Dissertação(mestrado) - Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2005. / Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2012-10-30T16:39:59Z No. of bitstreams: 1 rosylainemoura.pdf: 797486 bytes, checksum: f8f1e0d98ec21266a68ef7cfc6dd4d78 (MD5) / Approved for entry into archive by Bruna Vieira(bruninha_vieira@ibest.com.br) on 2013-06-13T17:12:18Z (GMT) No. of bitstreams: 1 rosylainemoura.pdf: 797486 bytes, checksum: f8f1e0d98ec21266a68ef7cfc6dd4d78 (MD5) / Made available in DSpace on 2013-06-13T17:12:18Z (GMT). No. of bitstreams: 1 rosylainemoura.pdf: 797486 bytes, checksum: f8f1e0d98ec21266a68ef7cfc6dd4d78 (MD5) Previous issue date: 2005 / Este estudo transversal objetivou estudar a prevalência da aderência ao tratamento anti-hipertensivo nos usuários das unidades de saúde da família em relação aos usuários das unidades básicas de saúde. Objetivou-se, ainda, descrever os fatores relacionados a esta aderência e comparar algumas características entre os dois tipos de unidade. Para isso, foram entrevistados 240 hipertensos(120 em cada tipo de unidade) com no mínimo 40 anos, com diagnóstico médico de hipertensão há pelo menos um ano, com prescriçãomédica para o uso de medicamento antihipertensivo há pelo menos um ano. Considerou-se usuário aquele que há pelo menos um ano está utilizando ou já utilizou (no caso específico das unidades de saúde da família), no mínimo um dos serviços disponíveis para o tratamento da hipertensão em uma das cinco unidades de saúde da família ou em uma das cinco unidades básicas de saúde selecionadas pelo estudo. A aderência ao tratamento medicamentoso foi medida através do Questionário Simplificado para Aderência à Medicação – SMAQ (KNOBEL, 2002). Para análise dos dados (bivariada e multivariada) foram utilizados o teste de qui-quadrado e regressão Poisson. Obtevese como resultado uma prevalência de aderência ao tratamento medicamentoso de 50% para toda a amostra. Não foi observada diferença entre as prevalências de aderência nas unidades estudadas (50% em ambas). Apesar disso, os usuários das unidades de saúde da família mostraram ter mais informações à respeito da doença e do tratamento. Os hipertensos de cor de pele branca e que vivem sem companheiro e com filhos mostraram ter mais probabilidade de aderir ao tratamento medicamentoso do que os de pele não-branca e que vivem com companheiro e filhos, respectivamente. / The objective of this transversal study is to study the prevalence of adherence to the anti-hypertensive treatment in users of the family health units in relation to the users of the basic health units. Another objective was to describe the factors related to this adherence and compare some characteristics between the two types of health units. In order to do this, 240 hypertensive people were interviewed (120 in each type of unit), of at least 40 years-old, and with a medical diagnosis of at least one year of hypertension, and to whom anti-hypertensive medication had been prescribed for at least one year. Were considered users those who, for at least one year, have been using or have used (in the specific case the family health units) one of the services available for the hypertension treatment in one of the five family health units or in one of the five basic health units selected for the study. The adherence to the salutary treatment was measured through the Simplified Questionnaire to Medicine Adherence – SMAQ (KNOBEL, 2002). For analysis of the data (bivariada and multivariada) the qui-square test and regression were used Poisson. It was obtained as result the adherence prevalence to the salutary treatment to the entire samples was of 50%. There were not differences observed to the adherence prevalence in the units studied (50% in both). In spite of that, the users of the family health units showed to have more information in respect to the disease and the treatment. The hypertensive people of white color skin and that live alone with the children show that are more likely to adhere to the medical treatment than those non-white that live with a spouse and children, respectively. / Este estudio transversal objetivo estudiar la prevalecía de la adherencia al tratamiento antihipertensivo en los usuarios de las unidades de salud de la familia con relación a los usuarios de las unidades básicas de salud. Se objetivo, todavía, describir los factores relacionados a esta adherencia y comparar algunas características entre los dos tipos de unidad. Para eso, fueron entrevistados 240 hipertensos (120 en cada tipo de unidad) con una edad mínima de 40 años, con diagnóstico médico de hipertensión hace por lo menos un año, con prescripción médica para el uso de medicamento antihipertensivo hace por lo menos un año. Se consideró usuario aquel que hace por lo menos un año está utilizando o ya ha utilizado (en el caso específico de las unidades de salud de la familia), en lo mínimo un de los servicios disponibles para el tratamiento de la hipertensión en una de las cinco unidades de salud de la familia o en una de las cinco unidades básicas de salud seleccionadas por el estudio. La adherencia al tratamiento medicamentoso fue medida a través del Cuestionario Simplificado para Adherencia a la Medicación – SMAQ (KNOBEL, 2002). Para analice de los dados (bivariada y multivariada) fueron utilizados o teste de qui-quadrado y regresión Poisson. Se obtuve como resultado una prevalecía de adherencia al tratamiento medicamentoso de 50% para toda la muestra. No fue observada diferencia entre las prevalecías de adherencia en las unidades estudiadas (50% en ambas). Además, los usuarios de las unidades de salud de la familia mostraron tener más informaciones respecto a la enfermedad y del tratamiento. Los hipertensos de color de piel blanca y que viven sin compañero y con hijos, mostraron tener más probabilidad de adherir al tratamiento medicamentoso del que los de piel no blanca y que viven con compañero y hijos, respectivamente.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-10-05T15:43:17Z No. of bitstreams: 1 marinamonteirodecastrecastro.pdf: 837007 bytes, checksum: 8accec4d823f8cadabfbd810ac05a27f (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-10-06T12:30:20Z (GMT) No. of bitstreams: 1 marinamonteirodecastrecastro.pdf: 837007 bytes, checksum: 8accec4d823f8cadabfbd810ac05a27f (MD5) / Made available in DSpace on 2016-10-06T12:30:20Z (GMT). No. of bitstreams: 1 marinamonteirodecastrecastro.pdf: 837007 bytes, checksum: 8accec4d823f8cadabfbd810ac05a27f (MD5) Previous issue date: 2009-04-15 / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / O presente estudo aborda o trabalho do assistente social na atenção primária à saúde em Juiz de Fora/MG no que se refere a sua organização e desenvolvimento, objeto, objetivos e instrumentos, e às condições de trabalho. O estudo foi construído a partir da compreensão de que o trabalho em saúde está situado na esfera dos serviços e que se efetiva na relação entre trabalhador/ usuário. Na atenção primária à saúde este trabalho adquire especificidades por este nível de atenção ser a porta de entrada dos serviços de saúde e ser uma estratégia de organização do sistema de saúde. O assistente social, por sua vez, se insere no trabalho em saúde atuando sobre os determinantes sociais que envolvem o processo saúde-doença com a perspectiva de atender as necessidades dos usuários. A metodologia utilizada teve como base a abordagem qualitativa e o método crítico-dialético. A pesquisa de campo foi realizada com nove assistentes sociais que estão inseridos em Unidades Básicas de Saúde Tradicionais, com Programa de Saúde da Família e com Programa de Residência em Serviço Social, no município de Juiz de Fora. Os resultados do estudo demonstraram que na saúde, os assistentes sociais, atuam no campo do trabalho vivo, uma vez que possuem uma relação direta com os usuários. O diferencial do seu trabalho está relacionado com a predisposição ao trabalho em equipe, a vinculação com os usuários, e o desenvolvimento de projetos de educação em saúde. Apesar dos desafios postos pela conjuntura neoliberal (adversa à consolidação e expansão de direitos sociais), o profissional de Serviço Social é cotidianamente desafiado a buscar alternativas competentes e criativas, explorando as possibilidades existentes na realidade e fortalecendo o caráter democrático dos serviços públicos de saúde. A realização desta dissertação visou trazer a tona uma reflexão sobre o trabalho dos assistentes sociais na atenção primária à saúde em Juiz de Fora, como também o fomento das discussões sobre a inserção do Serviço Social no trabalho em saúde. / This study focus on the role of the Social worker in Primary Assistance Health in Juiz de Fora - Minas Gerais concerning to: its organization, development, objective and used tools, the main object and work conditions. The study understands that the work in Health is located in the area of services and it relays on the relationship between worker/customer. Furthermore in Primary Health attendance, the Social Work is the front door of the Health Services and a strategy to the organization for Health System. The Social Workers include themselves in Health by acting on the social determinants that involves the health-illness process, and aims to achieve customers needs. It was used a qualitative approach and a dialectical critical methodology. The survey has been done with 9(nine) Social workers in Traditional Basic Health Units, dealing with Family Health Program and the Residence Formation in Social Service of Juiz de Fora Municipality. The results have shown that workers in Social Area deal with a lively field due to be in a direct relationship with customers. The main point of their work is to be able to work in multidisciplinary teams, the contact with customer and carry on Health Educational Projects. In spite of the challenges presented by the neo-liberal economy (which is adverse to the consolidation and expansion of social rights), Social Workers face the daily challenge to search for viable and creative alternatives, seeking out actual possibilities and strengthening the democratic character of public health care services. This presentation aims to have a reflection over the Social Workers in Primary Health in Juiz de Fora as well as to increase the discussions about the Social Service in Health Area.

À partir de l’étude ethnographique de la maladie en milieu arakanais, cette thèse réfléchit sur le rapport individu-cosmos et sur le caractère pluriel, hybride et intégrateur de ce rapport. Une telle approche, innovatrice pour la Birmanie, s’éloigne de toute catégorisation et suggère en revanche que la médecine locale, la médecine d’origine occidentale, le bouddhisme Theravāda, l’astrologie, etc. forment un seul et même système de conceptualisation et de maîtrise de l’état de santé comme fruit du rapport au cosmos. La problématique développée s’appuie sur le postulat selon lequel la cohérence structurelle de l’ensemble – de son hybridité et de sa souplesse – réside dans le fait que les composantes sont liées entre elles par des rapports hiérarchiques et complémentaires. La hiérarchie, visible principalement dans l’hégémonie du référent bouddhique, est nuancée par le fait qu’aucune composante, y compris le bouddhisme, ne se suffit à elle même ; il y a toujours des restes qui échappent et qu’il revient à d’autres composantes de concevoir ou de gérer. Quant au caractère intégrateur du système, il est ici montré à travers l’exemple de la biomédecine dont l’intégration n’a été rendu possible qu’à travers de nécessaires adaptions du système lui-même. La thèse est organisée en cinq parties : la première est dédiée aux conceptions de la maladie ; la seconde partie est consacrée aux approches mises en œuvre par les villageois en vue de maintenir l’équilibre à tous les niveaux ; les troisième et quatrième parties portent sur la diversité des thérapeutes, de leurs formations et de leurs pratiques – aussi bien en termes de prévention que de soin – et de leur statut social ; la cinquième et dernière partie est quant à elle consacrée aux itinéraires multiples et complexes des malades. / Based on the author’s personal ethnographic research on sickness-related conceptions and practices in an Arakanese context, this thesis examines the relationship between the individual and the cosmos with particular emphasis on the plural, hybrid and integrating nature of such relationship.This approach, rejecting any form of categorisation, represents an innovation in the context of Burma and suggests that both Burmese and Western medicine, as well as Buddhism, astrology, spirit cult, etc. form a single system of conceptualisation and management of the state of health as a fruit of the relationship with the cosmos. The central point of this structure – its hybridity and plasticity – relies on the fact that the links between the various components are hierarchical and complementary. The hierarchy, notably the hegemony of Buddhism at various levels (conceptual, practical and of values) is counterbalanced by the fact that no component is enough to cope with all factors; there is always something missing, a remainder that other components can conceive and manage. The integrative nature of the system is showed through the example of western medicine, whose integration has produced some changes in the previous system.This thesis is structured in five parts : the first part is dedicated to sickness related conceptions, the second one to the practices the villagers rely upon in order to maintain the balance at all levels, while the third and the forth parts examine different kind of healers, their trainings, their (preventive and healing) practices and their social status; finally in the last one, health seeking behaviours of sick people are discussed.

The diploma thesis deals with OSH management and related audit. The research handles the requirements of national and international health and safety legislation. The risk analysis and its evaluation are performed. Corrective action is proposed in justified cases.

Eugenics movements developed early this century in more than 20 countries, including Australia. However, for many years the vast literature on eugenics focused almost exclusively on the history of eugenics in Britain and America. While some aspects of eugenics in Australia are now being documented, the history of this movement largely remained to be written. Australians experienced both fears and hopes at the time of Federation in 1901. Some feared that the white population was declining and degenerating but they also hoped to create a new utopian society which would outstrip the achievements, and avoid the poverty and industrial unrest, of Britain and America. Some responded to these mixed emotions by combining notions of efficiency and progress with eugenic ideas about maximising the growth of a white population and filling the "empty spaces". It was hoped that by taking these actions Australia would avoid "racial suicide" or Asian invasion and would improve national fitness, thus avoiding "racial decay" and starting to create a "paradise of physical perfection". This thesis considers the impact of eugenics in Australia by examining three related propositions: 1. that from the 1910s to the 1930s, eugenic ideas in Australia were readily accepted because of concerns about declining birth rate; 2. that, while mainly derivative, Australian eugenics had several distinctive Australian qualities; 3. that eugenics has a legacy in many disciplines, particularly family planning and public health. This examination of Australian eugenics is primarily from the perspective of the people, publications and organisations which contributed to this movement in the first half of this century. In addition to a consideration of their achievements, reference is also made to the influence which eugenic ideas had in such diverse fields as education, immigration, law, literature, politics, psychology and science.

Eugenics movements developed early this century in more than 20 countries, including Australia. However, for many years the vast literature on eugenics focused almost exclusively on the history of eugenics in Britain and America. While some aspects of eugenics in Australia are now being documented, the history of this movement largely remained to be written. Australians experienced both fears and hopes at the time of Federation in 1901. Some feared that the white population was declining and degenerating but they also hoped to create a new utopian society which would outstrip the achievements, and avoid the poverty and industrial unrest, of Britain and America. Some responded to these mixed emotions by combining notions of efficiency and progress with eugenic ideas about maximising the growth of a white population and filling the "empty spaces". It was hoped that by taking these actions Australia would avoid "racial suicide" or Asian invasion and would improve national fitness, thus avoiding "racial decay" and starting to create a "paradise of physical perfection". This thesis considers the impact of eugenics in Australia by examining three related propositions: 1. that from the 1910s to the 1930s, eugenic ideas in Australia were readily accepted because of concerns about declining birth rate; 2. that, while mainly derivative, Australian eugenics had several distinctive Australian qualities; 3. that eugenics has a legacy in many disciplines, particularly family planning and public health. This examination of Australian eugenics is primarily from the perspective of the people, publications and organisations which contributed to this movement in the first half of this century. In addition to a consideration of their achievements, reference is also made to the influence which eugenic ideas had in such diverse fields as education, immigration, law, literature, politics, psychology and science.

The thesis describes the role of public relations and communication in the health sector and points at its specifications and differences if compared to the profitable sectors. The thesis analyses the current level of the issue in the Czech Republic, including legal and ethical perspectives of a health institution. The first part of the thesis explains the theory of the public relations and communicaiton sectors and includes a concise description of the health sector. The second part deals with internal, external and crisis communication of individual hospitals and institutions and analyses them through the method of qualitative research. Aside from other aspects, I describe pratical operation of public relations, usage of media communication tools in practice at individual health institutions. In addition to this, target audience, the public and the importance of a good reputation of a hospital have been defined in this part.

Detta är en fördjupande studie baserat på en kvantitativ folkhälsoundersökning som visade samband i särskilt utsatthet bland förekomst av vilka som allvarligt övervägt självmord och demografiska faktorer hos folkbokförda i Umeå. Byggt på premissen av det pågående suicidpreventiva arbetet i Umeå tar denna studie i anspråk att utforska vilka livsomständigheter som skiljer sig åt mellan den generella populationen i Umeå jämfört med de som allvarligt övervägt självmord, samt föreslå suicidpreventiva åtgärdsförslag utifrån resultaten.    Data som omsattes i denna studie var ursprungligen insamlat av Övergripande planering Umeå kommun genom ett stratifierat urval som svarade mot olika demografiska områden av Umeå som resulterade i 2588 svaranden, med en svarsfrekvens av 37% som deltog i en folkhälsoundersökning som omfattade 102 frågor vilka var kvalitetskontrollerade av SCB.  Studieförfattarna utformade en metod för att skala ner urvalet av livsomständigheter till 15 variabler som skulle överensstämma med studiens teman: demografi, ekonomiska förutsättningar, vanor, mående och stöd som alla ställdes mot frågan: “Har du allvarligt övervägt självmord?”, där 10,7% av de tillfrågade svarade affirmativt. Slutsatser av denna studie är att undersökta livsomständigheter såsom socioekonomiska faktorer, vanor, demografiska faktorer, mående och stöd indikeras vara relaterade till en högre förekomst av att ha allvarligt övervägt självmord för folkbokförda i Umeå. Bland annat visas fulltidsanställda vara 22,9% mindre sannolika- där studerande är mer än dubbelt så sannolika- där personer som har sjuk- eller aktivitetsersättning var 444,9% mer sannolika att allvarligt ha övervägt självmord. Svaranden anger oftare sämre sömn (42,9% jämfört med 70,7%) hos de som allvarligt övervägt självmord. 77,4% av svaranden med ångestrelaterade svårigheter- 43,0% av svaranden med behov av psykisk vård som inte sökt- och 56,4% av svaranden med psykiska funktionshinder uppger att de allvarligt övervägt självmord jämfört med 10,7% hos generella svaranden. Utifrån studiens resultat föreslår studieförfattarna kompletterande lokala suicidpreventiva åtgärder, men finner behov av åtgärder med nationellt omfång för att svara mot de bredare socioekonomiska- och sociala problem som premissen och resultatet av denna studie belyser. / This is an in-depth study based on a quantitative public health survey which raised cause for concern about sociodemographic differences in occurrence of who has seriously considered suicide in the municipality of Umeå. Following the premise built on the current suicide prevention work in Umeå this study aims to give insight on which living circumstances differ regarding those with suicidal ideation in Umeå compared to the general population and what proposed actions might be indicated from the results.   The data used in this study was originally sampled by Övergripande planering, Umeå municipality using a stratified selection of different demographics in Umeå resulting in 2588 participants, an answer rate of 37% who answered a public health survey consisting of 102 questions, which was quality checked by SCB.   By process of elimination finding relevant living circumstances the authors designed a method of selection resulting in 15 variables consistent with the subtypes: demographics, economical circumstances, habits, health and support, all of which to correlate with the question translated to: “Have you seriously considered suicide?” where 10,7% of respondents answered positively.   Conclusions from this study are that certain life circumstances such as socioeconomic factors, habits, demographic factors, well-being and support is indicated being related to a higher prevalence of having seriously considered suicide amongst habitants of Umeå. Key findings include full-time employed was 22,9% less likely-, where students were more than two times more likely- and people on welfare or sick leave were 444,9% more likely to have seriously considered suicide. Respondents are less likely to have a good nights sleep (42,9% compared to 70,7%) if they have seriously considered suicide. 77,4% of those with anxiety-related issues, 43,0% of those in need of medical care for psychological health and 56,4% of respondents with psychological disability responds to have seriously considered suicide compared to the average of 10,7%. The authors provide examples of local implementations based on the findings but arrive at the need for a national scope to come to terms with the wider socio-economic and social issues that is suggested by the premise and result of this study.

Introduction: Vulnerable European Union citizens (vulnerable EU citizens) are those who come to Sweden from EU member states. In Sweden the term “vulnerable EU citizens” is associated with the word “beggars”, which in turn is associated with Roma people. By November 2015 the number of vulnerable EU citizens in Sweden was estimated to be 4 700. The majority of these were from Romania. Roma as citizens of an EU member state have the right to reside in EU countries in accordance with the EU’s freedom of movement rights concept for up to but no longer than three months. However, to obtain the right for residence after three months, proof of financial resources and health insurance are required. Lacking these resources, vulnerable EU citizens have subsequently lost their right for residence and therefore became undocumented. They often find themselves in the same situation as undocumented migrants from outside the EU, having poor health outcomes and limited access to health care. In my study I aim to explore access to health care for vulnerable EU citizens in Umeå, a city in eastern Sweden. Methods: A qualitative design methodology has been applied in this thesis. Those contacted for this study were; Doctors of the World, Health on Equal Terms, Staff for planning and control Västerbotten Region, University Hospital of Umeå and representatives of vulnerable EU citizens’ community from Romania in Umeå. Seven in-depth interviews were collected with professionals and volunteers from these organisation/institutions and members of vulnerable EU citizens’ community. Questions were asked about their experience and knowledge regarding access to health care for vulnerable EU citizens. Data was analyzed using qualitative content analysis. Results: Three main categories and one final theme were developed during data analysis. The first category “Difficult to access health care for vulnerable EU citizens in Sweden without European Health Insurance” elaborates the dependence of vulnerable EU citizens’ access to health care on having health insurance, specifically European Health Insurance and National Health Insurance. It also describes what kind of access to health care vulnerable EU citizens have in Sweden. The second category “Decision about how much access to health care provide for vulnerable EU citizens lies on medical personnel” discusses the situation of health care personnel when they treat vulnerable EU citizens in hospitals. The third category “Organisations, Doctors of the World and Health on Equal Terms, mediate connection between vulnerable EU citizens and hospitals, so they can have their right to health fulfilled” elaborates about the role the organisation plays when vulnerable EU citizens are in need of health care. After grouping categories and looking at the data from more interpretive, abstracted higher level, the final theme was created “Lack of attention from the national and international levels to the situation of vulnerable EU citizens’ access to health care”. Conclusion: This study highlights the difficulty for vulnerable EU citizens to access health care in Umeå if they do not have European Health Insurance. Being treated as undocumented migrants is the only way they have access to emergency services. Health care personnel feel insecure when treating vulnerable EU citizens, because there are no clear guidelines when vulnerable EU citizens can be treated as undocumented migrants as well as what is included in the clause “the care that cannot wait”. Because of this situation, vulnerable EU citizens sometimes are not able to receive the medical help they need. Organisations, Doctors of the World and Health on Equal Terms, help to mediate the connection between vulnerable EU citizens and hospitals which helps them to access the health care and fulfille their right to health. Lack of attention from the national as well as international governments to this situation is found to be important factor influencing vulneralbe EU citizens’ access to health care

Luis Calandre Ibáñez (Cartagena 23/3/1890-Madrid 29/9/1961), estudió Medicina en Madrid, siendo discípulo de Cajal, Achúcarro y Madinaveitia en Madrid y de Nicolai y Benda en Alemania. Realizó estudios de Histología sobre la esructura de la fibra cardiaca, para comprender mejor la fisiopatología del corazón, campo de su especial dedicación, siendo uno de los introductores de la electrocardiografía en España, estudiando especialmente los trastornos del ritmo basándose en ella.Fundó y dirigió el Laboratorio de Anatomía Microscópica de la Residencia de Estudiantes (1914-1931). Fue Jefe del Servicio de Cardiología del Hospital Central de la Cruz Roja y Director del Hospital de Carabineros durante la guerra civil (1937.1939). Publicó más de setenta artículos en revistas especializadas y ocho libros de contenido científico. Fundó y dirigió la revista "Archivos de Cardiología y Hematología" (1920-1936). Desarrolló una intensa labor social, política y cultural y al finalizar la guerra civil fue procesado y condenado padeciendo el exilio interior y el olvido científico. / Luis Calandre Ibáñez (Cartagena 1890-Madrid 1961), studied medicine in Madrid, where he was a disciple of Cajal, Achúcarro and Madinaveitia and then of Nicolai and Benda in Germany. He specialised in cardiac physiopathology, and studied histology on the struc Civil war. He published more than seventy articles in specialist journals and eightscientificbooks. He founded and directed the journal "Archivos de Cardiología y Hematología" (1920-1936). Intensely involved in social, political and cultural activities, he was tried and sentenced at the