Nutrição social no Brasil: [mais] uma estratégia biopolítica?

Inspirés par la « méthode » artisanat intellectuel propose par le sociologue Wright Mills, notre étude porte sur la formation du champ de pratiques discursives et non discursives (Michel Foucault) de la nutrition sociale dans le contexte de la société brésilienne dans lequel s insère le champ de la santé. Le travail empirique s épuise sur une source de documents normatifs de ce champ et s oriente à vérifier et à comprendre comment le praticien de la nutrition émerge dans le scènario des pratiques de la santé au Brésil à partir du milieux du 20ème siècle, tout en construisant son « regime de vérité » fondé dans des processus biopolitiques du champ de la médecine sociale. Nous avons relié deux phénomènes: a) l émergeance du champ biomédical de la nutrition comme une instance biopolitique, en approchant cette formation à l'histoire de la médecine sociale, depuis ses débuts européens jusqu'au contexte brésilien ; b) les pratiques discursives et non discursives du champ de la nutrition lequel est compris dans le Sistema Único de Saúde (SUS - Système Unique de Santé) brésilien. La démarche de recherche comprend l'élaboration et analyse d'une archive composée de publications qui contiennent l'Histoire du praticien de la nutrition au Brésil et des publications officielles disponibles dans le site web « Política Nacional de Alimentação e Nutrição » (Politique Nationale d'Alimentation et de Nutrition) lesquelles sont considérées comme des guides d actions des praticiens de la nutrition sociale dans le Sistema Único de Saúde (SUS). Le concept de biopouvoir, décrit par Michel Foucault entre 1974 et 1979, et la notion de biopolitique, dans son sens réinterprété et mis à jour par Giorgio Agamben, Antônio Negri et Michael Hardt, ont fourni le support théorique de cette recherche

Diagnósticos de enfermagem do domínio nutrição em pacientes submetidos à hemodiálise

The study aimed to analyze the nursing diagnoses of the nutrition domain from NANDA International in patients undergoing hemodialysis. This is a transversal study conducted in a university hospital in northeastern Brazil, with 50 hemodialysis patients. The data collection instrument was an interview form and a physical examination, in digital format, applied between the months of December 2013 to May 2014. Data analysis was divided into two stages. In the first, defining characteristics, related factors and risk factors were judged as to their presence by the researcher, according to the data collected. In the second stage, based on data from the first, diagnostic inference by experts was held. The results were organized in tables and analyzed using descriptive and inferential statistics for the diagnoses that showed higher frequencies than 50%. The project was approved by the Ethics Committee responsible for the research institution (protocol number 392 535), with Certificate Presentation to Ethics Assessment 18710613.4.00005537 number. The results indicate a median of 7 (± 1.51) nursing diagnoses of the nutrition domain per patient. Six diagnoses with greater frequency than 50% were identified, namely: Risk for electrolyte imbalance, Risk for unstable blood glucose level, Excess fluid volume, Readiness for enhanced fluid balance, Readiness for enhanced nutrition and Risk for deficient fluid volume. The defining characteristics, related and risk factors presented an average of 34.78 (± 6.86), 15.50 (± 3.40) and a median of 4 (± 1.93), respectively, and 11 of these components had statistically significant association with the respective diagnoses. Were identified associations between adventitious breath sounds, edema and pulmonary congestion with the diagnosis Excess fluid volume; Expressed desire to increase fluid balance with the nursing diagnosis Readiness for enhanced fluid balance; It feeds regularly, Attitude to food consistent with the health goals, Consume adequate food, expresses knowledge about healthy food choices, expresses desire to improve nutrition, expresses knowledge about liquid healthier choices and following appropriate standard supply with diagnosis Readiness for enhanced nutrition. It is concluded that the diagnosis of the nutrition domain related to electrolyte problems are prevalent in customer submitted to hemodialysis. The identification of these diagnoses contributes to the development of a plan of care targeted to the needs of these clients, providing better quality of life and advance in the practice of care

Riscos à saúde dos trabalhadores em unidade de alimentação e nutrição de um Hospital Universitário

The Food and Nutrition Units (FNU) are designed to produce food for healthy and/or sick communities and need to be done in a way to ensure the quality of foodstuffs that were produced. In these units, in the working environment, in general, there is excessive noise, heat and physical condition with many adaptations, presence of obstacles, inadequate flows, as well as the ways of the working organization may represent risks for workers health and lead to errors during production and/or distribution of food. The main goal of this study was to analyse the working processes in the Food Production Unit of the university’s hospital and identify the workers' health risk factors, using for this the knowledge of ergonomics, specifically the method of Ergonomic Work Analysis (EWA). After this analysis it was possible to develop proposals that will bring improvements to the working conditions, minimizing health risk factors during the process of meals production. It’s crucial to reassert this method considers the work activity performed in real time and highlights the importance of listening and the engagement of the workers in the changing process. It is a descriptive research with a qualitative approach. In the field research were collected demographics data, employment characteristics of the individuals (age, education, stocking sector, the total length of service and length of service in the industry) and data related to their usual work (task analysis, activity analysis and Analysis of the working environment) in the FNU. The instruments that were used in this study were document analysis, global and systematic observations and semi structured interviews in order to identify the main complaints related to those activities developed by them. The study was based on data for the analysis of Bardin, 2011, so the documents have been selected and including those that treat issues related to risks to workers' health were selected. The result of semi-structured interviews, global and systematic observations took place a confrontation of this material to the theoretical framework, held the inference and the interpretation of results the light of the knowledge of ergonomics and legislation. Issues related to the risks and the perception of workers has crafted a table showing the frequency of responses to the physical, chemical and biological and even the risk of accidents and was made a descriptive analysis. The results of this analysis indicated that the unit in question presents several problems ambience of jobs, both in terms of physical structure, but also in the organization of work. Non-conformities that leads to a favourable environment to the development of disease and injury hazards and compromising the quality of food produced. It is necessary to comply with legislation and that short, medium and long-term measures are taken to ensure the physical integrity of workers and improve the working environment.