A factorial design was used to evaluate the effects of processing variables on the morphology and microstructural characteristics of titanium dioxide (TiO2) fibers produced by solution blow spinning (SBS). For this, tests were carried out varying TiO2 precursor content, feed rate, air pressure, polymer, and solvent. The TTIP concentration and feed rate statistically influenced the average diameters of the PVC/TiO2 system. The proper combination between polymer and solvent enables the obtaining of TiO2 nanofibers with similar morphologies either using hydrophilic or hydrophobic polymer, however, fiber diameter is influenced by type of system (polymer/solvent) used. Only the anatase crystalline phase was found in the fibers with the PVC polymer and THF solvent, while two crystalline phases were obtained in the fibers with PVP and alcohol, anatase and rutile, indicating that the variation of the polymer and solvent influences the crystalline phases of the TiO2 fibers studied.

Key points Pregnancy places a metabolic overload on the maternal thyroid, especially in the first trimester, mainly because of the demand imposed by the conceptus. The fetal thyroid becomes functionally mature only around pregnancy week 20. Until then, the fetus depends on the transfer of maternal thyroid hormones (THs). Thyroid hormones are essential for the adequate fetal neurofunctional and cognitive development. Hypothyroidism brings higher risks of obstetric and fetal complications, namely, first-trimester miscarriage, preeclampsia and gestational hypertension, placental abruption, prematurity, low birth weight, and higher perinatal morbidity and mortality. Primary hypothyroidism (involvement of the gland with difficulty in producing and/or releasing TH) is the most common form of disease presentation, with the main etiology of Hashimoto's thyroiditis of autoimmune origin. In about 85%-90% of cases of Hashimoto's thyroiditis, antithyroid antibodies are present; the antithyroperoxidase (ATPO) is the most frequent. Positivity for ATPO is determined when circulating values exceed the upper limit of the laboratory reference. It implies greater risks of adverse maternal-fetal outcomes. Such a correlation occurs even in ranges of maternal euthyroidism. The critical point for the diagnosis of hypothyroidism during pregnancy is an elevation of thyroid-stimulating hormone (TSH). The measurement of free thyroxine (FT4) differentiates between subclinical and overt hypothyroidism. In subclinical hypothyroidism, FT4 is within the normal range, whereas in overt hypothyroidism, FT4 values are below the lower limit of the laboratory reference. Treatment of hypothyroidism is performed with levothyroxine (LT4) replacement with the aim of achieving adequate TSH levels for pregnancy. Some women have a previous diagnosis of hypothyroidism, and may or may not be compensated at the beginning of pregnancy. Even in compensated cases, the increase in LT4 dose is necessary as soon as possible. In the postpartum period, adjustment of the LT4 dose depends on the condition of previous disease, on the positivity for ATPO, and also on the value of LT4 in use at the end of pregnancy. Recommendations In places with full technical and financial conditions, TSH testing should be performed for all pregnant women (universal screening) as early as possible, ideally at the beginning of the first trimester or even in preconception planning. In places with less access to laboratory tests, screening is reserved for cases with greater risk factors for decompensation, namely: previous thyroidectomy or radioiodine therapy, type 1 diabetes mellitus or other autoimmune diseases, presence of goiter, previous history of hypo or hyperthyroidism or previous ATPO positivity. The TSH dosage should be repeated throughout pregnancy only in these cases. The diagnosis of hypothyroidism is made from the TSH value > 4.0 mIU/L. Pregnant women with previous hypothyroidism, overt hypothyroidism diagnosed during pregnancy or those with the above-mentioned higher risk factors for decompensation should be referred for risk antenatal care, preferably in conjunction with the endocrinologist. Overt hypothyroidism in pregnancy is identified when TSH > 10 mIU/L, and treatment with LT4 is readily recommended at an initial dose of 2 mcg/kg/day. TSH values > 4.0 mUI/L and ≤ 10.0 mUI/L require FT4 measurement with two diagnostic possibilities: overt hypothyroidism when FT4 levels are below the lower limit of the laboratory reference, or subclinical hypothyroidism when FT4 levels are normal. The treatment for subclinical hypothyroidism is LT4 at an initial dose of 1 mcg/kg/day, and the dose should be doubled upon diagnosis of overt hypothyroidism. In cases of TSH > 2.5 and ≤ 4.0 mIU/L, if there are complete conditions, ATPO should be measured. If positive (above the upper limit of normal), treatment with LT4 at a dose of 50 mcg/day is indicated. If conditions are not complete, the repetition of the TSH dosage should be done only for cases at higher risk. In these cases, treatment with LT4 will be established when TSH > 4.0 mIU/L at a dose of 1 mcg/kg/day; if needed, the dose can be adjusted after FT4 evaluation. Women with previous hypothyroidism should have their LT4 dose adjusted to achieve TSH < 2.5 mIU/L at preconception. As soon as they become pregnant, they need a 30% increase in LT4 as early as possible. In practice, they should double the usual dose on two days a week. Levothyroxine should be given 30-60 minutes before breakfast or three hours or more after the last meal. Concomitant intake with ferrous sulfate, calcium carbonate, aluminum hydroxide and sucralfate should be avoided. The target of LT4 therapy during pregnancy is to achieve a TSH value < 2.5 mIU/L. Once the therapy is started, monthly control must be performed until the mentioned goal is reached. In the postpartum period, women with previous disease should resume the preconception dose. Cases diagnosed during pregnancy in use of LT4 ≤ 50 mcg/day may have the medication suspended. The others should reduce the current dose by 25% to 50% and repeat the TSH measurement in six weeks. Cases of ATPO positivity are at higher risk of developing postpartum thyroiditis and de-escalation of LT4 should be performed as explained.

ABSTRACT Many students dislike Physical Education classes in Brazil because of content repetition, unsatisfactory curricular organization, among other factors. The purpose of this study is to assess the efficiency of a proposal for Physical Education classes, which includes contents of physical activities and the use of comic books application. This is a qualitative study, which comprises both bibliographic and field researches. Twelve classes were held to a group of eight graders from a public school in the city of Piracicaba/SP/Brazil. Questionnaires were used to evaluate the proposal for Physical Education classes. We found out that the use of comic books application is an effective teaching resource, as it reveals the students’ experiences, what they felt, and the mediation between their “rational” and “sensitive” knowledge about physical activities. There is evidence that our experience has provided participating students with: 1- Leisure education and health education, 2- Awakening to knowledge of the body culture of movement, 3- Access to some leisure contents, mainly those related to physical, sports and artistic ones, 4- The creation of comics by App Flaras.

RESUMEN A muchos estudiantes no les gustan las clases de Educación Física en Brasil debido a la repetición de contenidos, organización curricular insatisfactoria, entre otros factores. El propósito de este estudio es evaluar la eficiencia de una propuesta de clases de Educación Física, que incluye contenidos de actividades físicas y el uso de la aplicación de cómics. Se trata de un estudio cualitativo, que comprende tanto investigaciones bibliográficas como de campo. Se impartieron doce clases a un grupo de ocho alumnos de una escuela pública de la ciudad de Piracicaba / SP / Brasil. Se utilizaron cuestionarios para evaluar la propuesta de clases de Educación Física. Descubrimos que el uso de la aplicación de cómics es un recurso didáctico eficaz, ya que revela las experiencias de los estudiantes, lo que sentían y la mediación entre sus conocimientos "racionales" y "sensibles" sobre las actividades físicas. Existe evidencia de que nuestra experiencia ha proporcionado a los estudiantes: 1. Educación para el ocio participativa y educación para la salud, 2. Despertar al conocimiento de la cultura corporal del movimiento, 3. Acceso a algunos contenidos de ocio, principalmente los relacionados con los físicos, deportivos y artísticos, y 4. La creación de cómics por App Flaras.

RESUMO Objetivo: analisar as relações de poder e saber, entre a equipe de saúde, que permeiam a implantação e disseminação do Método Canguru no estado de Santa Catarina. Método: pesquisa sócio-histórica, com abordagem qualitativa, realizada no estado de Santa Catarina, no período de janeiro a novembro de 2019, a partir de entrevistas com 12 profissionais de saúde. Os dados foram analisados à luz da proposta genealógica de Foucault, com auxílio do software Atlas.ti Cloud®. Resultados: as relações da equipe neonatal fortaleceram as ações do Método Canguru no estado, articulando os serviços e favorecendo a autonomia dos profissionais de saúde. Entretanto, a enfermeira Canguru se destaca nesse processo, e o discurso médico hegemônico, muitas vezes, ainda reprime as demais categorias profissionais. Conclusão: os profissionais desenvolvem estratégias para negociar as mudanças na prática do cuidado, transitando entre as tramas do poder e saber, ora o exercendo, ora sendo passivo a ele.

ABSTRACT Objective: to analyze the power relations and knowledge among health teams that permeate the Kangaroo Mother Care implementation and dissemination in the state of Santa Catarina. Method: socio-historical qualitative research, carried out in the state of Santa Catarina, from January to November 2019, based on interviews with 12 health professionals. Data were analyzed in the light of Foucault’s genealogical proposal, with the help of Atlas.ti Cloud®. Results: the relationships of neonatal team members strengthened Kangaroo Mother Care actions in the state, articulating services and favoring health professionals’ autonomy. However, Kangaroo nurses stand out in this process, and the hegemonic medical discourse often still represses the other professional categories. Conclusion: professionals develop strategies to negotiate changes in the practice of care, moving between the plots of power and knowledge, sometimes exercising it, sometimes being passive to it.

RESUMEN Objetivo: analizar las relaciones de poder y saber, entre el equipo de salud, que permean la implementación y difusión del Método Madre-Canguro en el estado de Santa Catarina. Método: investigación sociohistórica, con enfoque cualitativo, realizada en el estado de Santa Catarina, de enero a noviembre de 2019, a partir de entrevistas con 12 profesionales de la salud. Los datos fueron analizados a la luz de la propuesta genealógica de Foucault, con la ayuda del software Atlas.ti Cloud®. Resultados: las relaciones del equipo neonatal fortalecieron las acciones del Método Madre-Canguro en el estado, articulando los servicios y favoreciendo la autonomía de los profesionales de la salud. Sin embargo, la enfermera canguro se destaca en este proceso, y el discurso médico hegemónico muchas veces aún reprime a las demás categorías profesionales. Conclusión: los profesionales desarrollan estrategias para negociar cambios en la práctica del cuidado, moviéndose entre las tramas del poder y del saber, a veces ejerciendo, a veces siendo pasivos frente a él.

ABSTRACT Objective: To identify the potentialities, barriers and difficulties for the implementation of humanized care from the perspective of the Kangaroo Method. Methods: Integrative literature review with a time cut from 02/01/2015 to 06/01/2019, totaling ten articles in the final sample. Results: The findings were categorized into two categories: Potentialities for humanized care from the perspective of the Kangaroo Method; Barriers or difficulties to the implementation of the Kangaroo Method. Several potentialities for humanized care allied to technology and continuing education were identified, as well as several barriers to the implementation of the Kangaroo Method, such as lack of physical space, lack of professionals and team training, lack of knowledge, lack of adherence and professional demotivation. Final considerations: There are still few studies that address the potentialities, barriers and difficulties for the implementation of humanized care from the perspective of the Kangaroo Method, and most of those included in this review were conducted in Brazil and present a qualitative approach.

RESUMEN Objetivo: Identificar las potencialidades, barreras y dificultades a la implantación del cuidado humanizado en la perspectiva del Método Madre-Canguro. Métodos: Revisión integrativa de literatura con recorte temporal de 01/02/2015 a 01/06/2019, sumando diez artículos en su muestra final. Resultados: Los hallados fueron categorizados en dos categorías: Potencialidades al cuidado humanizado en la perspectiva del Método Madre-Canguro; Barreras o dificultades a la implementación del Método Madre-Canguro. Varias potencialidades al cuidado humanizado aliadas a tecnología y educación permanente fueron identificadas, así como varias barreras en la implementación del Método Madre-Canguro, tales como falta de espacio físico, falta de profesionales y entrenamiento del equipo, desconocimiento, falta de adhesión y desmotivación profesional. Consideraciones finales: Aún son pocos los estudios que abordan las potencialidades, barreras y dificultades a implantación del cuidado humanizado en la perspectiva del Método Madre-Canguro, y la mayoría de aquellos incluidos en esta revisión fueron realizados en Brasil y presentan abordaje cualitativo.

RESUMO Objetivo: Identificar as potencialidades, barreiras e dificuldades para a implantação do cuidado humanizado na perspectiva do Método Canguru. Métodos: Revisão integrativa de literatura com recorte temporal de 01/02/2015 a 01/06/2019, perfazendo dez artigos em sua amostra final. Resultados: Os achados foram categorizados em duas categorias: Potencialidades para o cuidado humanizado na perspectiva do Método Canguru; Barreiras ou dificuldades para a implementação do Método Canguru. Várias potencialidades para o cuidado humanizado aliadas à tecnologia e à educação permanente foram identificadas, assim como várias barreiras na implementação do Método Canguru, tais como falta de espaço físico, falta de profissionais e de treinamento da equipe, desconhecimento, falta de adesão e desmotivação profissional. Considerações finais: Ainda são poucos os estudos que abordam as potencialidades, barreiras e dificuldades para a implantação do cuidado humanizado na perspectiva do Método Canguru, e a maioria daqueles incluídos nesta revisão foram realizados no Brasil e apresentam abordagem qualitativa.

SUMMARY OBJECTIVE: The aim was to investigate the acute effect of kinesthetic motor imagery of the 2-minute walk test on hemodynamic and cardiopulmonary variables in patients with heart failure. METHODS: Twenty participants were recruited for the analysis of these variables before and after the execution and imagination of the 2-minute walk test, with the number of laps executed and imagined being recorded. RESULTS: The main results observed showed that (1) there was no difference in the number of laps executed and imagined (p=0.41), indicating that the participants actually imagined the test and (2) the motor imagery of the 2-minute walk test immediately increased (p<0.001) the heart and respiratory rates. CONCLUSION: The motor imagery seems to have acute effects on the cardiopulmonary anticipatory responses of a patient with heart failure.

RESUMO A baixa fertilidade do solo associada à falta de manejo adequado da irrigação são fatores que mais limitam a produção das culturas. Diante disso, objetivou-se avaliar os atributos químicos de um Oxisol e a produtividade da goiabeira ‘Paluma’ sob irrigação com água salina e adubada com fósforo, esterco bovino e boro. Os tratamentos foram distribuídos em blocos ao acaso, com quatro repetições e duas plantas por parcela, incluindo bordaduras nas laterais da área útil experimental, utilizando um esquema fatorial de (5 × 2) + 1, referentes a cinco doses de fósforo (0, 0.08, 0.16, 0.24 e 0.32 kg de P2O5 planta-1), duas doses de esterco bovino, 0 e 30 kg por planta e um tratamento adicional composto por 0.16 kg de P2O5 mais 30 kg de esterco bovino e 1.0 g de boro, utilizando como fonte o bórax. No solo avaliaram-se pH, fósforo, potássio, cálcio, magnésio e a capacidade de troca catiônica nas camadas de 0-20 cm e de 20-40 cm. Nas plantas, estimou-se a produtividade média por hectare em duas safras. O pH diminuiu com as doses de fósforo sem esterco bovino e no tratamento com boro na camada de 20-40 cm. A capacidade de troca catiônica aumentou com aplicação das doses de fósforo associadas ao esterco e diminuiu nas duas camadas do solo com a presença do boro. Os macronutrientes avaliados não foram influenciados pelo boro. As doses de fósforo associadas ao esterco bovino aumentaram a produtividade superando a média de 50 t ha-1 ano-1 determinada para a goiabeira ‘Paluma’, enquanto que o boro não aumentou a produtividade.

ABSTRACT The low soil fertility associated with the lack of adequate irrigation management are factors that most limit crop production. Therefore, the study aimed to evaluate the chemical attributes of an Oxisol and the yield of ‘Paluma’ guava under irrigation with saline water and fertilized with phosphorus, cattle manure, and boron. The treatments were distributed in randomized blocks, with four repetitions and two plants per plot, including borders on the sides of the useful experimental area, arranged in a factorial scheme (5 × 2) + 1, referring to five phosphorus doses (0, 0.08, 0.16, 0.24 and 0.32 kg of P2O5 plant-1), two doses of cattle manure, 0 and 30 kg per plant and an additional treatment consisting of 0.16 kg of P2O5 plus 30 kg of cattle manure and 1.0 g of boron, using as source the borax. In the soil, pH, phosphorus, potassium, calcium, magnesium, and the cation exchange capacity were evaluated in the 0-20 cm and 20-40 cm layers. In plants, the average yield per hectare in two harvests was estimated. The pH decreased with phosphorus doses without cattle manure and in the treatment with boron in the 20-40 cm layer. The cation exchange capacity increased with the application of phosphorus doses associated with manure and decreased in both soil layers with boron. The macronutrients evaluated were not influenced by boron. Phosphorus doses associated with cattle manure increased yield, exceeding the average of 50 t ha-1 year-1 determined for ‘Paluma’ guava. In contrast, boron did not increased the yield.

Abstract Aim: The sports facilities development and use optimization has been one of the main objectives of sports organizations. To understand how the management is performed, the knowledge about the manager and his function is crucial and may aid to improve facilities management and impact service quality. This study aimed to analyze the functional profile of sport facilities managers and verify their managerial behavior. Methods: A survey was conducted, 76 managers of public and non-profit sports facilities of São Paulo answering a questionnaire regarding their personal data and tasks performed in five related areas (Economic-Administrative Management, Human Resources Management, Maintenance, Supply and Exploration, and Marketing and Promotion). The data was analyzed through an Exploratory Factorial Analysis using the principal component method. Results: The low participation of managers in tasks related to the Economic-Administrative Management area was identified. The manager's other areas of activity had their tasks divided into the following factors: Human Resources (Work organization; Communication and Training); Maintenance (Maintenance and monitoring; Expansion, Construction, and Renovation); Supply and Exploration (Activities Organization; Activity Planning for Groups; Assignment and organization of use); Marketing (Communication, supply and demand analysis; Operation and occupation analysis). Conclusion: There is no standard managerial behavior of sport facilities managers since their performance is not focused on the proactive or non-proactive characteristic of the task, but rather on the field that the organization and/or manager deems necessary to be planned and developed.

Resumo Objetivo: Investigar a morbidade por esquistossomose na população indígena Xakriabá usando a ultrassonografia. Materiais e Métodos: Estudo de campo censitário realizado na terra da população indígena Xakriabá (166 convidados; 148 participantes; idade de 0-77). Foram feitos ultrassonografia abdominal, exame físico e coproscopia (EPF). Os testes Mann-Whitney U e qui-quadrado foram usados para comparações. Foram realizadas análise de risco (odds ratio - OR) e regressão logística. Resultados: De 116 índios com resultado de EPF, 31 (26,7%) tiveram ovos de Schistosoma; 22/31 (70,9%) tinham idade entre 4-16 anos. A carga parasitaria mediana foi 144 ovos/g (intervalo interquartílico: 264). De 105 examinados por ultrassom, 68 (64,8%) tiveram lobo hepático esquerdo aumentado, 6 (5,7%) tiveram esplenomegalia e 4 (3,8%) tiveram hipertensão portal. EPF+ foi mais frequente nos indivíduos com lobo esquerdo aumentado (OR: 3,4; intervalo de confiança (IC) 95%: 1,1-11,2; p = 0,043). Fibrose periportal ocorreu em 30/105 (28,6%) examinados, e desses 30, 9 (30%) apresentavam padrão C, 10 (33,3%) apresentavam padrão D e 11 (36,7%) apresentavam padrão Dc. A idade foi o único fator de risco independente para fibrose (p = 0,007). A fibrose ocorreu até nove vezes mais em usuários de álcool que em não usuários (OR: 9,28; IC 95%: 2,60-33,06; p < 0,001). Formas crônicas ocorreram em 54/138 (39,1%) participantes, sendo 32 dos 54 (64,8%) em menores de 30 anos; um (1,8%) era hepatoesplênico. Conclusão: A esquistossomose na população Xakriabá caracteriza-se por alta positividade, predomínio em crianças e presença de formas hepáticas crônicas em jovens, especialmente entre usuários de álcool.

Abstract Objective: To use ultrasound to investigate the morbidity related to schistosomiasis in the Xakriabá indigenous population. Materials and Methods: This was a field-based census study conducted in the territory of the Xakriabá people. A total of 166 individuals were invited, and 148 (≤ 77 years of age) agreed to participate. Most participants underwent abdominal ultrasound, physical examination, and stool examination. Mann-Whitney U and chi-square tests were used for comparisons. We determined risk by calculating odds ratio (OR) and performed logistic regression analysis. Results: Schistosoma mansoni eggs were found in 31 (26.7%) of the 116 stool samples examined, 22 (70.9%) of the 31 being from individuals 4-16 years of age. The median count was 144 eggs/g of feces (interquartile range, 264). Of the 105 participants examined with ultrasound, 68 (64.8%) had hepatomegaly (left lobe), 6 (5.7%) had splenomegaly, and 4 (3.8%) had portal hypertension. Egg-positive stool samples were more common in those with an enlarged left lobe (OR = 3.4; 95% confidence interval (CI): 1.1-11.2; p = 0.043). Periportal fibrosis was found in 30 participants (28.6%), of whom 9 (30%) had pattern C, 10 (33.3%) had pattern D, and 11 (36.7%) had pattern Dc. Age was the only independent risk factor for fibrosis (p = 0.007). Fibrosis was up to nine-fold more common in alcohol drinkers than in nondrinkers (OR = 9.28; 95% CI: 2.60-33.06; p < 0.001). Among the 138 participants in whom the clinical form was classified, the chronic hepatic form was identified in 54 (39.1%), of whom 32 (59.2%) were under 30 years of age and one (1.8%) was hepatosplenic. Conclusion: Schistosomiasis in the Xakriabá population is characterized by a high frequency of egg-positive stool samples, predominantly in children/adolescents, and by chronic hepatic form in the young, especially among alcohol drinkers.

Abstract Background: Anabolic/catabolic disorder in heart failure (HF) favors cardiac cachexia, implying a reduction in HF survival. Objectives: To assess the accuracy and concordance of the diagnosis of protein malnutrition and excess fat among the anthropometric and body composition methods in individuals with HF. Method: A study of accuracy that included 60 individuals with HF. Body mass index (BMI), arm circumference (AC), triceps skinfold thickness (TST), adductor pollicis muscle thickness (APMT), arm muscle circumference (AMC) and corrected arm muscle area (cAMA). Fat free mass index (FFMI) and body fat percentage (BF%), obtained by electrical bioimpedance (EBI), were used to compare the diagnosis of protein malnutrition and excess fat. Accuracy was assessed by calculating sensitivity, specificity, positive and negative predictive value. The concordance of the EBI diagnosis and other methods was performed by the chi-square test and kappa (k) statistic, where p<0.05 was considered significant. Results: Higher frequencies of protein malnutrition were identified by cAMA and AMC, and excess fat by BF%. BMI presented low sensitivity (43%) and accuracy (38.5%), with moderate concordance (0.50). AMC sensitivity was 86%, accuracy 66.4%, and acceptable concordance (0.36) compared to FFMI. Similar percentages of moderate sensitivity and low accuracy were observed for TST and BMI. Conclusion: AMC may be useful to identify protein malnutrition and TST has not been adequate to diagnose adiposity. BMI was not sensitive to assess muscle and adipose reserve. EBI was more accurate.

RESUMO O Fluxograma Descritor é caracterizado pela elaboração cartográfica de processos dinâmicos do cotidiano e configura uma importante ferramenta de gestão. Propõe-se relatar a experiência dos autores, quanto ao ensino do Fluxograma Descritor, e ao acompanhamento dos alunos (gerentes e coordenadores de atenção básica) na aplicação dessa ferramenta nas equipes de trabalho, durante um Curso de Aperfeiçoamento em Gerência de Unidades Básicas de Saúde, Gestão da Clínica e do Cuidado, na modalidade Ensino a Distância. Estudo descritivo, do tipo relato de experiência, realizou-se uma análise dos relatos, classificada em: Etapa I – Aproximação/Aprendizagem do Fluxograma Descritor; e Etapa II – Aplicação do Fluxograma Descritor/Atividade 1 no Ambiente Virtual de Aprendizagem. Considerando a Etapa I, percebeu-se que as discussões geraram várias reflexões e inquietações, a partir do momento que observaram os nós críticos no processo de trabalho. Já na Etapa II, observou-se o reconhecimento do fluxograma para desenvolver um trabalho mais eficiente, pois permite a identificação das necessidades do usuário e a participação de toda equipe. Assim, essa ferramenta merece ser divulgada nos serviços de saúde, uma vez que, além de corroborar na organização dos serviços, contribui para uma reflexão do processo de trabalho.

ABSTRACT The Descriptor Flowchart is characterized by the cartographic elaboration of dynamic processes of daily life and can be configured as an important management tool. It is proposed to report the authors’ experience regarding the teaching of the Descriptor Flowchart, and the monitoring of students (managers and coordinators of primary care) in the application of this tool to their work teams, during an Improvement Course in Management of Basic Health Units, Clinical Management and Care in the Distance Education modality. Descriptive study, of the experience report type, an analysis of the reports was carried out, classified as: Stage I – Approach/Learning of the Descriptor Flowchart; and Stage II – Application of the Descriptor/Activity 1 Flowchart in the Virtual Learning Environment. Considering Step I, it was noticed that the discussions generated several reflections and concerns, from the moment they observed the critical nodes that the work process may present. In Step II, it was noted that the flowchart can develop a more efficient work, as it allowed the identification of user needs and the participation of all team members. Thus, this tool deserves to be disseminated in health services, once, besides corroborating the organization of services, it contributes to a reflection the work process.

RESUMO O Fluxograma Descritor é caracterizado pela elaboração cartográfica de processos dinâmicos do cotidiano e configura uma importante ferramenta de gestão. Propõe-se relatar a experiência dos autores, quanto ao ensino do Fluxograma Descritor, e ao acompanhamento dos alunos (gerentes e coordenadores de atenção básica) na aplicação dessa ferramenta nas equipes de trabalho, durante um Curso de Aperfeiçoamento em Gerência de Unidades Básicas de Saúde, Gestão da Clínica e do Cuidado, na modalidade Ensino a Distância. Estudo descritivo, do tipo relato de experiência, realizou-se uma análise dos relatos, classificada em: Etapa I – Aproximação/Aprendizagem do Fluxograma Descritor; e Etapa II – Aplicação do Fluxograma Descritor/Atividade 1 no Ambiente Virtual de Aprendizagem. Considerando a Etapa I, percebeu-se que as discussões geraram várias reflexões e inquietações, a partir do momento que observaram os nós críticos no processo de trabalho. Já na Etapa II, observou-se o reconhecimento do fluxograma para desenvolver um trabalho mais eficiente, pois permite a identificação das necessidades do usuário e a participação de toda equipe. Assim, essa ferramenta merece ser divulgada nos serviços de saúde, uma vez que, além de corroborar na organização dos serviços, contribui para uma reflexão do processo de trabalho.

ABSTRACT The Descriptor Flowchart is characterized by the cartographic elaboration of dynamic processes of daily life and can be configured as an important management tool. It is proposed to report the authors’ experience regarding the teaching of the Descriptor Flowchart, and the monitoring of students (managers and coordinators of primary care) in the application of this tool to their work teams, during an Improvement Course in Management of Basic Health Units, Clinical Management and Care in the Distance Education modality. Descriptive study, of the experience report type, an analysis of the reports was carried out, classified as: Stage I – Approach/Learning of the Descriptor Flowchart; and Stage II – Application of the Descriptor/Activity 1 Flowchart in the Virtual Learning Environment. Considering Step I, it was noticed that the discussions generated several reflections and concerns, from the moment they observed the critical nodes that the work process may present. In Step II, it was noted that the flowchart can develop a more efficient work, as it allowed the identification of user needs and the participation of all team members. Thus, this tool deserves to be disseminated in health services, once, besides corroborating the organization of services, it contributes to a reflection the work process.

RESUMO Este manuscrito apresenta uma narrativa de tutores de diferentes estados do Brasil sobre a experiência do exercício da tutoria, no período de 2016 a 2018, no âmbito de um curso de aperfeiçoamento de modalidade semipresencial direcionado a gestores de Unidades Básicas de Saúde. Um dos grandes desafios da atenção à saúde constitui-se na qualificação de gestores para atuação no Sistema Único de Saúde. Aos gerentes de Unidades Básicas de Saúde, são necessárias competências de gestão clínica e do cuidado para que sejam produzidos modos efetivos de fazer saúde de maneira colaborativa e efetiva. Os processos de gestão na esfera da atenção básica requerem o uso de ferramentas que possibilitem a adoção de outros modos de ser gerente, como o processo circular, a comunicação não violenta, o fluxograma descritor, o projeto terapêutico singular, além da valorização das tecnologias relacionais para a qualificação dos processos de gestão. Constata-se a capacidade do curso para a ativação de mudanças na qualificação de profissionais para o exercício da gestão de unidades básicas, haja vista o seu potencial de provocar deslocamentos de olhares, posições e saberes no que concerne à função de gerência.

ABSTRACT This manuscript presents a narrative of tutors from different states of Brazil regarding the experience of tutoring, from 2016 to 2018, as part of a semi-presential improvement course aimed at managers of Basic Health Units. One of the major challenges of health care is the qualification of managers to work in the Unified Health System (SUS). Managers of basic health units need skills of clinical management and care to produce effective ways to make health care in a collaborative and effective way. Management processes in the sphere of primary care require the use of tools that enable the adoption of other ways of being a manager, such as the circular process, nonviolent communication, the descriptor flowchart, the unique therapeutic project, besides the enhancement of relational technologies for the qualification of management processes. The ability of the course to activate changes in the qualification of professionals for the management of basic units is verified, considering its potential to provoke shifts of perspectives, positions and knowledge regarding the management function.