Avaliação em saúde: reflexões inscritas no paradigma sanitário contemporâneo

O presente estudo apresenta uma análise reflexiva dos métodos de avaliação em saúde em uma perspectiva do cuidado pensado e praticado segundo as necessidades dos usuários. Várias são as formas e abordagens dos processos avaliativos na busca de uma melhor apreensão do objeto de avaliação; neste contexto, a satisfação do usuário surge como um indicador de qualidade dos serviços de saúde, ligada à maior adequação e promoção de reais mudanças nas práticas de saúde. Diante da inovadora proposta do Programa Saúde da Família (PSF), baseado nos princípios de integralidade, cuidado à saúde e humanização, a participação e a satisfação do usuário surgem como elementos-chave na formulação de suas ações, possibilitando mudanças no modelo assistencial hegemônico, a saber, positivista, assistencialista e curativista. A presença do usuário no processo avaliativo irá permitir uma peculiar atuação, remodelando as práticas de saúde - quiçá tornando-as mais humanas, acolhedoras e, conseqüentemente, mais resolutivas..

Phylogenetic systematics of dart-poison frogs and their relatives (Amphibia: Athesphatanura: Dendrobatidae)

The known diversity of dart-poison frog species has grown from 70 in the 1960s to 247 at present, with no sign that the discovery of new species will wane in the foreseeable future. Although this growth in knowledge of the diversity of this group has been accompanied by detailed investigations of many aspects of the biology of dendrobatids, their phylogenetic relationships remain poorly understood. This study was designed to test hypotheses of dendrobatid diversification by combining new and prior genotypic and phenotypic evidence in a total evidence analysis. DNA sequences were sampled for five mitochondrial and six nuclear loci (approximately 6,100 base pairs [bp]; x=3,740 bp per terminal; total dataset composed of approximately 1.55 million bp), and 174 phenotypic characters were scored from adult and larval morphology, alkaloid profiles, and behavior. These data were combined with relevant published DNA sequences. Ingroup sampling targeted several previously unsampled species, including Aromobates nocturnus, which was hypothesized previously to be the sister of all other dendrobatids. Undescribed and problematic species were sampled from multiple localities when possible. The final dataset consisted of 414 terminals: 367 ingroup terminals of 156 species and 47 outgroup terminals of 46 species. Direct optimization parsimony analysis of the equally weighted evidence resulted in 25,872 optimal trees. Forty nodes collapse in the strict consensus, with all conflict restricted to conspecific terminals. Dendrobatids were recovered as monophyletic, and their sister group consisted of Crossodactylus, Hylodes, and Megaelosia, recognized herein as Hylodidae. Among outgroup taxa, Centrolenidae was found to be the sister group of all athesphatanurans except Hylidae, Leptodactyidae was polyphyletic, Thoropa was nested within Cycloramphidae, and Ceratophryinae was paraphyletic with respect to Telmatobiinae. Among dendrobatids, the monophyly and content of Mannophryne and Phyllobates were corroborated. Aromobates nocturnus and Colostethus saltuensis were found to be nested within Nephelobates, and Minyobates was paraphyletic and nested within Dendrobates. Colostethus was shown to be rampantly nonmonophyletic, with most species falling into two unrelated cis- and trans-Andean clades. A morphologically and behaviorally diverse clade of median lingual process-possessing species was discovered. In light of these findings and the growth in knowledge of the diversity of this large clade over the past 40 years, we propose a new, monophyletic taxonomy for dendrobatids, recognizing the inclusive clade as a superfamily (Dendrobatoidea) composed of two families (one of which is new), six subfamilies (three new), and 16 genera (four new). Although poisonous frogs did not form a monophyletic group, the three poisonous lineages are all confined to the revised family Dendrobatidae, in keeping with the traditional application of this name. We also propose changes to achieve a monophyletic higher-level taxonomy for the athesphatanuran outgroup taxa. Analysis of character evolution revealed multiple origins of phytotelm-breeding, parental provisioning of nutritive oocytes for larval consumption (larval oophagy), and endotrophy. Available evidence indicates that transport of tadpoles on the dorsum of parent nurse frogs-a dendrobatid synapomorphy-is carried out primitively by male nurse frogs, with three independent origins of female transport and five independent origins of biparental transport. Reproductive amplexus is optimally explained as having been lost in the most recent common ancestor of Dendrobatoidea, with cephalic amplexus arising independently three times. © American Museum of Natural History 2006.

Phylogenetic analysis of the Neotropical social wasps of the genus Angiopolybia Araujo, 1946 (Hymenoptera, Vespidae, Epiponini)

A morphological cladistic analysis of the Neotropical swarm-founding genus Angiopolybia Araujo is presented. A single cladogram resulted from the analysis, with the following ingroup topology: (A. pallens + A. zischkai) + (A. paraensis + A. obidensis). The monophyly of the genus is supported by four synapomorphies. A new identification key is presented for the genus. Copyright © 2007 Magnolia Press.

A família do paciente em situação crônica de vida: a visão de enfermeiros de um hospital de ensino

This exploratory descriptive study, of qualitative nature had the purpose to study how the nurses from a hospital school see the family as care participants. Six nurses from clinics of chronically ill patients were interviewed. The data analysis allowed to infer that the nurses had only little knowledge of the family's thematic during graduation, making the relationship with the accompanying families very difficult. Daily care during hospitalization period is marked by easy moments when members are willing to participate in the process, and by difficulties when they attempt to break institutional rules. It was suggested that new nurses have theoretical foundation to attend the family in several scenarios of care. It was considered the need of investments in professional training, and that the advance of humanization of services implies in exchange and integration of knowledge among patients, family members, health professionals, support staff and managers beyond the science field.

Avaliação da assistência pré-natal e puerperal desenvolvidas em região do interior do Estado de São Paulo em 2005

Objectives: to evaluate the structure and process of the prenatal and puerperal care given by Direção Regional de Saúde (DIR) XI, at the city of Botucatu, State of São Paulo, Brazil. Methods: an evaluation of resources and activities developed during prenatal and puerperal care in twenty municipalities comprising DIR XI which had adhered the Prenatal and Birth Humanization Program until 2003. Interviews with city managers and analysis of 385 sampled patient charts taking into account recommendations by the Health Department. Results: structure analysis showed that caregiving was centered on medical work; basic equipment and instruments were available; 85.2% of patients began prenatal care with up to 120 days of pregnancy, and 75.9% had at least six prenatal consultations. The active search for absentees and strategies for early prenatal care initiation were observed in 30% and 50% of the municipalities, respectively. Process indicators showed that 3.6% of women had six prenatal consultations, one puerperal consultation, all basic exams and tetanus immunization. Recording of gestational age, arterial blood pressure and weight was of approximately 90%; 58.7% of the women underwent childbirth review and 31.5% were vaccinated. Conclusions: the performance of the set of activities is a challenge to prenatal care at DIR XI.

Avaliação dos resultados neonatais do método canguru no Brasil

Objective: To evaluate the results of the kangaroo mother method in Brazil. Methods: A prospective cohort study comparing 16 units that have or do not have the second phase of the kangaroo mother method: eight were national centers of excellence for the kangaroo mother method (study group) and eight were part of the Brazilian Neonatal Research Network (control group). A total of 985 newborn infants with birth weights of 500 to 1,749 g were enrolled. Multivariate analyses employedmultiple linear regression and Poisson regression with robust adjustment. Results: The adjusted analysis (controlled for birth weight, gestational age, Score for Neonatal Acute Physiology Perinatal Extension II, Neonatal Therapeutic Intervention Scoring System, and maternal age and educational level) demonstrated that mean length of hospital stay (p = 0.14) and intercurrent clinical conditions in the intermediate or kangaroo unit were equal for both groups. Weight (p = 0.012), length (p = 0.039) and head circumference (p = 0.006) at 36 weeks' corrected gestational age were all lower at the kangaroo units. The kangaroo units exhibited superior performance in relation to exclusive breastfeeding at discharge (69.2 vs. 23.8%, p=0.022). Conclusions: The evidence suggests that the humanization strategy adopted by the Brazilian Ministry of Health is a safe alternative to conventional treatment and a good strategy for promoting breastfeeding. Copyright © 2008 by Sociedade Brasileira de Pediatria.

O conceito de saber escolar clássico em Dermeval Saviani: Implicações para a Educação Matemática

The aim of this paper is initially to consider some issues related to the relationship between humanization and alienation in the process of historical social development of human gender. These considerations are fundamental for understanding the concept of classical in Dermeval Saviani and the consequences for research about the historical development of Mathematics currently found in school curriculums. The intention is to value the appropriation of school mathematics as a humanizing element that becomes accessible through the activity of teaching.

O pensamento educacional de Célestin Freinet e suas aproximações aos ideais do movimento da escola nova

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A inserção da criança pré-escolar no universo da cultura escrita pela mediação do desenho

Pós-graduação em Educação - FFC

Timidez na escola: um estudo histórico-cultural

Pós-graduação em Educação - FCT

O papel mediador da educação musical no contexto hospitalar: uma abordagem sócio-histórica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação do conhecimento, formação e capacitação do TSB e ASB no desenvolvimento das atividades no serviço público de saúde

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A humanização na atenção básica de saúde: visão de um grupo de idosos de Araçatuba-SP

Pós-graduação em Odontologia Preventiva e Social - FOA

A percepção da equipe de enfermagem de um hospital especilizado sobre o seu processo de trabalho

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Percepção da humanização das condições de trabalho por trabalhadores de enfermagem da unidade de terapia intensiva adulto

Pós-graduação em Enfermagem (mestrado profissional) - FMB