Ampliação da capacidade de análise: a produção de sentidos na Política Nacional de Humanização

The article refers to the collective construction performed from the Multicentric Research on Humanization Training of SUS. It is about production and building consensus on different interpretations of the superfamily "expansion of the analysis capability." The methodological approach is related to the creation of analytical reports coming from four sources: Intervention Plans built at the time of training courses offered in three states (Rio Grande do Sul, Santa Catarina and São Paulo) by the institutional supporters in training.Also, there were questionnaires answered via Form-SUS by graduated supporters after four years of the course closing; data and analysis produced by supporters in focus groups and interviews, conducted as the research final stage in the three states.Thus, considering the inclusive methodological framework not only from the courses, but also the research that evaluated them, the participants (graduates from the training courses) produced data and started to play the active role of researchers/panelists because they got “surprised" by partial analyzes.Therefore, the article discusses the analysis capability of demand required by supporters before their working areas and the relationship of that capability with concepts and elements of Institutional Analysis.It was possible to highlight the inseparability between demands of emergency and the exercise of being next to another person and his/her interests. The conclusion is that the methodology proposed by the course allowed the supporters in training to stimulate and develop a critical capacity on their work.However, it is noticed that the expansion of such analytical capability often remained linked to the supporter, without the contagion of other workers in the territories.It was also possible to see that the course and political framework of PNH could equip the supporters, promoting empowerment from their analysis, which is essential to the interventions performance.

Errâncias e itinerâncias de uma pesquisa avaliativa em saúde: a construção de uma metodologia participativa

The study presents the construction process of research methodology "Training in SUS Humanization: effects evaluation of training processes from institutional supporters on health productionin Rio Grande do Sul, Santa Catarina and São Paulo territories." There was a search for developing an appropriate evaluative practice to the training processes, a methodology that instead of evaluating on something, assessed along with the supporters who attended the training-intervention, a participatory methodology.Therefore, the constitution of the Research Interest Group was an eminent tool. Trained supporters comprised the research team to expand participatory possibilities of a large and dispersed group, producing interferences in the investigative process conduction, described and analyzed in the study.At the same time, their experiences interfered in the understandings they had until then about the intervention-training experiences and effects on their daily lives, after almost four years.Thus, the methodological approach was intrinsically linked to the construction of a subjectivity differentiated plan and necessarily collective, which shifted the position of supporters involved from mere data suppliers to a lateralityposition in relation to other actors.The trial afforded by participatory strategies allowed researchers and supporters to interfere and compose the evaluation scenario with remarkable performances throughout the investigative process.The survey configuration was like a bet on a given methodological architecture that, in seeking to overcome evaluator-evaluated logic produced information for (retro) feedingthe intervention triggered by it. In the formative dimension, it also went through working processes analyzed by supporters rescuing the indissoluble characteristic that health activities mobilize among intervening, training and reviewing.

Territórios e sentidos: espaço, cultura, subjetividade e cuidado na atenção psicossocial

In the light of the collective health and of the mental health, the concept of territory is present in multiple dimensions and meanings. It appears in documents that express principles and guidelines of the health policies and in the planning of local actions, and it is a central element to organize the care network in psychosocial attentiveness. This present essay aims to discuss the concept of territory and its uses in the practices of psychosocial care, developing a dialogue with the geographer Milton Santos and the philosophers Gilles Deleuze and Félix Guattari who, from different fields and perspectives, work with this concept. This dialogue made it possible to think the territory in its complexity, as space, process and composition, in order to optimize the relationship between service, culture, production of care and production of subjectivity.

O apoiador caipira: o desafio/arte de articular redes regionais a partir de territórios/desejos singulares

Considering the experience taken from the institutional support given by the Humanization’s Brazilian Policy in three health’s regions in São Paulo State, Brazil, this text intends to expose some problems refering to the articulation process of other health’s regional networks mainly composed by cities with less than twenty thousands inhabitants. By problematizing the articulation of inlad health’s networks it is put on the agenda the process of descentraliztion and the interfederaditive relations emphasizing the political and institutional aspects that goes through and modulates these relations, mainly in the small cities. Thus, we are questioning the ways how the current health policies are implemented in these territories and the way how they are articulated, having as a goal the challenge of the process’ ascendance and transversality.

Physical activity: practice this idea

Sedentary habits or insufficient activities to promote health benefits can influence the occurrence of chronic diseases. The cardiovascular risk factors arise, at least partially, from the individual-environment interaction during life, and worsen with aging and lack of physical exercise. Health promotion and prevention are among the greatest challenges of public health policies. However, physical activity turns out to be rarely recommended and, thus have a very poor adhesion. In spite of consensus about the benefits of physical activity in both primary and secondary prevention, only 32% of adults and 66% of children and adolescents, according to Healthy People 2010 guideline, practice leisure-time physical activity. Thus, the regular practice of physical activity and healthy habits require changes in basic concepts in government and social policies. The higher involvement of public and private sectors related to health and education, the more expressive would be the reduction in socioeconomic costs and the improvement in quality of life.

Atenção farmacêutica em idosos com hipertensão participantes da estratégia saúde da família

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A intersetorialidade das políticas de saúde e de assistência social no sistema de atenção domiciliar em Franca/SP

Pós-graduação em Serviço Social - FCHS

O cuidado em saúde mental e o agir em rede: como se agencia um caso de intensa complexidade?

Pós-graduação em Psicologia - FCLAS

Participação social nos conselhos de unidades de saúde

This exploratory and qualitative study sought to investigate how health service users? participation on the Councils of Health centers occurs in the municipality of Botucatu in São Paulo. Data was collected in September and October 2008 via interviews guided by a semi-structured script, administered to 9 service users who are members of the Council at four primary health care centers. After content analysis, three thematic categories emerged: Knowing the service user/councillor, The Health Centers? Council and Participation on the Council. The results show the unpreparedness and lack of knowledge of the councillors representing health service users on the subject of the role of the Councils and on public health policies, evidencing the need for actors from the health services to invest in guidance, consciousness-raising and preparation of citizens with critical ability to influence, guide, demand and question the health services? actions.

Óleos essenciais: aspectos gerais e usos em terapias naturais

Traditional knowledge is now a source for research in the search for new biologically active compounds and how effective therapy that addresses the current health care. Health policies using these sources have been encouraged by international and national organizations like the World Health Organization and the Brazilian Ministry of Health. Aromatherapy and essential oils are one of these strands rising trade and as an object of study. This monograph aims to present general aspects about essential oils and their use in natural therapies such as aromatherapy.

A avaliação da efetividade de um modelo de intervenção breve (método BASICS) para o uso de risco de álcool em estudantes do ensino médio

Pós-graduação em Saúde Coletiva - FMB

Private and Public Dental Care in the City of Sao Paulo in the First Decade of the XXI Century

Two concomitant movements occur in the first decade of the XXI century within the private and public dental services in Brazil: the entrance of oral health on the agenda of political priorities of the federal government and the vigorous growth of additional dental care. We analyzed the occurrence of these phenomena in the city of Sao Paulo, by seeking information in official documents and electronic databases in the Municipality of Sao Paulo, the Ministry of Health and National Health Agency (ANS), and also in scientific literature. During the studied period - January 2000 to December 2009 - and with basis on indicators such as coverage of First Consultation Program and Dental coverage Population Potential, percentages were found that characterize low public assistance and a situation far short of the constitutional principle of universal access to dental care. The growing number of beneficiaries of additional services through exclusively dental coverage insurance plans and other types of private insurance plans in the same period was significant, accounting for a major expansion of population coverage in this mode of care. It was found that, compared to the overall national framework, the city of Sao Paulo offers poor access to public dental care, with reduced supply of services to adults and aged people. Furthermore, considering the limitations of market additional services to provide dental care to all Brazilians, it reinforces the need for continuity and expansion of Brasil Sorridente, which is the programmatic expression of the National Oral Health Politics.

Suicide rates and income in Sao Paulo and Brazil: a temporal and spatial epidemiologic analysis from 1996 to 2008

Background: In a classical study, Durkheim noted a direct relation between suicide rates and wealth in the XIX century France. Since that time, several studies have verified this relationship. It is known that suicide rates are associated with income, although the direction of this association varies worldwide. Brazil presents a heterogeneous distribution of income and suicide across its territory; however, evaluation for an association between these variables has shown mixed results. We aimed to evaluate the relationship between suicide rates and income in Brazil, State of Sao Paulo (SP), and City of SP, considering geographical area and temporal trends. Methods: Data were extracted from the National and State official statistics departments. Three socioeconomic areas were considered according to income, from the wealthiest (area 1) to the poorest (area 3). We also considered three regions: country-wide (27 Brazilian States and 558 Brazilian micro-regions), state-wide (645 counties of SP State), and city-wide (96 districts of SP city). Relative risks (RR) were calculated among areas 1, 2, and 3 for all regions, in a cross-sectional approach. Then, we used Joinpoint analysis to explore the temporal trends of suicide rates and SaTScan to investigate geographical clusters of high/low suicide rates across the territory. Results: Suicide rates in Brazil, the State of SP, and the city of SP were 6.2, 6.6, and 5.4 per 100,000, respectively. Taking suicide rates of the poorest area (3) as reference, the RR for the wealthiest area was 1.64, 0.88, and 1.65 for Brazil, State of SP, and city of SP, respectively (p for trend <0.05 for all analyses). Spatial cluster of high suicide rates were identified at Brazilian southern (RR = 2.37), state of SP western (RR = 1.32), and city of SP central (RR = 1.65) regions. A direct association between income and suicide were found for Brazil (OR = 2.59) and the city of SP (OR = 1.07), and an inverse association for the state of SP (OR = 0.49). Conclusions: Temporospatial analyses revealed higher suicide rates in wealthier areas in Brazil and the city of SP and in poorer areas in the State of SP. We further discuss the role of socioeconomic characteristics for explaining these discrepancies and the importance of our findings in public health policies. Similar studies in other Brazilian States and developing countries are warranted.

Homens, saúde e políticas públicas: a equidade de gênero em questão

O artigo tem por objetivo estabelecer questões acerca do tema Homens, Saúde e Políticas Públicas para a viabilização do debate sobre o assunto, com base em referências teóricas e empíricas relacionadas a essas questões. Inicialmente, alguns marcos históricos de temática são apresentados para que melhor se situe o debate. Em seguida, apresenta-se panorama da agenda de gênero nas políticas públicas para se introduzir a discussão acerca da inserção dessa perspectiva no âmbito das políticas de saúde. Após essa discussão, aborda-se o questionamento sobre o fato de as políticas de saúde dos homens promoverem ou não a equidade de gênero. Nas considerações finais, aponta-se para a complexidade que envolve a elaboração, a implementação e a avaliação das políticas de saúde que visam à equidade de gênero, bem como se destaca a necessidade de a política brasileira voltada para a saúde dos homens articular-se com outras políticas para que a matriz de gênero seja transversal no campo da saúde.

Prevalence of chronic rhinosinusitis in Sao Paulo

Introduction: Studies designed to investigate chronic rhinosinusitis (CRS) epidemiology play an important role to assess population's distribution and risk factors to result in the development and promotion of public health policies. Method: This study design is a survey carried out with a complex two-stage cluster sampling plan. Personal interviews were carried out with 2,003 individuals. The questionnaire included the epidemiological criteria for CRS. Demographic data, history of physician-diagnosed respiratory diseases (asthma, sinusitis, rhinitis), smoking, family income, educational attainment, and household characteristics were also evaluated. Results: The overall response rate was 93.9% of the households. Mean age was 39.8 +/- 21 years; 45.33% were male. The overall prevalence of CRS in the city of Sao Paulo was 5.51%. We found a significant association between diagnosis of CRS and diagnosis of asthma and CRS and diagnosis of rhinitis and a significant association between presence of CRS and belonging to the low-income subgroup. Conclusion: The municipality of Sao Paulo has an urban population of 11 million. According to the present study, the prevalence of CRS is 5.51%, which represents more than 500,000 individuals affected by this condition in the city.