Práticas institucionais/discursivas acerca dos cuidados com os bebês prematuros e/ou de baixo peso: o programa canguru

The Kangaroo Program was implemented in Brazil in 2000 through the Unified Health System (Sistema Único de Saúde SUS) sustained with a humanized rethoric of health care assistance. This program adopts the skin-to-skin contact contributing to the mother-infant bond, breastfeeding and promoting security in mother s care. The users of SUS are encouraged to live in the maternity ward to follow the baby health improvement. However, it was verified in previous observations that mothers participation in the Kangaroo Program has been done through an imposed practice. Therefore, this study intended to understand the texts that permeate the kangaroo practice. This research was developed through two studies: 1) an historic exploration of motherhood concept and an analysis of how the motherhood is presented in the official document that orients the program; 2) an analysis of institutional dynamic of Kangaroo Program, emphasizing the study about the health workers everyday practice, the mothers view about their life in the maternity wards, and the attendance practice. It is highlighted that the relation between this two studies allowed the comprehension abouthow the official discourses can influence the health workers behaviors and how their viewpoint and position can shape the everyday work in a public health program. This research, supported by Institutional Ethnography, considers that people s practices and experiences are socially organized and shaped by broad social forces. The discourse method was used in the documental analysis and in the analysis of qualitative data from empiric research. The research showed that the kangaroo program has been an excellent way to save resources and to improve some baby s biologic and psychological aspects. However, this program has failed to consider the social, economic and cultural complexity of mothers and the structural limitation of the health care system. The official document uses the economic and medical approach, following the hegemonic biomedical model and the life style of the people that don t use the public health system. Consequently, the program has not been successful because it is planned without people participation. On the other hand, it was verified that although some professionals are committed with their work, the mainly does not consider mothers participation as an active process, using the institutional power as a social control to keep mothers uninformed about the possibility to leave the maternity wards. As a result, the research also showed that mothers perceive the program as mandatory and not as option that can improve pleasure moments. It is, therefore, necessary to consider the complex social determinants of health that can increase mothers participation in the Kangaroo Program. Bringing these issues into debate can be a reflective exercise on citizenship and governance, allowing spaces for the improvement of public health programs

Interação entre a analgesia de parto e o seu resultado: avaliação pelo peso e índice de Apgar do recém-nascido

JUSTIFICATIVA E OBJETIVOS: Existem controvérsias quanto à possibilidade de a analgesia de parto interferir no andamento do trabalho de parto e na vitalidade do recém-nascido. O objetivo deste estudo foi a interação entre analgesia do parto pelas técnicas peridural contínua e duplo bloqueio, com pequena dose de anestésico local, e o tipo de parto ocorrido, pela análise do peso e índice de Apgar do recém-nascido. MÉTODO: Analisaram-se, prospectivamente, os resultados de 168 analgesias de parto (janeiro de 2002 a janeiro de 2003), divididas em quatro grupos: G1 (n = 58) peridural contínua e evolução para parto vaginal; G2 (n = 69) duplo bloqueio e evolução para parto vaginal; G3 (n = 25) peridural contínua e evolução para cesariana; G4 (n = 16) duplo bloqueio e evolução para cesariana. Para G1 foi administrada ropivacaína a 0,125% (12 a 15 mL), para G2, bupivacaína a 0,5% (0,5 a 1 mL), sufentanil (10 mg), por via subaracnóidea. Administrou-se ropivacaína a 0,5%, por via peridural, para o parto vaginal (8 mL) e para cesariana (20 mL). Avaliaram-se idade, peso, altura, índice de massa corpórea (IMC), idade gestacional (IG), paridade e complicações (hipotensão arterial, bradicardia e hipóxia), e, do recém-nascido, peso e índice de Apgar (1º, 5º e 10º min). RESULTADOS: A maioria das parturientes era primigesta, com gestação de termo (uma IG de 28 semanas e nenhum pós-datismo), com peso, G2 < G4, e, IMC, G2 £ G4. Para o peso do RN, G1 < G3 e G2 < G4, e o Apgar do 1º min, G1 > G3. CONCLUSÕES: As técnicas de analgesia, peridural contínua e duplo bloqueio, com pequenas doses de anestésico local, não apresentaram interação com o resultado do parto, se a análise estiver focalizada no peso e no índice de Apgar do recém-nascido.

Estimativa de la edad y peso a la primera monta de novillas en el Pantanal brasileño

Esto trabajo tuvo como objetivo estimar la edad y peso a la primera monta de novillas de las razas Nelore (N), Pantaneira (P) y Mestizas Pantaneira x Nelore (PxN). Se utilizó un total de 98 hembras, siendo 51, 24 y 23 pertenecientes a las razas N, P y PxN, respectivamente. El análisis estadístico de los datos no reveló diferencia significativa (P = 0,3595) para el peso a la primera monta entre las razas estudiadas. El análisis de varianza no reveló diferencia significativa (P = 0,307) entre las edades a la primera monta entre razas, mostrando 3,5, 3,4 y 3,2 años para las novillas P, N y ½PxN, respectivamente.

Panorama de la Agricultura de América Latina y el Caribe en las últimas décadas: indicadores de comportamiento en cuadros y gráficos = Survey of agriculture in Latin America and the Caribbean over recent decades: performance indicators in charts and tables

Incluye Bibliografía

La grieta de las drogas: desintegración social y políticas públicas en América Latina

Incluye Bibliografía

La revalorización de las materias primas y sus efectos en América Latina

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Las empresas de biotecnología en Argentina

Incluye bibliografía

Políticas nacionales y la profundización del MERCOSUR: el impacto de las políticas de competitividad

Includes bibliography

América Latina: las exportaciones de productos básicos durante los años noventa

Incluye Bibliografía

Estudio comparativo de las economías de Canadá y México en el período 1994-2011

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Elementos de competitividad sistémica de las pequeñas y medianas empresas (PYME) del Istmo Centroamericano

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Avance de la Cuenta Satélite de Servicios de Salud en la Región de las Américas

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Las relaciones de género entre la población rural del Ecuador, Guatemala y México

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Crisis económica y energética en América Latina: su impacto en las operadoras españolas

Incluye Bibliografía

Participación de las empresas transnacionales en las exportaciones argentinas

Incluye Bibliografía