Trycksår : – undersköterskors kunskaper om att förebygga trycksår

Background and aims: The population of older people in our society is increasing. Agerelated changes in the skin results in a diminished perception of pain and pressure and a decreased microcirculation in the skin affects its ability to adapt to injury. Occurrence of pressure sore on geriatrikal clinics are 5-10%, witch means that between five and ten thousand patients gets daily treat for pressure sores. When the patient gets a pressure sore the need for help increases. A common apprehension is that if the patient’s affects with pressure sores it’s because of deficiency in care. According to the law, all nursing interventions should be performed according to scientific and evidence and the nurse’s assistants are responsible for how they perform. The aim of this study was to examine how much knowledge the nurses assistants in community care services has about preventing, predicting and locate riskfactors for pressure sores and if they get the right education. Methods: A questionnaire based on 20 questions was maid and used for this purpose. Out of 99 persons the questionnaires was answered bye 65 nurses assistants working in community care service in a small town in Sweden. Results: The results shown that the nurses assistants don’t use risk assessment scales in attempt to identify patients vulnerable to pressure sores and they are not well associated with the riskfactors. The study even shows that they have little knowledge in how to prevent pressure sores from appearing. The nursing model are some times out of date and the nurses assistants personal view attends to decide witch care they will perform instead of scientific and evidenced based nursing.

UUm Modelo Exploratório, Baseado nas Comunidades Linux, para Desenvolvimento da Tecnologia da Informação no Brasil

presente trabalho objetiva construir um Modelo Exploratório de desenvolvimento de tecnologia da informação, aplicável no Brasil, tendo como referência as formas de organização do trabalho e da produção das comunidades Linux. O Modelo deve ser aplicado em ambiente Internet, ou em outras redes de telecomunicação. Por essa razão, utiliza métodos e técnicas de aprendizado à distância e e-Iearning. A construção do Modelo apoia-se, como alicerce teórico fundamental, no conceito de convivialidade de Illich (1976), no entendimento de Inose e Pierce (1984) sobre comunidades de interesse e democratização da produção de software, nos estudos de Malone (1997, 1998) referentes a modelos de organização em rede, nos estudos de Weber (2000) sobre comunidades de interesse online, na metodologia de capacitação "Pensamento Digital" de Joia (1999-1, 1999-2) e na estratégia pedagógico-metodológica do Australian National Training Authority (T AFE/SA). No entanto, as pesquisas de Matesco (2000, 2001) tomaram exeqüível a idéia da construção do Modelo, tendo que vista que o Modelo Exploratório proposto aplica-se, preferencialmente, a países, regiões, empresas ou organizações dependentes tecnologicamente de seus parceiros negociais e com escassez de recursos para aplicar em pesquisa e desenvolvimento. O caminho metodológico para a construção do Modelo inicia-se com uma sucinta abordagem sobre o sistema operacional Linux, a descrição das formas de organização das comunidades Linux e a identificação das formas de organização do trabalho e da produção no Fordismo-Taylorismo e no pós-Fordismo. Situa o funcionamento das comunidades Linux em relação a essas formas de organização. Descreve o processo de formação do conhecimento no aprendizado à distância e no elearning. Aborda a experiência de outros países com o Linux e com as comunidades Linux. Principalmente, o sucesso obtido pelos países nórdicos em absorção de tecnologia. A seguir, fundamentando-se em duas pesquisas de Matesco (2000,2001), analisa a dependência tecnológica do Brasil e propõe o Modelo Exploratório, cujo objetivo é, prioritariamente, colaborar para a redução dessa dependência, por meio de um processo de formação de conhecimento, baseado no aprendizado à distância e e-Iearning do Linux e na propagação de comunidades Linux, empregando-se o modelo de organização em rede.

As escolas comunitárias da Rocinha: 1968/1986: um fator de conservação ou de transformação social?

O presente trabalho apresenta a experiência das escolas comunitárias da favela da Rocinha, durante o período de 1968 a 1986, e a analisa a partir de duas vertentes: - a questão urbana - a escola comunitária enquanto uma forma de organização popular, que aliada aos outros grupos comunitários da Rocinha, questiona a alocação desigual de recursos públicos e luta pela melhoria das condições de vida na favela. A questão educacional - a prática pedagógica dessas escolas junto às crianças, jovens e adultos; a busca de uma metodologia e de conteúdos que partam da realidade dos alunos e dos objetivos do trabalho comunitário. O estudo de caso foi elaborado a partir de entrevistas (realizadas junto a lideranças, educadores, pais, alunos, agentes externos e técnicos), de fontes documentais e da participação da autora no trabalho comunitário da favela, iniciada em 1976. Procurou-se apreender a origem dessa experiência junto à precariedade/ineficácia do sistema oficial de ensino e ao processo de reorganização das classes populares, e perceber também a relação entre as diferentes conjunturas e a configuração que as escolas comunitárias foram assumindo ao longo dessa trajetória.

Condição ocular dos indivíduos facectomizados na região centro-oeste do estado de São Paulo: estudo populacional

OBJETIVO: Avaliar as causas de baixa visão e cegueira em indivíduos facectomizados, de amostra da população de cidades da região centrooeste do estado de São Paulo. Métodos: Estudo transversal, observacional, feito em cinco cidades da região centro-oeste do estado de São Paulo, em amostra domiciliar e baseada nos dados do último Censo Demográfico (IBGE, 1995), com escolha sistemática dos domicílios. Foi considerada para o presente estudo uma subamostra de indivíduos facectomizados, dos quais foram obtidos dados de identificação e exame oftalmológico completo. Os dados foram avaliados por estatísticas descritivas, análise de freqüência de ocorrência e proporção de concordância, com intervalo de confiança de 95%. RESULTADOS: Dos indivíduos amostrados, 2,37% haviam sido submetidos à facectomia. Dos 201 olhos operados, 26,9% apresentavam acuidade visual compatível com cegueira ou deficiência visual. Com a melhor correção óptica, a acuidade visual permaneceu <0,3 em 19,0%. O exame refracional proporcionou melhora da acuidade visual para 27,9% dos indivíduos facectomizados. As causas de baixa visão foram os erros refrativos não corrigidos, opacidade de cápsula posterior (19,4%), ceratopatia bolhosa (8,3%) coriorretinite cicatricial (8,3%), afacia (8,3%), degeneração macular relacionada a idade (5,5%), leucoma (5,5%), glaucoma (5,5%), atrofia de papila (5,5,%), descolamento de retina (2,8%), atrofia de epitelio pigmentado da retina (2,8%) e alta miopia (2,8%). CONCLUSÃO: Apesar da catarata ser causa de cegueira que pode ser evitável, mesmo após a correção cirúrgica porcentagem expressiva de indivíduos permanece com baixa visão, em geral, em decorrência de fatores relacionados ao seguimento pós-operatório negligenciado.

Anemia em crianças menores de dois anos atendidas nas unidades básicas de saúde no Estado de São Paulo, Brasil

The present study sought to determine the prevalence of anemia in 2,992 children, aged between 6 and 23 months, who voluntarily attended 160 Basis Health Care Units, located in 63 cities of the 5 Regional Health Coordinating areas of the State of S. Paulo, Brazil. Blood samples were collected by venous puncture and hemoglobin was measured by the cianometahemoglobin method. The WHO criteria for the diagnosis of anemia (Hb < 11.0 g/dl) were used: 59.1% of the children were shown to be anemic, with prevalence varying from 47.8% to 68.7% in the 5 RHCs. RHC 1, which comprises the Greater S. Paulo Region, presented a prevalence of anemia significantly lower than the other 4 RHCs, which cover the rest of the State. Hemoglobin levels 9.5 g/dl were found in 25.1% of the children. Anemia was more frequent in male children in male children, in those born, with a weight of less than 3,000 gr, in those who were breastfed for less than 2 months and in those that who presented some degree of energy deficient proteic malnutrition, according to Gomez's criteria. This is the first of a series of 4 articles whose purpose is the determining the prevalence of anemia in the State of S. Paulo and of testing the intervention alternatives with a view to curtailing the incidence of this pathology which today is the most prevalent nutritional disturbance in the world.

E psiquiatra é médico? A psiquiatria na atenção psicossocial e seu dilema entre luto, liberdade e renegação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O trabalho do agente comunitário de saúde no município de Marília - SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A dimensão educativa na prática profissional do assistente social no trabalho com comunidades em Campinas-SP 2001-2004

Pós-graduação em Serviço Social - FCHS

Prática diária dos agentes comunitários de saúde: dificuldades e limitações da assistência

This qualitative study aimed to identify difficulties experienced by Community Health Agents (CHA) in the course of daily practice of care. Data were collected from semi-structured interviews with twelve CHA from four Basic Health Units in a city of the state of São Paulo, Brazil. From an analysis of the speech of subjects, we found that the deficiency of health services, the workload of the nurses responsible for the team and the service rejection by users make it difficult to implement the health actions. This research emphasizes the limitations expressed by the health agents, and points towards the necessity of an evolving discussion of this theme, seeking strategies that enable the consolidation of community health principles.

Andarilhos de estrada e os serviços sociais de assistência

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

O lugar da psicanálise e a universidade

As a usual practice in society, psychotherapy is considered a normal procedure, but how does it take place in an investigation method of subjectivity in the university? The theory of speech of Lacan helps us to locate a place to psychoanalysis in the university as a language practice in the role of teaching, research and extension (community work). In this sense, the university submits the ideas of conscience to science and material rationality, excluding the individual and the unconscious. The theory of speech helps us to see the difference between the speech the students use and the speech the annalist uses in his practice. The psychoanalysis has its own knowledge based on the unconscious, due to the clinic work precedes as well as the work in university extension (community work). The work of the annalist has his particular world to treat his mane object — the unconscious.

Exploring Assistance in Sweden and the United States

Few international comparisons of health services are performed using microlevel data. Using such data, this paper compares the need for and receipt of assistance with activities of daily living (ADLs) in comparable samples in the United States and Sweden, a country with a universal system of community-based services.Design and Methods: Data from national surveys of community residents completed at approximately the same time in each nation are used to create comparable measures of need and assistance. Descriptive and logistic regression analyses compare need and assistance patterns across the nations and identify individual factors that explain receipt of assistance and unmet needs.Results:Our results indicate that a simple story of greater use of paid formal services in Sweden and more unpaid informal use in the United States masks a more complex relationship. Assistance with ADLs seems to be more targeted in Sweden; narrow differences in assistance widen considerably when the analysis is limited to those reporting need. Implications:Although these two different health systems result in similar levels of overall ADL assistance, a detailed microlevel comparison reveals key distinctions. Further microlevel comparisons of access, cost, and quality in cross-national data can further aid our understanding of the consequences of health policy.

Die soziale Ökonomie des Gemeinwesens - Eine sozialpolitische Entwicklungsaufgabe

Community work and development - Now, that market economy is no longer faced with territorial boundaries, the spheres of life within the limits of local communities are gaining new importance in terms of sustained patterns of development. This extended meaning of local community as a place for mastering the challenges of life and as a framework for developing future-oriented solutions to social, ecological and economic problems, corresponds to the extended meaning of community-based social work as an effort to shape social life and generate social change. Community-economy follows the original sense of human economy, defined by Aristotle. It is the idea of the “oikos”, an economy for the satisfaction of needs of the “whole house” - of the young and the old, the healthy and sick, of the living and future generations and the not-human world. In this sense “oikonomia” means household management.

Marginalized Youth, the ‘Modern’ Professional and the ‘Modern’ Workplace: A note on the Need for a Critical Approach to ‘Modernizing’ Strategies

This paper briefly examines plans to ‘transform’ social work services for socially marginalized children and young people in England. More specifically, it will focus on moves to privatize social work services for children and young people who are in public care, or ‘looked after’. In what follows, the focus will be on how the promotion of ‘social work practices’ (SWPs) – the name of these envisaged new structures – is discursively embedded in the idea the idea that ‘liberation’ and worker fulfillment can only be delivered within a privatized sphere. In this context, it will be maintained, the work of Boltanski and Chiapello may help to illuminate how the government and other primary definers are seeking to ‘win hearts and minds’ for further neoliberal ‘transformations’ within Children’s Services in England.

Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration

INTRODUCTION HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. METHODS Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. RESULTS Most sites reported serving urban (61%; region range (rr): 33-100%) and both adult and paediatric populations (77%; rr: 29-96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services - nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) - were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. CONCLUSIONS This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.