Studien syftar till att försöka förstå vilka förutsättningar yrkesverksamma inom ideella organisationer upplever sig ha i arbetet med målgruppen - våldsutsatta kvinnor i missbruk. Vilka kontexter de yrkesverksamma upplever att deras ideella organisationer verkar inom samt hur de agerar i förhållande till samma kontexter i arbetet med målgruppen. Studiens resultat och analys bygger på upplevelser från nio respondenter som är yrkesverksamma inom ideella organisationer och som arbetar med nämnd målgrupp. Analysmetoden som använts är av kategorin, innehållsanalys. Studiens teoretiska referensram innefattar ett politiskt processperspektiv men också ett intersektionellt perspektiv, vilket används för att skapa djupare förståelse av insamlat material. Det visar sig att de ideella organisationerna själva har en intersektionell förståelse av sin målgrupp, en förståelse som utgör grunden för dess funktion som komplement till det offentliga. De ideella verkar inom kontexter där viktiga faktorer utgör det offentligas olika krav och syn på målgruppen och dess behov, vilket styr finansiellt. Andra faktorer är avsaknaden av allierade och hur det påverkar samarbete, genom kunskapsutbyte och målgruppens synlighet. Det här har gjort att de har utvecklat organisationen som flexibelt kan anpassa sig till behoven samtidigt som de bedriver opinionsbildning i syfte att långsiktigt förändra bilden av målgruppen och därmed även förutsättningarna för sin verksamhet.

Bakgrund: Demenssjukdom är en global sjukdom som ökar i antal insjuknade för varje år. Fysiska och kognitiva förmågor försämras ständigt under sjukdomsförloppet. Det är vanligt att person och/eller personer med demenssjukdom (PMD) drabbas av malnutrition eftersom de glömmer av att äta och hur de ska äta. Vårdpersonalen behöver därför kunskap om hur måltidssituationer för PMD kan anpassas efter de behov som finns och hur matintaget kan ökas. Syfte: Att belysa aspekter av vårdpersonals kunskap kring måltidssituationer för personer med demenssjukdom på särskilt boende. Metod: En litteraturöversikt baserat på 15 vetenskapliga artiklar. Elva artiklar var av kvalitativdesign och fyra artiklar var av mixad design. Databaserna som användes vid artikelsökning var CINAHL och PubMed. Resultat: Ett huvudresultat visade att vårdpersonalen behövde mer kunskap vid måltidssituationer för att bidra med ökat matintag hos PMD. Genom att vårdpersonalen anpassade måltidssituationer i enlighet med PMD förmågor kunde behoven lättare tillfredsställas. Vårdpersonalen tog hänsyn till bland annat möblering, ljud, ljus och servering för att minska oönskade stimuli vid måltidssituationer för PMD. Slutsats: Vårdpersonalen hade kunskap men inte tillräcklig för att kunna utföra en optimal omvårdnad till PMD. Behoven bland PMD är många och kunskapsbrist hos vårdpersonalen råder. Kunskapsbristen hos vårdpersonalen om måltidssituationer blir tydliga då PMD inte har tillräckligt matintag för att upprätthålla en god nutritionsstatus. / Background: Dementia is a global disease that increases for every year. Physical and psychological abilities reduce continuously during the disease course. It is usual that people with dementia is affected by malnutrition since they forget how and when to eat. Healthcare professionals’ need more knowledge about mealtime situations for people with dementia and how to customize their needs about increasing food intake. Aim: To illustrate aspect of healthcare professional’s knowledge about mealtime situations for people with dementia in nursing homes. Method: A literature review based on 15 research articles. Eleven articles were qualitative design and four were mixed design. Used databases were CINAHL and PubMed. Results: A main result showed that healthcare professionals needed more knowledge about mealtime situations and how to provide increased food intake. Healthcare professionals adjust mealtime situations according to the abilities that people with dementia had. Healthcare professionals did consideration about different kind of arrangement to reduce stimuli in mealtime situations for people living with dementia. Conclusion: Healthcare professionals had knowledge about nursing for people with dementia but not enough. The needs among people living with dementia are many and the lack of knowledge in healthcare professionals' work is not approval. In mealtime situations the lack of knowledge about optimal nutrition status among people with dementia and surrounded by healthcare professionals' is not clearly to sustain.

Migration has become an important feature of health labour markets due to the global shortage of health professionals. While there exists an extensive Labour Economics literature studying the general migration, policy development remains hampered by limited research undertaken in the health sector. This thesis fills some of that gap by examining the economic influences on and impacts of the migration of health professionals. The migration of skilled health professionals has exhibited strong sectoral properties, such as the motivation of career development and various regulatory regimes. We incorporate these features into the self-selection model by Borjas and Bratsberg (1996) and examine factors that influence the scale and skill composition of the migration flow. Our model suggests that the restrictive relicensing regime and work permit requirements for non-EEA professionals adopted by the British government to maintain practice standards and secure employment opportunities for native graduates, could only limit the migration from countries with higher returns to skills. The effect is ambiguous for most donor countries, which provide lower returns to skills.Using the administrative data derived from the Scottish dental system, we also examine the impacts of health professional migration within EU on the host country by investigating the performance of EEA dentists contracted under the Scottish NHS in terms of retention and treatment provision. A discrete-time survival analysis has been applied to characterize the time trend of the retention and identify factors associated with the likelihood of a dentist leaving the NHS. We also compare treatments provided by migrant and non-migrant dentists by estimating a difference-in-differences model. Unobserved heterogeneity in dentists is controlled using fixed effects.Our results suggest that EEA health professionals can be a good substitute to British graduates. They provide marginally different treatments and exhibit strong assimilation within two years post-entry. However, a constant issue we have found is their high turnover rates in the NHS: half of them left the service by the 26th month following entry. The primary policy recommendation of our analyses is that there is need for the government to develop recruitment initiatives so as to retain migrant dentists. Our results suggest hazards of leaving are significantly associated with dentists’ age-at-entry, arrival cohort and patient composition, but not with dentists’gender, country and practice deprivation. These findings potentially help to set evidence-based targets for international recruitment programmes

O objeto de estudo desta pesquisa qualitativa é o entendimento dos trabalhadores dos hospitais psiquiátricos sobre a Reforma Psiquiátrica e como lidam com esse processo. A finalidade é contribuir para a ampliação arsenal teórico prático da Reforma Psiquiátrica e propor novas luzes para a sua análise. Tem como objetivos: conhecer o que os trabalhadores dos hospitais psiquiátricos pensam sobre a função do hospital psiquiátrico no contexto da Reforma Psiquiátrica; compreender como os trabalhadores de saúde mental lidam com o processo da desinstitucionalização nas suas práticas. O cenário do estudo foi dois hospitais psiquiátricos, um público e outro privado, sem fins lucrativos, integrados ao SUS e situados no município de São Paulo. Participaram deste estudo 12 (doze) trabalhadores (de nível médio e superior). Os dados empíricos foram obtidos por meio de entrevista individual semi-estruturada. O material empírico foi analisado de acordo com as categorias analíticas: instituição, institucionalização, transição, desinstitucionalização e crise e foi referenciado em Minayo. A análise dos dados deu origem às categorias: a) o hospital psiquiátrico: o lugar da crise; b) a internação da crise; c) desinstitucionalização: a desconstrução de saberes; d) o hospital e a rede em crise; e) a persistência da cultura hospitalocêntrica; f) o hospital psiquiátrico e a família em crise; g) o hospital psiquiátrico e a sociedade. Os trabalhadores descrevem um novo hospital, cuja função é o acolhimento da crise e internação de curta permanência; identificam medidas reformistas de ordem técnica e administrativa, ocorridas no hospital como: especialização no atendimento da clientela; regime de internação de curta permanência x cronicidade; intervenção multidisciplinar x trabalho isolado; melhoria da estrutura física e de recursos humanos; melhoria da ambiência; implantação de projeto terapêutico; redução de leitos hospitalares, em função do atendimento às exigências das portarias ministeriais. Evidencia-se o entendimento de desinstitucionalização como desospitalização. Os discursos dos entrevistados evidenciam uma relação em crise do hospital psiquiátrico com a rede substitutiva de atenção à saúde mental de base comunitária. Os trabalhadores enfrentam dificuldades no processo de des-internação de pacientes com grave problemática social. O hospital psiquiátrico tem sido a própria contradição no atual modelo de atenção em saúde mental no Município de São Paulo e, portanto, nesta perspectiva, sustenta dentro de si as várias contradições advindas de sua própria gênese enquanto instituição, somadas às condições atuais em que se encontra “inexistente" na rede. O hospital psiquiátrico: lugar da crise porque lugar das contradições / The object of study of this qualitative research is the understanding of the psychiatric hospital\'s workers about the Psychiatric Reform and how they deal with this process. The purpose of the study is to contribute for the expansion of the Psychiatric Reform\'s theoretical-practical arsenal and propose new lights to its analyses. Objectives are: know what the psychiatric hospital\'s workers think about the psychiatric hospital in the context of the Psychiatric Reform; understand how mental health workers deal with the process of desinstitutionalization in their practices. The scenery of this study were two psychiatric hospitals, one public and the other private, nonprofit, integrated to SUS and placed in the city of São Paulo. 12 (twelve) workers (medium level and high education) participated in the study. Empirical data were gathered through semi-structured individual interview. The empirical material was analyzed according to the categories: institution, transition, desinstitutionalization and crises, according to Minayo. Data\'s analyses originated the categories: a) the psychiatric hospital: the crisis\'s place; b) crisis\' hospitalization; c) desinstitutionalization: knowledge\'s deconstruction ; d) the hospital and the net in crisis; e) hospital-centered culture\'s persistence; f) the psychiatric hospital and the family in crisis g) the psychiatric hospital and society. Workers described a new hospital, which\'s function is welcoming of crises and short-term hospitalization; it\'s identified reformist\'s technical and administrative measures in the hospital, such as: humanization; attendance of clientele\'s specialization ; short term hospitalization regime X chronic ness; muldisciplinary intervention x isolated work; physical structure\'s and human resource\'s improvement; environment\'s improvement; therapeutic project implantation; hospital wards\' reduction, due to the attendance of Ministry laws. It leads to the understanding of desinstitutionalization as des-hospitalization. Interviewed\'s speech show articulation in crisis between the psychiatric hospital and the substitutive mental health care net, community based. Workers deal with difficulties in the process of des-hospitalization of patients with serious social problematic. The psychiatric hospital has been the contradiction itself in the current mental health care model in the city of São Paulo and, therefore, in this perspective has in itself many contradictions that come from it\'s own genesis as an institution, added to current condition in which it \"doesn’t exist\" in the net. The psychiatric hospital: the crisis\'s place because the place of contradictions

Este trabalho teve como objetivo identificar os significados que os alunos da escola de educação básica atribuem à atuação dos profissionais de saúde tanto dentro da escola, como nos serviços de saúde que eles frequentam. Trata-se de uma pesquisa qualitativa, fundamentada na abordagem histórico-cultural de Vigotski, que considera o desenvolvimento humano e a construção dos significados culturais a partir das relações sociais. A coleta de dados foi realizada em uma escola de educação básica da rede municipal de ensino do interior do estado de São Paulo. Foram realizados grupos focais com alunos matriculados da escola de educação básica. Participaram da pesquisa 13 alunos de duas turmas do 4º ano do ensino fundamental. Os dados foram transcritos analisados e realizada análise temática proposta por Braun e Clarke. Os resultados encontrados neste trabalho levaram aos seguintes temas: Profissionais da saúde e seu trabalho, Relação com profissionais da saúde, Saúde X Doença, Saúde na escola. A análise aponta que alguns profissionais de saúde são mais citados pelos alunos. As influências externas que os alunos sofreram, como suas vivências e lembranças com os profissionais de saúde, era o que mais determinava o seu olhar sobre o trabalho deles. A ideia curativista sobre o trabalho de profissionais de saúde aparece muito forte e a promoção da saúde dentro das escolas ainda é bem inexpressiva, pois poucas ocorrências foram narradas pelos alunos / This work aimed to identify the significances that the primary education school students attribute to the work of health professionals, both inside the school and in the health services they attend. It is a qualitative research, based on the historical-cultural approach of Vygotsky, which considers human development and the construction of cultural meanings from social relations. Data collection was carried out in a primary education school of the municipal education network, of the interior of São Paulo state. Focus groups were held with students enrolled in the primary education school. Thirteen students from two classes of the 4th year of elementary school participated in the study. The data were transcribed, analyzed and done thematic analysis proposed by Braun and Clarke. The results found in this study led to the following themes: Health professionals and their work, Relation with health professionals, Health X Disease, Health in school. The analysis points out that some health professionals are more cited by the students. The external influences that the students suffered, such as their experiences and memories with health professionals, was what most determined their look on his work. The curativist idea about the work of health professionals appears very prominent and the promotion of health within the schools is still quite inexpressive, because few occurrences were narrated by the students

A discussão sobre “inclusão social" ganha crescente relevância na nossa sociedade. Ela trata do respeito às diferenças, dos direitos e da participação igualitária dos cidadãos. A diversidade de pessoas que evoca essa premissa é imensa, decorrente de aspectos étnicos, sócio-econômicos, sexuais e ligados às necessidades especiais. No caso de crianças com necessidades especiais, particularmente daquelas com deficiências, a inclusão abarca sua participação na sociedade em geral e, especificamente, em instituições de educação regular (“inclusão escolar"). Porém, a despeito da criação de leis e regulamentações, os preconceitos, além da não observância de aspectos como capacitação de educadores e acessibilidade física, dificultam a concretização da inclusão. Considerando a relevância e complexidade do problema e, ainda, que esse processo é freqüentemente mediado por profissionais de saúde, traçou-se como meta estudar a inclusão de crianças com Paralisia Cerebral, com foco nesses profissionais. Indagou-se como eles concebem a e participam da inclusão dessas crianças. Foram investigados os vários profissionais que atendiam duas crianças de três anos, em seguimento em serviços de saúde da região de Ribeirão Preto - SP. O corpus para análise foi obtido por entrevistas semi-estruturadas (neurologista infantil, pediatra, médico de saúde da família, enfermeira, fisioterapeuta, fonoaudióloga, terapeuta ocupacional, psicóloga e assistente social), por visita domiciliar às crianças e famílias e por notas de campo. A coleta e análise foram feitas com base na Rede de Significações. As crianças pivôs - Davi e Letícia - têm comprometimentos decorrentes da Paralisia Cerebral. Porém, cada criança apresenta características distintas. Em Letícia os comprometimentos motores são mais evidentes no lado esquerdo, ela não tem comunicação verbal e usualmente rejeita contato interpessoal. Em Davi a limitação motora é mais evidenciada nos membros inferiores, além disso, ele comunica-se verbalmente e busca o outro. Cada família se organiza e participa no tratamento de maneira bem diversa. A família de Davi é bastante participativa e a de Letícia demonstra-se confusa, quanto ao quadro e tratamento da criança. Os profissionais que atendem às crianças atuam em contextos diversos (serviços públicos primário/secundário/terciário, além de serviços filantrópicos e universitários particulares). Constatou-se que cada contexto proporciona distintas oportunidades aos e práticas discursivas dos profissionais e das pessoas que neles são atendidas, estes aspectos influenciando a forma de atuação com relação à inclusão daquelas crianças. Predominantemente, o olhar destes profissionais é dirigido de maneira descontextualizada à criança individualmente. Porém, tanto as características das crianças, como a organização dos contextos familiares, revelaram-se importantes circunscritores das concepções, expectativas, relações e atuações dos profissionais. A articulação de todos aqueles elementos contribui para circunscrever, para os profissionais, o papel de competente/ impotente frente ao caso, participativo/não-participativo dos processos de inclusão. Ainda, explicita muitas vezes a sobreposição de exclusões, tendo os profissionais dificuldade em lidar com estas situações. Constatamos que o processo de inclusão social e escolar de crianças com Paralisia Cerebral não é algo naturalizado, e sim, a acontecer. E, finalmente, que o processo de inclusão se faz na dialética da inclusão/exclusão das crianças e suas famílias, abarcando situações que nem sempre se dão de maneira digna e decente. / The debate regarding “social inclusion" increasinly acquires relevance in our society. It highlights issues such as respect to differences, common rights and citizens egalitarian social participation. The diversity of groups who evokes the inclusion premise is enormous, mostly related to ethnic, socio-economic, sexual and special needs aspects. In the case of children with special needs, especially those with disabilities, inclusion encompasses their participation in society in general, besides in regular education institutions (“scholar inclusion"). Although there has been the creation of laws and resolutions concerning inclusion, its concretization is being considered as a difficult task, as there are problems such as prejudices, lack of teachers’ training and the presence of architectonic barriers. On account of the relevance and complexity of this issue, besides considering that this processes are usually mediated by health professionals, we set our objective in studying the children with special needs inclusion, focusing on these professionals. The aim is to investigate how health professionals conceive the and participate of the inclusion processes. The various professionals who consult two three-year-old children with Cerebral Palsy were investigated. The emprical data was obtained by semi-structures interviews (child neurologist, pediatrician, family health doctor, nurse, physiotherapist, phonoaudiologist, occupational therapist, psychologist and social assistant), besides domiciliary visit and field notes. Data collection and analysis were made based on the Network of Meanings perspective. The pivot children – Davi and Letícia – have limitations due to the Cerebral Palsy. However, each child presents distinct characteristics. In Letícia, motor limitations are more evident in the child’s left side; besides she does not speak and usually rejects interpersonal contact. In Davi, the motor limitations are highly manifested on the lower limbs; besides, he speaks clearly and he often aims to interact with other people. Regarding the families, both organization and participation in the treatment reveals very diverse characteristics among them. Davi’s family is very much participative, unlikely in Letícia’s family who demonstrates confusion concerning the child’s clinical findings and treatment. The professionals who follow up the children exercise their practices in very diverse contexts (public services - primary, secondary, tertiary -, besides philanthropical and private universitary services). Analysis made evident that, besides the professional graduation, each service context provides distinct opportunities to and discursive practices for the professionals and the families who are attended in that place, constraining diversely the way they conceive and enact regarding those children’s inclusion processes. Predominantly, that professionals act considering the individual child, in a de-contextualized manner. Moreover, the children’s characteristics and the family organization also revealed to be important constraints of the professionals conceptions, expectations, relations and performances. Those elements were undestood to constrain the situation not by themselves, but through their intrinsic articulation, helping to set the professionals on competent/incompetent roles regarding the case; leading them to feel as a participant / not participant in the inclusion processes. Dominantly, it could be identified the superposition of several exclusions, within which the health professionals have difficulties to cope. We have evidenced that the inclusion processes of children with special needs is not a naturalized one, but is continously in development. Finally, it can be said that the children’s and their families’ inclusion processes happen in an inclusion/exclusion dialectics, in which the inclusion situations does not always happen in a decent and respectable manner.

O trabalho em equipe de saúde e enfermagem tem sido apontado como um importante aspecto da organização dos serviços para alcançar a produção do cuidado integral. Assim, o estudo tem como objetivo identificar e analisar as concepções dos profissionais de enfermagem sobre o trabalho em equipe de enfermagem bem como as concepções sobre a prática do cuidado integral e da integralidade à saúde. A pesquisa, de abordagem qualitativa, foi realizada num hospital especializado em oncologia em duas unidades, ambulatório de especialidades e clínica cirúrgica. Foram entrevistadas 21 profissionais, enfermeiras e técnicas de enfermagem e no tratamento do material empírico, utilizou-se a técnica de análise de conteúdo. Os resultados mostram que a concepção de trabalho em equipe de enfermagem é majoritariamente, ação interprofissional e que as entrevistadas elegem como elementos necessários para o trabalho em equipe a comunicação, confiança, vínculo, respeito mútuo, reconhecimento do trabalho do outro e colaboração. Identifica-se a presença de conflitos na equipe de enfermagem que ocorrem predominantemente entre enfermeiras e técnicas de enfermagem e obstaculizam o trabalho em equipe. Os conflitos em sua maioria são decorrentes da ausência de reconhecimento das contribuições das técnicas de enfermagem por parte das enfermeiras e da ausência de colaboração e compartilhamento do plano de cuidados entre as distintas categorias. Quanto às concepções sobre o cuidado integral de enfermagem as entrevistadas o referem como alternativo ao modelo de organização funcional, ancorado na abordagem biopsicossocial e fortalecido pelo modelo de enfermeiro referência. No tocante às práticas de integralidade à saúde identificam-se três categorias, a articulação entre os profissionais da equipe no atendimento do paciente, a articulação dos setores do hospital e a articulação do hospital na rede de atenção à saúde. Conclui-se que o trabalho em equipe de enfermagem caracteriza-se pela estreita interface com as ações desenvolvidas pela equipe interprofissional e que a colaboração e o planejamento dos cuidados de enfermagem realizado em conjunto entre enfermeiras e técnicas de enfermagem podem ampliar a qualidade da assistência de enfermagem com foco nas necessidades de cuidado do paciente. / The teamwork in the health and nursing area has been pointed as an important aspect from services organization seeking for the achievement of the integrated care concept. This study aims to identify and analyze the concepts sustained by nursing professionals concerning the teamwork in the nursing area as well as the concepts related to the practice of an integrated care and comprehensive health care. This qualitative research was developed in two different areas, out patient clinic and surgical clinic, from an oncology specialized hospital. There were 21 professionals interviewed including nurses and the nursing assistants. For the empirical treatment the content analysis technique was used. The results demonstrate that the understanding related to teamwork in nursing is mostly interprofessional practice and the interviewed people point as necessary elements for the teamwork the communication, trust environment, linkage among the professionals, respectful environment and the valorization of the work performed by each of the team members as well as the collaboration along with them. Conflicts mostly between nurses and the nursing assistants can be identified, establishing a barrier for the team work achievement. The majority of the conflicts derive from the lack of valorization from the nurses towards the contributions delivered by the nursing assistants as well as the lack of collaboration and sharing with regards to nursing care plan. With respect to the concept concerning the comprehensive health care the interviewed professionals mention it as an alternative model to functional organization, sustained by the biopsychosocial approach and reinforced by the primary nursing model. With regards to the integrated care practices three categories can be identified: the articulation between the professionals from the team when treating the patient, the articulation from the different sectors in the hospital and the articulation from the hospital in the health care system. It concludes that the nursing teamwork characterizes itself by the strict interface with actions carried out by the interprofessional team and that collaboration and nursing health care planning, performed together both by nurses and the nursing assistants, can increase the quality of the nursing assistance focusing on the patient centered care.

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Thesis (MPH.) --University of Limpopo, 2018 / Background: Obesity and physical inactivity have been reported as the major contributing factors to non-communicable diseases and a public health problem worldwide. According to World health organization the global prevalence of obesity has increased more than doubled between 1980 and 2014. Many healthcare professionals fail to achieve sufficient levels of physical activity and most of them display poor dietary habits. The study conducted in South Africa among health care professionals in urban hospital in Gauteng province confirmed that 20% of them developed at least one NCD of which the contributing factors are obesity and physical inactivity. The aim of the study was to determine the prevalence of obesity and level of physical activity among health care professional in rural hospitals in Sekhukhune district, Limpopo province, South Africa. Methods: A quantitative descriptive study was conducted on 400 HCPs. The global questionnaire was closed ended. GPAQ was used for physical activity and anthropometric measurements were taken for BMI. A stratified random sampling method was used to sample HCPs. Data was analysed using SPSS version 23.0. Results: Most participants were females (71%), majority were between 30-39 years of age (46.3%), the highest category were nurses (77.8%), most of them their job title were assistants (44.5) and blacks (99.3%). The results revealed that 40.8% of HCPs were obese and 30.3% were overweight. Majority of (79.3%) were not engaging on work vigorous PA, however were engaging on work moderate PA. Also (60.5%) were not engaging on leisure vigorous PA, though 55.5% were engaging on leisure moderate PA. Majority (88.3%) had high sedentary (sitting) time. (35.50%) engaged in high activity of walking from one place to the other. In conclusion: There is a need for regular health promotion programmes among health care professionals with regard to obesity and importance of physical activity. The hospitals need to be equipped with onsite fitness centre that will be accessible to all HCPs. Physical activities support groups need to be established such as aerobics classes and fun run. Policies that guide participation in physical activities need to be drawn and be implemented accordingly in health sector, so as to promote healthy living habits. Key words: Obesity, Overweight, Level of physical activity, Health care professionals