O cuidar de enfermagem e da família à pessoa idosa no domicílio: uma abordagem etnográfica

O envelhecimento é um processo multidimensional que envolve entre outros os aspectos físico-biológicos, sociais, econômicos e psicológicos. Ao avaliar essa fase da vida dentro de uma visão social e cultural, percebe-se que ser idoso ou não varia com as concepções culturais, sendo necessário investigar as variações que atuam no processo e rege o fenômeno sociocultural da realidade em que se está inserido. Com o aumento da população idosa mundial, esse processo tende a se intensificar. Estima-se que até em 2050 existam cerca de dois bilhões de pessoas com mais de 60 anos no mundo, e a maioria delas vivendo em países em desenvolvimento. No Brasil, acredita-se que existam, atualmente, cerca de 20 milhões de idosos. A normatização e legislação brasileira de amparo ao idoso em relação à saúde iniciaram-se a partir da Constituição Federal de 1988 e da Lei 8080 que regulamenta o Sistema Único de Saúde em 1990, em seus níveis de complexidade: atenção básica, média e alta complexidade. Para auxiliar nessa prestação dos serviços na atenção básica de saúde é importante observar as condições sociais, culturais, econômicas e de saúde dos idosos e seus familiares. Nesse sentido, a visita ao domicílio e a avaliação deste idoso em seu ambiente doméstico torna-se fundamental para acompanhar o cuidar prestado e o quanto esse processo irá interferir no sistema de saúde, na família e na qualidade de vida dos idosos. Neste contexto, o enfermeiro como integrante da Equipe de Saúde da Família, presta assistência à saúde do idoso no domicílio. Nesse sentido, o objetivo do estudo é analisar o cuidado de enfermagem e da família à pessoa idosa no domicílio com vistas à identificação das influências socioculturais. Trata-se de um estudo do tipo descritivo e de abordagem qualitativa, norteados por princípios teórico-metodológicos da etnografia com vistas ao estudo da influência dos aspectos culturais e sociais na assistência da família e do enfermeiro à idosos em domicílio. Foi realizado no município de Santana do Matos, RN, tendo como participantes, idosos, familiares e enfermeiros da equipe da ESF, definidos a partir da população do município e obtendo-se uma amostra intencional de 25 participantes: 6 enfermeiras, 10 idosos e 9 grupos familiares. Para a coleta de informações, utilizou-se observação, entrevista, diário de campo e grupo focal. Os resultados foram apresentados em forma de narrativa descritiva, na perspectiva dos conceitos de Boris Cyrulnik, com análise interpretativa cultural de Geertz, na busca dos significados e símbolos próprios da cultura da velhice de idosos e dos seus familiares, sobre cuidados que são realizados, tanto pela família, como pelos enfermeiros em domicílio. Observou-se que a família e o cuidador, dentro de sua realidade social e cultural, precisam ser mais compreendidos pela equipe de saúde para ser melhor orientados e capacitados na realização do cuidar de forma adequada. Por sua vez, os profissionais de saúde, em especial o enfermeiro, enfrentam dificuldades para realizar o cuidado ao idoso no domicílio como a grande demanda de atribuições na unidade de saúde como consultas e atendimentos; falta de transporte até os domicílios; extensão territorial do município e das áreas assistidas; número de pessoas atendidas por cada equipe; falta de compreensão dos profissionais de saúde quanto à importância da visita domiciliária na atenção básica. Entendem a necessidade de realizar ações de promoção em saúde, prevenção de agravos e de educação em saúde, além de reconhecerem a importância de uma melhor formação acadêmica para atuar nessa perspectiva e contribuírem para as mudanças necessárias na prática dos cuidados ao idoso em domicílio

Violência contra a mulher : estudo de caso em uma instituição de ensino

The study research case with a quantitative approach and prospective data, carried out between December 2010 and February 2011 with the aim of identifying the profile of women in the study, to characterize the acts of violence in the type, frequency, location occurrence and aggressor, analyze the steps taken after the occurrence of acts of violence and the main consequences on the victims. The population consisted of 285 workers in a tertiary institution in Rio Grande do Norte. The results showed that 99 (34.74%) have between 51 to 60 years of age, 78 (27.37%) of 41 to 50 and 62 (21.75%) between 20 and 30 years, are considered color white, 162 (56.84%) have completed higher education, 171 (60.00%) and of these 97 (56.73%) reported having some post-graduate degrees, are married, 141 (49.47%) and have from zero to one child, 148 (51.93%) reside in the south of the city of Natal, 146 (51.23%) have a monthly income of three to five minimum wages, 171 (60.00%) and are mostly in the Technical Administrative Sciences 152 (53.33%), 77 (27.02%) reported having experienced violence, 60 (62.50%) episodes of verbal aggression, 26 (27.08%) of bullying , 05 (5.21%) of physical abuse and 05 (5.21%) sexual harassment; 05 (100.00%) assaults were made by the spouse or partner of the victims and co-workers is another profession were responsible for 18 (30.00%) verbal aggression, 15 (57.69%) bullying and 03 (60.00%) sexual harassment, 02 (40.00%) of victims of physical aggression and 18 (30.00 %) of verbal abused only once, 10 (38.46%) of bullying and 02 (40.00%) of sexual harassment experienced four or more times 05 (100.00%) assaults occurred at domestic and work stood out with 36 (60.00%), verbal abuse, 22 (84.62%), moral harassment and 04 (80.00%) sexual harassment, 35 (36.46%) told colleagues work and 31 (32.29%) for family and friends in 75 (78.13%) cases there was no intervention, 07 (7.29) were unable to respond if something had been done and 14 (14.58% ) have been reported intervention of these, 09 (64.29%) were taken by the heads of the victims, 26 (32.10%) did not notify the fact on the ground that no action would be taken, 62 (80.52%) felt stress , 5 (1.76%) of women turned away from work after the episode of violence, accounting for 198 days of absenteeism. It is concluded that there is a high rate of violence against women, even when they have a good socioeconomic status, and in this sense is important to establish bases of new proposals for improving control of cases of health professionals, especially nurses, to approach patients with a more investigative, and that by identifying a case of violence, be instructed about the paths to be followed for notification while providing psychological support to victims.

As ações de controle da tuberculose na atenção primária à saúde: a visão do doente

Tuberculosis is a disease of great impact on the world context today. In Brazil, the disease management was directed to the Primary Health Care, due to the determination of the Ministry of Health to decentralize health actions for primary care. Thus, since the actions of diagnosis, treatment and control of the disease should happen in this context, however, there are still many barriers that may hinder the realization of these determinations. This study aims to analyze the development of tuberculosis control activities conducted in the services of primary health care from the patient's vision. This is a descriptive, cross-sectional and quantitative study. The population consists of 517 tuberculosis patients treated in units of Primary Health Care in the city of Natal-RN; the sample consists of 93 TB patients. The collect instrument is structured, based in The Primary Care Assessment Tool (PCAT), validated in Brazil and adapted to assess attention to TB in Brazil, with modifications. This instrument was divided into blocks: the first one describes the socio-demographic information of patients with TB and the second one describes the health services working in control, diagnosis and treatment of TB, and includes issues related to the dimensions of primary care: access, bond, services, coordination of care, guidance to the community and family focus. For quantitative analysis, were built indicators for each item of the instrument. The response patterns are followed according to the Likert scale, which was assigned a value between one and five meant that the degree of preference relation (or agreement) of the statements. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. The results indicate that 62.37% of patients are male, 27.96% aged 41 to 50 years old, and 34.41% unemployed, with low education and low family income. It was found that the reference hospital services are the front door to the patient (59.14%), and are also the local diagnosis of the disease (72.04%). On access, the conditions satisfactory found are: the number of times the patients need to pick up the health care issue, the marking and the facility to get a consultancy in the HS, assistance provided without harm to the individual's attendance labor and facilities related to the proximity between the residence and services; were considered unsatisfactory conditions related to travel to the HS, and on hours and days of operation of services. As for the cast of services were satisfactory and regular actions related to the request for examination to become viable in the first HS, the availability of pot to perform smear and medicines for the treatment, as well as consultations control and receiving information about the disease and the treatment performed; it is considered unsatisfactory the performance of the home care for patients with TB by the HS that acts as a front door, for implementation of the Directly Observed Treatment (DOT), home visits during treatment, the provision of transportation allowance to the patient and the existence of groups for TB patients. Regarding the coordination of care, resulted in regular the action of referring the patient to other HS to obtain examinations, and as unsatisfactory referral to obtain medications. The relationship bond between patient and health team were considered satisfactory in the majority or regular. As for the family and community focus, is satisfactory only the indicator relating to questions from professionals to the patient about the existence of respiratory symptoms in the family. It is considered that there is need for greater commitment from government entities to the incentives required to TB control, as well as the availability of necessary inputs and training of human resources working in the PHC in the ongoing quest to strengthen primary care, as a place of broader host needs to contact the user with the actions and health professionals. It is recommended the adoption of management mechanisms possible to expand the capacity of the health PHC, promoting the service delivery to the user and ensuring attention to population health.

Inclusão da criança com deficiência na estratégia de saúde da família

The objective of analyze the shift of the working process of the ESF team in care of children with disabilities, from awareness-raising actions. It is a qualitative study, with the action-research method. Thirteen health professionals were involved from two teams of ESF unit area of the Unidade de Saúde da Família Dr. Chico Porto (UBSFCP) in Mossoró, from March to August 2011. Data were analyzed following the direction of freirean s thematic analysis. In the situational diagnosis of the current reality of CwD assistance in that UBSFCP, through participant observation and application of semi-structured interviews with professionals, we realize that despite these actions carry some assistance to the CwD, in practice few are used for inclusion and accessibility. The monitoring of the CwD is done through individual consultations by each team professional, home visits when possible, both ruled on the complaints and problems, with little solving in the used actions. Since the need for a change in the treatment model and training requirements as pointed out by professionals in the interview, then we decided to build the proposed of training suggested by the multidisciplinary team and put together collectively the achievement of this moment in all its phases. In the step of implementation (action), aspects related to the current situation in Brazil and Mossoró (Laws, policies and health care) for the CwD and CwD Assistance and their family in the ESF in the first two moments of the first training (action) were contemplate. On the second day we discussed the specialized care to CwD, contribution of the Handicapped Parents and Friends Association of Mossoró and in a second moment a workshop was held in which awareness for inclusion of CwD and actions of ESF were discussed. All these moments were discussed and collectively constructed. In the evaluation, we found that implementation (action) allowed to the professional the comprehension of new understandings about people with disabilities, on ways to include, guiding, caring, watching, and mainly to have a new vision on health assistance of the CwD, expanding assistance beyond clinical aspects and recognizing the educational aspects of the rights and duties of citizens and the inclusion of these children in the social spaces area. As difficulties, we face the need for some professionals to be absent to attend another job, solve personal problems, and little or no participation. Thus, during this action-research, the subjects were able to realize the importance of carrying out their practice to the quality of life for him and to the one they care

Aconselhamento em HIV/AIDS: ações e reflexões dos profissionais do Centro de Testagem e Aconselhamento (CTA)

The counseling on HIV/Aids consists in a prevention strategy that contributes to increase the diagnosis of HIV and start earlier the treatment. The counseling has as pillars the emotional and educational support, risks evaluation that aim at the adoption of safe practices and the individual s responsibility for his own health. To accomplish these results, it is necessary that health workers understand counseling as a unique educational moment that stimulates the user s critical-reflection when it comes to his role as an active subject in this process. This study aimed to analyze the counseling on HIV/Aids conducted by the professionals of the Testing and Counseling Center (CTA), based on the educational perspective of Paulo Freire . This is a descriptive qualitative study with a critical reflexive design based on the principles of Action-Science. All the professionals acting as counselors in the Joao Pessoa, PB CTA, eight in total, took part in the study. Data were collected during the month of March, 2011, through non participative observation and semi-structured interviews with a critical-reflexive focus, analyzed according to the tenets of the critical-reflexive methodology, and discussed taking into consideration the Paulo Freire s pedagogy and pertinent literature. It was observed that most of the professionals expressed the work philosophy of CTA as the diagnosis and prevention of the disease, associated with the utilization and demonstration of condoms. However, upon observation of their counseling sessions, these ideas were not converted in actions. Educational themes were not covered and the condom wasn t offered at any time. The counseling actions focused on the provision of information and filling out the paper forms which are necessary for attendance. The sessions were conducted with brief dialogues and little opportunity for the users to expose or complement their thoughts and needs. The professionals mentioned as facilitating conditions for counseling, the team interaction and physical structure. The difficulties focused on the users low cognition, the large demand for attendance, aspects related to the service organization, and the counselors absences and delays. After reflecting about the actions observed in the counseling, the majority of professionals admitted the need to modify their practice in the incorporation of educational principles for the achievement of a broader prevention, and seemed to be willing to work in this perspective. In conclusion, although the counselors show ideas consistent with the purposes of CTA, these ideas are limited when it comes to the understanding of the meaning of prevention in HIV/Aids. Taking into consideration that they express a certain comprehension and act differently during the counseling, they demonstrate a lack of bond between the theories in use and the proposed ones, in accordance with the contribution of the action-science theory. The counseling, as an educative practice, doesn t materialize in the counseling itself and the orientation for reflection is not given during the attendance. These findings suggest the need to include the process of reflection in the execution of the actions of counseling, so that these practices are guided by reflexive practice, aiming at transforming the way of thinking and acting into a more educational perspective toward a more democratic and holistic assistance.

História oral de vida de pacientes transplantados renais: novos caminhos a trilhar

The therapeutic possibilities for chronic renal failure closely are related to the biological and social condition, and in this perspective the renal transplant is considered the best option, for providing quality of life better. This study it objectified to apprehend, by means of the rescue of the verbal history of life of the kidney transplant patients, the experiences lived since the diagnosis of the renal to the current with the current therapeutic modality. One is about a study of qualitative boarding, exploratory and descriptive, having the verbal history of life as a technique and method. The colony was formed with the ten first kidney transplant patients of the Rio Grande of the North, taken care of in the clinic of the Nephrology in the University Hospital Onofre Lopes-UFRN, located in the city of Christmas-RN. The net was composed for collaborators of both the sex, in the age band between 21 and 56 years of age, submitted it more than has one year to the renal transplant and that, in some cases, together of its familiar ones, they had voluntarily accepted to participate of the study. The first collaborator interviewed for this was excluded not to desire to participate the study more than. After approval for the Committee of Ethics in Search of the UFRN, we carry through the collection of data, by means of a halfstructuralized interview, recorded individually, in environment chosen for the collaborators. We carry through the transcription of the interviews and later we return to the interviewed ones so that the same ones made the conference, what it made possible in them to carry through the transcriation, after consecutive readings. We analyze the stories by means of the analysis of content of Bardin. Guiding the analysis of the stories of the collaborators, we find three axles thematic: Impact in the social relations, Impact in the social condition and Behavior front the illness and treatment. We conclude in this study that the loss of the renal function reed-echo drastically in the life of the collaborators, but that the acceptance of the pathological condition emerged, mainly for the support of the family and in the belief in God. The renal transplant was seen as the chance for a new life, however, so that they reach an improvement in the quality of life, other questions must be optimized, as the guarantee of constitutional laws, the rescue of the citizenship and offer of bigger support of the professionals of the health, family and society for the confrontation of the problems generated for the chronic renal illness and its treatments

Biossegurança e a saúde do trabalhador na assistência a pacientes em tratamento onco-hematológico

In recent years, the biosafety has been made possible a new look which are based the conceptions of health and illness process, as well as human needs. This new vision is focused on health vigilance that is referenced specifically in this study to the worker s health. The health of workers is essential for the prevention and control of epidemics and outbreaks of diseases as well as emerging and reemerging diseases. The present study wants to show the importance of biosafety measures for health workers, showing them through the concepts in their daily work. It is also to direct the use of biosafety measures in the care of oncology and hematology patients care, because of its infection susceptibility. OBJECTIVES: To analyze the conceptions of health workers in the biosafety pratice to the patients in oncological and hematological treatment in an oncological institution in Natal / RN, as well as make a socio-demographic profile of these workers and to know their difficulties to adequate biosafety measures. METODOLOGIA: The research is exploratory descriptive with qualitative approach, using the technique of oral history. The use of this technique is justified for the possibility of analyze the conceptions of health workers in the face of biosafety measures. From the definition of analysis categories that have emerged in the study. The categories were: daily work, education, occupational risk and onco-hematological care. The research population was the health workers who provide care to patients in oncological and hematological treatment. The study was conducted in the League against Cancer, in Natal / RN, specifically in the unit Luiz Antonio Hospital. Data collections were conducted from June to August of 2011 and were interviewed sixteen employees who assist in oncology and hematology. Structured interviews were conducted in three shifts, given the prospects of expanding the possibilities of analysis of the biosafety concepts. After data collection, the interviews were analyzed qualitatively by the technique of oral history. This genre, thematic oral history is a modern resource used for preparation of documents, files and studies concerning the social experience of people and groups with the construction of a script prior to the interview moment (MEIHY, 2002). ANALYSIS OF INFORMATION: It was made a reflection about the concepts and practices of professionals who take care of patients in oncology and hematology as well as its relation to biosafety measures. The speech of employees revealed that the adoption has been very supportive of these standards, although some have been highlighted gaps in the understanding of employees in relation to biosafety and the proposed categories. CONCLUSION: The analysis of information showed that biosafety has been cited by employees as an immeasurable benefit to safety and occupational health. And the strengths marks in their understanding were: the excellence of care and safety in occupational diseases risk reduction and infections resulting from their work activities, despite some difficulties in adopting appropriate biosafety standards

Carga de trabalho de enfermagem e infecções relacionadas à assistência à saúde na unidade de terapia intensiva

In recent decades, the search for quality care has been widely discussed by the institutions and health professionals. In this context, it is the nurse coordinator of the process of providing nursing staff, reflecting the commitment to quality of care. In this process, it is the appearance of Infections Related to health care and its potential association with the workload in nursing as a valuable indicator of quality of care. Thus, this research contributes to studies to characterize the demand of nursing work to promote a safe healthcare practice. This study aimed to identify the association of nursing workload with the number of cases of Ventilator-Associated Pneumonia, urinary tract infection and central venous catheter infection in the intensive care unit. This is a quantitative research approach, descriptive, cross-sectional and prospective, held at Unimed Hospital in Natal-RN. The study population consisted of all patients treated in the Intensive Care Unit, Hospital for a period of 90 consecutive days in 2011. The convenience sample was compostapelos patients admitted to the ICU during the period of data collection, a total sample of 286 patients. To perform the data analysis software were used: Statistica 6.0, SPPS (Statistical Package for Social Sciences) version 17.0 (2004) and Excel 2007. In the descriptive analysis, we used Measures of Central Tendency and Measures of Dispersion or Variability and the use of nonparametric tests. Of the 286 patients, 88 were from the ICU and 198 ICU II II. Males predominated in the ICU I (51.1%) and female ICU II (57.6%) patients in the ICU I were aged 61-80 years (39.8%) followed by greater than 80 years (39.8%). In the ICU II, most of the patients were aged 61-80 years (38.9%) and then from 41 to 60 years (24.2%). In relation to the class of TISS inlet predominant class II in the two ICUs (59.1%), followed by Class III also in the two units (34.6%). Most patients (70.6%) out of the ICUs belonging to class II TISS. In the ICU I, the average number of forms of the TISS 28 was 6, has in ICU II this value drops to 3.2 forms. The overall mean was 19.9 TISS points in ICU patients I and ICU II.the 17 points in the average hours required to provide adequate nursing care to patients in the ICU I found that is 10 , 7 hours, and the ICU II 9.2 hours. It was found that the time provided by the nursing staff were higher in ICU II, with an average of 19 hours available for nurses in this sector. In the ICU I, which showed higher need of available hours, it was found that the mean value of 12.7 available hours. It was found that only 2.4% of patients had these units Ventilator-Associated Pneumonia, 1.0% were infected central venous catheter and 1.4% of patients had urinary tract infection. Infection associated with health care occurs, on average, on the tenth day of hospitalization. In the ICU II, this average value extends to the twelfth day with an excess of 2.7 hours of nursing care while in ICU I value decays to the ninth day of hospitalization with a deficiency of 12-hour assistance. It is concluded that patients generally showed a need for classification of semi-intensive care and has been assisted in their need to load. As for his association with the Related Infections Health will assist this analysis could not be performed due to the small number of notifications in this period. It is suggested further study how other factors related to infections me a longer period of analysis

Atuação e o conhecimento dos profissionais de enfermagem quanto a morte encefálica e manutenção do potencial doador de órgãos e tecidos para transplantes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Análise crítica dos produtos de mobilidade sentada - cadeiras de rodas - utilizados por crianças e adolescentes com paralisia cerebral em Natal/RN e outros municípios do Rio Grande do Norte

The objective of this work is to critically analyze the seated mobility adaptive equipment, wheelchair, used by non-ambulatory children/adolescents diagnosed with cerebral palsy of the quadriplegy type with ages in between 0-18 years old in the municipal city of Natal/RN and of other ones in the state of Rio Grande do Norte. This study is characterized as descriptive as it took into consideration the individualized conditions of each child/adolescent and of their home environment, and also evaluates the condition of the used seated mobility devices such as wheelchairs or strollers. Thirty three (33) subjects which had a wheelchair prescribed by a healthcare professional specialist in adaptive equipment within the past 3 years were selected. A questionnaire was applied through a phone with the patient s primary care giver or parents. The results obtained showed that all the equipment being used had an anatomical seat and back and the tilt system mechanism and even though most of the patients required small individual adjustments upon receiving the wheelchair in order to accommodate to the patients characteristics. From the point of view of the caregiver/parents interviewed, 97% described satisfied with the equipment and report assistance with mobility (97%), comfort (82%) and good posture (82%) as the main positive aspects from the equipment. The results also describe the aspects related to the maintenance, time used and activities developed that were reported by the patients. The conclusion therefore is that in order to select the equipment to meet the needs of the consumer it is necessary that: an appropriate wheelchair prescription takes place, the up-to-date knowledge of equipment available in the market, the appropriate use of the resources from the concession programs of the government that purchase equipment and the establishment of link in between the manufacturers, patients and the caregivers

Variáveis relacionadas ao processo de adesão a um programa de prevenção de quedas em idosos cadastrados na Estratégia de Saúde da Família

Introduction: Falls among older adults is a public health problem, therefore it is necessary preventive actions, however the adherence is the major problem faced by practitioners and researchers working on falls prevention programs. Objective: To evaluate the variables related to the adherence to falls prevention programs among the elderly enrolled in a Basic Health Unit (BHU). Methods: Was performed an observational cross-sectional analytical study. All elderly registered in a BHU and able to ambulate independently were invited to participate in a falls prevent program. The Elderly who Adhered to the Program (EAP) were evaluated at BHU; and the Elderly Not Adhered to the Program (ENAP) were identified and assessed at home. The assessment for both groups was performed using an evaluation form containing personal data, measures and clinical scales to assess cognitive status, balance, mobility, fear of falling, handgrip strength. Data were analyzed with SPSS 20.0. In addition to this assessment, the ENAP underwent a semi structured interview, in which we used the qualitative approach based on the figure of the Collective Subject Discourse. Results: The study included 222 elderly, 111 EAP and 111ENAP, most aged between 70 and 79 years (48.2%), female (68.5%), married (52.3%) and illiterate (47.7%). Consolidated as protective factors for adherence, worst rates of physical activity (p = 0.001), balance (p = 0.010) and cognition (p = 0.007). The interview of ENAP identified two themes: "Local implementation of programs for the prevention of falls" and "Relationship between BHU and the elderly health care," and found that the elderly who did not adhere were unable to displace and did not mention that primary care programs are related to health care in elderly. Conclusions: Elderly who do not adhere to the program differ from elderly who adhere as worst indices of cognition, balance and physical activity which implies greater risk of falling; and they were unable to participate in falls prevention program and by to be caregiver and showed displacement difficult

Atenção precoce do câncer de mama :um olhar sobre o cotidiano institucional de uma unidade de saúde de Natal

Breast cancer has been considered a grave global public health problem due to its increase in incidence, in women s mortality and in the amount of financial resources spent on the therapeutic interventions used in the treatment of this neoplasia. However, this scenario presents some variations. In developing countries, the incidence of breast cancer is increasing but, on the other hand, the mortality is declining among patients because of public health actions toward early diagnostic that also result in cure of patients and decreasing levels of physical and psychosocial stress. In Brazil, we face of both the increasing number of breast cancer incidence and number of mortalities. Almost always the reason for that is a delayed detection that will provide a late diagnostic. The early detection of breast cancer has been studied in several researches. Some of them are concerned with women s experiences. Despite that, there is a lack of researches on dynamic comprehension of early attention to breast cancer from the health professionals points of view. The present research was carried out at the Unidade Mista de Felipe Camarão (UMFC) and it was conducted with 11 professionals who work in the Family Health Program (PSF). The aim was to understand how early diagnostic and attention to breast cancer is being planned, discussed and accomplished by health professionals in their day-to-day actions. Semi-structure interviews were held individually with each professional, in a way that they could feel free to express their ideas about several issues. All the information from these interviews was analyzed and discussed using an Institutional Ethnographic approach. It was observed that the actions of health professionals working with early detection of breast cancer does not take place in a vacuum; they occur within institutional, relational and social ways. This interdependence influences their actions and points of view on the theme

Adolescentes preocupadas em conquistar um corpo magro: Um estudo sobre discursos produzidos em diários eletrônicos

The concern about a good physical condition is heavily present nowadays, in documentary films about health and in the media, and it is also expressed through the outstanding growth of physical academies, beauty institutes and aesthetic medicine and all kind of aesthetic surgeries. In the western world the body wave is a significant trend, characterized by the great investments in body image. However, what is overlooked is the fact that in parallel trend grows the number of teenagers, especially females, with all kind of problems related to their body image. As adolescence is a moment of transformations, teenagers tend to be more aware of their body image and often neglect food ingestion and try to build their bodies following the images they have from top models and movie stars. The low self-esteem accompanying this sort of experience is an additional problem. Therefore the research aim to analyze discourses regarding the body image produced in world wide web diaries (blogs). The blogs selection was made through the site www.blogs.com.br, which is considered the widest guide of electronic diaries in Brazil. We looked after blogs including the keyword body and from adolescents aged 10 to 19, who showed concern about a slim body. Three blogs were chosen, considering the example criteria. Discourse analysis shows that these teenagers feel unsatisfied with their bodies, searching by all means the thinness presented as a aesthetic paradigm in western societies which often implies neglecting their own health, using appetite inhibitor drugs, restricting or totally abstaining food ingestion for long periods of time, or provoking themselves vomits after ingesting food. These behaviors, together with intense fear of gaining weight, can be characterized as alimentary disorders, related to the body image. As they usually hide this sort of behaviors from family and friends who do not share this concern, the blogs seem to be an easy tool for adolescents to find peers with whom to share common values and ideas and reaffirm their identities and virtual sense of community

Frequencia de enteroparasitoses em usuários do servico público de saúde na mesorregião do oeste potiguar

Em um mundo de grande pobreza, as enteroparasitoses podem exercer um papel importante no que se refere às desigualdades sociais, pois estas mazelas se apresentam, em sua grande maioria, na população mais carente. Estas mesmas doenças causam inúmeros casos de faltas ao trabalho e a escola, gerando preocupação dos profissionais de saúde, já que estes parasitas podem agravar ou desencadear quadros de anemia e desnutrição. O trabalho procurou pesquisar a prevalência de enteroparasitas na Mesorregião do Oeste Potiguar, em uma população que utiliza o sistema público de saúde, buscando associar as variáveis, como: sexo, faixa etária, período sazonal, renda familiar e número de parasitas. Foi utilizada a técnica de Hofmann (sedimentação espontânea) e o material fecal foi analisado pelos funcionários do Laboratório Central de Mossoró e Pau dos Ferros. Foi realizado no período de 02 de março de 2010 a 28 de março de 2011 o exame coprológico em 16.246 pessoas no laboratório Central de Mossoró (Lacen) e Pau dos Ferros, RN. A análise dos exames mostrou que 69,23% dos infectados eram mulheres e 33,07% eram homens. A maior prevalência ocorreu com Endolimax nana (41,61%), seguido de Entamoeba coli (18,46%) e Giardia lamblia (18,59%) em 3.407 parasitas encontrados. Dentre os exames realizados, o Endolimax nana foi o mais prevalente entre os organismos encontrados. A diferença nos resultados entre mulheres e homens pode determinar um foco domiciliar, pelo descaso do poder público com as políticas de saneamento básico e falta de higiene da população, e pela atividade das mesmas com trabalhos domésticos

Avaliação do programa de atenção à saúde do trabalhador: uma abordagem da atenção primária

The accelerated industrialization, coming with the Industrial Revolution, caused profound changes in the working world. These changes led to the households risks from work environment. Trying to assist comprehensively the health of workers, Brazil has a program of Health Care Workers in the Primary Care, and the Family Health Strategy is the main entrance for this system. The study sought to determine if the actions of the health care worker have been developed in primary care through the Family Health Strategy. This is a quantitative study with a methodological evaluation, focusing on normative assessment. The sample was formed by professionals from Team Family Health Strategy, in the municipalities of Pau dos Ferros, Caicó and Natal in Rio Grande do Norte state. The sample consists of 202 professionals (Doctors, Nurses, Assistant / Technician Nursing and Community Health Workers) in 52 Health Family Units from the 3 municipalities cited. The instrument used consists of a checklist, from Manual of Primary Care 5 - Family Health - Occupational Health, Ministry of Health. The data were analyzed describing the variables by its frequency and doing a classification of cities from the scores obtained by each. It was observed that the Family Health professionals know the program of health care worker, however do not know the Manual of Primary Care 5, which is a guidance tool. As a result of non-appropriation of the FHT professionals with worker health, these activities are not performed, mainly surveillance in occupational health and health education labor