organized into two groups: interdisciplinarity in academic training and professional performance. Among the evidences it was found that although health work has as a guiding principle comprehensive care, and the National Curricular Guidelines are based on interdisciplinary training, curricula based on disciplines are still predominant in undergraduate courses related to health, which reflects in disjointed and isolated practices. It is concluded that interdisciplinary practices in line with the principle of integrality of health actions become increasingly necessary, both to maintain the dialogue between different fields of knowledge and to strengthen professional relationships, as well as to better respond to health needs. (AU)

Esteartículo tiene como objetivoaranalizarcríticamentela interdisciplinariedady cómo se entiendee implementa en el trabajo de salud. La recopilación de datos se realizóa través de la investigación bibliográfica y la revisión integrativa de artículos científicos en elárea de salud en revistas indexadas en las bases de datos SCIELO, VHL, LILACS, PUBMED, publicadas entre enero de 2007 y diciembre de 2020.Identifíquela faltadeconsenso sobre el conceptooy see encontró que el tema impregna diferentes áreas de conocimiento.Los resultados se organizaron endosnúcleos: interdisciplinaria en la educación académicay la práctica profesional. Entre las evidencias, se encuentra que, aunque el trabajo de salud tiene como principio rector la atenciónintegral, y las Directrices Nacionales de Currículo primym por una formacióninterdisciplinaria, sigue siendopreponderante n cursos depregrado relacionados conlosplanes de estudios de salud basados en disciplinas,que se refleja en prácticas desarticuladas y aisladas.Se concluye que las prácticas interdisciplinarias en consonancia con el principio de integralidad de las acciones sanitariassoncada vezmásnecesarias, tanto paramantener el diálogo entre los diferentes campos del conocimiento y fortalecer lasrelaciones profesionales, como para responder mejor a las necesidades de salud. (AU)