Assist��ncia a mulher com c��ncer de mama em um cenro de refer��ncia no Estado da Para��ba

The assistance to women who have breast cancer is studied in a Reference Center in Paraiba and also the way this assistance is performed in a School Hospital maintained by SUS (Single Health System) is questioned. Breast cancer demands institutional organization, provision of financial, material and human resources, requiring, from the health system, effective assistance with new technologies which make it possible for the population their access to specialized medical services although it not always is able to guarantee those services nor the rights which the legislation granted them, inhibiting a proper relationship between the health professional and the patient. The theme is discussed through a transdisciplinary knowledge view and has as its theoretical referential the contribution of classical and contemporary authors from the human and social sciences and, as an empirical research strategy, the structured interview. The objectives of the research were: identify how the assistance to women with breast cancer is carried on at a Reference Center on Oncology in Campina Grande, Paraiba, identifying their difficulties and their satisfaction with the received assistance; draw up a profile of the women with breast cancer who were assisted in this Reference Center; understand their gynecological and obstetric antecedents, life styles, age group and stage of the disease when the treatment started; check their knowledge about their rights and which benefits they had received. Most women ranged between 40 and 59 years old (63%), which corresponds to the risk range of developing breast cancer. As to their occupations, 38.3% were housewives and 30.1% retired, whose family income was among those who received between less than a minimum salary and one minimum salary (58.2%). This population was mainly constituted of married women (60.2%), whose most frequent schooling was an incomplete elementary school (27.6%) and complete elementary school (24.1%), which added up to 51.6%. It was observed that the majority of the women seemed to be satisfied with the assistance received, noting that a minimum care was enough to define this satisfaction, although it is perceived that the access to the health system does not ensure the ideal attention conditions they need; it was verified that the availability of the services and the assistance itself are seen (in the local culture) as a favor and not as a right. It is also observed that only 30% of the women mentioned that they knew about their rights and the most mentioned ones were the disease assistance (13%), the medicines (13%) and the treatment (12%), which represent the most important triad to face the disease and around which the oncologic assistance most focus on. It is concluded that the condition of the users�� minimum existential of a public health unit and the condition of belonging to a lower social stratum were variables that influenced the respondents�� satisfaction in relation to the assistance received but the importance of the Reference Center for the women with breast cancer��s assistance for the whole region cannot be denied as well as the need to broaden the way the policy of the oncologic assistance in Brazil in the local realm is seen

A forma����o acad��mica do enfermeiro para o SUS na percep����o de docentes e discentes da faculdade de enfermagem/UERN

The model of attention to health in Single Health System (Sistema ��nico de Sa��de SUS) presupposes a human-resources policy which prepares professionals of health to guide the services and sanitary practices. The nurse, a member of health staff, takes over an important role in implementation of principles and standards of SUS, being its professional formation necessary to labor organization in this purpose. In this way this study objectifies to analyse the process of formation of the male nurse in the Politic-Pedagogical Project (Projeto Pol��tico-Pedag��gico PPP) in the perception of learning and teaching of the Faculty of nursing FAEN of the University of The Rio Grande do Norte State UERN. It treats about a descriptive-exploratory study with qualitative and quantitative approach carried out with learning and teaching of the graduation nursing course. In the field research carried out between the months of november, 2006 and february, 2007, were used like instruments the documental research below PPP��s, structured interview directed to the learning and the closed questionnaire applied to the students of eighth and ninth semesters of graduation course. The results of data about the questionnaires elaborated according to National Curricular Patters (Diretrizes Curriculares Nacionais DCN) and the Instrument of Evaluation Course of Graduation MEC were organized according to six lists about the profile of the learning and teaching that participate of the research; of the didactical-pedagogical organization and PPP��s objectives to the just-graduates person to the didactical-pedagogical curriculum organization. For considering the interviews it was adopted thematic analysis of content discribed in lexical analysis by informatical program ALCESTE which provided the organization of the material in five categories: daily problems of SUS consolidation versus nurse formation, dichotomies about FAEN��s nursing course of curriculum versus principles of integralization of graduating process, the just-graduated one from FAEN and its professional insertion united to SUS politic-pedagogical project and the concern about the overcoming of dichotomies of graduation process abilities and necessary competences to the SUS performing nurse. The analysis of informations deriving from documental performance and field research resulted on the verification that, in spite of good intentions, the implementation strategies showed themselves fragile to cope with the rendering of expressed ideal on PPP. There is still a great gap between what��s thought as innovating graduating process and what��s being really implemented

A����es dos agentes comunit��rios de sa��de diante do usu��rio da estrat��gia sa��de da fam��lia com estados depressivos no Munic��pio de Abaiara-CE-BR

Brazilian health public assistance is going through two Reforms, Sanitary and Psychiatric, and through these the assistance is guaranteed in the three levels: primary, secondary and tertiary. Thus, mental health assistance should be offered since preventive cares until the ones that demand larger technological apparatus. Programs like Health Community Agent's Program (HCAP) and Family Health Strategy (FHS), besides increasing the services coverage, have been making possible the system reorientation in the meaning of integrality, universalization and equity. Thus, united intervention of mental health team and FHS can offer several benefits to the population, providing assistance and follow-up to patients with mental disorder. It was aimed to assess health community agents facing the user of Family Health Strategy in depressive state. This quanti-qualitative study took place in the municipal district of Abaiara-CE. Semi-structured interview was applied with health community agents and Beck Depression Inventory with the users registered in Family Health Strategy. It was verified that among the 64 users interviewed, 12.5% didn't present symptoms of depression, 10.9% presented symptoms of light depression, 14.1% symptoms of moderate depression and 62.5% symptoms of serious depression. For the 22 health community agents interviewed, they all reported the existence of people with symptoms of depression in their personal micro-areas, being difficult to work with them, once the FHS team is not qualified to work with mental health problems. It was verified that the Municipal district doesn't have specialized professionals, making difficult the routing and treatment. Based on these results, it was concluded that in spite of the articulation of mental health with FHS is necessary and benefactor to the population, it still doesn't exist, worsening the situation, mainly in small Municipal districts, once they don't have mental health services. Thus, the population is exposed and without follow-up, which allows the identification of installed diseases and with gravity, like depression, because there are no prevention and control activities. It is recommended, due the extreme need, the elaboration and implantation of a mental health program in these municipal districts, articulated with FHS

A educa����o permanente em sa��de na ��tica dos cirurgi��es dentistas

This study aimed to examine the perception of dentist-surgeon about the Permanent Education in Health (PEH). It is characterized as a qualitative research with focus in the field of public health policies. It refers specifically to the development of Permanent Education policy in Health in the state of Rio Grande do Norte. They were participants of this research 42 dentist surgeons and 83.3% females and 16.7% males, participants in Specialization courses approved and agreed by the Permanent Education Center in Health (PEC-RN) in the period 2005 to 2007. These professionals are part of the Family Health Strategy (FHS), and 11.9% work in management at the central level and 88.1% are directly related to oral health care in the Basic Health Units of the Family, 30 cities in the state. Data collection was through a questionnaire, with questions that guided the research development and achieve the objectives proposed. The socio-demographic data were analyzed using the descriptive statistics and subjective content was subjected to content analysis by Bardin. The emerging categories from the textual material generated by respondents were: program content, methodological approach and concepts of Permanent Education in Health. The subjects surveyed reported that the program content is more comprehensive and directs to the reflection of everyday practices, with regard to the methodological approach, concern that occurs through discussion and reflection with dynamic, participative, varied and constructive activities, questioning and putting as the main focus. As for understanding of the concepts of the PEH, there was a consensus that define as education stable strategies which contributing to transform and improve the health workers to have the upgrade, improvement of practices, being based on everyday experience and taking into account the accumulation and renewal of these experiences. Therefore, results presented showed that there is a clear understanding of the subjects on the proposals and guidelines of the PEH. It was concluded that lack continuous access to the policies proposed by Ministry of Health involving health workers, managers, communities, through social control and the teaching-service integration and that they are worked within the health system and can classify all these segments of society favor the existence of a more participatory, effective, fair and better quality health service

As diretrizes da pol��tica p��blica de sa��de bucal e suas inflex��es nos servi��os da Cl��nica Odontol��gica da UFRN

The crisis that the Brazilian State have been crossing throughout the last decades has revealed intense oscillations in the the way of life of the population reality. In the health area, specifically of buccal health, new alternatives of attending to demands for odontological services have been increasing from the 1990 decade. The research had as objective to analyze the demand of the services of the clinic-school of odontology of the UFRN to identify the socio-economic profile of the users and the inflections of the standards of the National Politics of Buccal Health. The methodology is based on a dialectic perspective and a quali-quantitative boarding. It was used as instrument of data collection forms with open and closed questions, applied to two distinguished groups of citizens: 53 users of the services and 12 pupils of 9th and 10th term of the Odontology Course. The results reaffirm that, with the aggravation of the crisis of SUS (Sistema ��nico de Sa��de- Single Health System) grow the difficulties of accessing the odontological services of the users majority. The subjects of the research make use of a regular socio-economic condition, with high school, own house, formal bond to labor and monthly medium income between 1 and 2 minimum wages. The conclusive analyses point to the selective and exculpatory character of the buccal health right, mainly, those users who find themselves in situation of extreme poverty and social vulnerability. Immediate and of lesser cost odontological assistance is what it s aimed, but the standards praised in the Public Politics of Buccal Health walk in another direction, requiring a bigger strongness of the formation bases and implementation of the programmatical actions since the academic field until the effectiveness of Politics of Buccal Health as a right while as a right to attention and care

Aten����o �� sa��de da pessoa idosa na estrat��gia sa��de da fam��lia no munic��pio de Santo Ant��nio/RN: um estudo de caso

According to demographic estimates, by the year 2025 Brazil will be the sixth country in the world in number of elderly. For this reason, it is a purpose of public policies to help people to reach that age being healthier. The current health care model of health surveillance through the Family Health Strategy (EFS, in portuguese) is configured as a gateway into the care of the elderly in the Unified Health System (SUS, in portuguese). It is also an area of development of practices to promote health, prevention and control of chronic nondegenerative diseases. The aim of this study was to analyze the health care of the elderly provided by ESF professionals for the achievement of a full care. The study is descriptive case study with a quantitative approach, performed in the city of Santo Ant��nio/RN. The population included all health professionals, who are FHS members of the city that agreed to participate of the survey, a total of 80 professionals. Data were collected using a structured questionnaire, having mostly closed questions and divided into two parts: one containing sociodemographic information of health professionals and vocational training and the other, the activities carried on by the professionals in senior care, being analyzed from a database tabulated in a spreadsheet and discussed according to the descriptive statistics in tables, graphs and charts using frequencies, medians and values of central tendency. It was verified a predominance of professionals who finished highschool, mostly female, aged from 30 to 34 years old, with training completed in the last 10 years, without being graduated in the field of geriatrics or gerontology and mostly without training in gerontology. Family members and caregivers were the components of the social support network most identified by the professionals (66.3%).The elderly access to the Family Health Basic Unit was considered by83.8% of professionals as the most important factor that interferes in the activities of health care of the elderly. Considering the inclusion of the family in care: 98.8% of professionals consider the family as one of the goals of care, but 82.5% assist the family to know their role and participate in the care of the elderly, emphasizing that no professional makes use of tools for evaluating the functionality of the family. Regarding the actions taken to assist the elderly, 91.25% have home visits program to the elderly, 88.75% use the host program; 77.5% know the habits of life, cultural, ethical and religious values of the elderly, their families and their community ;51.25% complement the activities through intersectoral actions, 50%participate in groups of living with the elderly; 33.75% keeps track and maintain updated the health information of the elderly; 11.25% of the professionals perform the Single Therapy Planning (PTS, in portuguese) and few implement the actions to promote health according to PTS; there is a deficit in the number of professional categories in the identification and monitoring of the frail older people in their households. It is concluded that the health care of the elderly developed by ESF professionals differs among the professional categories. It was identified weaknesses in the promotion of an active and healthy aging and also in the establishment of an integrated and full care of the elderly. It is recommended the adoption of permanent educational activities by the City Management, initially for ESF professionals in the the perspective of the guidelines of the National Policy of Health Care for the Elderly and later to the other professionals that are part of the health care network of the elderly, at all levels of care in the city for the development of strategies and practices that promote the improvement of the quality of healthcare for the elderly, expecting concrete and effective results in terms of promoting health within Brazilian reality

A organiza����o da demanda em servi��os p��blicos de sa��de bucal: universalidade, eq��idade e integralidade em sa��de bucal coletiva

RONCALLI, Angelo Giuseppe. A organiza����o da demanda em servi��os p��blicos de sa��de bucal: universalidade, eq��idade e integralidade em Sa��de Bucal Coletiva. ra��atuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista ���J��lio de Mesquita Filho���

Incid��ncia de c��rie dent��ria em adolescentes em munic��pio do Nordeste brasileiro, 2006

NORO, Luiz Roberto Augusto et al. Incid��ncia de c��rie dent��ria em adolescentes em munic��pio do Nordeste brasileiro, 2006, Cadernos de Sa��de P��blica, Rio de Janeiro, v. 25, n. 4, p. 783-790, abr. 2009.

A utiliza����o de servi��os odontol��gicos entre crian��as e fatores associados em Sobral, Cear��, Brasil

NORO, L. R. A. et al. A utiliza����o de servi��os odontol��gicos entre crian��as e fatores associados em Sobral, Cear��, Brasil. Cad. Sa��de P��blica, v. 24, n. 7, p. 1509-1516. 2008. ISSN 0102-311X.

Sa��de bucal no programa de saude da fam��lia: o caso do distrito sanit��rio norte em Natal - RN

The inclusion of the dentist in the Family Health Program (FHP) teams designates a reorganization of the mouth health care in your country and establishes a new scenario in Brazilian odontology, through of a new way to organize the basic health care, creating conditions to consolidate in mouth health practice actions, in the level of the basic attention, the validation of Unique Health System (UHS) constitutional principles. The purpose of this research is to verify if the actuation of mouth health teams (MHT) dentists, in Natal city north sanitary district, is tuned with FHP goals.The target research population was composed by all dentists working in Basic Health Units (BHU) of Natal north sanitary district. Fifth-eight questionnaires were applied and using open and closed questions we look for identify the functional characteristics of each BHU, the dentists professional attributions on each BHU, as well as the clinical procedures that they execute. This research also searched to identify the factors that facilitate and/or difficult the inclusion process and the dentists activities performance on these BHUs, as well as the necessary actions to north sanitary district MHTs to fulfill the objectives proposed by FHP. The results point that the inclusion of mouth health actions in north sanitary district FHPs brought the incorporation of new values to the used practices. Whoever, its necessary a more frequent evaluation of the carried actions, in a way they can be adapted to the real community necessities, and, is fundamental the data accompaniment, for that these serve of base for planning and redirecting activities, in a way that we do not have only a reproduction of traditional practices, fragmented and isolated, but a truly substitution of the traditional practices and a new way of promoting health

Viol��ncia institucional no ��mbito da sa��de reprodutiva : a percep����o de mulheres usu��rias do SUS, na cidade de Natal/RN

Institutional violence ranges from the most widespread lack of access to the poor quality of services provided. It includes abuses committed by virtue of the unequal power between patients and professionals within institutions. The aim of this study was to analyze the perception of women with regard to this type of violence, in the services offered at a reproductive health facility belonging to the National Health System (SUS) in Natal, Brazil. Interdisciplinary perspective is important, in that it provides interaction and complementarity between various disciplines, favoring, in an integrated way, a thematic approach in research activities, teaching and extension, involving professionals, students and researchers in medicine, social services, psychology, nursing, anthropology and physical therapy. A quantitative/qualitative approach was used, involving a sample of 401 women, as part of a transversal observational study. In the qualitative stage, which consisted of participatory observation and semi-structured interviews, we used an intentional sample of 10 individuals. The data were analyzed using logistic regression techniques, correspondence analysis and categorical thematic content analysis, showing that the 2 questions that investigated directly the perception of institutional violence obtained affirmative response frequencies of 28.2% and 31.8%, respectively. In regard to data collected in a field diary related to participatory observation, the main complaints referred to the health providerpatient relation, translated into dissatisfaction with the interpersonal relationship and with the resolution of the specific demand that required care. From content analysis, we classified 4 categories: Access; Information; Health professionalpatient relation; and Respect/dignity. We identified 6 subcategories: Impossibility of choice; Repressed demand; Communication difficulty; Asymmetric interpersonal relations; Privacy/confidentiality; Disrespect. We concluded, therefore, that the data presented show that in the reproductive health care programs, there are indicators of institutional violence. However, it is difficult to approach this phenomenon, mainly because of the power relations involved in the patient-health care provider interaction, resulting from unawareness that determinate situations violate sexual and reproductive rights. This can be explained by sociostructural questions that reveal marked inequalities, ratified by issues related to violation of the rights of National Health System (SUS) patients

Discursos e pr��ticas na forma����o de profissionais fisioterapeutas: a realidade dos cursos de fisioterapia na regi��o nordeste do Brasil

This study had a multidisciplinary focus, investigating the areas of health and education, and proposes to discuss the formation of health professionals, requiring their understanding of the factors involved in the production of knowledge, given that this formation has an impact on the quality of human and social life. The aim of this work was to investigate the relationship existing between the process of physical therapist formation and the practical activities developed during the undergraduate course in the Northeast of Brazil. This is an exploratory descriptive study with qualitative significance. The sample consisted of 73 subjects (33 professors and 40 students) from 6 physical therapy courses at different institutions in the Northeast of Brazil. Data collection was conducted through focus group interviews. In addition, we used a school assessment instrument from the health area. The data, analyzed using dialectical hermeneutics, showed that the Northeast of Brazil has the second largest number of physical therapy courses in the country, with 93 (11 public and 82 private) out of a total of 510. These numbers represent a growth of 1062.5% since 1991. The pedagogical projects are guided by National Curricular Directives as well as by the country s health system. The prevalent pedagogy is that of transmission, and the contents/disciplines are generally not integrated with practice, a situation that hinders the integrality and interdisciplinarity of health care. It can be concluded that there is a need for implementing integrated curricula and for better qualified professors to effectively put this process into practice

Investiga����o farmacoepidemiol��gica do uso do clonazepam no distrito sanit��rio leste em Natal-RN

Prescription errors are the most serious type of medication errors found in the health system. The main purpose of this study was to evaluate the quality of clonazepam prescriptions. A descriptive and observational study with retrospective data collection was conducted at 30 community pharmacies in Natal/RN, Brazil, after informed consent was obtained from the pharmacists. A sample of 313 prescription notifications was randomly collected in October 2009. They were analyzed for legible handwriting and completeness. During the study, one researcher, two pharmacists, and one pharmacy undergraduate student evaluated patient and purchaser identification, pharmaceutical form, dosing regimen, administration route, and prescription by generic name. This research was approved by the institutional Ethics Committee. Among the 313 collected notifications, only 44.1% were legible. A total of 55.91% (175/313) had at least one illegible item, 100% contained incomplete information, and 97.12% (304/313) contained one or more abbreviations. The proportion of illegible handwriting related to the patient s identification (p=0.0001) was statistically significantly greater than that related to the drug purchaser s identification (p=0.0004). Contrary to legal requirements, prescriptions with the generic name accounted for 13.42% (42/313) of the total. All the examined notifications were handwritten. Prescription errors, which potentially can have serious consequences, have been evaluated worldwide, although little is known about this subject as it relates to community pharmacies. This study showed high percentages of prescribing problems, which justifies the development of future research about medication errors in community pharmacies and education activities for prescribers

Doen��a cardiovascular em mulheres com hist��rico de pr��-ecl��mpsia e seguimento no sistema ��nico de sa��de

The aim of the present study was to analyze cardiovascular risk of women with a history of preeclampsia, as well as its follow-upin the National Health System.This is a cross-sectional quantitative research conducted at the Janu��rio Cicco Maternity School. The study population was composed of 573 women selected from a databank belonging to the Women s Health Research Group of the Gynecology Department at Universidade Federal do Rio Grande do Norte, with a history of preeclampsia, and normotensives who gave birth at this institution five years before. The final sample consisted of 147 women, 64 in the group with a history of PE and 83 normotensives. Data were collected on a questionnaire containing the following: sociodemographic aspects, anthropometric measures, life habits, personal and family history of pregnancy-induced hypertension, family history of cardiovascular diseases and frequency of measuring current blood pressure levels. In relation to the association between cardiovascular risk and altered blood pressure (≥130x85 mmHg), the likelihood of exhibiting the latter condition was significantly higher in women with a history of preeclampsia (CI 95% 4.12-38.92), the overweight and obese (CI 95% 1.70-20.75), and in those with a family historyof CVD and personal history of PIH (CI 95% 0.78-47.07 and CI 95% 3.20-25.39) respectively. Likewise, the probability of having altered blood pressure was higher in women with fasting glycemia ≥100mg/dL (CI 95% 2.09-24.73), as well as in those with triglycerides ≥150mg/dl (CI 95% 1.72-9.66). After fitting the logistic model, diagnosis previous preeclampsia and altered triglycerides remained as explanatory variables.The women with a history of preeclampsia five years before exhibited altered blood pressure levels, clinical and laboratory manifestations suggestive of elevated risk for cardiovascular disease, as well as family and personal history of hypertension. There is no differential treatment or adequate outpatient follow-up for this population in basic health care units

Pr��ticas clientelistas e d��divas como estrat��gias de hegemonia pol��tica: uma an��lise sobre o campo da sa��de em Mossor��-RN

The reality experienced by many families and individuals who seek and require the services of the Unified Health System - SUS, the relationships between users, health professionals, and political representatives, establishes the core of the issue that guides the choice and interest of this study concerning the prominence of clientelist practices and gifts that permeate the health field. The research is based on the analysis and reflection of the intrinsic relationship between the health and political fields. It analyses the health field and its relationship with the dynamics and developments of the local political scenario relating it to the implementation of the Family Health Program and Community Health Agents Program (PACS/PSF health programs) in the city of Mossor��, State of Rio Grande do Norte which refers to the period 1991-2010; and falls into a methodological perspective of qualitative approach. The methodological tools and techniques used were based on semi-structured interviews, direct observation of the field, journalistic texts and documentary sources. The construction and questioning of the object of the research were based on theoretical contributions from authors discussing the social field and symbolic power: Bourdieu (2005); clientelist relationships and gifts from asymmetric exchanges: Rouland (1997), Lanna (1995), Martins (1999), Carvalho (1999), Diniz (1982); exercise of hegemony and political strategy from authors who analyse this subject: Gramsci (1995), Coutinho (1981), and Gruppi (1978). Furthermore, the research has established dialogues with authors who address the dynamics of Brazilian politics such as Baquero (2001) and Weffort (1993). The collected data were subjected to qualitative content analysis. The results showed that with the implementation of the PACS/PSF programs in the aforementioned city, the health field has established itself as a key scenario for the exercise of political hegemony of the factions that dominate this socio-political context, resizing clientelist practices, however, without modifying the power structures within this social scenario