800 resultados para nível de saúde
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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 Januário 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
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Objective: To evaluate the implementation of the Family Health Strategy (FHS) in Brazilian cities of the Northeast, expanding coverage, analyzing the progress, challenges and innovations. Methods: Multicentric Evaluation Research, Studies Baselines in urban centers, using as a case study method. Selected cases of Aracaju, being capital, advanced coverage with extended team, and Fortaleza, capital coverage incipient and minimal staff. In Fortaleza, purposive sample of 11 Units Primary (APS), 03 managers, 53 professionals and 109 users. In Aracaju, 09 units of APS, 02 managers, 36 professionals, and 90 users. Structured interviews for managers, and structured to professionals and users. Descriptive analysis focusing on the political and institutional dimensions, organization and comprehensive care. Results: There was consensus that the ESF is the preferred port users and acts as inducing changes in care. In the case of Fortaleza, the specificities were: care protocols and community activities aimed at chronic conditions (100%) , with greater participation of doctors and nurses (93%) ; conjunction with more complex services, but the teams reported difficulties with the examination center and experts, the long waits and poor access to local services were the main difficulties reported by users., As innovative practice, the therapeutic group of elderly caregivers mentioned by respondents; There was intersectoral initiatives and teams 87 % of users have participated in meetings about health problems. In the case of Aracaju, care protocols were directed to the lines of care and formulated locally, 85 % coverage of the population with FHS counterpart local financing; employees hired by public tender; 70 % of teams with expertise in public health center for continuing education acting; democratization in management; access technologies, welcoming and computerization in different integrated networks, and evaluation matrix. Conclusions: The ESF has promoted access to health care and inclusion of disadvantaged populations. Different perceptions and practices in the organization of care, with distinct trajectories of reorganization. In the case of Fortaleza, predominance of model programs valuing older, with evidence of advances in care practices and teamwork, but restricted to primary care practices and incipient in public policy perspective. In Aracaju, had network integration with technologies related to the family, in which the ESF is consolidated as public policy. It can be argued that the XII APS expanding coverage, exhibited efficacy, despite the challenges inherent to the different degrees of implementation
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The aim of the present study was to identify the representational elements of workrelated accidents in the health field, as well as investigate their most frequent occurrences at a university hospital, seeking to understand the cognitive, affective and social elements subjacent to the work process involved in health. The analysis focused on 470 middle and senior support staff of this hospital, based on the theoretical-methodological support of the Social Representations Theory. A combination of the following instruments was used for data collection: a free wordassociation test, a questionnaire, an interview and a field journal. Evoc 2000 software was used to identify representational structure. Chi-square and Mann-Whitney tests, at a significance level of 5%, were performed to verify the association between the independent variables and the occurrence of work accidents. In addition, thematic content analysis and lexicographic analysis by ALCESTE software program were used to understand textual content. It was observed that social representations of work-related accidents in the health area are centered in the contamination category, while the categories of prevention and professional unpreparedness are found peripherally. There was a significant association between the existence of multiple employment, the use of personal protective equipment (PPI) during work, job satisfaction and the occurrence of work accidents. The conclusions indicate that perforating-cutting occupational accidents predominated in the hospital and that the representations of the subjects intertwined, with a traditional discourse of work accidents strongly present in Occupational Health. It is therefore suggested that certain subjective aspects related to culture, in terms of controlling work accidents, such as: management, process, organization and the increasing precariousness
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The study aimed to analyze the influence of chronic health conditions (CHC) on quality of life (QOL) of UFRN servers assaulted by CHC. It is a descriptive and cross-sectional study with prospective data and quantitative approach, accomplished in the ambulatory clinic of the Department of Server Assistance (DSA) of the Pro-Rectory of Human Resources, during three months. The sample was composed by accessibility, totaling 215 people, being 153 active and 62 inactive servers, in chronic health condition. The data were collected through the application of the sociodemographic characterization, health, environmental and laboral form, the Medical Outcome Study 36-Item Short Form (SF-36). The study was evaluated by the HUOL Ethics Committee (CAAE no. 0046.0.294.000.10), obtaining assent. The results were analyzed in the SPSS 15.0 program through the descriptive and inferential statistics. It was identified servants predominantly male (59,1%), under 60 years old, married or in stable union, Catholics, brown color, living in the capital and residents in own home. Regarding labor issues, there was a predominance of active servers technical-administrative with intermediate and medium level positions and small proportion of docents. Among the CHC, the non-communicable diseases - NCDs (95.8%) had a higher frequency, followed by persistent mental disorders - PMDs (18.6%) and, finally, the continuous and structural physical deficiency - CSPD (16.9 %). The QOL of servers was considered good, with a mean score of 72.5 points in the total score, with the most affected domains: physical (59.1), general health (66.2), bodily pain (66.3) and functional aspects (72.0). The mental health dimension (76.5) had a better average than the physical dimension (68.0 points). It was found that the decrease in QOL scores is significant statistically related to higher number of CHC (ρ <0.001), with no statistical significance regarding the functional situation (p = 0.259). The administrative technicians of elementary, primary, secondary levels and docents had the worst QOL scores. After the correlation analysis of CHC with the domains and dimensions of the SF-36, there was statistically significant, negative and weak correlation of the domains: functional aspect (ρ = 0.002, r = -0.207), physical aspects (ρ = 0.007; r = -0.183), vitality (ρ = 0.002, r = -0.213), social function (ρ = 0.000, r = -0.313), emotional aspects (ρ = 0.000, r = -0.293), mental health (ρ = 0.000 , r = -0.238), physical health dimension (ρ = 0.002, r = -0.210) and mental health dimension (ρ = 0.000, r = -0.298). The presence of PMD isolated or together, contributed to a lower SF-36 scores, being the domains variation of mean significant, except for bodily pain, general health and physical aspects. By correlating the categories of CHC and QOL, there was a weak correlation (r ≤ -0.376) and significant (ρ ≤ 0.011), mainly related to the NCD, PMDs and NCD + PMD, affecting the mental health, social function, emotional aspects, vitality and functional aspect domains. Front of the results, it was concludes that the servers quality of life is influenced by the CHC. Thus, it was inferred that the presence of CHC causes a negative effect on quality of life, leading the active and inactive servers to exposure their overall life activities and work over the years, due to the morbidity affected, mainly related to NCDs and PMDs. Descriptors: Quality of life. Chronic disease. Occupational Health. Nursing
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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 Mossoró, 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
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According to Brazil s Ministry of Fisheries and Aquaculture, artisanal fishermen are responsible for a significant fish production at national level, highlighting the importance of this activity. In Rio Grande do Norte State, Brazil, fishing has become an important part of economic and social processes. In this context, there are many inland fishing communities such as Barreiras, Diogo Lopes and Sertãozinho, which are part of Ponta do Tubarão State Reserve of Sustainable Development (RDSEPT), located in Macau and Guamaré, Rio Grande do Norte coastline cities. Fishermen and women, the last ones known as marisqueiras who work alongside the menfolk at sea, especially in the shellfish harvest, have been developing narrow relationships with nature, mainly with the sea, from where they extract their families subsistence. However, those communities have been facing several issues related to living conditions, health and diseases. Social representations have been analyzed in the speeches of fishermen/women who were registered active members in a fishermen association named Associação Colônia de Pescadores Z-41, regarding the period from 2008 to 2011. The analysis involved socio-economic profiles verification, identification and analysis of the group s main representative diseases and representations related to health and illness. This study searched for elements in order to provide the comprehension of the relationships among people s social representations and the fishing environment in which they live.. This qualiquantitative study was performed using recordings and transcriptions of structured and open-question interviews. The Collective Subject Speech tecnique proposed by Lefevre & Lefevre (2002) was applied to perform the interviews analysis using QualiQuantiSoft® software. The results showed that health and illness phenomena as well as social representations related to them in the fishing environment are not only abstract states but also physical ones, which interfere in all life extensions, establishing a set of relevant information that indicates that those people realize their own socio-cultural, economic, environmental and political context
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This study approaches the topic of humanization in health that involves the set of policies implemented by the Ministry of Health in Brazil. Its aims are directed towards a reflection on the guiding theoretical and organizing axes of the National Humanization Policy (NHP) and their repercussions on municipal health policy of Natal, Brazil; an analysis of the results of the policy at the local level; knowledge of the views and experiences of the humanization agents in the daily work process and identification of the main challenges of the policy. The empirical field of investigation was the Family Health Strategy (FHS) of the city of Natal. The assumption of the study is that the FHS has produced local experiences with potentialities that must not be wasted, in which there are difficulties and discrepancies between the real and proposed model. The contradictions and challenges in the social and political context of Brazil in the early XXI century and their consequences in the field of health reflect anti-utilitarian aspects anchored strongly in the theoretical concepts of Boaventura de Sousa Santos about the sociology of privations and emergencies as well as of the work of translating. The predominantly qualitative approach collects some complementary quantitative data. The study procedures used were the following: bibliographic research; documental research; interviews; and direct observation. Interpretation of the information obtained was based on documental analysis and on the symbolic cartography of the social representations. Cartographic evidence suggests that practices still take place under dehumanizing conditions that compromise the quality of care given. However, there is a movement aimed at changing the work process that has been strengthening the link and widening the measures developed, incorporating new directions in diversity, integrality and solidarity. The map drawn shows a reality manifested by explicit intentions in a political agenda, by concrete solutions marked by an assortment of difficulties and expressed in the words of the agents and by latent clues identified in successful local experiences, posing many challenges for the consolidation of the proposed changes
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Currently, we attend a reverence of concepts ahead as health, life, youth and body. In we widen amount the ideals concerned to the healthful life, to the quality of life, the longevity and joviality and the extremities of the body represented by the illness, for the virus infection, the physical deficiency and the aging. Of the historical shades of the plague, of the hunger and the war that gagged the defenseless individual and its body, in the current days we increase the search for a full and powerful life, independent of a religious imaginary to predict the epidemic curse, the threat represented for the sick people and the incarnate divine anger in the death; or of medical science presented in the spaces of the technology and the physiology, being left fragile the social and psychological dimensions of the human confined to the patient issue and, finally, the commanded urban health politics in quantitative goals of hygienic cleaning, of the medical techniques and the education citizen. For beyond these instances, emerges in our days a plural, close and biographical agreement well of the body and welfare. On the other hand, an understanding of the healthful life and well-being that more certifies the presence of something the one that clear landmarks amongst normality and the irregularity, the esteem and the destructive vice: it has a projection of healthful life measures without conceptual models of body and health under the doctor-scientific standard occidental. This thematic one will confide in way to the enclosure for spaces to the muscles and fitness exercises and the bars from the city of Natal, in the state of Rio Grande do Norte, Brazil, while comprehensive interchange concerning as the individual comes dealing with the notion the body and health and, mainly, if perceiving inside of its body and its health. Amongst these two spaces of typical leisure of the modern urban phenomenon, the hedonism bodily with its muscles and salience and one another form of hedonism in the fruition of allowed drugs will be across itself in a dialogue about which social s relationships are really in game in an imaginary construction amongst an doctor-aesthetic ideal of health and the social and subjective experience in the option for a healthful life
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
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If, on one hand, only with the 1988 Federal Constitution the right to health began to receive the treatment of authentic fundamental social right; on the other, it is certain since then, the level of concretization reached as to such right depicts a mismatch between the constitutional will and the will of the rulers. That is because, despite the inherent gradualness of the process of concretization of the fundamental social rights, the Brazilian reality, marked by a picture of true chaos on public health routinely reported on the evening news, denatures the priority status constitutionally drew for the right to health, demonstrating, thus, that there is a clear deficit in this process, which must be corrected. This concern regarding the problem of the concretization of the social rights, in turn, is underlined when one speaks of the right to health, since such right, due to its intimate connection with the right to life and human dignity, ends up assuming a position of primacy among the social rights, presenting itself as an imperative right, since its perfect fruition becomes an essential condition for the potential enjoyment of the remaining social rights. From such premises, this paper aims to provide a proposal for the correction of this problem based upon the defense of an active role of the Judiciary in the concretization of the right to health as long as grounded to objective and solid parameters that come to correct, with legal certainty, the named deficit and to avoid the side effects and distortions that are currently beheld when the Judiciary intends to intervene in the matter. For that effect, emerges as flagship of this measure a proposition of an existential minimum specific to the right to health that, taking into account both the constitutionally priority points relating to this relevant right, as well as the very logic of the structuring of the Sistema Único de Saúde - SUS inserted within the core of the public health policies developed in the country, comes to contribute to a judicialization of the subject more in alignment with the ideals outlined in the 1988 Constitution. Furthermore, in the same intent to seek a concretization of the right to health in harmony with the constitutional priority inherent to this material right, the research alerts to the need to undertake a restructuring in the form of organization of the Boards of Health in order to enforce the constitutional guideline of SUS community participation, as well as the importance of establishing a new culture budget in the country, with the Constitution as a compass, pass accurately portray a special prioritization directed constitutional social rights, especially the right to health
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The overall objective of this study is to analyze the efficiency in the use of resources and the quality of public health in the municipalities of Rio Grande do Norte, from 2004 to 2008. It also seeks to identify the determinants of municipal inefficiency and measure the productivity of public spending on health. To this end, three methods of analysis are used: the DEA, the Malmquist index and the Tobit regression model. Among other findings, it appears that municipalities considered more inefficient in the measurement of expenditure on health make the largest expense in this function. On the other hand, from 2004 to 2008, only 13 municipalities showed an increase in the productivity of public spending. It is also noted that municipalities considered efficient in quality of health, although having more physical and human resources, offer fewer health services to the population. In all, the major determinants of health spending inefficiencies are the variables: age of the mayor, coalition, population density, literacy race and budget revenues. Regarding the inefficiency of the health quality, variables such as: coalition, literacy race have strong influence on this behavior. Thereby, the hypotheses proposed by the study have been fully accepted. In other words, for the efficiency of the quality and health spending it is needed more than resources, i.e., the expenditure shows itself as essential, but not enough, for political and economic aspects also interfere with the performance of spent and in the quality of health care offered to the population
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The present study is about an etnographic research based on the Theory of Social Representation and its complementary approach, the Theory of Central Core based on the bourdiesianos concepts of field and habitus , concerning that these concepts, articulated to the constructed social representation, may contribute to the study of social identities. Its aim is to acknowledge which identity references community health agents (CHA), agents from Community Health Agent Program (CHAP) and Family Health Program (FHP) from João Pessoa PB and which social representation is constructed by them towards health education. The study had the participation of 119 CHAs, from which 90,3 % were female and 9,7% were male. Since the identity is also built by the representation of others towards the group, 63 professionals of the FHP group (16 nurses, 16 nursing assistents, 12 doctors, 9 dentists, 6 dentistry office assistents, 4 coordinators, 1 psicologist and 1 receptionist) and 1 nurse from CHAP took part of the study, oficial documents from the Health Ministry were analyzed, verbal information from its representatives were also taken into consideration, as well as reports from the many benefitiaries of the CHA, CHAP and FHP. For data collecting, we used the combination of (a) Direct Observation and Participant Observation of the functioning micro-areas of the CHA at the Family Health Units, and the Union of the Agents; (b) Free-Association of words and expressions to stimulate the CHA , Health Education and Health ; (c) Questionnaire; (d) Interviews. The interviews were submitted to a thematic analysis of its topic. The free-association was analyzed taking in consideration the vèrgesiana proposal (a combination of the frequency and average order of evocation) which treatment enabled the identification of the central and peripheral systems of social representation towards health education and the community health agent. A test of central refutation, associated to the analysis of the indicated evocations as the most important, provided empirical evidence of social representation towards health education as orientation , prevention and hygiene , as well as the identity of CHA as supervisor , friend , help , important , and the link between the community and the Family Health Staff. Other professionals from CHAP, FHP and the Health Ministry share all of these representational contents, especially the concepts of friend and link , also shared by the community. A habitus towards the community health agents was identified, as a representation based on trust and friendship, which gives the professional a great importance towards the daily inconsistencies faced by the community
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The aim of this study is to assess the contribution of the Pan American Health Organization (PAHO) to the field of human resources for health in Brazil. The assumption is that this organization not only influenced the development of this field, but but that it was also influenced by Brazilian institutions and by national political movements, through the interaction of its consultants with these movements. Four projects were selected, through which the contribution of PAHO was evaluated: the Program for the Strategic Preparation of Health Personnel (PPREPS), the Project for the Large Scale Formation of Middle and Low Level Personnel (Large Scale Project), the Project for Qualification in the Development of Human Resources in Health (CADRHU) and the Project for the Managerial Development of Basic Units of the National Health System (GERUS). To operacionalize the study, we used three basic complementary procedures: a bibliographic research, documental research and an interview. The time frame considered was from 1975, the year an agreement was signed between PAHO, the Ministry of Health and the Ministry of Education and Culture, establishing PPREPS. It was through this program that the first PAHO team of national human resource consultants was contracted. The period between 1975 and 1999 was marked by political and social movements that changed the course of health in the country; among these was the Movement of Sanitary Reform in Brazil, which culminated in the implementation of the National Health System (SUS). This paper shows the connections of the PAHO consultants with this movement and the implications that this had for the Program of Cooperation in the Development of Human Resources of PAHO/Brazil. It also demonstrates that as the program became contaminated by national movements of health system reorganization and of democratization of Brazilian society, it proposed, in cooperation with national institutions, an organization of determinate areas of operation of these same institutions. The manuscript further reveals that, with the Large Scale Project, the human resources program determined the pedagogical and methodological option that would be the model for various other educational projects undertaken by a number of Brazilian institutions with the technical cooperation of PAHO. And finally, the repercussions and contributions of these projects, which strengthened the the field of human resources in the public health services of the country, are identified. Data analysis was based mainly on the theories of Bourdieu, Gramsci and Freire
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This thesis proposes that the idea expressed in Juvenal s quotation Mens Sana in Corpore Sano, produced in the Ancient Greek-Roman civilization includes undestandings of body, heath and education that were reapropriated and reorganized by scientific and pedagogical theories in the XIX and XX centuries. These theories, especially the ones that received contributions from the biomedical sciences, have influenced Physical Education in the search of becoming a science. In order to realize this reapropriation, we have analyzed the transformations in the concepts of body, health and education produced in the area discourse, aiming at pointing out elements to the configuration of a theory that is being called Corpore Sano. The theory constitutes in possible systematization of scientific, philosophical and pedagogical concepts, and as such, an understanding of the scientific fundaments of Physical Education. The corpus of this analysis was composed by 148 articles that were published in Revista Brasileira de Ciências do Esporte digitalized in the period between 1979 and 2003 and selected according to theme: body, biology, physical activity, effort physiology and health. The analysis of the content and the referential interpretation allowed the combination of philosophical reflection with attention to the empiric field as a comprehensive dimension. Based on the corpus of the analysis it is possible to configure meta-arguments about the concepts of body, health and education in the scientific production of Physical Education. As a metaresearch. Our study did not intend to judge the analyzed production, but look for theoretical elements that may generate a reflection about the scientific rationality in Physical Education and developments in the pedagogical field and in body practices. Such a reflection might be recognized as a theory of the living body, susceptible to modifications and interrogations that are proper of knowledge and practices of Physical Education. It is a theory rejects the idea of the complete truth and holds the comprehension that the truth is built historically through relations among different kinds of knowledge and Physical Education practices
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This research, whose theme is related to climacteric, aims to know the social representation of menopause developed by the nurses working for Estratégia Saúde da Família (Family Health Strategy) in João Pessoa PB, as well as identifying its structure and verifying the way it interferes with the assistance and educational practices to the climacterial user. In the theoretical level, it is based on a model that articulates the social representations theory, the central nucleus complementary theory and the central concepts of Pierre Bourdieu s praxiology: habitus, cultural capital, social field and symbolic power. A hundred and forty-seven female nurses who work for Estratégia Saúde da Família (Family Health Strategy) in João Pessoa (PB) took part in this research, and the data collection period was from February 2008 to March 2009. As to the methods and techniques, we used the method to determine the central nucleus based on the free association of words, a questionnaire to identify certain regularities that constitute the nurses habitus, and the semi-structured interview to explore opinions and attitudes when facing assistance situations and educational practices and to collect other relevant information. The data analysis was developed, when referring to the free associations, with the help of the EVOC software, which is a group of articulated programs which carry out the statistical analysis of the evocations and the identification of the possible elements of both the central nucleus and the peripheral system of the social representation. As to the questionnaire, we used the descriptive statistical analysis and the analysis of correlation between the variables. The interviews were submitted to a categorical analysis of the content. The EVOC result indicated that the cognition hormone was the only element of the central nucleus of the social representation of menopause. Due to its symbolic value and structuring power, this central nucleus ensures the strict and, at the same time, flexible character of the representational content. The analysis of the social advancement, of some fundamental features of the group habitus, as well as the analysis of its insertion in the health field and of the attitudinal opinions and dispositions concerning the assistance given to the climacterial user, and the analysis of the pedagogical dimension of this assistance, all these analyses lead to the conclusion that the nurses who took part in this research share a social representation of the menopause resulting from the association of different technical and scientific knowledge. These derive from the biomedical pattern as well as from hegemonic values which disqualify old age and overvalue youth, from pedagogical conceptions arising from patterns that are presently regarded as authoritative and old-fashioned and from cultural references (responsible for the semantic variations concerning the central nucleus) which are specific to the subgroups the nurses belong to. This research enables the creation of opportunities for discussion between active nurses working for Estratégia Saúde da Família, and the nurses who are teachers at institutions of higher education, aiming at linking theory to practice, so that they can find ways of thinking about the climacteric and working, in a more comprehensive way, with users who are experiencing this stage of life