In 2016, prostate cancer was the second leading cause of fatality in the United States. However, the population in this study 'Black American men, ages 40 and older, in selected counties in Fulton, DeKalb, Gwinnett, Clayton and Atlanta metropolitan areas' tended to underutilize prostate cancer care. The purpose of this quantitative, nonexperimental descriptive study was to determine whether socio-economic barriers and perceptions of Black American men about prostate cancer reduce their ability to access quality care in this county in Georgia. The Health Belief Model (HBM) was used to inform the predictive validity of perceptions, attitudes, and belief on individual health behaviors. Data were collected from 303 men through online and mailed researcher-made surveys that had been piloted using the demographic/medical background instrument; data from these surveys were then analyzed using frequency distribution and analysis of variance, coupled with Tukey's honest significant difference test. According to the results, 90% of the respondents stated that early detection and treatment were a perceived benefit of undergoing prostate cancer screening, and respondents perceived early detection, early treatment, and the reduced chance of dying from prostate cancer as the main reasons for undergoing the screening. A potential social significance to this study is that it provides information to health care providers and policy makers to better understand the patterns of Black American men and their motivation to seek early prostate cancer screening. Early screening could reduce costs, both economically and socially, associated with late diagnosis of this disease.

Parameter estimation of respiratory infection surveillance dynamics commonly utilize data aggregated over space and time. However, estimates derived from aggregated data may fail to account for biologically meaningful spatiotemporal heterogeneity of effects or to identify where and when transmissions occur. This dissertation shows that high-resolution temporal and spatial data can improve our understanding of heterogeneity while producing more valid and precise estimates of transmission parameters (e.g., contagiousness), behavioral trends (e.g., face mask utilization), and intervention effects (e.g., at-home test distribution). In three projects, we evaluate spatiotemporal heterogeneity in the context of two major respiratory pathogens: Tuberculosis and SARSCoV-2. First, in project one, we identify disease transmission hotspots from a tuberculosis case surveillance system in Greater Vitória, Brazil. Utilizing a human mobility model and recently developed method to quantify disease transmission, we overcome multiple methodological constraints that often obscure spatially and temporally accurate transmission measurements. We estimate that two cities in Greater Vitória, Vila Velha (reproductive number = 1.05, 95%CI: 1.03–1.07) and Vitória (reproductive number = 1.04, 95%CI: 1.02–1.06), help sustain tuberculosis transmission in the entire region and may be effective targets for intervention, while Cariacica (reproductive number = 0.95, 95%CI: 0.94–0.97) fell below the critical threshold of 1 required to sustain transmission alone. Next, in project two, we utilize interrupted time series methods to estimate the effect of mask mandates on mask adherence using a nationally representative digital health survey on masking and a comprehensive database of pandemic-related government policies. The analysis focuses on improving previous attempts at measuring the effectiveness of mask mandates at the state level, by utilizing county-level exposure and outcome data. We find that mask mandates were associated with a large heterogeneity of effects, ranging from increasing masking approximately 8% in counties with low levels of prior masking to 1% or lower change in masking in places like the Northeast U.S. where masking levels were already high. Last, in project three, we leverage the same nationally representative digital health survey to understand at-home testing patterns in the United States. We utilize two different economic measures of resource allocation and a regression model with autoregressive integrated moving average errors to examine if the Covidtests.gov government program reduced at-home testing inequities. We show that Covidtest.gov did increase at-home testing across all demographics; however, income-, geographic- and race-based disparities in at-home test utilization were heightened during periods when the program was active. Specifically, the regression results estimate that Theil’s T, an economic metric used here to measure at-home testing disparities, was 53% (95%CI: 6%–121%) higher for household income, 214% (95%CI: 86%–429%) higher for race, and 90% (95%CI: 23%–193%) higher for geography during Covidtest.gov dissemination periods. Disparities were not elevated for age. Together, these three projects demonstrate the substantial role that high-resolution data can play in improving our understanding of respiratory infection surveillance and informing effective public health interventions.

Submitted by admin tede (tede@pucgoias.edu.br) on 2016-11-29T12:10:22Z No. of bitstreams: 1 JOÃO ALCIONE CARDOSO SANTOS.pdf: 2045029 bytes, checksum: 7f9f2c4810fbd94b17606435feab0766 (MD5) / Made available in DSpace on 2016-11-29T12:10:22Z (GMT). No. of bitstreams: 1 JOÃO ALCIONE CARDOSO SANTOS.pdf: 2045029 bytes, checksum: 7f9f2c4810fbd94b17606435feab0766 (MD5) Previous issue date: 2016-09-29 / There are major remaining obstacles to consolidation of programs, policies and actions involving assistance, promotion, monitoring and prevention of work related diseases. Changes are needed in the work process covering the health-work relations in all of its complexity. The creation Integrated Attention to Workers’ Health Subsystem (SIASS) structuring base of the Attention to Health and Safety of Federal Civil Workers Policy (PASS) emerges with the task of ensuring sustainability and effectiveness through work management. This dissertation, Occupational Health in the Federal Public Service: Challenges the policies of health care and work safety at the University Hospital context, aims to analyze the effectiveness of the policies on health and safety in implementation by the Federal Government in the context of the University Hospital at the Federal University of Goias (HC/UFG). We sought to understand and analyze the social, economic, technological organization influencing the process of disease in the workers. To support the debate on the existing conceptual differences of workers’ health; health and work; and genre and work, theoretical references of researchers have been studied. We also sought to further the principles, objectives and guidelines of established public policies of health and safety as reference. This study is presented methodologically as a quantitative and qualitative research. The methodological procedure as the objective of this study was an exploratory research. The research location was chosen mainly because the University Hospital (HC/UFG) has the largest number of absences due to sickness in the Federal University of Goias. A proportional stratified probability sampling of simple random type was performed. The study population consisted of 986 effective workers linked to the Unitary Judicial Regime and 131 workers were selected to participate. As for the data collection, two questionnaires were especially developed with objective and subjective questions. One questionnaire was used for the technical and administrative staff of the University Hospital/ UFG, and the other was applied to the managers at SIASS/ UFG. The review of specialized literature, documental research, and field research, all contributed with the reflection and analysis of data. A discussion was sought out about the perception aspects of technical and administrative staff; managers of SIASS/UFG, as the executing agency of the institution analyze the development and implementation of PASS. Regarding the profile of those involved in the research, there’s a prevalence of women with 79% aged between 41 and 60 years, with 71% prevalence of qualified education, 90% did not undergo periodic examinations, and 56%of respondents with double employment bond. The analysis of data infers that the implementation of Federal Health Care Policy is unsatisfactory relating to Public Workers in the University Hospital/UFG regarding health promotion and work safety, and it has been unable to cope with sickness of the workers. / Persistem grandes obstáculos à consolidação de programas, políticas e ações envolvendo assistência, promoção, vigilância e prevenção dos agravos relacionados ao trabalho. São necessárias mudanças nos processos de trabalho que contemplem as relações saúde-trabalho em toda a sua complexidade. A criação do Subsistema Integrado de Atenção à Saúde do Servidor (SIASS), base estruturante da Política de Atenção à Saúde e Segurança do Trabalho do Servidor Público Federal (PASS), surge com a tarefa de garantir sustentabilidade e efetividade através do gerenciamento de trabalho. A presente dissertação, Saúde do Trabalhador no Serviço Público Federal: desafios para uma política de atenção à saúde e segurança do trabalho no contexto de hospital universitário tem o objetivo de analisar a efetividade da política de atenção à saúde e segurança do trabalho em implementação pelo governo federal no contexto do hospital universitário da Universidade Federal de Goiás (HC/UFG). Buscou-se compreender e analisar os fatores sociais, econômicos, tecnológicos, organizativos que influenciam o processo de adoecimento desses servidores. Para subsidiar o debate sobre as diferenças conceituais existentes sobre a saúde do trabalhador, saúde e trabalho e gênero e trabalho, estudou-se referenciais teóricos de pesquisadores da área. Buscou-se ainda os princípios, objetivos e diretrizes das políticas públicas instituídas de Saúde e Segurança como referência. Este estudo se apresenta metodologicamente como uma pesquisa quanti-qualitativa. O procedimento metodológico quanto ao objetivo nesse estudo foi pesquisa exploratória. A escolha deste local para ser pesquisado ocorreu devido à unidade Hospital das Clínicas/UFG possuir o maior número de afastamentos por adoecimentos no âmbito da Universidade Federal de Goiás. Foi realizada uma amostragem probabilística estratificada proporcional do tipo aleatória simples. A população do estudo foi constituída de 986 servidores do quadro efetivos, vinculados ao Regime Jurídico Único e selecionados 131 servidores participantes. Para o instrumento de coleta de dados utilizou-se dois questionários especificamente desenvolvidos para este estudo, elaborados com questões abertas e fechadas para aplicação de um questionário aos servidores técnico-administrativos do Hospital das Clínicas/UFG e outro questionário específico aplicado aos gestores do SIASS/UFG. A revisão da literatura especializada, a pesquisa bibliográfica, a pesquisa documental e a pesquisa de campo contribuíram na reflexão e na análise dos dados. Procurou-se discutir os aspectos relativos à percepção dos servidores técnico-administrativos da PASS e ainda como os gestores do SIASS/UFG, enquanto órgão executor da instituição, analisam o desenvolvimento/implementação da PASS. O perfil dos pesquisados há predominância de mulheres com 79%, faixa etária entre 41 e 60 anos com 71%, predominância de escolaridade qualificada, 90% não realizaram exames periódicos e duplo vínculo de servidores técnicos 56% dos pesquisados. A analise dos dados permitem inferir que a implementação da Política de Atenção à Saúde do Servidor Público Federal, no contexto do Hospital Universitário/UFG é insatisfatória como instrumento de promoção à saúde e segurança do trabalho e não tem sido capaz de enfrentamento do processo de adoecimento dos servidores.

O presente estudo objetivou caracterizar e analisar o acesso às Órteses, Próteses e Meios Auxiliares de Locomoção (OPM) no Sistema Único de Saúde de uma microrregião de saúde do município de São Paulo - SP. Trata-se de um estudo de abordagem quantitativa e qualitativa, acontecendo em duas etapas. Uma primeira de desenho metodológico transversal, retrospectivo e exploratório com dados de prontuários de usuários que tiveram OPM prescrita para um Centro Especializado em Reabilitação (CER) no período de janeiro de 2015 a dezembro de 2017. Uma segunda de abordagem qualitativa por meio de grupos de discussão com profissionais e gestores de serviços da atenção básica e especializada do território para a constituição de um Fluxograma Analisador para a concessão de OPM e por meio de entrevistas não diretivas com usuários de OPM indicados por profissionais da atenção básica para a constituição de Itinerários Terapêuticos. Com distribuição não normal dos quantitativos, foi utilizado o teste Kruskal-Wallis para análise da diferença entre as medianas, sendo considerado estatisticamente significativo um p <= 0,05. Técnicas de Fluxograma Analisador e de Análise de Conteúdo foram utilizadas para análises dos dados qualitativos. Na análise de 729 prontuários, houve uma predominância da filantropia no processo para concessão de OPM, sendo que 51,9% dos dispositivos foram dispensados pela instituição filantrópica conveniada. Porém, isto vem diminuindo, sendo que em 2017, 74,9% dos dispositivos solicitados foram dispensados pelo próprio CER. Não se observou um incremento no número de dispositivos dispensados no período, mas redução do tempo de dispensação com significância estatística e o CER levou em média 4,3 para dispensar dispositivos. Observa-se um fluxo pactuado entre os profissionais e serviços para concessão de OPM com algumas lacunas apontadas por profissionais e usuários na comunicação entre CER e atenção básica sobre recebimento do dispositivo pelos usuários e a respeito dos fluxos de reparos e manutenção. Conclui-se que há ainda predominância da filantropia no processo para fornecimento de OPM. Observou-se redução do tempo de dispensação de dispositivos, mas não acompanhado de aumento no acesso a eles no período e região estudados. Nota-se também um fluxo pactuado entre profissionais e serviços, porém com ausência de um fluxo de reparo e manutenção de OPM no território / The present study aimed to characterize and to analyze the access to Orthosis, Prosthesis and other Mobility Aids (OPM) in the Unified Health System of a micro region of health of São Paulo city. It is a study with quantitative and qualitative approach, which happened in two steps. The first cross-sectional, retrospective and exploratory with data of medical records of OPM users who had OPM prescribed to a Specialized Center in Rehabilitation (CER) in the period from January 2015 until December 2017. A second of qualitative approach by means of discussion groups with professionals and managers of primary care and secondary specialized care services of territory to the constitution of Analyzer Flowchart to the OPM grant and by means of non-directive interviews with OPM users who were indicated by primary care professionals to the constitution of Therapeutic Itineraries. With a non-normal distribution of quantitative data, the Kruskal-Wallis test to analyze of difference between the medians was used, being considered statistically significant p <= 0.05. Techniques of Analyzer Flowchart and Content Analyze were used to qualitative data analysis. In the analyze of 729 medical records, there was predominance of philanthropy in the process to OPM grant, being that 51.9% of devices were dispensed by agreed philanthropic institution. However, this has decreasing, being that in 2017, 74.9% of requested were dispensed by CER itself. It was not observed an increase in the number of dispensed devices in the period, but decrease of dispensation time with statistical significance, and the CER took in average 4.3 months to dispense devices. It is observed a flow agreed between the professionals and users to OPM grant with some gaps pointed by professional and users in the communication between CER and primary care about receipt of device by users and with respect the flows of repair and maintenance. It is conclude that there was decrease in the dispensation time of devices, but not accompanied of increase in the access to them in the period and region studied. It is also noted a flow agreed between professional and services, but with no a flow of repair and maintenance of OPM in the territory

The most common and enduring explanation for the way research is used (or abused or not used) in policy is the ‘two communities’ theory. According to this theory, the problematic relationship between research and policy is caused by the different ‘cultures’ inhabited by policy makers and researchers. The most common and enduring types of strategies that are put forward to increase research use in policy involve bridging or linking these ‘two communities’. This study challenges this way of thinking about the relationship between research and policy. Four case studies of national public health policy in Australia—breast cancer screening, prostate cancer screening, needle and syringe programs in the community, and needle and syringe programs in prisons—are used to present the context, events, processes, research, and actors involved in policy making. Three theories are deployed to explore the relationship between research and policy in each of the cases individually and across the cases as a whole. These theories bring different determinants and dynamics of the relationship to light and each is at least partially successful in increasing our understanding of the relationship between research and policy. The Advocacy Coalition Framework (ACF) understands the relationship in terms of a power struggle between competing coalitions that use research as a political resource in the policy process. The Policy Making Organisation Framework (PMOF) understands the relationship in terms of institutional and political factors that determine the way data is selected or rejected from the policy process. The Governmentality Framework (GF) understands the relationship in terms of the Foucauldian construct of power/knowledge that is created through discourse, ‘regimes of truth’ and ‘regimes of practices’ found in public health policy and research. This study has found that in three of the four case studies, public health policy was strongly influenced by research, the exception being NSP in prisons. In all cases, however, it is not possible to construct a robust and coherent account of the policy process or the policy outcome without considering the multifaceted role of research. When these theories are explored at a more fundamental level they support the argument that when research influences policy it is transformed into knowledge-for-policy by being invested with meaning and power. This process of transformation occurs through social and political action that mobilises ideal structures (such as harm minimisation and the World Health Organisation’s principles for evaluating screening programs) and material structures (such as medical journals and government advisory bodies) to resolve meta-policy problems (such as how to define complex public health problems in a way that makes them amenable to empirical research and practical action). This study provides good evidence that the notion of ‘research transfer’ between ‘two communities’ is a flawed way of understanding the research–policy relationship. Rethinking the relationship between research and policy involves building an enhanced theoretical repertoire for understanding this complex social interaction. This step is essential to the success of future efforts to make public health policy that is effective, just and emancipatory. This study makes a contribution to this task.

Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2017-02-07T19:13:36Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) katia_souza_rezende.pdf: 994405 bytes, checksum: 01d7b89ce9d1aaf319258bb17ea16f84 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2017-03-06T11:56:27Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) katia_souza_rezende.pdf: 994405 bytes, checksum: 01d7b89ce9d1aaf319258bb17ea16f84 (MD5) / Made available in DSpace on 2017-03-06T11:56:27Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) katia_souza_rezende.pdf: 994405 bytes, checksum: 01d7b89ce9d1aaf319258bb17ea16f84 (MD5) Previous issue date: 2016 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / A escola se apresenta como um campo f?rtil para a implementa??o de propostas, estrat?gias e a??es de promo??o da sa?de, tornando-se lugar de interlocu??o entre sa?de e educa??o. As a??es de sa?de que s?o desenvolvidas nas escolas podem ser compreendidas a partir da concep??o de sa?de que circula neste espa?o. O Programa Sa?de na Escola (PSE) ? visto como elemento que altera o cotidiano escolar, fazendo emergir representa??es sociais sobre sa?de atravessadas pelas a??es de sa?de que s?o realizadas neste espa?o. Estas representa??es, por sua vez, influenciam as atividades, percep??es, valores, julgamentos e decis?es dos professores no ?mbito da sa?de. Diante do exposto, este trabalho teve como objetivo identificar as Representa??es Sociais sobre sa?de dos professores de tr?s escolas da rede p?blica de ensino de Belo Horizonte e seu impacto no desenvolvimento do Programa Sa?de na Escola. Para tanto, foram realizados tr?s grupos focais com os professores das tr?s escolas estudadas. Para a an?lise dos dados, utilizou-se a t?cnica de an?lise de conte?do, que permitiu identificar o processo de mudan?a de paradigma marcado de um lado, por a??es de sa?de na escola ancoradas no modelo biom?dico e de outro, por uma perspectiva ampliada de sa?de que considera os fatores biopsicossociais. Ao analisar a constitui??o dessas duas marcas de sentido, observou-se que ambas geram atitudes distintas e antag?nicas. O estudo aponta que a escola, enquanto institui??o de regula??o social revela-se conservadora, dissociada das transforma??es que ocorrem na sociedade. Portanto a Teoria da Representa??o Social enquanto conhecimento compartilhado pelo grupo favorece o processo pelos quais os indiv?duos em intera??o social, constroem explica??es acerca dos objetos sociais. O caminho percorrido pelo estudo permitiu a identifica??o dos pontos de ancoragem e objetiva??o dos professores das tr?s escolas estudadas. Tal constata??o implica fazer uma leitura com aux?lio do contexto sociocultural elaborado e compartilhado pelo grupo de perten?a. Assim, ? poss?vel perceber como as representa??es se estabelecem. / Disserta??o (Mestrado) ? Programa de P?s-gradua??o em Ensino em Sa?de, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2016. / The school presents itself as a fertile ground for the implementation of proposals, strategies and health promotion, becoming a place of dialogue between health and education. Health actions that are developed in schools can be understood from the concept of health circulating in this space. The School Health Program (PSE) is seen as an element that changes the school routine, giving rise to social representations of health traversed by health actions that are performed in this space. These representations, in turn, influence the activities, perceptions, values, judgments and decisions of teachers in health. Given the above, this study aimed to identify the social representations about health of teachers from three public schools of Belo Horizonte teaching and its impact on development of the School Health Program. Therefore, it was carried out three focus groups with teachers of the three studied schools. For data analysis, it was used the content analysis technique, which identified the changing process of paradigm, shift on one side, by health actions in school, anchored in the biomedical model and the other by an enlarged perspective of health that considers biopsychosocial factors. When analyzing the constitution of those two sense marks, it was observed that both generate distinct and antagonistic attitudes. That study points out that the school, while an institution of social regulation, proves to be conservative, dissociated from the changes occurring in society. Thus, the theory of Social Representation as knowledge shared by the group, favors the process by which, individuals in social interaction construct explanations about social objects. The way taken by the study, allowed the identification of anchor points, and objectivation of teachers of the three public schools studied. Such a finding implies to do a reading with the help of socio-cultural context, developed and shared by the belonging group. So, it is possible to perceive how representations are established.

Made available in DSpace on 2015-07-22T20:49:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-11-24. Added 1 bitstream(s) on 2015-08-11T03:26:09Z : No. of bitstreams: 1 Publico-12681a.pdf: 1321581 bytes, checksum: 85bbbf686d62af12b61dc5d7adb5690e (MD5). Added 1 bitstream(s) on 2015-08-11T03:26:09Z : No. of bitstreams: 2 Publico-12681a.pdf: 1321581 bytes, checksum: 85bbbf686d62af12b61dc5d7adb5690e (MD5) Publico-12681b.pdf: 1614881 bytes, checksum: 1cca2373c4ad763f74a3ae45292b5727 (MD5) / A construcao do social tem inicio na familia e sua ampliacao se realiza no decorrer do processo educacional. Falar do social e falar de cidadania, de direitos e deveres que sao postos e vivenciados a cada dia. Nesse processo de construcao do social e preciso se alimentar para viver, mas nao qualquer alimento. E sim uma alimentacao promotora de saude. Nada mais completo entao do que trabalhar a promocao da saude no ambito educacional. Para isso o Brasil tem um Programa com mais de 55 anos: Programa Nacional de Alimentacao Escolar (PNAE), com uma trajetoria historica cuja participacao social tem permitido que a alimentacao adequada seja praticada como direito da populacao e tambem na ampla vertente educacional que o Programa proporciona. O PNAE, para ser executado, conta com a participacao social de acompanhantes e fiscalizadores do Programa. E, uma das formas que a sociedade tem para sinalizar a execucao do PNAE sao as denuncias que chegam de todo o pais trazendo informacoes que nao foram estudadas a fundo. Considerando esse cenario, as denuncias foram tomadas como objeto desta pesquisa. Assim, este trabalho tem como objetivo principal investigar as denuncias produzidas no escopo do PNAE e recebidas pelo FNDE (Fundo Nacional de Desenvolvimento da Educacao), no ano de 2008. Este estudo foi desenvolvido tendo por base os documentos relativos ao ano de 2008, identificados como ¡°Denuncias ao Programa Nacional de Alimentacao Escolar¡±. Fizeram parte desse corpus cartas, emails, oficios, relatorios remetidos ao FNDE por cidadaos, profissionais em geral, conselhos, sindicatos e demais atores sociais. Adotou-se uma abordagem que permitiu quantificacao, bem como analise qualitativa com o objetivo de dar significado as dificuldades de atendimentos a populacao escolar no que se refere a alimentacao, embora o PNAE disponha de mecanismos de monitoramento. A analise quantitativa foi apresentada por frequencias e porcentagens e a analise qualitativa foi evidenciada a partir dos documentos das denuncias que chegam ao PNAE, por meio de analise de conteudo, segundo a modalidade tematica. O Brasil, na voz dos cidadaos, reclama de problemas na alimentacao escolar na seguinte ordem: Gestao, Alimentacao, Nutricionista, Conselho de Alimentacao do Escolar (CAE) e Instalacoes. A gestao inadequada reflete diretamente a falta e/ou a baixa qualidade da alimentacao escolar. Os resultados por regiao mostram que a maior frequencia de denuncias se refere a Regiao Nordeste, seguida pelas regioes Sudeste, Norte, Centro-Oeste e Sul. Outro ponto que fica claro e que atores como nutricionistas e CAE.s precisam ser mais amparados em termos de formacao/capacitacao, bem como nas suas estruturas de condicoes de trabalho. Um trabalho como este reflete o crescimento que a participacao social vem alcancando no Pais, a ponto de se ter um retrato Brasil na otica do detentor de direito do PNAE. E a sociedade representada como cidadaos denunciantes dos problemas vivenciados na execucao do PNAE. Fica claro que, se a educacao for colocada de maneira permanente/ continuada com todos os atores do PNAE, a administracao publica vai ganhar com parceiros atuantes no exercicio da cidadania. A gestao publica tem agora disponivel, tanto por Regioes como por Estados, informacoes acerca do olhar do usuario do PNAE oferecendo subsidios para acoes futuras, uma vez que, apos ter conhecimento da realidade denunciada, fica mais claro o caminho a seguir. / The construction of social well - being begins in the family an d expa nds through the educational process. When we talk about social well - being, we are talking about citizenship, about the rights and duties that are experienced every day. In this process of social well - being creation, it is necessary to eat , but not just any food – health - promoting food. Thus, there is nothing more basic than working for health promotion in the educational context. Brazil has had a program to accomplish this for more than 55 years: the Nationa l School Food Programme (PNAE). Over its history, social participation has guaranteed the right to a proper diet to the population at large as well as providing a wide - ranging education program . To achieve its goals, the PNAE relies on social participat ion in the schools as a way of monitoring the program . And one of the ways society participates in the running of PNAE is through complaints from around the country. These complaints provide information which has heretofore not been thoroughly studied. T he se complaints were thus taken as the object of this research. This study aims to investigate allegations arising within the scope of PNAE received by the FNDE (National Fund for Education Development) in 2008. This study was based on documents relating to 2008, identified as "Complaint s to the National School Food Program. " L etters, e - mails, reports submitted to the FNDE by citizens, members of professions in general, councils, unions and other social actors were part of the corpus . We adopted an approach that allowed both quantification and qualitative analysis in order to give meaning to the difficulties involved in providing food service to the school po pulation, although PNAE has monitoring mechanisms. The quantitative analysis was presented as frequenc ies and percentages and the qualitati ve analysis, which was based on the complaint documents arriving at PNAE, used thematic content ana lysis . Brazil ian citizens complain about school food problems in the following order : management, f ood, the nutritionis t, school food councils (CAEs) and f acilities. Poor management is directly reflected in the absence and / or the poor quality of school meals. Results by region show that the highest frequency of complaints came from the Northeast, followed by the Southeas t, North, Center - W est and South . It is also clear that actors such as nutritionists and CAEs need more support in terms of ttraining/education, as well as in the structure of their working conditions. A study lik e this one reflects the growth of social participation in the country, to the point of being a portrait of Brazil from the point of view of the PNAE stakeholder. S ociety is re presented by citizens pointing out the problems involved in carrying out PNAE. Clearly, if the permanent/ continuing educ ation of all PNAE stakeholders is emphasized, the public administration will gain active partners in the exercise of citizenship. P ublic managers now have i nformation from both the regional and state levels about the user's view of PNAE . This ca n provide support for future actions, since an awareness of the situation being complained about makes the way forward clearer . / TEDE / BV UNIFESP: Teses e dissertações

Orientador: Ana Maria Canesqui / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T11:49:03Z (GMT). No. of bitstreams: 1 Separavich_MarcoAntonioAlves_D.pdf: 1788537 bytes, checksum: d1966895682261ea6fb5d37aa815fa18 (MD5) Previous issue date: 2014 / Resumo: Este estudo analisou as experiências e representações de homens trabalhadores com o corpo, saúde, doença e cuidado, e os problemas principais de saúde por eles percebidos, quais sejam, a hipertensão arterial e as lombalgias crônicas. Analisou-se como explicam as suas causas; a forma como enfrentam e buscam a resolução ou mitigação desses problemas de saúde, as terapêuticas utilizadas, a interferência que elas acarretam em suas rotinas de vida e identidades. A revisão da literatura da Saúde Coletiva sobre a saúde do homem e masculinidades mostrou que as demandas masculinas na busca por tratamentos nos serviços públicos de saúde e a percepção de que são portadores de necessidades específicas de saúde são minoritárias. Constatou-se também que as abordagens socioantropológicas de como eles convivem e lidam com as enfermidades que os acometem também são raras. Justifica-se, portanto, o interesse e as razões que motivaram este trabalho. As demandas minoritárias masculinas aos serviços de saúde, concebidas a partir da masculinidade tradicional socialmente vigente, e os dados epidemiológicos das altas taxas de morbimortalidade masculina, embasaram a formulação da Política Nacional de Atenção Integral à Saúde do Homem (PNAISH), cujos objetivos buscam promover a melhora da saúde da população masculina na faixa etária dos 20 aos 59, facilitando o seu acesso aos serviços de atendimento integral à saúde na atenção primária. Campinas abriga projeto piloto de tal política. Analisou-se o processo de implementação da PNAISH em um dos centros de saúde da cidade elegido como piloto, cujos serviços estruturam-se na Estratégia Saúde da Família. Entrevistou-se 9 profissionais que nele atuam, especificamente na saúde do adulto, considerando o conhecimento que têm de tal política, as atividades que realizam para o seu atendimento, e os obstáculos observados que dificultam a sua implementação. Para o estudo da experiência da enfermidade com a hipertensão e dores lombares crônicas, entrevistou-se 15 homens, com média etária 56 anos, residentes no bairro da unidade de saúde em questão e que utilizaram em algum momento o serviço público de saúde. As entrevistas de todos os entrevistados foram transcritas, lidas exaustivamente para identificar os temas recorrentes. Na análise, os temas classificados foram distribuídos em categorias gerais, como corpo masculino, cuidados, problemas de saúde, interpretando-os à luz das leituras socioantropológicas realizadas e sempre que possível, articulando a experiência e as representações da enfermidade, através dos relatos interpretados pelo pesquisador. Concluiu-se que as experiências da enfermidade são sempre peculiares e biográficas, no entanto, trazem consigo referências sociais e culturais mais amplas, devendo ser ambas consideradas, para não cobrir de opacidade, tanto as experiências quanto as representações, as pessoas que as vivem e os modos de interpretá-las e significá-las. O estudo da experiência da enfermidade pode, assim, contribuir para a reflexão sobre a inserção e visibilidade masculinas nos serviços públicos de saúde, ampliando o olhar dos agentes implementadores da política de saúde do homem sobre suas ações / Abstract: This study examined the experiences and representations of male workers about the body, health, illness and care, and major health problems perceived by them, namely, hypertension and chronic back pain. Analyzed as explain its causes; how face and seek the resolution or mitigation of these health problems, therapeutic use, they entail interference in their daily lives and identities. The literature of Public Health on the men¿s health and masculinities showed that male demands in the search for treatments in public health services and the perception that they are carriers of specific health needs are minority. It was found that sociological and anthropological approaches to how they live and deal with the illness that affect them are also rare. It is justifiable, therefore, the interest and the reasons that motivated this work. The male minority demands on health services, designed from traditional masculinity prevailing social and epidemiological data of high rates of male mortality, provide the basis for formulating of Brazilian Comprehensive Healthcare Policy for Men, whose objectives seek to promote improving the health of the male population aged 20 to 59, facilitating their access to comprehensive health care in primary care services. Campinas (Brazil) is a home pilot projects this policy. We analyzed the process of implementation of this policy in a health center city chosen as a pilot, whose services are structured in the Family Health Strategy. We interviewed 9 professionals working in it, specifically in adult health, considering their knowledge this policy,care activities they perform to meet the objectives this policy, and perceived obstacles that hinder their implementation. The study of illness experience with hypertension and chronic back pain were collected from 15 men, mean age 56 years, residents in the health unit concerned district and used at some point the public health service. The interviews all respondents were transcribed, read thoroughly to identify recurring themes. In the analysis, ranked themes were divided into broad categories such as male body, care, health problems, interpreting them in the light of the sociological and anthropological readings taken and where possible, combining the experience and representations of illness through reports interpreted by researcher. It was concluded that the illness experiences are always quirky and biographical, however, bring with broader social and cultural references, and should be considered, not to cover opacity, both experiences and representations, the people who live and ways to interpret and signify them. They may also widen the debate on inclusion and male visibility in public health services, expanding the eye of policy makers on their political actions directed to men¿s health / Doutorado / Ciências Sociais em Saúde / Doutor em Saude Coletiva

Syftet med denna studie är att kartlägga hur Skånes 33 kommuner har implementerat de nationella målområdena för folkhälsa. Studien har genomförts som en enkätundersökning samt intervjuer med folkhälsosamordnare i ett urval av dessa kommuner.Resultaten i studien visar att prioriteringen av målområdena primärt ligger på strukturella faktorer. Dock är målområde 11 (Minskat bruk av tobak och alkohol, ett samhälle fritt från narkotika och dopning samt minskade skadeverkningar av överdrivet spelande) det målområde som är högst prioriterat i Skåne.Kartläggningen visar att 18 av Skånes kommuner har en anställd folkhälsosamordnare. Resultatet visar att 17 av Skånes kommuner har en verksamhetsplan/folkhälsoplan, varav 14 av dessa kommuner har en anställd folkhälsosamordnare. Större delen av dessa har även implementerat de nationella målområdena för folkhälsa i kommunens folkhälsoplan. Enligt propositionen Mål för folkhälsan 2002/03:35 är det av största vikt att ställa upp folkhälsoplaner för att få ett sektorsövergripande och långsiktigt fungerande folkhälsoarbete.Studiens resultat visar även att endast ett fåtal kommuner har utarbetat välfärdsbokslut, men samtidigt finns det en stark vilja att påbörja arbetet med att ta fram lokala välfärdsbokslut. / The purpose of this study has been to map how Skanes 33 municipalities have implemented the 11 national public health objective aims. The study has been performed as a questionnaire together with interviews with public health coordinators chosen from these municipalities.The results from this study show that the main priorities lay within structural factors. Yet it also shows that the 11th objective aim (Reduced use of tobacco and alcohol, a society free from illicit drugs and doping and a reduction in the harmful effects of excessive gambling) bears the highest priority in Skane.The mapping shows that 18 of Skanes municipalities have public health coordinators. The result shows that 17 of Skanes municipalities have a public health plan and 14 of them also have public health coordinators. The majority of these municipalities have also implemented the 11 national public health objectives within their public health plan. According to the proposition (Mål för folkhälsan 2002/03:35) Aims for public health it is important to prepare a public health plan in order to achieve a comprehensive long-term well functioning of public health activity.The results from the study also show that only a few municipalities have prepared a welfare annual account, but that there is a strong urge to initiate their introduction on a more widespread scale.

Throughout its history, the EU has been centred around economic integration. Today, however, the EU's political ambitions extend to more areas, such as environment and health. How does the legacy of economic integration affect the EU's ability to pursue policy in these areas, especially when it may offset commercial objectives? One such area is alcohol policy. While alcohol policy often involves a trade-off between health and commercial objectives, EU alcohol policy has historically prioritised the latter. This appeared to change with the announcement of Europe's Beating Cancer Plan in 2021. This thesis, using the Advocacy Coalition Framework, studies EU alcohol policy to determine whether or not a policy shift towards a more ambitious public health policy occurred as a result of the plan. The results show that policy change did not happen in the wake of the cancer plan. Instead, policy was delayed or changed to not interfere with commercial goals. The findings also show that two coalitions fought for influence over the policy process. One, centred around public health actors, and one centred around alcohol industry actors. The study shows that the industry coalition was more influential at key stages that affected the outcome of the policy deliberations. The conclusions show that the political culture and commercial structures set up to accommodate single market integration also act as defenders of commercial priorities. Notably, corresponding structures for public health were either limited or non-existent. This suggests that a bias exists that hinder significant political progress on health policy.