Avaliação longitudinal do impacto da saúde bucal na estratégia saúde da família em Natal

As a result of the financial incentive provided by the GM / MS 1.444, since 2000, Brazil has experienced a substantial increase in the number of oral health services at the Family Health Strategy. There is, however, evidence that these teams have produced qualitatively different experiences which do not translate necessarily into improved quality of life and health. Thus, evaluative research of great importance. This study aims to assess the impact of the Family Health Strategy in oral health in a longitudinal perspective natalense the years 2006 and 2009. This is an intervention study whose design is a community trial in parallel, nearly randomized. The sample consisted of census tracts covered by oral health teams in the Family Health and the Traditional Model (Basic Health Units and non-FHS Program of Community Health Agents and areas not covered.) The sample was determined by drawing ten census tracts to form the experimental group and ten other sectors for the control group by pairing intentional based on socio-economic and geographic. To check the net effect of the intervention was performed multivariate analysis by Poisson regression. As a result of cross-sectional analysis of year 2009, it was found that the effects of the ESF in Natal were satisfactory only for the variables of injuries and for other purposes without and with negative impact on stock coverage reclaimers. However, the longitudinal analysis revealed that the ESB / ESF improved their performance in dealing with grievances, access and coverage of the type of actions and this fact is independent of age, sex and social and economic conditions. In other employees' words are related to the presence of the Family Health Strategy in the region. However it does not say that both models under study (the Family Health Strategy Model and Traditional) are different in terms of performance and it is pertinent to reflect on the need for further development of evaluation studies that use other approaches able to clarify the dynamics of the process whose results can come to the knowledge of the actors responsible for leading the ESF and encourage them to incorporate the assessment in their routine

Infâncias :o lugar do lúdico nas tramas do trabalho infantil

Considering infancy as the socio-historic construction required from the researcher, not only gives problems to the natural character of the human development, that for a long period in the history of psychology has sown to be predominant, but before anything assumes the position in which the vision of the social condition, i.e., for the contexts of the insertion of the human being, is predominant. In this sense, it is not possible to talk about infancy in the singular, once the different developmental contexts enable different forms of immersion in the daily experiences, amongst which this research focuses on the experience of the ludic. According to various theories of development amongst which we emphasize the socio-historic, this element brings important contributions in the processes of the human being constitution. From the legal aspect this recognition is present in the Code of Practice of the Child and Adolescent which considers playing to be a right of the child. However, the childhood of many children have this aspect affected by many factors. It is in the context of this discussion that we developed this research which has as its objective investigate how children in a working environment experience playing on a daily basis. Four children, girls, took part in this research, who develop activities in the process of the usage of cashew nuts. We used interviews, observations, photographs and drawings. The perspective of analysis which guided this task is based on socio-historic and discursive studies. In this way, the elements which constitute the child s discourse, formed from the corpus were: be a child, the ludic culture, the work in the child s life and the perspective of future and change. The participants discourse showed to be conflicting, contradictory, arisen from a specific ideological formation. In the children s daily routine it was possible to verify that there is an existence of a rich ludic culture, even if it is lived in few moments of the day in consequence of the workload

Por trás das grades :reflexões sobre a experiência do ser apenado na situação de privação de liberdade

This research has resulted of investigations appeared from our work experience as psychologist in a prison of the state Rio Grande do Norte. It deals with the meeting with prisoner in the search for the rescue of the human being dignity, discovering the being that finds annulled by backwards of the prison. The current debate on the prisoners in Brazil has as focus the creation of efficient strategies in the combat to the criminal acts, not being worried in understanding the historical and social conditions in the context in which such acts develop. Our objective was to reach an understanding of the experience of the prisoner in the situation of freedom deprivation in Natal (RN) city. Its significant social relevance meets in emphasized thematic which intends to be revealing of the not-said one of these citizens. The epistemological space and the vision of adopted human being support in the humanist ideas of the Centered Approach in the Person and construct self, central nucleus of the personality theory proposal by Carl Rogers. We opt to the phenomenological method as way of access to the singularity of the experience of each one of the participants, supporting us in the strategy of the narrative as expression of the lived world. The results had pointed that the investigated experience is through suffering, that is, the way to be in the world of prisoner in the situation of freedom deprivation is felt by him/her as difficult to support. This reality is had by him/her as difficult to control, having a negative emotional repercussion for the self, leading the citizen to the alienation of his/her existential flow in these circumstances. The reflections produced in this work take us to consider that the punishment practices on behalf of a normalization of the behavior, linked to the recovery idea, do not meet to the intention of the arrests, that come demonstrating to the inefficacy of the objectives shown in the law as well as the loss of the human being dignity

Produção e validação de um indicador de saúde bucal para idosos a partir de dados secundários do SB Brasil 2010

Dentre os vários aspectos da saúde do idoso, a saúde bucal merece atenção especial pelo fato de que, historicamente, nos serviços odontológicos, não se considera esse grupo populacional como prioridade de atenção. Por isso, se faz necessária a produção de um indicador multidimensional capaz de mensurar todas as alterações bucais encontradas em um idoso, facilitando a categorização da saúde bucal como um todo. Tal indicador representará um importante instrumento capaz de elencar prioridades de atenção voltadas à população idosa. Portanto, o estudo em questão propõe a produção e validação de um indicador de saúde bucal a partir dos dados secundários coletados pelo projeto SB Brasil 2010 referente ao grupo etário de 65 a 74 anos. A amostra foi representada pelos 7619 indivíduos do grupo etário de 65 a 74 anos que participaram da pesquisa nas 5 (cinco) regiões do Brasil. Tais indivíduos foram submetidos à avaliação epidemiológica das condições de saúde bucal, a partir dos índices CPO-d, CPI e PIP. Além disso, verificou-se o uso e necessidade de prótese, bem como características sociais, econômicas e demográficas. Uma análise fatorial identificou um número relativamente pequeno de fatores comuns, através da análise de componentes principais. Após a nomenclatura dos fatores, foi realizada a soma dos escores fatoriais por indivíduo. Por último, a dicotomização dessa soma nos forneceu o indicador de saúde bucal proposto. Para esse estudo foram incluídas na análise fatorial 12 variáveis de saúde bucal oriundas do banco de dados do SB Brasil 2010 e, também 3 variáveis socioeconômicas e demográficas. Com base no critério de Kaiser, observa-se que foram retidos cinco fatores que explicaram 70,28% da variância total das variáveis incluídas no modelo. O fator 1 (um) explica sozinho 32,02% dessa variância, o fator 2 (dois) 14,78%, enquanto que os fatores 3 (três), 4 (quatro) e 5 (cinco) explicam 8,90%, 7,89% e 6,68%, respectivamente. Por meio das cargas fatoriais, o fator um foi denominado dente hígido e pouco uso de prótese , o dois doença periodontal presente , o três necessidade de reabilitação , já o quarto e quinto fator foram denominados de cárie e condição social favorável , respectivamente. Para garantir a representatividade do indicador proposto, realizou-se uma segunda análise fatorial em uma subamostra da população de idosos investigados. Por outro lado, a aplicabilidade do indicador produzido foi testada por meio da associação do mesmo com outras variáveis do estudo. Por fim, Cabe ressaltar que, o indicador aqui produzido foi capaz de agregar diver sas informações a respeito da saúde bucal e das condições sociais desses indivíduos, traduzindo assim, diversos dados em uma informação simples, que facilita o olhar dos gestores de saúde sobre as reais necessidades de intervenções em relação à saúde bucal de determinada população

A inserção das mulheres na luta pela terra: movimento de participação e/ou submissão

The following dissertation studies the insertion of peasant women in the conflict for land since the occupation process, dispossession and construction of the settlement New Horizon II, in the municipal district of Maxaranguape. It analyses their participation in the conflict Valley of the Hope", that resulted in the settlements New Life II and New Horizon II in the municipal district of Maxaranguape. The analysis exposes the reasons which took the peasant women, after the land conquest, to go back into domestic space and/or to assume positions of lesser relevance in the political organizations of the settlement. In the conflict Valley of the Hope, the women had a fundamental role, facing the police violence, being front line of the conflicts against the repression forces, risking their lives and the life of their families. After the conquest of the land, transformed into the New Horizon II Settlement, there are a lot of changes in the participation of the women. We can observe that, despite the protagonism of the families, in special of the women in the Valley of the Hope conflict, these female workers still experiment unequal social, economic, political and cultural conditions in relation to the men, expressing the gender inequalities which are found in the daily life of the settlement: in the community, in the domestic and agricultural task. The conflict for the land in the Valley of the Hope and the conquest of the settlement did not necessarily mean the incorporation of the emancipation of the peasant women. However, the political participation in the development of the conflicts allowed to the women the self discovering and the beginning of an emancipation process as gender. There are signals of continuities and ruptures of the present culture, almost always stimulated by the organization of the agricultural female workers

Identidade em Caucaia: etnografia e vicissitudes de uma perícia antropológica

Esse artigo analisa a perícia e o laudo antropológico realizados entre os índios Tapeba do município de Caucaia, área metropolitana de Fortaleza (Ceará). Discuto as diversas circunstâncias e as condições sociais de possibilidade que levaram a esse trabalho. Enfoco as várias questões sociais e culturais, além de políticas, que trataram dos usos e efeitos da história, da performatividade das tradições e das lutas da identidade, envolvendo diretamente esse grupo étnico numa ação judicial recente

Toothache and social and economic conditions among adolescents in Northeastern Brazil

O objetivo deste estudo foi relacionar dor de dente com condição socioeconômica, acesso aos serviços de saúde bucal e estilo de vida em adolescentes do município de Sobral, Ceará, desenvolvido com delineamento transversal analítico, com amostra composta por 688 indivíduos. A prevalência de dor de dente no grupo pesquisado foi de 31,8%. Para avaliar a relação entre as variáveis independentes e a dor de dente, realizou-se teste de associação pelo qui-quadrado, estimando-se a razão de prevalências por meio da regressão de Poisson. Os fatores que mais demonstraram relação com a dor de dente foram severidade da cárie, motivo do atendimento odontológico relacionado com urgência, frequência ao dentista e recebimento de escova na escola. Observou-se que a alta prevalência de dor de dente em adolescentes está diretamente relacionada às condições de acesso, assim como às características das ações desenvolvidas pelos serviços de saúde. Assim como há necessidade da implantação de serviços vinculados à promoção de saúde, pautados pela equidade e integralidade, é necessária a implantação de serviços de urgência que não simplesmente intervenham na dor de forma mutiladora, mas a encarem como mecanismo de estímulo ao desenvolvimento de procedimentos de prevenção das doenças bucais.

Efeito de diferentes divisões territoriais na flutuação aleatória de indicadores socioeconômicos relacionados à determinação social da saúde

This research aimed to analyse the effect of different territorial divisions in the random fluctuation of socio-economic indicators related to social determinants of health. This is an ecological study resulting from a combination of statistical methods including individuated and aggregate data analysis, using five databases derived from the database of the Brazilian demographic census 2010: overall results of the sample by weighting area. These data were grouped into the following levels: households; weighting areas; cities; Immediate Urban Associated Regions and Intermediate Urban Associated Regions. A theoretical model related to social determinants of health was used, with the dependent variable Household with death and as independent variables: Black race; Income; Childcare and school no attendance; Illiteracy; and Low schooling. The data was analysed in a model related to social determinants of health, using Poisson regression in individual basis, multilevel Poisson regression and multiple linear regression in light of the theoretical framework of the area. It was identified a greater proportion of households with deaths among those with at least one black resident, lower-income, illiterate, who do not attend or attended school or day-care and less educated. The analysis of the adjusted model showed that most adjusted prevalence ratio was related to Income, where there is a risk value of 1.33 for households with at least one resident with lower average personal income to R$ 655,00 (Brazilian current). The multilevel analysis demonstrated that there was a context effect when the variables were subjected to the effects of areas, insofar as the random effects were significant for all models and with different prevalence rates being higher in the areas with smaller dimensions - Weighting areas with coefficient of 0.035 and Cities with coefficient of 0.024. The ecological analyses have shown that the variable Income and Low schooling presented explanatory potential for the outcome on all models, having income greater power to determine the household deaths, especially in models related to Immediate Urban Associated Regions with a standardized coefficient of -0.616 and regions intermediate urban associated regions with a standardized coefficient of -0.618. It was concluded that there was a context effect on the random fluctuation of the socioeconomic indicators related to social determinants of health. This effect was explained by the characteristics of territorial divisions and individuals who live or work there. Context effects were better identified in the areas with smaller dimensions, which are more favourable to explain phenomena related to social determinants of health, especially in studies of societies marked by social inequalities. The composition effects were better identified in the Regions of Urban Articulation, shaped through mechanisms similar to the phenomenon under study.

Processo de trabalho em saúde: uma análise das condições de trabalho dos assistentes sociais no âmbito hospitalar

This paper presents the survey results: PROCEDURE FOR WORK IN HEALTH: an analysis of working conditions of social workers in hospitals. Analyzes the inclusion of social workers in work processes in healthcare, specifically in the public hospital, from the objective conditions of work, according to which materializes professional action. The aim is to understand them from the point of view of its relationship with users and other health professionals through the privatization of health, which prevents the Unified Health System (SUS), limiting the operation of the services and the guarantee of rights. The approach to the reality studied was through theoretical and methodological procedures based on the qualitative and quantitative research, focusing on documentary research, observation, semi-structured interview and the theoretical foundation. It is observed that the inclusion of social workers in this context arises from the demands derived from expressions of social issues, "raw material" of professional work, and the gaps resulting from contradictions in the process of rationalization / reorganization of the SUS, meaning that the needs the population are confronted with the content and form of organization of services. At the hospital, the professional actions are developed through the shift, space contradictory clash between the collective and individual, in which individual activities are prioritized and ad hoc unplanned and reduced to the solution of "problems" of users, through actions assistance in an emergency and bureaucratic. These findings emphasize the inadequacy of space and lack of minimum conditions of service to users, which undertakes the professional with regard to ethical and political principles of the profession, since it is the responsibility and duty of the social guarantee the secrecy and privacy of users what is revealed during the process of professional intervention. The professional social workers is permeated by the diversity of skills and competence; lack of planning activities, by incorporating the institutional discourse at the expense of professional goals, by knowing the Code of Professional Ethics, for small number of professionals, the increasing number informality; by poor working conditions and wages; by discouraging research and participation in social policy councils, as well as professional training

O estado como empregador de última instância: uma proposta de pleno emprego, estabilidade e condições dignas de trabalho para o Brasil

GOMES, Z. B. ; LOURENÇO, André Luís Cabral de . Atuação do Estado como empregador de última Instância: uma proposta para eliminar o desemprego estrutural do Brasil. In: Encontro Nacional de Economia Política, 13. 2008, João Pessoa/PB. Anais... João Pessoa: ENEP, 2008.

Condições de trabalho e saúde na perspectiva de bem-estar um estudo realizado entre os profissionais de saúde da policlínica

This study had like general objective analyzed the relation observed between working conditions and healthy, in the welfare perspective, by the Policilínica Zona Oeste´s healthy professionals. Were used like theoretical bases the categories of working conditions of Borges et al. (2013): working conditions and contractual legal; physical working conditions and materials; working conditions and characteristics of the work processes and working conditions and social management. For the analise of personal wellness in the job, were used the categories of Dessen and Paz (2010): friendship relations, relationship with the organization, growth opportunity, relations with customers , valuation and realization. For this, this research use the descriptive statistic and Bardin (1977) ´s content analysis besides the help of Manyeyes software, using the word clouds and trees words. Was possible identify that the working conditions have strong relations with the health of the health professionals of Policlínica, mainly about the physical and materials conditions that are precarious and influences the other dimensions of working conditions and conditions health. The welfare professionals is spoiled in the dimensions of realization and growth opportunity and influences the professional´s health

A cidade sem barreiras é para todos?: avaliação das condições de deslocamento no bairro da Cidade Alta, Natal/RN

In this present work, the conditions of displacements and the behaviors of the users are evaluated, face to the physical adequacies in accessibility in the inserted area in the central quadrilateral of the Quarter of Cidade Alta, in the City of Natal/RN, space clipping established by its great meaning historical and cultural. For this reason such area was a target of an integrated actions plan during the years of 1993 and 1998, with the implantation of part of the Project CIDADE SEM BARREIRAS (City without Barriers) and, later, the implementation of the Project CIDADE PARA TODOS's proposals (City for All), having as supports the constant Brazilian norms inserted into the NB9050/1994 and in the Municipal law number 4.090/92, effective ones in the period of the interventions. Considering that the carried through actions at the time were directed to the elimination of the architectural barriers to guarantee the right to go and to come, the research received a human universe formed by all the people in situation of displacement in the central area of the interventions in the quarter of the Cidade Alta, independently of their locomotive or sensorial conditions, emphasizing the aspects most excellent how much to the accessibility of the sidewalk, as promotional of mobility, integration and urban organization, as well as of the public squares of that one quadrilateral, conceived, originally, as spaces of aggregation and social inclusion. The work appealed to the direct comment and the gotten results had been collated with the ex port facto law and technique norms, of the year of 2004, and with the legal devices contained in the Federal Decree number 5.296/2004, as way to certify the levels of efficiency of these adaptations in that it says respect to the current conditions of demanded accessibility and urban mobility

Representações sociais dos trabalhadores de saúde da atenção básica sobre envelhecimento e o atendimento ao idoso

This study aims to identify the social representations built on senior care health workers of Primary Care. This is an exploratory research within the subsidized social representations held in 100 Basic Health Units in the city of João Pessoa-PB, with a sample of n= 204 workers of both sexes, who agreed to participate. To collect the data used to set an interview in two parts: the first looked at the Test of Free Association of Words using the inductive stimulus "senior care". The interviews were analyzed with the help of a software for quantitative analysis of textual data ALCESTE (version 2010). The results were interpreted from the theoretical framework of social representations. The study included 178 women (87.25%) and 26 men (12.75%), working in Family Health Units in the city of João Pessoa, the majority are aged between 40-49 years of age ( 28.92%), and have higher education with 81.86%. The results of Alceste link to the term inducer six (6) where the hierarchical classes representing senior care workers as synonymous with care and attention, showing situations neglect of the elderly, for that patience is required to promote the increase of disease prevention and living with the elderly to generate humanization in health services. It is considered that the social representations of health workers on assistance to the elderly may support modeling of strategic actions in health services with health promotion programs for large groups, able to modify practices and behavior in elder care and strengthening the policy was directed at the elderly

Ambiente pesqueiro e saúde: representações sociais sobre saúde e doença de pescadores e marisqueiras nos distritos de Diogo Lopes, Barreiras e Sertãozinho Macau RN

According to Brazil s Ministry of Fisheries and Aquaculture, artisanal fishermen are responsible for a significant fish production at national level, highlighting the importance of this activity. In Rio Grande do Norte State, Brazil, fishing has become an important part of economic and social processes. In this context, there are many inland fishing communities such as Barreiras, Diogo Lopes and Sertãozinho, which are part of Ponta do Tubarão State Reserve of Sustainable Development (RDSEPT), located in Macau and Guamaré, Rio Grande do Norte coastline cities. Fishermen and women, the last ones known as marisqueiras who work alongside the menfolk at sea, especially in the shellfish harvest, have been developing narrow relationships with nature, mainly with the sea, from where they extract their families subsistence. However, those communities have been facing several issues related to living conditions, health and diseases. Social representations have been analyzed in the speeches of fishermen/women who were registered active members in a fishermen association named Associação Colônia de Pescadores Z-41, regarding the period from 2008 to 2011. The analysis involved socio-economic profiles verification, identification and analysis of the group s main representative diseases and representations related to health and illness. This study searched for elements in order to provide the comprehension of the relationships among people s social representations and the fishing environment in which they live.. This qualiquantitative study was performed using recordings and transcriptions of structured and open-question interviews. The Collective Subject Speech tecnique proposed by Lefevre & Lefevre (2002) was applied to perform the interviews analysis using QualiQuantiSoft® software. The results showed that health and illness phenomena as well as social representations related to them in the fishing environment are not only abstract states but also physical ones, which interfere in all life extensions, establishing a set of relevant information that indicates that those people realize their own socio-cultural, economic, environmental and political context

Iniqüidade em saúde: uma extensão das desigualdades sociais no sistema público de saúde do Brasil (2003-2006)

This issue analises the unevenness in the brazilian system of public health care as an extension of socials inequities. It is a theoretical study based in a historical method, using empirical camp from academic, corporation and institution researchs, along the period 2002-2006. Equality and effectiveness in health systems are analitical basic cathegories grap in the root of the doctrine, principles and organization of the Unique Health System, in which sectorial actions are inserted. Discuss the estructural prodution and determined those inequalities through some social determiners of health system: income, land, food securitiy, nutritional situation, basic sanitation, epidemiological inequities and public management policy. Carry out a thematic review over health social production, it formlation and the goals of social policies, as well as the insertion of the equality principle in the assistance system, in the frame of the running public health regulations. It uses reflections that enlighted the correlation between the process of political-institutional actions and equity on health assistance. Analized the pertinency of sectorial reorganizational strategies on basic attendance, confronting the hipothesis that those strategies reinforce social inequities in health system, because it organize diferential assistance levels over not equal baselines. The results show up that social inequalities, even remaining, have had a small decrease; that the selectiviness of actual public policies and the duplication of the health system, increases the differences within and between the social classes and configures the assistance as inequal. The basic care system has great shortages that also appeares in middle and complex assistance levels. As conclusion, it remarks that the health assintance system, even with it integrality has limits; structural problems on material conditions of living and health system could not be reversed only with institutional legal arragements; by the contrary, in border conditions, these strategies produce policies that reinforce inequities, neglecting the equity principle of the system in which frame, they work. One patina of this tim