Herbal medicines remain integral part of indigenous health care system in Ghana. Most conventional health medicines are directly or indirectly derived from plants or herbs. Despite its significant role in modern medicine indigenous herbal practices has been on the low light for some time due to perceived antagonistic relationship that exists between practitioners of herbal medicine and their counterpart in the conventional system. Using an indigenous knowledge discursive framework, the thesis examined the relevance of herbal medicine to the contemporary Ghanaian society. The thesis also examined the tension between the indigenous herbal practitioners and their orthodox counterparts. The thesis noted that for health care system in Ghana to be effective, there is a need for collaborate relations between these two practitioners. Also, it was noted that for health care system to be effective in Ghana, spirituality has to be central in the works of the herbal practitioners.

Made available in DSpace on 2014-12-17T15:43:55Z (GMT). No. of bitstreams: 1 CamillaDSL_DISSERT.pdf: 2070923 bytes, checksum: 3bc8a344eb0d2752af26a1492fe79e04 (MD5) Previous issue date: 2014-06-27 / A inicia??o sexual ? um marco significativo na vida do indiv?duo, ocorrendo geralmente na adolesc?ncia. Importantes transforma??es biopsicossociais ocorrem nesta fase, denotando vulnerabilidades ? vida do adolescente, dentre elas, as decorrentes da inicia??o sexual, sendo o risco de infec??o pelo HIV/aids a mais grave. A infec??o pelo HIV/aids constitui atualmente um importante problema de Sa?de P?blica, estando os jovens no centro da epidemia mundial. No Brasil, dados do ?ltimo boletim epidemiol?gico, lan?ado em 2013, apontam para a tend?ncia de aumento de sua preval?ncia na popula??o jovem. Desta forma, o presente estudo teve por objetivo investigar a associa??o entre inicia??o sexual e o perfil sociodemogr?fico, o indicador de conhecimento das formas de transmiss?o do HIV/aids e fatores biopsicossociais autoestima e habilidades sociais, em adolescentes de 16 a 19 anos, de ambos os sexos, estudantes do n?vel m?dio t?cnico integrado, do Instituto Federal de Educa??o, Ci?ncias e Tecnologia do Rio Grande do Norte, Campus Natal. Trata-se de um estudo transversal, cuja amostra foi constitu?da aleatoriamente por 200 alunos que responderam de forma an?nima a quatro instrumentos: perfil sociodemogr?fico, question?rio da Pesquisa de Conhecimentos, Atitudes e Pr?ticas na Popula??o Brasileira (PCAP), Escala de Autoestima de Rosenberg e o Invent?rio de Habilidades Sociais para Adolescentes de Del-Prette (IHSA). A an?lise estat?stica dos dados foi realizada atrav?s do teste qui-quadrado de Pearson e do exato de Fisher (&#945; <5%). A m?dia de idade para a primeira rela??o sexual foi de 15,96 anos, com o in?cio mais cedo para o sexo masculino. Verificou-se associa??es estatisticamente significativas entre inicia??o sexual e as seguintes vari?veis: idade, sexo, situa??o conjugal, religi?o, renda familiar, autoestima e o repert?rio de habilidades sociais. Observou-se ainda que apenas 11% dos adolescentes possu?am conhecimento correto acerca das formas de transmiss?o do HIV/aids. Conclui-se que os esfor?os para a preven??o das DST/aids precisam ser direcionados a campanhas e programas mais eficazes, que considerem n?o somente o car?ter informativo, mas tamb?m os fatores psicossociais j? que estes mostraram-se associados ao in?cio da vida sexual

Health care service providers in South Africa and elsewhere in the world are increasingly faced with an enormous challenge of modeling their approach to health care to meet the needs and expectations of the diverse societies they serve. The norms and customs that are inherent in these indigenous cultures are fundamental to the day-to-day existence of the people concerned and may hold a key to the understanding of many aspects of their lives, including the understanding of disease, in the case of this thesis, those transmitted sexually. A grounded theory study was used based on its theory of symbolic interactionism to explore the indigenous knowledge and health practices of the Vhavenda in sexually transmitted diseases. Data was collected through in-depth interview with traditional healers and key informants. Snowball sampling was used to idenify key informants as categories continued to emerge. Dara was analyzed using three basic types of coding namely, open coding, axial coding and selective coding. The findings of the study revealed a variety of terms used to identify SDs. Also emerging from the results was that cultural gender roles in the Vhavenda society justify women as sole agents of STDs. In accordance with grounded theory the decriptions of types of diseases, disease patterns, signs and symptoms culminated in "dirt" as the core category. It came out clear that dirt in the form of women'svaginal discharges and moral dirt is the main course of a STDs. It was also evident that strategies for combating STDs will have to take into account popular beliefs and attudes regarding views on STDs as well as the role and influence of traditional healers. Based on the above findings guidelines for designing a module for teaching health professionals has been formulated to aid them in understanding the beliefs and practices of people they serve. / Health Studies / D. Litt et Phil. (Health Studies)

This study was undertaken with the objective of assessing whether the ingestion of a Multivitamin Complex with Calcium and Magnesium would be efficacious in reducing stress. Tlrree hundred subjects who were suffering from stress were selected in Gauteng and Kwa-Zulu Natal, South Africa. The selection was based on a stress questionnaire. The subjects took a battery of tests and questionnaires to assess the level ofthe stress they were experiencing. A 30 day supply of effeiVescent tablets was given to all subjects - half placebos and half the vitamin supplement. These were randomly allocated. At the end of30 days a further battery oftests were administered. The results were statistically analysed. It was found that both the placebo and the vitamin supplement proved beneficial but the Multivitamin Complex with Calcium and Magnesium had a greater effect in reducing and helping to manage stress. / Psychology / M.A. (Psychology)

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-16T13:50:39Z No. of bitstreams: 1 heloisahelenadasilvaguedes.pdf: 828564 bytes, checksum: c49b428aeb22ad8b853bdec20dec88cd (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:21:54Z (GMT) No. of bitstreams: 1 heloisahelenadasilvaguedes.pdf: 828564 bytes, checksum: c49b428aeb22ad8b853bdec20dec88cd (MD5) / Made available in DSpace on 2016-09-26T20:21:54Z (GMT). No. of bitstreams: 1 heloisahelenadasilvaguedes.pdf: 828564 bytes, checksum: c49b428aeb22ad8b853bdec20dec88cd (MD5) Previous issue date: 2010-08-27 / O presente trabalho discute as práticas de saúde desenvolvidas para o enfrentamento da epidemia com vistas à prevenção, promoção da saúde e adesão ao tratamento, tendo por cenário a experiência de Juiz de Fora/MG, considerado segundo município de Minas Gerais com o maior número de casos. Discute-se as práticas desenvolvidas, em especial as de cunho educativo, uma vez que, a aids no Brasil e no mundo configura-se numa epidemia que necessita de práticas de saúde de longo alcance, que visem não apenas o aspecto biológico da doença – a infecção pelo vírus HIV – mas também incorpore a influência de aspectos sociais, culturais e econômicos presentes na vida dos indivíduos que carregam o vírus ou estão sujeitos a ele. O estudo aponta que, para controle da aids, o governo brasileiro disponibiliza ações e serviços de saúde visando abarcar a sociedade como um todo. Assim, o estudo em questão torna-se relevante, na medida em que descortina como se materializam as práticas de saúde para enfrentamento da epidemia e no que elas contribuem para contenção do avanço da doença. / This article discusses the health practices designed to combat the epidemic with a view to prevention, health promotion and treatment adherence, with the background of experience in Juiz de Fora / MG, considered second city of Minas Gerais with the largest number of cases. It discusses the practices developed, especially with an educational, as, AIDS in Brazil and the world presents itself in an epidemic that requires health practices long-range, aiming not only the biological aspect of the disease - the HIV virus - but also incorporates the influence of social, cultural and economic life of the present in individuals who carry the virus or are subject to it. The study shows that to control AIDS, the Brazilian government provides health services and actions aimed at encompassing society as a whole. Thus, the study in question becomes relevant in that it reveals how they materialize health practices to combat the epidemic and what they contribute to containment of disease progression.

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2016-05-17T19:36:39Z No. of bitstreams: 1 Giselle Gomes Borges.pdf: 2928602 bytes, checksum: 0f6004796d06237d4fade7e9f6aaca8d (MD5) / Made available in DSpace on 2016-05-17T19:36:40Z (GMT). No. of bitstreams: 1 Giselle Gomes Borges.pdf: 2928602 bytes, checksum: 0f6004796d06237d4fade7e9f6aaca8d (MD5) Previous issue date: 2015 / Mestrado Profissional em Enfermagem Assistencial / O câncer é um evidente problema de saúde pública mundial. A quimioterapia trouxe uma maior taxa de cura para muitos tumores através da utilização de agentes químicos. Durante o manuseio dos quimioterápicos antineoplásicos (QA) é recomendado que o profissional utilize equipamentos de proteção individual (EPI) já que estes agentes oferecem efeitos indesejados e podem vir a constituir risco ocupacional. Este estudo tem como objeto o risco químico a que estão expostos os enfermeiros que desenvolvem suas atividades laborais em Centrais de Quimioterapia (CQT). Objetivo geral: implantar um manual de boas práticas com a finalidade de minimizar a exposição ao risco químico na CQT. Objetivos específicos: analisar os Conhecimentos, Atitudes e Práticas (CAP) dos enfermeiros a respeito do risco químico na CQT e elaborar um manual de boas práticas para os enfermeiros na CQT sobre a exposição ao risco químico a partir dos resultados do inquérito CAP. Trata-se de uma pesquisa descritiva com abordagem quantitativa, do tipo inquérito CAP. O estudo teve como amostra 26 enfermeiros de duas CQT. Utilizado para a coleta de dados um questionário autoadministrativo sem identificação, misto, contendo perguntas em que se utiliza uma escala de resposta paramétrica tipo Likert. Antecedendo a coleta dos dados o trabalho foi submetido ao Comitê de Ética em Pesquisa (CEP) com aprovação nº 12361613.4.00005274 em 12/09/2014. Resultados: Constatou-se que o conhecimento constituído a respeito do risco químico foi adequado nas duas CQT. Contudo, as atitudes e práticas diante do risco químico não foram coerentes. Dos enfermeiros, 96,2% consideram-se vulneráveis ao risco químico; o uso de EPI é considerado por 76,9% como um cuidado para que ocorra o manuseio seguro dos QA; quanto aos cuidados dispensados pelo Instituto aos que manuseiam QA, 53,8% citam os exames periódicos. O manual foi elaborado a partir dos resultados do inquérito CAP e implantado no Instituto, cenário do estudo, através do sistema Intranet. Para complementar, o manual de boas práticas, foram confeccionados sinalizadores com o intuito de embasar os enfermeiros a minimizarem a exposição ao risco. Conclusão: os profissionais que trabalham em CQT conhecem e consideram-se expostos ao risco químico. São necessárias intervenções para ampliar a adesão às medidas preventivas como o uso de EPI e subsídios com infraestrutura estratégica para a segurança do trabalhador. / Cancer is an obvious problem of global public health. The chemotherapy brought greater cure rate for many tumors through the use of chemical agents. During handling of antineoplastic drugs (QA) is recommended that professionals use personal protective equipament (PPE) as these agents provide unwanted effects and are liable to occupational risk. This paper studied the chemical risk they are exposed to nurses who develop their work activities on Chemotherapy Centers (CQT). Overall objective: to implement a manual of good practices in order to minimize exposure to chemical risk in the CQT. Specific objectives: to analyze the Knowledge, Attitudes and Practices (KAP) of nurses about the chemical risk in the CQT and prepare a manual of good for nurses in CQT on exposure to chemical risk from the KAP survey results. It is a descriptive research with a quantitative approach, the KAP. The study had as sample 26 nurses from two CQT. Used to collect data one auto administrative questionnaire unmarked, mixed, containing questions which uses a parametric response Likert scale. Preceding data collection work was submitted to the Research Ethics Committee (CEP) with approval number 12361613.4.00005274 on 09/12/2014. Results: It was found that knowledge made about chemical risk was adequate in both CQT. Yet attitudes and practices before the chemical risk were not consistent. 96,2% of nurses consider themselves vulnerable to chemical risk; the use of PPE is considered by 76,9% as a caution to occur safe handling of QA; as the care provided by the Institute to handling QA 53,8% cite the periodic examinations. The manual has been prepared from the KAP survey results and implanted in the study setting Institute through the Intranet system. In addition to the manual of good practice were made flags in order to base nurses to minimize exposure to risk. Conclusion: professionals working in CQT know and consider themselves exposed to chemical risk. Interventions are needed to increase the adherence to preventive measures such as the use of PPE and subsidies to strategic infrastructure for worker safety.

This study aims to analyze health practices that support obstetric violence as a legal possession right by the medical-scientific knowledge-power of bodies, sexual and reproductive processes of women during their pregnancies and labor. This appropriation is a particular configuration in health care, in which the risk discourse embedded in this kind of knowledge-power that highlights biological factors, pathologizing and fragmented, making it the only way to manage the risk during pregnancy and childbirth, rather than expansion of autonomy, act producing docile bodies in the sense used by the philosopher Michel Foucault. I seek to relate relationships between risk concepts with medical and hospital discursive practices, marked by the logic of maximum production profits in the shortest time and built the scientific truth of value-legitimize the interventions on the bodies-of-women that acts reinforcing a dispossession of pregnancies and births. Expanding the locus of obstetric violence beyond the hospital, we identify their presence in some prenatal care practices in both the public or private health sector. It also emphasize gender concepts, body, human sexuality and reproduction, all common topics in our society , working in naturalization and perpetuation of obstetric violence as gender-based violence against women ;that are pregnant or have children. We also question a certain understanding of humanized birth and their individualizing, statist or marketing shots, which tend to take you to a land in which the role of women is narrowly. By endorsing labor humanisation, social movements and public policies give other senses about issues related to women's health, in which obstetric violence is of them; this notoriety, however, must be transformed into specific actions to be implemented to not only identify and criminalize those who practice obstetric violence, but also to incorporate workers, managers and users of health systems in order to exercise their protagonists to others, linking relations, accountability and sharing decisions about ways to gestate and give birth. The path of this research was born in intervention research as a methodology. in which the relationship between search object and the search engine are related by implication, that is, the ability to produce changes to each other. So, I bring experiences as a mother, activist of the Movement for Birth Humanization (MBH) woman medical health officer, medical school teacher, and the health system user; roles that mix, transform and dialogue to the practice of research involved, designing research in social, ethical and aesthetic commitment. / Este trabalho tem como objetivo a análise de práticas em saúde que sustentam a violência obstétrica como apropriação pelo saber-poder médico-científico dos corpos, dos processos reprodutivos e sexuais das mulheres durante suas gestações e partos. Tal apropriação assume especial configuração nos serviços de saúde, nos quais o discurso do risco incorporado por esse tipo de saber-poder adquire formas marcadamente centradas em fatores biológicos, patologizantes e fragmentários, configurando um modo singular de gestão dos riscos na gestação e parto, que ao invés de ampliação de autonomia, atuam produzindo corpos dóceis, no sentido utilizado pelo filósofo Michel Foucault. Busco ainda tecer relações entre conceitos de risco com práticas discursivas médico-hospitalares que, marcadas pela lógica da máxima produção de lucros no mínimo de tempo possível e embutidas do valor de verdade científica, legitimam-se nas intervenções sobre os corpos-das-mulheres-que-parem e atuam reforçando uma desapropriação das gestações e partos pelas mulheres. Ampliando o lócus da violência obstétrica para além do hospital, identificamos sua presença em algumas práticas de acompanhamento pré-natal, seja no setor público ou privado de saúde. Ressaltamos também conceitos de gênero, corpo, sexualidade e reprodução humana comuns em nossa sociedade que atuam na naturalização e perpetuação da violência obstétrica como violência de gênero contra mulheres que gestam e parem. Problematizamos ainda um certo entendimento de parto humanizado e suas capturas individualizantes, estatizantes ou mercadológicas, que tendem a leva-lo a um terreno no qual o protagonismo das mulheres ocorre de forma restrita. Ao tomar a bandeira da humanização do parto, movimentos sociais e políticas públicas conferem outros sentidos dando visibilidade a outras questões relativas à saúde das mulheres, sendo uma delas o problema da violência obstétrica; esta notoriedade, entretanto, precisa ser transformada em ações específicas a serem implementadas no sentido de não somente identificar e criminalizar quem pratica a violência obstétrica, como também de incorporar trabalhadores, gestores e usuárias dos sistemas de saúde de modo a exercerem seus protagonismos uns com os outros, apontando para relações de vínculo, responsabilização e partilha de decisões sobre os modos de gestar e parir. O percurso desta pesquisa fundou-se na pesquisa-intervenção, como metodologia na qual a relação entre objeto de pesquisa e pesquisador relacionam-se pela implicação, ou seja, pela capacidade de um produzir mudanças no outro. Assim, trago alguns relatos de experiências vividas como mãe, ativista do movimento pela humanização do parto (MPH), mulher, médica sanitarista, docente do curso médico, além de usuária do sistema de saúde; papéis que se misturam, se transformam e dialogam com a prática da pesquisa implicada, desenhando a pesquisa com compromisso social, ético e estético.

Cette thèse propose d’interroger les conditions locales d’insertion d’un modèle de gestion autonome de la maladie chronique dans le contexte d’émergence du diabète comme problème de santé publique au Burkina Faso. La réflexion prend appui sur un corpus ethnographique qui croise des récits d’expérience de la maladie, l’observation d’activités médicales et de pratiques de soins, ainsi que l’expérience singulière de l’anthropologue impliqué dans la quête thérapeutique de son logeur. Une approche socio-ethnologique d’un village bwa permet de caractériser un espace social alimentaire local et d’identifier les dimensions culturelles et sociales de la santé et de la maladie. Des éclairages historiques et politiques sont convoqués pour penser le rapport des patients au système de soins local. Les savoirs ordinaires sur le diabète sont interrogés dans leurs modalités de construction et leurs finalités pratiques. Les itinéraires thérapeutiques des patients révèlent la perception de risques sociaux liés à une individualisation des comportements alimentaires. Une logique de la “débrouillardise“ permet de “contenir“ le diabète dans un contexte d’incertitudes que majore le coût rédhibitoire des traitements. Les limites actuelles d’une médicalisation du diabète sont analysées en regard de la qualité de vie des patients. Cette approche du contexte laisse penser que l’application locale du projet global d’autonomisation des patients fait émerger de nouveaux enjeux au cœur même de la relation de soins. La thèse ouvre sur une réflexion concernant l’articulation des pratiques locales, du modèle global, et du paradigme du care dans la perspective d’une amélioration du quotidien des patients. / This PhD dissertation proposes to examine local conditions of the insertion of a model of self-management of chronic disease in the context of the emergence of diabetes as a public health problem in Burkina Faso. The reflection is based on an ethnographic corpus that includes stories of illness experience, observation of medical activities and care practices, as well as the singular experience of the anthropologist involved in a therapeutic quest for his host. A socio-anthropological approach of a bwa village (Dédougou area) characterizes the local food social space and identifies the cultural and social dimensions of health and disease. Historical and political insights are invited to think about the relationship between patients and the local health system. The modalities of construction and practical purposes of lay knowledge about diabetes are questioned. Therapeutic itineraries of patients reveal the perception of social risks related to individualized eating behaviors. A logic of "resourcefulness" can "manage" diabetes in a context of uncertainty that increases the prohibitive cost of treatment. The current limits of medicalization of diabetes are analyzed with respect to patients’ quality of life. This contextualisation suggests that the local application of the global project to empower patients produces the emergence of new issues at the heart of care relationship. The thesis opens a reflection on the articulation between local practices, global model, and the paradigm of care, understood in the perspective of improving patients’ lives.

As escolas médicas brasileiras encontram-se diante do desafio de mudar para formar protissional crítico, capaz de aprender a aprender, de trabalhar em equipe, de levar em conta a realidade social para prestar atenção humana e de qualidade. As mudanças necessárias são profundas porque implicam a transformação de concepções, práticas e de relações de poder, tanto nos espaços internos das universidades, como em suas relações com a sociedade, especialmente como os serviços de saúde e com a população. O objetivo deste estudo foi analisar algumas das principais causas das sucessivas histórias de resultados desfavoráveis nas tentativas de mudar a educação médica; analisar como essas questões e problemas cruciais vêm sendo tratados em dois processos de mudança na educação médica atualmente considerados promissores, quais sejam as transformações curriculares de Marília e de Londrina; e construir um conjunto de idéias, propostas e instrumentos que contribuam para a produção de mudanças efetivas na educação médica no Brasil. A metodologia adotada foi a de estudo de caso informado pelo referencial crítico-dialético. Foi feita uma análise política dos processos, assumindo o poder como categoria analítica central. Nos dois casos estudados estão em curso mudanças profundas no âmbito da organização institucional, das concepções e das práticas, bem como das relações entre professores, estudantes, profissionais dos serviços e população. Há avanços significativos, mas também problemas e conflitos, níveis diferentes de acumulação de poder técnico e político, sendo necessário um período de consolidação. / Brazilian medical schools have to face the challenge of changing so as to graduate professionals capable of critical and self conducted learning, of working in teams, of taking social reality into account in the clinical practice and of delivering health attention of good quality. Deep changes will be necessary as conceptions, practices and of relations of power inside and outside the university have to be addressed. This study meant to analyze the main causes of the previous unsuccessful experiences of changes in medical education in Brazil; to analyze how the identified critical questions are being dealt in two changing processes that are taking place in Marília and Londrina and build a set of ideals, proposals and tools that can be useful for changing medical education in Brazil. The adopted methodology was a case study orientated through the critical-dialectic reference. A political analysis was made, taking power as the central analytical category. Both of the studied cases reveal deep changes in the fields of institutional organization, conceptions and practices and relations between faculties, students, health professionals and people. Both groups present relevant results, but also problems and conflicts and different leveis of technical and political power accumulation, what makes necessary a consolidation phase to take place.

L’objectif de cette recherche qualitative était de porter un regard sur la problématique du poids chez l’homme à partir des déterminants de la santé masculine définis par Courtenay (2003). En donnant la parole à 17 hommes québécois en surpoids lors d’entrevues individuelles, différentes variables associées à leur préoccupation à l’égard du poids, sont examinées. Selon ces hommes, il existe un comportement alimentaire typiquement masculin autant dans le choix des aliments que dans la façon de manger. La présence féminine joue pour eux un rôle prépondérant dans ce domaine. La vision masculine de la santé suit souvent la fonctionnalité de leur corps tandis que leur description du surpoids semble davantage partir du « vécu » et être moins stricte que la définition purement médicale. Néanmoins, beaucoup d’hommes sentent la pression de l’image du corps idéal masculin et sont souvent insatisfaits de leur corps selon la masculinité valorisée et selon la stigmatisation subie. La préoccupation des hommes à l’égard de leur santé est très présente parmi les hommes de 30-45 ans et perdre du poids dans ce contexte devient alors légitime mais les raisons évoquées varient : la santé, l’apparence, le bien-être. L’expression des douleurs émotionnelles autour du poids est difficile pour les hommes et trop souvent la masculinité traditionnelle constitue une barrière de taille à la consultation pour ces problèmes. Pour le futur, il sera donc important pour les professionnels de la santé d’intégrer les différentes caractéristiques de cette masculinité traditionnelle dans leur approche et leur communication avec les hommes en surpoids. / The purpose of this study was to explore different weight issues of men by using the « key determinants of the health and the well-being of men » established by Courtenay (2003). By interviewing 17 overweight men of Québec, different variables were examined that could possibly explain the preoccupation with their weight. According to these men, a typical masculine behaviour in the food choice and in the way of eating can be acknowledged and by traditional masculine standards, women often play an important role in this area. The health beliefs of men is often limited to the functionality of their body while the description of overweight is more based on their lived experience and less restrictive than the pure medical definition of health. Nevertheless, the social pressure of the ideal masculine body is felt by many men and makes them often dissatisfied with their body depending on the masculinity that is valued and the stigmatisation that they encounter. Men’s health concerns are predominant in the 30-45 age group and legitimize their desire for weight loss although given reasons may vary: health, appearance or well-being. Expression of emotional pain in weight issues is difficult for a lot of men and very often the traditional masculine values constitute a serious barrier to consulting for these kinds of problems. Health professionals in the future will therefore need to recognize the different characteristics of this masculinity and integrate them in their approach and communication with overweight men.