SOCIAL POLICY AS REGIONAL POLICY: MARKET AND NONMARKET FACTORS DETERMINING REGIONAL INEQUALITY

We decompose the recent changes in regional inequality in Brazil into its components, highlighting the role of spatially blind social programs. We aggregate personal income micro data to the state level, differentiating nine income sources, and assess the role of these components in the observed changes in regional inequality indicators. The main results indicate that the largest part of the recent reduction in regional inequality is related to the dynamics of the market-related labor income, with manufacturing and services favoring deconcentration. Labor income in agriculture, retirement and pensions, and property rents and other sources favored concentration. The social programs Bolsa Familia and Beneficios de Prestacao Continuada are responsible for more than 24 percent of the reduction in inequality, although they account for less than 1.7 percent of the disposable household income. Such positive impact on regional concentration is impressive, since the goals of the programs are clearly nonspatial.

Challenges for nursing education in Angola: the perception of nurse leaders affiliated with professional education institutions

Background: Angola is one of the African countries with the highest morbidity and mortality rates and a devastating lack of human resources for health, including nursing. The World Health Organization stimulates and takes technical cooperation initiatives for human resource education and training in health and education, with a view to the development of countries in the region. The aim in this study was to identify how nurses affiliated with nursing education institutions perceive the challenges nursing education is facing in Angola. Methods: After consulting the National Directory of Human Resources in Angola, the nurse leaders affiliated with professional nursing education institutions in Angola were invited to participate in the study by email. Data were collected in February 2009 through the focus group technique. The group of participants was focused on the central question: what are the challenges faced for nursing education in your country? To register and understand the information, besides the use of a recorder, the reporters elaborated an interpretative report. Data were coded using content analysis. Results: Fourteen nurses participated in the meeting, most of whom were affiliated with technical nursing education institutions. It was verified that the nurse leaders at technical and higher nursing education institutions in Angola face many challenges, mainly related to the lack of infrastructure, absence of trained human resources, bureaucratic problems to regularize the schools and lack of material resources. On the opposite, the solutions they present are predominantly centered on the valuation of nursing professionals, which implies cultural and attitude changes. Conclusions: Public health education policies need to be established in Angola, including action guidelines that permit effective nursing activities. Professional education institutions need further regularizations and nurses need to be acknowledged as key elements for the qualitative enhancement of health services in the country.

THE ACHIEVEMENT OF EXCELLENCE IN BRAZILIAN PROGRAMS OF POST-GRADUATION STRICTO SENSU WITH A DOCTORATE IN NURSING

This study aimed to identify how the graduate programs in nursing stricto sensu evaluated by the Nursing field at Coordination of Improvement of Higher Education Personnel, in the triennium 2007-2009, achieved excellence - grade 6. Descriptive exploratory study of nature documentary, which examined the data of Reports Indicators of these Programs at the site of the Coordination cited, in 2010. We analyzed 99 chips of 33 programs for the triennium 2007 to 2009, grouped in sub-clauses of Social and item categories for grades 6/7. Presents the indicators of excellence of Americans and Brazilians Programs, the results of the triennial assessment relating to sub-items of item 5 and the description of program performance specified for the grade 6. It follows that the excellence of Programs has been gradually achieved, with performance in certain categories as those required by international standards, overcoming the obstacles to the achievement of excellence in all its fullness.

The identification of the pillars of education in the class comprehensiveness in healthcare

The objective of the present study was to verify, based on the analysis of student portfolio narratives, if the four pillars of education were approached in the class "Comprehensiveness in health care", part of the integrated curriculum of the Baccalaureate in Nursing Program of the University of Sao Paulo at Ribeirao Preto College of Nursing. A qualitative, documental study was performed using 46 portfolios constructed during the classes. Data collection was performed using an assessment tool that contained items addressing cognitive and affective dimensions. The data were submitted to thematic categorical analysis using the pillars of education as predefined categories. The results show that the pillars of education were, apparently, included in the class. Despite the present study findings, no evidence was found that the expected competencies were actually discussed among students and faculty, according to the records regarding the evaluations of each pedagogical cycle of the studied class.

The production of critical-reflexive narratives and their effect on nursing students' portfolios

The objective of this study is to analyze the process of producing reflexive narratives on nursing students' portfolios. This qualitative study performed an analysis of the portfolios of the class discipline Health Promotion in Primary Education, taught in the fourth semester of the Nursing Licensure Course. Results showed an initial predominance of descriptive records, with the incipient approach of theoretical aspects associated with the aspects regarding their experience. Further, in the group and experience discussions, there were narratives containing more critical and reflexive elements, with justifications for the described actions and the relationships with the theoretical-practical aspects studied in the class and in the course. In conclusion, there is a process of producing critical-reflexive narratives in portfolios that could include a summarized description, using common sense and idealization which allows for including the differences and the theoretical review.

Infant mortality in Brazil, 1980-2000: A spatial panel data analysis

Background: Infant mortality is an important measure of human development, related to the level of welfare of a society. In order to inform public policy, various studies have tried to identify the factors that influence, at an aggregated level, infant mortality. The objective of this paper is to analyze the regional pattern of infant mortality in Brazil, evaluating the effect of infrastructure, socio-economic, and demographic variables to understand its distribution across the country. Methods: Regressions including socio-economic and living conditions variables are conducted in a structure of panel data. More specifically, a spatial panel data model with fixed effects and a spatial error autocorrelation structure is used to help to solve spatial dependence problems. The use of a spatial modeling approach takes into account the potential presence of spillovers between neighboring spatial units. The spatial units considered are Minimum Comparable Areas, defined to provide a consistent definition across Census years. Data are drawn from the 1980, 1991 and 2000 Census of Brazil, and from data collected by the Ministry of Health (DATASUS). In order to identify the influence of health care infrastructure, variables related to the number of public and private hospitals are included. Results: The results indicate that the panel model with spatial effects provides the best fit to the data. The analysis confirms that the provision of health care infrastructure and social policy measures (e. g. improving education attainment) are linked to reduced rates of infant mortality. An original finding concerns the role of spatial effects in the analysis of IMR. Spillover effects associated with health infrastructure and water and sanitation facilities imply that there are regional benefits beyond the unit of analysis. Conclusions: A spatial modeling approach is important to produce reliable estimates in the analysis of panel IMR data. Substantively, this paper contributes to our understanding of the physical and social factors that influence IMR in the case of a developing country.

HOLISTIC WOMEN: "GREEN BLOUSE" NURSES TO THE SERVICE OF THE NATION

This study aims to investigate the role assigned to the holistic nurse and the education she receives to perform her role with maximum efficiency within the Brazilian Holistic Action (Acao Integralista Brasileira), a right-wing political party that emerged in Brazil in the 1930s. It uses holistic newspapers, the "Holistic Encyclopedia" collection, and records about the Holistic School of Nursing which compose the criminal collection by the Political Police, organized by the Special Police of Political and Social Safety as source material. As a result, the study presents a significant investment of holistic thinking in formally educating nurses, women who took the opportunity of the moment to expand their social arenas. It concludes that, although holistic thinking strengthened social roles described as female, the women's relationship with the movement was innovative because it enabled new practices and representations that they also started to develop in the public sphere, for example, working as nurses.

Effect of a video on developing skills in undergraduate nursing students for the management of totally implantable central venous access ports

Background: Handling Totally Implantable Access Ports (TIAP) is a nursing procedure that requires skill and knowledge to avoid adverse events. No studies addressing this procedure with undergraduate students were identified prior to this study. Communication technologies, such as videos, have been increasingly adopted in the teaching of nursing and have contributed to the acquisition of competencies for clinical performance. Objective: To evaluate the effect of a video on the puncture and heparinization of TIAP in the development of cognitive and technical competencies of undergraduate nursing students. Method: Quasi-experimental study with a pretest-posttest design. Results: 24 individuals participated in the study. Anxiety scores were kept at levels 1 and 2 in the pretest and posttest. In relation to cognitive knowledge concerning the procedure, the proportion of correct answers in the pretest was 0.14 (SD=0.12) and 0.90 in the posttest (SD=0.05). After watching the video, the average score obtained by the participants in the mock session was 27.20. Conclusion: The use of an educational video with a simulation of puncture and heparinization of TIAP proved to be a strategy that increased both cognitive and technical knowledge. This strategy is viable in the teaching-learning process and is useful as a support tool for professors and for the development of undergraduate nursing students. (C) 2011 Elsevier Ltd. All rights reserved.

Teaching of the Integrated Management of Childhood Illness strategy in undergraduate nursing programs

Objective: To describe and analyze the teaching of the Integrated Management of hildhood Illness (IMCI) strategy on Brazilian undergraduate nursing programs. Method: Integrating an international multicentric study, a cross-sectional online survey was conducted between May and October 2010 with 571 undergraduate nursing programs in Brazil Results: Responses were received from 142 programs, 75% private and 25% public. 64% of them included the IMCI strategy in the theoretical content, and 50% of the programs included IMCI as part of the students’ practical experience. The locations most used for practical teaching were primary health care units. The ‘treatment’ module was taught by the fewest number of programs, and few programs had access to the IMCI instructional manuals. All programs used exams for evaluation, and private institutions were more likely to include class participation as part of the evaluation. Teaching staff in public institutions were more likely to have received training in teaching IMCI. Conclusion: In spite of the relevance of the IMCI strategy in care of the child, its content is not addressed in all undergraduate programs in Brazil, and many programs do not have access to the IMCI teaching manuals and have not provide training in IMCI to their teaching staff.

O alcance da excelência por programas brasileiros de pós-graduação stricto sensu com doutorado em enfermagem

Objetivou-se identificar como os programas de pós-graduação em enfermagem stricto sensu, avaliados pela Área de Enfermagem da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, no triênio 2007-2009, alcançaram a excelência - conceito 6. Estudo descritivo-exploratório, de cunho documental, que investigou os dados dos Cadernos de Indicadores destes programas, disponibilizados no site da mencionada Coordenação, em 2010. Foram analisadas 99 fichas, de 33 programas, referentes ao triênio 2007 a 2009, agrupadas nos sub-itens do quesito Inserção Social e categorias para notas 6/7. Apresentam-se os indicadores de excelência de programas norte-americanos e brasileiros, os resultados da avaliação trienal referentes aos sub-itens do quesito 5 e a descrição do desempenho dos programas indicados para o conceito 6. Conclui-se que a excelência dos programas vem sendo gradativamente conquistada, com desempenho em determinadas categorias, semelhantes às exigidas pelos padrões internacionais, vencendo-se os obstáculos para o alcance desta excelência, em sua plenitude.