Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / Nas Ãltimas dÃcadas, a AtenÃÃo BÃsica à SaÃde (ABS) tornou-se um tema especialmente relevante, resultando na reformulaÃÃo do Sistema Nacional de SaÃde. Assim, a rede bÃsica no Brasil tornou-se um espaÃo de prÃtica potencial e necessÃria, na qual os vÃrios cursos de formaÃÃo de profissionais de saÃde deverÃo inserir seus estudantes. Neste contexto, o programa interministerial PET-SaÃde (Programa de EducaÃÃo pelo Trabalho para SaÃde) tem contribuÃdo para a integraÃÃo universidade-serviÃo. O preceptor à a figura inserida no PET-SaÃde que surge no cenÃrio de prÃtica, como o profissional de saÃde-educador que oferece ao aluno ambiente que lhe permita construir e descontruir conhecimentos e experimentar vivÃncias prÃticas de um atendimento humanizado. O presente estudo buscou analisar a preceptoria do PET-SaÃde na EstratÃgia SaÃde da FamÃlia nos MunicÃpios de Fortaleza, Pacatuba e MaracanaÃ, tendo como pÃblico-alvo 82 preceptores da EstratÃgia de SaÃde da FamÃlia (ESF) do MunicÃpio de Fortaleza, 12 de Maracanaà e 06 de Pacatuba. Em relaÃÃo aos alunos bolsistas, foi pesquisada uma amostra de 113 alunos de Fortaleza, 24 de Maracanaà e 12 de Pacatuba. Trata-se de um estudo quantitativo, descritivo, observacional e transversal. A coleta de dados foi realizada atravÃs de um questionÃrio semiestruturado direcionado aos alunos e preceptores. As informaÃÃes foram analisadas no programa estatÃstico SPSS versÃo 17.0. A pesquisa foi aprovada pelo Comità de Ãtica em Pesquisa, com o parecer n 751292. Buscou-se identificar e correlacionar as percepÃÃes dos preceptores e alunos sobre as competÃncias exigidas na preceptoria, as principais dificuldades para o seu exercÃcio e quais resultados prÃticos foram alcanÃados com a realizaÃÃo da preceptoria em relaÃÃo preceptor/serviÃo. A pesquisa mostrou que 54,43% dos preceptores realizaram curso de pÃs-graduaÃÃo apÃs inÃcio da preceptoria e 65,82% afirmaram que a preceptoria influenciou na escolha desse curso. Os resultados apontaram as seguintes dificuldades na preceptoria: despreparo pedagÃgico dos preceptores, infraestrutura deficiente e pouca valorizaÃÃo da preceptoria pelo serviÃo. Com os resultados alcanÃados, pode-se concluir que o exercÃcio da preceptoria do PET-SaÃde à uma experiÃncia que apresenta possibilidades de crescimento para o profissional e desafios em relaÃÃo ao melhor preparo dos preceptores e serviÃos que devem ser superados com uma maior interaÃÃo entre gestores, preceptores, profissionais do serviÃo, instituiÃÃes de ensino e comunidade. / In recent decades, the Primary Health Care (ABS) has become a particularly important issue, resulting in the reformulation of different national health systems. The basic field has become a potential and necessary practice space, in which the various health professionals training courses shall insert its students. In this context, the inter-ministerial program PET-Health (Education Program for Working for Health) greatly contributes to the university-service integration. The Preceptor is the figure inserted into the Pet-health that arises in practical scenario, such as health educator professional who provides the student environments that allow them to build and deconstruct knowledge and experiment practical experiences of humanized care. This study investigated the PET-health preceptorship in Family Health Strategy in the municipalities of Fortaleza, Pacatuba and MaracanaÃ, having as target 82 preceptors professionals of the Family Health Strategy (FHS) in the city of Fortaleza, 12 from Maracanaà and 06 from Pacatuba. Regarding the scholarship students will be surveyed a sample of 113 students from Fortaleza, 24 students and 12 students from Maracanaà and Pacatuba. It is a quantitative and qualitative, descriptive, observational and cross-sectional study. Data collection wasconducted through semi-structured questionnaire directed to students and preceptors. The study was approved by the Research Ethics Committee opinion n 751 292. It sought to identify and correlate perceptions of competence required on preceptorship according to the preceptors and students, the main difficulties for exercise and what practical results preceptorship in Strategy Family Health brought to preceptors, students and service. Research has shown that 54.43% of the preceptors made a graduate course after the initiation of preceptorship and 65.82% said preceptorship influenced in the choice of course. The results showed the following difficulties in preceptorship: the pedagogical unpreparedness of preceptors, poor infrastructure and little appreciation of preceptorship by the service. With the results it can be concluded that the exercise of PET-health preceptorship is an experience that offers growth possibilities for professional and challenges relative to better preparation of preceptors and services that must be overcome with greater interaction among managers, preceptors, service professionals, educational institutions and community.

O estudo teve como objetivo avaliar a eficácia e o efeito residual de uma intervenção de promoção do aleitamento materno (AM) entre escolares da quinta-série por meio de um ensaio clínico randomizado, por conglomerado. O estudo envolveu 564 escolares de ambos os sexos, sorteados em grupo controle (n=253) e grupo de estudo (n=311). Para comparar seus conhecimentos, percepções e mitos sobre AM antes e três meses após a intervenção, utilizouse questionário padronizado contendo 25 questões objetivas sobre diversos aspectos do AM, em que o escolar recebia pontos quando optava pela resposta mais favorável à amamentação. A intervenção foi desenvolvida na escola, em três sessões, com intervalo de uma semana. Para as comparações, utilizou-se o teste t de Student para médias, o teste qui-quadrado para proporções e o teste de Mann-Whitney U para deltas percentuais. Os resultados mostram que os escolares do grupo de estudo aumentaram significativamente os seus escores quando testados imediatamente após a intervenção, mantendo esse efeito após três meses. (Copntinuação) A intervenção teve maior impacto nos escolares das escolas públicas (p=0,002) e entre as meninas (p=0,055). Foi quase consenso a importância da participação do pai na amamentação, embora cerca de 70% dos escolares tenham relatado que a forma de o pai ajudar é dando mamadeira para o bebê. Após a intervenção, apenas dois tópicos, um relacionado à duração do AM e outro ao uso do chá em bebês amamentados, persistiram com um percentual abaixo de 50% de acertos. A intervenção aumentou o número de escolares que responderam que amamentariam exclusivamente os seus filhos e diminuiu o dos que tinham restrições à amamentação em público. Conclui-se ser possível melhorar os conhecimentos, as percepções e as crenças de meninos e meninas em relação ao AM por meio de atividades desenvolvidas nas escolas, mantendo-os inalterados até pelo menos três meses após a intervenção. / The present work aimed at evaluating the efficacy and the residual effect of an intervention of improvement of breastfeeding amongst the scholars of fifth grade through a clinic random test, by conglomerate. The study involved 564 scholars of both sexes, picked in a control group (n=253) and study group (n=311). In order to compare their knowledge, perception and myths about breastfeeding before and three months after the intervention, a standardized questionnaire containing 25 objective questions about various aspects of breastfeeding, in which the scholar received points when opted for the most appropriate to breastfeeding. The intervention was developed in the school in three sessions, with an interval of one week. For the comparisons, the t for student test was utilized for the averages, the qui-square test for the proportions and the Mann-Whitney U for the delta rates. The results show that the scholars in the group of study had their scores improved significantly when tested immediately after the intervention, keeping this effect after three months. The intervention had the bigger impact in the scholars of public schools (p=0,002) and amongst girls (p=0,055). The importance of father participation in breastfeeding was practically consensual, although about 70% of scholars have claimed that the way the father has to help is giving the bottle to the baby. After the intervention, only two topics, one related to the duration of breastfeeding and another to using tea in breastfeeding babies, persisted with rate below 50% of right questions. The intervention increased the number of scholars who answered that they would exclusively breastfeed their children and it decreased the ones who have restrictions to breastfeeding in public. Finally, it is possible to improve knowledge, perceptions and beliefs of boys and girls in relation to breastfeeding by doing activities developed at school, keeping them steady until, at least, three months after intervention.

Orientador: Solange L'Abbate / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T05:13:42Z (GMT). No. of bitstreams: 1 Malaman_LiaBissoli_M.pdf: 2427575 bytes, checksum: 3e61cb5e40ab48625e7038ce56d27f98 (MD5) Previous issue date: 2006 / Resumo: O diabetes é um grave problema de Saúde Pública, alcançando níveis epidêmicos significativos e associando-se à complicações, que comprometem a produtividade e a qualidade de vida da população. É uma patologia na qual o compromisso do paciente com a mudança do seu estilo de vida é fundamental. Daí a orientação do Ministério da Saúde, propondo a realização de atividades grupo-educativas para diabéticos e hipertensos. Dados de produção das Unidades de saúde de São João da Boa Vista/SP onde foi realizada esta investigação, mostram, porém, que a adesão dos usuários às atividades educativas é baixa, quando comparada à procura por consultas médicas. Para identificar os motivos dessa não adesão, realizou-se uma pesquisa qualitativa junto à equipe de enfermagem das Unidades de saúde e aos usuários, considerados não aderentes às atividades grupo-educativas. O material das entrevistas foi analisado mediante o referencial da Análise institucional, tendo como fundamento, o princípio de integralidade do SUS.Concluiu-se que os usuários não aderentes às atividades grupo-educativas privilegiam, sobretudo, o uso de medicamentos e que os usuários aderentes são os mais dependentes do serviço, mais inseguros e com maior dificuldade em aceitar a própria doença. Concluiu-se também que, embora a atividade educativa seja bastante efetiva para o tratamento de doenças crônicas, os profissionais carecem de preparação adequada para realizá-Ias, dado a complexidade dessas ações. Finalmente, a não adesão revelou-se um analisador importante de certas deficiências das Unidades de Saúde, em relação à infra-estrutura e às condições de trabalho dos profissionais da equipe de enfermagem / Abstract: The diabetes is a serious Public Health issue, reaching significant epidemic levels and associating with complications which compromise the productivity and the quality of life of the population. It is a pathology in which the commitment of the patient with the change of his life style is paramount. Hence the orientation of the Ministry of Health, proposing the undertaking of group-educating activities for diabetics and hypertenses. Production data ITom the Health Units of São João da Boa Vista/SP, where this investigation took place have shown, nevertheless, that the adhesion of users to educational activities is low when compared to the search for medical appointments. In order to identify the reasons for this non-adhesion, a qualitative survey has been carried out jointly with the nursing teams ITom the Health Units and to users, considered non-adherent to group-educating activities. The material of the interviews has been analysed under the referential of Institutional Analysis, having as foundation the integrality of SUS. It has been concluded that, although the educational activity is rather effective for the treatment of chronicle diseases, the professionals lack in adequate preparation to undertake them, given the complexity of such actions. Finally, the non-adhesion has revealed an important analyzer of certain deficiencies of Health Units, in relation with the intra-structure and the working conditions of the professionals of the nursing team / Mestrado / Saude Coletiva / Mestre em Saude Coletiva

<p> The lack of cultural specificity in sexuality education conjunct with a myriad of other social factors influences the disproportional impact of HIV on Black/African American adolescent females. Using a focus group methodology with 17 Black/ African American female middle and high school students, I harmonized the intersectionalities between the fields of Afrocentric rites of passage, public health education, and educational leadership toward providing insights and design of culturally conscious healthy sexuality instructional strategies and communal leadership.</p><p> The three aims of this exploratory study included: (a) ascertaining the perceived need for, and interest in, the co-creation of Bititi&rsquo;s Harvest&reg;, a gender and culturally specific, age-appropriate intervention using an Afrocentric rites of passage framework augmented with factual information on sexuality and healthier sexual practices, (b) examining participants&rsquo; current levels of knowledge and specific awareness of age, gender, and ethnic HIV risk, and (c) evaluating developments in my leadership praxis and pedagogy. </p><p> The key findings of this study included: participants&rsquo; indications of lacking fidelity in current educational systems&rsquo; strategies of culturally-specific education including comprehensive healthier sexuality education, differences between perceived and actual HIV knowledge accuracy), confidence in protective self-sufficiency, comfort speaking with peers and partners about HIV, participants&rsquo; recommendations to create curriculum that is inclusive and empowering, and participant interest in co-constructing said curriculum.</p><p> Finally, following an examination of my own leadership developments, I discuss how the findings and their practical application make an original, theoretically-relevant contribution to the literary body, including insights into culturally-specific programming, use of empowerment with metropolitan adolescent Black females 13-21 years, gender-specific use of Afrocentric theory, and rites of passage concept and practice, along with youth-centric and gender-specific input regarding HIV transmission among members of the African diaspora. I conclude with implications and recommendations for the three professional fields.</p><p>

<p> Research has shown that child abuse is a serious public health issue that may warrant child welfare agency intervention and removal of children from their homes. Placement with kin caregivers is considered the least restrictive placement option by social workers. It has been recognized that kin caregivers require some type of formal parental training to prepare them to care for relative children. A large city implemented the Caring for Our Own training program as prelicensing training to prepare relatives for roles as kin caregivers. Prior to this study, no research had assessed whether this training program adequately addressed caregivers&rsquo; ability to adopt effective discipline practices in response to perceived child misbehavior. The purpose of the study was to examine how the Caring for Our Own prelicense training impacted kin caregivers&rsquo; use of ineffective discipline practices, as measured by change in scores on the 3 subscales of the Parenting Scale. The theoretical framework for this study was based on Ajzen&rsquo;s theory of planned behavior. One-way repeated measures ANOVA revealed no statistically significant difference in kin caregivers&rsquo; (<i>n</i> = 27) use of ineffective discipline practices as measured by the 3 subscales of the Parenting Scale over time. In light of this finding, the child welfare agency may create an evidence-based curriculum to assist in the development of competent kin caregivers. Social change to improve training and thus foster more effective responses from kin caregivers may occur within educational departments of child welfare agencies, through assessing and developing prelicensing kin caregiver training that allows for effective child behavior discipline management.</p><p>

<p> This qualitative research study addressed the problem that the healthcare industry has no clear evidence of the academic competencies that influence the attainment of organizational success. The study was based on one case study at a Commission on Accreditation of Healthcare Management Education (CAHME) accredited Masters of Health Administration (MHA) program at an Illinois University Case Site. The case study explored the various perspectives related to the value of academically prepared leaders along with the emerging competencies required to prepare the future healthcare leadership pipeline. The research followed a hermeneutic approach of 22 semi-structured interviews with four sub-groups of faculty and alumni from the university case site along with healthcare administrators and human resource executives using a criterion-based snowball strategy. The open systems theoretical lens and criterion based snowball strategy implicated leadership&rsquo;s impact and influence to sustain change within teams. These interviews were designed to uncover the practical nature of healthcare competencies as key predictors for successful professional development programs, as well as barriers for professionalization. The participants indicated that interpersonal skills, conceptual skills, and technical skills were vital for healthcare administration competencies and professionalization. Traditional knowledge-based programs, tactical training, and a balanced blend conceptual and interpersonal skills emerged as a compulsory enhancement to the fundamental deliverables of core curriculum. Future research should include defining the specific core competencies and factors that influence the success or failure of formal education initiatives that provide the requirements necessary for organizations to build strong leadership, developing solid succession strategies, and creating educational accountabilities to deliver safe and high quality outcomes for key stakeholders. Additional recommendations for future research should focus on quantitative initiatives that measure the value of core leadership competency and the incorporation of those skill into the healthcare delivery system. Several analogous barriers were uncovered among each sub-group for consideration in the standardization of competencies for the professionalization of leadership positions in healthcare administration. Future research should explore enhanced objectivity in the execution of succession planning programs. Additionally, further research will be needed to uncover which licensure tools provides the best assurance that core competencies are being met.</p><p>

Magister Legum - LLM / This paper reports on the findings of a study on the importance of documentation for unaccompanied separated migrant children on South African soil. The objectives of the study is to identify what the international and national laws and policies state about protecting children’s rights, particularly, their socio-economic rights, in the context of irregular migration. Their rights to have legal documentation, their right to education as well as health care, among others. Most importantly, the paper attempts to gain an understanding of the role and obligations of South African stakeholders in terms of the requirements of documentation and the implementation of the relevant laws and policies. To understand what the relevant stakeholders such as NGO’s, DE, Health, DSD and DHA do to protect USMC’s socio-economic rights. Their right to documentation, their right to education, to health care, to the justice system and child protection systems.

Many of the more than one million people infected with the HIV virus in the United States continue to work after a positive test for the antibody to the virus that causes AIDS. As the numbers of HIV infected people grow in this country, more and more employers, co-workers, counselors, friends or family, will have to deal with the compound issues of HIV infection and work. Therefore, knowing and understanding the issues of concern to HIV infected individuals while they continue to work will become increasingly important. To gather this information, a series of Focus Groups were conducted. From the tapes and transcriptions of the groups, discussion items were identified and clustered for each group. They were then analyzed for: convergence across groups; areas of common concern; and inferences into attitudes held by those who are HIV infected. Because the disease is relatively new and because very little data exists about the impact it is having on those who are working and infected, this research project was an exploratory one. It attempted to gain insight into how people are coping with these two issues while learning more about them. Because of the lack of current information on this topic, the groups were facilitated with low structure to generate as many ideas as possible from the participants. The purpose of the research was to supplement existing information about the impact of HIV/AIDS in the workplace. This study changed the prevailing focus of existing research/writing and brought it to those individuals who are both dealing with the disease as a personal reality and continuing to work. In gathering this data, another goal was to provide information that will help make the work-life, and thus the overall quality of life, better for those who are HIV infected.

Esta pesquisa teve como objetivo acompanhar e analisar os efeitos que a Educação Permanente em Saúde (EPS) pode produzir na organização e execução do trabalho no SUS. Para isso, percorremos e habitamos territórios de experimentação e formulação da EPS, numa tentativa de esboçar os jogos de força que conformam os campos de possibilidade de a EPS se fazer potência instituinte, dispositivo de problematização e transformação das práticas constitutivas do trabalho no SUS. Foi-nos útil, para tanto, as contribuições do Movimento Institucionalista, o qual aponta, dentre outros, a radicalização da experiência de problematização como princípio ético e estético do pesquisar. Com a Pesquisa-Intervenção, encontramos reafirmada a perspectiva implicada de produção do conhecimento, onde o pesquisar é tomado como uma produção coletiva que se dá em ato, no processo de produção de encontros e co-engendramentos entre o pesquisador e o território no qual se atualizam as potencialidades do tema pesquisado. Encontramos parceiros e atores da proposta colocada por esta pesquisa em uma Coordenadoria Regional de Saúde do estado do Rio Grande do Sul (CRS-RS), onde um grupo de trabalhadores tem buscado problematizar os modos como a organização e execução do próprio trabalho se instituíram ao longo do tempo naquele espaço, fissurando o instituído e abrindo passagem à experimentação coletiva de outros modos de se organizar e trabalhar. Implícita e explicitamente, recorrem à Educação Permanente em Saúde como tecnologia (leve e leve-dura) de operacionalização e sustentação dessas mudanças. / This research aimed to monitor and analyze the effects that Permanent Education in Health (PEH) can produce in the organization and execution of work in the National Health System (NHS). We traverse and inhabit territories of experimentation and formulation of PEH, an attempt to sketch the power games that make up the field of possibility for the PEH do, instituting power of questioning and transforming work practices in constituent SUS device. It was useful to us, therefore, the contributions of Institutionalist Movement, which aims, among others, the radicalization of experience as problematic ethical and aesthetic principle of search. With Research-Intervention, we find reaffirmed the implied knowledge production, where the search is taken as a collective production that occurs in act, in the production process of meetings between the researcher and the territory in which perspective are updated the potential of the research topic. We found partners and stakeholders of the proposal raised by this research in a Regional Health Directory of Rio Grande do Sul (RHD-RS), where a group of workers have sought to problematize the ways in which the organization and execution of the work himself got instituted over time in that space, hitting the opening set and move to collective experimenting with other ways of getting organized and work. Implicitly and explicitly, they resort to Permanent Health Education as a technology for the deployment and support of these changes.

Esta pesquisa teve como objetivo acompanhar e analisar os efeitos que a Educação Permanente em Saúde (EPS) pode produzir na organização e execução do trabalho no SUS. Para isso, percorremos e habitamos territórios de experimentação e formulação da EPS, numa tentativa de esboçar os jogos de força que conformam os campos de possibilidade de a EPS se fazer potência instituinte, dispositivo de problematização e transformação das práticas constitutivas do trabalho no SUS. Foi-nos útil, para tanto, as contribuições do Movimento Institucionalista, o qual aponta, dentre outros, a radicalização da experiência de problematização como princípio ético e estético do pesquisar. Com a Pesquisa-Intervenção, encontramos reafirmada a perspectiva implicada de produção do conhecimento, onde o pesquisar é tomado como uma produção coletiva que se dá em ato, no processo de produção de encontros e co-engendramentos entre o pesquisador e o território no qual se atualizam as potencialidades do tema pesquisado. Encontramos parceiros e atores da proposta colocada por esta pesquisa em uma Coordenadoria Regional de Saúde do estado do Rio Grande do Sul (CRS-RS), onde um grupo de trabalhadores tem buscado problematizar os modos como a organização e execução do próprio trabalho se instituíram ao longo do tempo naquele espaço, fissurando o instituído e abrindo passagem à experimentação coletiva de outros modos de se organizar e trabalhar. Implícita e explicitamente, recorrem à Educação Permanente em Saúde como tecnologia (leve e leve-dura) de operacionalização e sustentação dessas mudanças. / This research aimed to monitor and analyze the effects that Permanent Education in Health (PEH) can produce in the organization and execution of work in the National Health System (NHS). We traverse and inhabit territories of experimentation and formulation of PEH, an attempt to sketch the power games that make up the field of possibility for the PEH do, instituting power of questioning and transforming work practices in constituent SUS device. It was useful to us, therefore, the contributions of Institutionalist Movement, which aims, among others, the radicalization of experience as problematic ethical and aesthetic principle of search. With Research-Intervention, we find reaffirmed the implied knowledge production, where the search is taken as a collective production that occurs in act, in the production process of meetings between the researcher and the territory in which perspective are updated the potential of the research topic. We found partners and stakeholders of the proposal raised by this research in a Regional Health Directory of Rio Grande do Sul (RHD-RS), where a group of workers have sought to problematize the ways in which the organization and execution of the work himself got instituted over time in that space, hitting the opening set and move to collective experimenting with other ways of getting organized and work. Implicitly and explicitly, they resort to Permanent Health Education as a technology for the deployment and support of these changes.