O puerpério é considerado uma fase de modificações biossocioculturais que, muitas vezes, não são compreendidas pela mulher, o que exige maior atenção dos profissionais, dos familiares e das redes de contato envolvidos em seu cuidado. A literatura e a prática profissional mostram que as crenças sobre o cuidado da puérpera têm relevância em seu cotidiano e, muitas vezes, se sobrepõem às orientações recebidas na instituição de saúde. Diante desta situação, este estudo teve como objetivo: explorar as práticas de cuidado adotadas no pós-parto pela mulher usuária de uma Unidade Básica de Saúde da cidade de Rio Claro, SP. Trata-se de estudo qualitativo, que teve como referencial teórico o Modelo de Competência Cultural de Purnell e cujos dados foram tratados pelo Discurso do Sujeito Coletivo (DSC). A pesquisa foi aprovada por Comitê de Ética em Pesquisa e atendeu à Resolução 196/96. Os dados foram coletados em 2011, por meio de entrevistas realizadas com 20 puérperas entre o 30º e 45º dias de pós-parto. Identificou-se a condição sociodemográfica e familiar das entrevistadas, além de sua vivência no puerpério. Os dados mostraram que as puérperas eram jovens, apresentavam baixo índice de tabagismo, etilismo e drogadição, com renda média em torno de 3 salários mínimos. Os relatos obtidos originaram 21 DSC, cujos conteúdos mostraram a influência de crenças sobre as práticas de cuidado no puerpério; crenças que foram transmitidas intergerações pelos cuidadores de sua rede familiar e cultural. Os profissionais de saúde se fizeram presentes por meio de orientações de práticas, com enfoque no biológico, oferecidas de maneira verticalizada e, por vezes, fragmentada e divergente, o que demonstrou sua dificuldade em acompanhar as influências culturais envolvidas no processo. Por conta disso, as práticas de cuidado no puerpério sofreram maior influência das crenças e dos padrões da cultura da mulher, como também das informações obtidas na internet, que preencheram lacunas e apontaram caminhos para a mulher seguir com maior segurança nesta fase do ciclo gravídico-puerperal. Diante dos achados, propõem-se o estabelecimento de estratégias para incorporação da bagagem cultural da mulher à assistência prestada pelo profissional de saúde, de modo a prover o cuidado culturalmente competente; a programação de grupos voltados à educação em saúde, focados na vivência do puerpério, para a mulher e sua rede de contato; a implementação da Estratégia Saúde da Família; e a inclusão do egresso de curso de Obstetrícia nos programas de saúde dos municípios, para agregar este novo profissional no cuidado da mulher e de seu recém-nascido. / Puerperium is considered a phase with biological, social and cultural changes often not correctly understood by women, the main reason why requires special attention from professionals, and caregivers networks involved on the care. Literature and professional practice shows that beliefs about postpartum care has a strong relevance in a womans routine and often overlaps guidance received at the health institutions. From this perspective, this study had as objective to explore practices adopted in postpartum by women served in the Basic Health Unit in a city of Rio Claro state of São Paulo (Brazil). This is a qualitative study and followed Purnell Cultural Competence Model as a theoretical approach and whose data was treated by the Collective Subject Speech (CSS). The data was approved by Ethics in Research Committee and complied with Resolution 196/96. The data was collected in 2011 through interviews with 20 women in the puerperium between 30 and 45 days of postpartum. We identified social and demographic conditions from each interviewed as well as from her family, besides their experiences at the puerperal period. The data showed that women in the puerperium were young, had low smoking rates, alcoholism or drugs addictions, and on average had an income that was equivalent to 3 minimum salaries. The reports had originated 21 CSS, and the contents showed the stronger beliefs influence on postpartum care practices; beliefs that were passed by intergenerational family and cultural caregivers. Health professionals demonstrated their presence through guidelines with practices with a biological focus and offered in a vertical manner, and sometimes divergent and fragmented, which demonstrated difficulty in following the cultural influences involved in the process. For this reason, puerperal care practices had suffered greatly due to the influence of beliefs and cultural woman patterns, as well as information obtained from the Internet. The Internet filled gaps and provided greater security methods to follow at pregnancy stage, childbirth as well as at puerperium. Upon reviewing the results, it is suggested that the following take place to incorporate the cultures of women to the experiences of the health care professionals to provide a culturally competent care; programming groups on health education focused on the puerperium experience for women and her caregivers; the implementation of Family Health Program, and the inclusion of Midwifery in the health programs to allow this new professional to take care the woman and her newborn.

INTRODUCAO: Os sintomas de climaterio podem perturbar intensamente a vida, sendo o fogacho o sintoma de maior incidencia. Aromaterapia e yogaterapia podem oferecer tratamentos eficazes para sintomas de climaterio, em especial o fogacho, por apresentarem mecanismos terapeuticos semelhantes ao eixo fisiologico do fogacho. OBJETIVO PRINCIPAL: Verificar e analisar os desfechos clinicos fisiologicos e psicologicos da aromaterapia olfativa e de exercicios respiratorios de yogaterapia, associados e individualmente, na qualidade de vida, nos niveis de stress subjetivo e na intensidade e frequencia do fogacho de mulheres na fase do climaterio. METODO: Foram avaliadas 85 mulheres na fase do climaterio, das quais 64 participaram da Fase 1 (somente avaliacao) do estudo e 34 participaram da Fase 2 (tratamento). A coleta foi realizada no CEPE-USP. O estudo consiste de um ensaio clinico pragmatico com randomizacao restrita, controlado por grupo controle e placebo, duplo-cego, com intervencao baseada no modelo psiconeuroendocrinoimunologico. Foram realizados tratamentos com inalacao de sinergia aromaterapeutica com ou sem exercicios respiratorios de yogaterapia, durante 12 semanas, duas vezes por semana em sessoes de uma hora. O estudo foi aprovado pelo Comite de Etica em Pesquisa da Escola de Educacao Fisica e Esporte da Universidade de Sao Paulo e foi inscrito no clinicaltrials.gov. RESULTADOS E DISCUSSAO: Os resultados da pesquisa mostraram melhora estatisticamente significante dos sintomas de climaterio para os tres grupos de intervencao. Houve diminuicao significativa do sintoma de fogacho, assim como da queixa de fogacho, sendo que o fogacho foi eliminado em cinco sujeitos. A intensidade e a frequencia de fogacho diminuiram em todos os grupos de intervencao e se mantiveram constantes no grupo controle. O tratamento proposto de aromaterapia se mostrou mais eficaz do que o tratamento proposto de yogaterapia na diminuicao do sintoma de fogacho, quando esses tratamentos eram aplicados isoladamente. A associacao das duas terapias se mostrou benefica, aumentando a eficacia e intensificando a melhora do sintoma de fogacho. Os efeitos globais dos tratamentos variaram intensamente quanto aos outros dominios de sintomas do climaterio. A melhora dos sintomas vasomotores do climaterio (fogacho e suor noturno), foi acompanhada de melhora significativa nos niveis de stress subjetivo, na qualidade do sono e da qualidade de vida em todos os grupos de intervencao. Esse trabalho tambem permitiu discussoes secundarias sobre o climaterio e as terapias, permitindo a sua compreensao a partir do modelo psiconeuroendocrinoimunologico. CONCLUSAO: Esse estudo serviu como um delineamento geral dos sintomas de climaterio, da aromaterapia e da yogaterapia a partir do modelo psiconeuroendocrinoimunologico. Os resultados apresentados nao podem ser generalizados para a populacao por causa da amostra pequena, mas podem indicar os resultados mais promissores e, com isso, esse trabalho pode ser o ponto de partida para novos estudos, auxiliando na elaboracao de questoes de pesquisa claras e metodos de pesquisa adequados para estuda-las / INTRODUCTION: Climacteric symptoms can disturb life considerably. Hot flashes are the symptom with highest incidence. Aromatherapy and yogatherapy can offer efficient treatments for climacteric symptoms, specially hot flashes, because their therapeutic mechanisms are similar to the physiological mechanism of hot flashes. MAIN OBJECTIVE: To analyze the psychological and physiological clinical outcomes of olfactory aromatherapy and breathing exercises of yogatherapy, associated or individually, on the quality of life, subjective stress levels and intensity and frequency of hot flashes in women in the climacteric period. METHODS: 85 women in the climacteric period were evaluated, 64 of these subjects participated in Phase 1 (assessment) and 34 participated in Phase 2 (treatment) . Data collection was performed at CEPE-USP. The study consists of a doubleblind, pragmatic clinical trial with restricted randomization, controlled by control and placebo groups. The intervention was based on the psychoneuroendocrineimmunological model. Treatments were performed with inhalation of an aromatherapeutic synergy developed for the study with or without yogatherapy breathing exercises for 12 weeks, twice per week in one hour sessions. The study was approved by the ethics comitte Comite de Etica em Pesquisa da Escola de Educacao Fisica e Esporte da Universidade de Sao Paulo and was registered in clinicaltrials.gov. RESULTS AND DISCUSSION: The results showed statistically significant improvement in symptoms of menopause for the three intervention groups. There was significant decrease in symptom of hot flashes, as well as complaints of hot flashes and this symptom was eliminated in five subjects. The intensity and frequency of hot flashes decreased in all intervention groups and remained constant in the control group. Aromatherapy was more effective than yogatherapy to decrease the symptoms of hot flashes, when these treatments were applied separately. The combination of the two therapies proved beneficial, increasing the effectiveness and enhancing the improvement of the symptom of hot flashes. The overall effects of the treatments varied intensely for other climacteric symptoms. The improvement of vasomotor symptoms of menopause (hot flashes and night sweats), was accompanied by a significant improvement in stress levels, quality of sleep and quality of life in all intervention groups. This research also permitted secondary discussions about climacterium and the therapies, permiting their understanding through the psychoneuroendocrineimmunological model. CONCLUSION: This study served as a general outline of climacteric symptoms, aromatherapy and yogatherapy through the psychoneuroendocrineimmunological model. The results cannot be generalized to the population because of the small sample size. However, the most promissing results can be indicated and this research can be the starting point for further studies, assisting in the preparation of clear research questions and suitable research methods to study them

Introduction: The consequences of the opioid epidemic and various prevention, mitigation, and treatment strategies have a strong hold on Appalachian communities. However, limited research has been conducted to understand the experiences of special populations impacted by opioids in this region, such as women of childbearing age living with opioid use disorder (OUD) prior to and during pregnancy. The objective of this review is to summarize existing literature on the care experience for women of childbearing age receiving treatment with medications for opioid use disorder (MOUD) in rural east Tennessee. This literature review will allow for better understanding of current treatment practices, potential gaps in care, and needed care system improvements for this patient population. Methods: A systematic PubMed search identified studies focused on MOUD and pregnancy in the rural eastern Tennessee region. Search results were screened to remove publications older than five years or from outside the region. Relevant information concerning the MOUD care experience for women of childbearing age in the area was collected from these studies. Results: Five studies were included: four surveys and a systematic review. All were published within the last five years and described experiences spanning preconception to postnatal care as well as Tennessee opioid laws that affect women of childbearing age. Two studies detailed the pre-pregnancy care experience, including information about prior pregnancies, intention of conception, contraceptive use, and perceived barriers to contraception access among women receiving MOUD. Two studies described the care experience during pregnancy and its evolution in recent years with changes in acceptance of insurance for MOUD treatment, rates of MOUD-positive prenatal drug screens, and MOUD tapering practices during pregnancy. The final included study reviewed several Tennessee opioid laws enacted over the years to combat prenatal substance use and neonatal abstinence syndrome (NAS). Notably, while total reported cases of NAS have decreased statewide in recent years, the highest rates continue to be observed in east Tennessee, with a majority of cases linked to MOUD exposure. The requirements and enforcement of NAS-related legislation in Tennessee have changed over time but their existence may deter pregnant women from seeking treatment due to fear of punitive consequences. Conclusion: The evidence compiled in this literature review points to many areas in which the care experience can be improved for women of childbearing age receiving MOUD in east Tennessee. There are concerns regarding pregnancy planning, contraceptive access, availability of evidence-based OUD treatment, cost of treatment, and fear of actual or potential negative repercussions from opioid use during pregnancy. These findings suggest multiple efforts can be undertaken by clinicians, researchers, and policymakers to enhance the experience of care for women of childbearing age living with OUD, and consequently improve the health of the population in general, in this region of Appalachia.

This study examined women's health messages found on ten endometriosis websites. Qualitative research methods were used to investigate messages available via Internet media about causes and treatments of endometriosis, particularly as they relate to the suggestion that hysterectomy and pregnancy are effective treatments. Messages about infertility, physician-patient communication, and accessibility were also examined. Findings indicate that the websites provided similar messages regarding the symptoms, causes, and treatments of endometriosis; results pertaining to infertility were mixed. Little information was available on methods of improving physician-patient communication. Most websites provided additional low-cost information while requiring minimal technological competency or additional software of site patrons. The results of this study have implications for future research in medical science and communication and reflect the importance of research on women's health communication. A detailed discussion of findings and suggestions for further research are offered. The author's own experiences with endometriosis are incorporated into the analysis.

Thesis (MCur)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Title: Awareness, knowledge and experiences of women regarding cervical cancer in rural Kwa- Zulu-Natal, South Africa. Background: Cervical cancer has been identified as the second most common cancer in women and contributes to the high mortality rate in women. Among all cancers in women, cervical cancer is rated the second most common cancer in women worldwide. In poorly resourced settings, access to services offering cervical screening is still a challenge and it is estimated that more than 50% of women in developing countries have never had a single screening test for cervical abnormalities. Purpose: The purpose of this study was to assess women’s awareness, attitudes and experiences regarding cervical smear testing and for cervical cancer in rural KwaZulu-Natal and to better understand factors influencing access to and utilization of cervical cancer screening services by rural women. Methods: The method employed was a descriptive study using a questionnaire to collect quantitative data. The sample consisted of 69 women aged 30 years and above, was taken from women who were enrolled in the on-going Microbicide Clinical Trial and attending follow-up clinic visits between July and August 2009. The primary outcome measure for the analyses was who has been screened for cervical cancer and this was assessed from the previous history reports of the women. The secondary outcome measure was to investigate knowledge and perceptions regarding cervical cancer and screening. Socio-demographic factors associated with having been screened were also explored. Results: Out of 69 women, only N=13 (18.8%) reported ever screening for cervical cancer. More than half of women who had never screened reported lack of information as a barrier to screening N=50 (71.4%). Older women aged 35-45, 45 and above were less likely to screen compared to women aged 30 to 34 years of age (OR: 0.06). Having an educational background seemed to increase the likelihood to screen, twice if a woman had primary education (OR 2.0) and almost three times (OR 2.67) if a woman had a secondary or a higher education. More than half of the respondents considered themselves at risk for cervical cancer N=42 (60.8%) and almost all showed a willingness to screen in the future N=64 (93%). Conclusion: Most of the women in this study had never been screened for cervical cancer in their lifetime as reflected by n=55 (82%) while only n=14 (18%) ever screened for cervical cancer. The results of this study cannot be generalised to the population due to the small sample size. However, there is need to facilitate comprehensive health education and the implementation of cervical screening programmes to target women in rural communities to contribute to the success of the cervical screening programme. The results of this study showed that 60% of respondents were informed by health care professionals on cervical cancer screening. Health care workers also should play a vital role in educating communities on cervical cancer and on the benefits for cervical cancer screening, through reaching all patients who utilise health care services with cervical cancer information and also communities through outreach programmes. / AFRIKAANSE OPSOMMING: Titel: Vrouens se bewustheid, houding en ervarings van smeertoetse en servikale karsinoom in die landelike gebiede van KwaZulu-Natal Agtergrond: Servikale kanker is geïdentifiseer as die tweede mees algemene karsinoom in vrouens en dra by tot die hoë sterftesyfer in vrouens. Van al die tipes karsinoom wat by vrouens voorkom, is servikale karsinoom die tweede mees algemene karsinoom onder vrouens wêreldwyd. Die beskikbaarheid van dienste wat servikale smeer toetsing bied, is nog steeds ’n uitdaging in arm gebiede en daar word geskat dat meer as 50 % van vrouens in ontwikkelende lande nog nooit ’n toets vir enige servikale abnormaliteite gehad het nie. Doel: Die doel van hierdie studie was om vrouens se bewustheid, houding en ervarings van servikale smeer toetsing en van servikale karsinoom in die plattelandse gebiede van KwaZulu-Natal te toets en om ’n beter begrip te kry van faktore wat ’n invloed het op toegang tot en gebruik van servikalesmeer toetsing by vrouens in landelike areas. Metode: Die metode wat gebruik is, is ’n beskrywende studie waarin gebruik gemaak is van vraelyste om kwantitatiewe data te versamel. Die monster het bestaand uit 69 vrouens, ouderdom 30 jaar en ouer, wat deelnemers was aan die “Microbicide Kliniese Navorsingsprojek” en wat opvolgbesoeke by klinieke gehad het tussen Julie en Augustus 2008. Die primêre bevinding, wie al ooit vir servikale karsinoom getoets is, is bereik deur die inligting in die laboratorium verslae van die vroue na te gaan. Die sekondêre bevinding was om die deelnemers se kennis en persepsies aangaande servikale karsinoom te toets. Sosio-demografiese faktore wat verband hou met of deelnemers ooit getoets is, is ook ondersoek. Resultate: Van die 69 vrouens, het slegs N=13 (18.8 %) gerapporteer dat hulle ooit getoets is vir servikale kasinoom. Meer as die helfte van die vrouens wat ooit getoets is vir servikale karsinoom het gerapporteer dat ’n gebrek aan inligting ’n weerhoudende faktor was tot die toetse, N=50 (71.4%). Ouer vrouens tussen die ouderdom van 35 – 45, 45 en ouer was minder bereid om te toets in vergelyking met vrouens tussen die ouderdom van 30 tot 34 (OR: 0.06). Dit blyk asof skoolonderrig die kanse op toetsing verhoog, vrouens met primêre skoolopleiding se kanse dat hulle getoets is, is twee keer groter (OR 2.0) en amper drie keer meer (OR 2.67) as ’n vrou sekondêre onderrig of hoër onderrig ontvang het. Meer as die helfte van die respondente dink hulle loop ’n risiko om servikale kanker te kry N=42 (60.8%) en feitlik almal was bereid om hulle te laat toets in die toekoms N=64 (93 %). Bevinding: Die meeste vroue in hierdie studie n=55 (82%) was nog nooit in hul leeftyd getoets vir servikale karsinoom nie terwyl slegs n=14 (18%) ooit getoets was vir servikale karsinoom. Die resultate van hierdie studie kan nie veralgemeen word nie, aangesien die navorsingspopulasie as gevolg van die klein steekproef te klein was. Nietemin is daar ‘n behoefte vir die fasilitering van omvattende gesondheidsopvoeding en die implementering van servikalesmeer toetsing programme. Die resultate van hierdie studie het aangedui dat 60% van die respondente deur professionele gesondheids werkers ingelig is met betrekking tot servikalesmeer toetsing. Gesondheidswerkers behoort ‘n vitale rol te speel in die opvoeding van gemeenskappe in verband met servikale karsinoom en die voordele van hiervan deur alle pasiente wat gesondheidsdienste benut in te lig omtrent servikale karsinoom en ook deur middel van gemeenskaps-uitreikings programme.

O ressurgimento da obstetrícia como profissão autônoma após mais de três décadas do fechamento do último curso de formação direta no Brasil apresenta-se no contexto das necessárias políticas de humanização da assistência à saúde materno-infantil, quando o país responde pelos piores índices de resultado, sendo um dos mais violentos do mundo e com o maior percentual de cesarianas desnecessárias. Diante desse quadro e da observação de que corporações profissionais autárquicas representativas da medicina e da enfermagem parecem se opor à disseminação de novas práticas encampadas pelo Ministério da Saúde por meio de diretrizes e regulamentações em consonância com organismos internacionais de referência na área, este trabalho busca analisar os elementos formadores da consciência política de integrantes do movimento da obstetrícia na Universidade de São Paulo, trazendo as vozes de ex-alunos e docentes da Graduação em Obstetrícia da Escola de Artes, Ciências e Humanidades (EACH-USP) e representantes da Associação de Alunos e Egressos do Curso de Obstetrícia da Universidade de São Paulo (AO-USP) por meio de entrevistas semiestruturadas em que se buscaram elementos para a compreensão de seu papel na luta por uma identidade positiva da profissão, a melhoria na atenção à saúde da mulher no país e à afirmação de seus direitos fundamentais instituídos pelo Sistema Único de Saúde na Constituição de 1988. A compreensão da formação da consciência política acerca do movimento da obstetrícia à luz das dimensões propostas no Modelo da Consciência Política de Salvador Sandoval contribui para a clarificação dos elementos macro e micro políticos que agem contra e a favor do movimento de humanização do parto e nascimento e sua importância para a superação da realidade de violência e desrespeito aos direitos femininos no campo da assistência à saúde. Com a proposição do novo curso, pôde-se construir um espaço de formação baseado nos princípios da humanização, que norteiam as práticas em saúde em muitos países, recorrendo-se às melhores tecnologias disponíveis nas ciências biomédicas e humanas, contribuindo para um olhar inovador em nosso país quanto à formação de profissionais aptos a exercer uma assistência de qualidade e não violenta / After more than three decades of closure of formal obstetrician studies, in a moment of desperate need for humanization policies in mother-child health assistance, we see the option of autonomous obstetrics reappearing when Brazil lives the worst record of unnecessary cesarean procedures. Amidst this scenario, and the observation that government representatives of medical and nursing departments seem to oppose the dissemination of the new practices approved by the Ministry of Health, in alignment with international organizations that are a reference in this area, this study will analyze the elements which build the political consciousness of members of the obstetrician movement in the University of São Paulo by bringing to light the voices of former students and professors of the grad course Graduação em Obstetrícia da Escola de Artes, Ciências e Humanidades (EACH-USP) and representatives of the obstetrician course student association Associação de Alunos e Egressos do Curso de Obstetrícia da Universidade de São Paulo (AO-USP). Data was collected through semi structured interviews where we sought to find elements to understand the strive for a positive identity of this profession, the improvement of the care for women health and the affirmation of their fundamental rights instituted by the Central health Constitution of 1988. The comprehension of the formation of the political consciousness in light of the dimensions proposed in Salvador Sandoval\'s Political Consciousness Model, contributes to the clarification of macro and micro political elements that act against and in favor of the birth humanization as well as its importance to overcoming the reality of violence and disrespect to human rights in the health assistance field. With the proposition of the new course, it was possible to construct a training space based on the principles of humanization, which guide health practices in many countries, using the best available technologies in the biomedical and human sciences thus contributing to an innovative look in our country regarding the training of professionals able to provide quality and non-violent assistance

Dados epidemiológicos têm demonstrado crescente envolvimento da mulher idosa na epidemia de aids, esta constatação foi a motivação para a realização do presente estudo. Trata-se de uma pesquisa qualitativa, que teve como referencial teórico a Antropologia Médica; para o tratamento dos dados adotou-se o Discurso do Sujeito Coletivo. Os objetivos do estudo foram: verificar a percepção sobre a epidemia de aids por mulheres com idade igual ou superior a 50 anos, moradoras em uma comunidade de baixa renda no Município de São Paulo; verificar sua percepção de risco à infecção pelo HIV, e se adotam ações preventivas da infecção. Como critérios de inclusão consideraram-se: mulheres com idade igual ou superior a 50 anos e tempo de residência no local do estudo superior a um ano. Os dados foram coletados por meio de entrevista com questões sobre caracterização da mulher e com uma pergunta norteadora. Foram entrevistadas 13 mulheres, que mostraram ter como características comuns: baixa escolaridade, reduzida renda familiar e religiosidade. O tratamento dos dados resultou na construção de 12 discursos narrados na primeira pessoa, nos quais se verifica que as mulheres do grupo cultural estudado apresentam lacunas no conhecimento a respeito da aids e do cotidiano do indivíduo infectado pelo HIV. Atribuem significado religioso à epidemia; não se vêem sob risco de infecção pelo HIV por via sexual, principalmente devido à confiança na fidelidade do parceiro; negam o uso do preservativo nas relações sexuais, embora temam a aids por identificarem-na como uma doença incurável. Valorizam a necessidade de adoção de medidas preventivas à infecção pelo HIV, porém, pelos jovens, considerados mais susceptíveis. A análise dos dados, segundo o referencial teórico adotado, mostrou que a aids, para o grupo de mulheres estudado, não se constitui em preocupação, quando a abordagem recai na transmissão sexual em si própria, fato que alerta para a necessidade de planejamento de ações educativas culturalmente embasadas sobre a infecção pelo HIV nesse segmento. / Epidemic data has been demonstrating the senior woman\'s growing involvement in epidemic aids, this seen, it suited as motivation for the present study\'s realization. It\'s over a qualitative research, which had as theoretical reference the Medical Anthropology; for the data treatment the Collective Subject\'s Speech was adopted. The study objectives were: to verify the perception of 50-year-old women or older on epidemic aids, residents in a community of low income in the Municipal district of São Paulo; to verify their risk perception to the HIV infection, also if preventive actions are adopted. As inclusion criteria were considered: 50 year-old women or older along with time of residence in the place of study superior to one year. The data was collected through subjects\' interview over the woman\'s characterization and with a leading question. 13 women were interviewed that showed to have as common characteristics: low school education, reduced family income and religiosity. The treatment of the data resulted in the construction of 12 first person narrated speeches, which verify that women from the studied cultural group present gaps in the knowledge regarding aids and the HIV infected individual\'s everyday. They attribute religious meaning to the epidemic; not seeing each other under infection risk for HIV under sexual way, mainly due to trust in the partner\'s fidelity; they deny the use of preservatives in their sexual relationships, although they fear aids for identifying it as an incurable disease. They value the need to adopt preventive measures to the HIV infection, however, for the youths, considered more susceptible. The data analysis, according to the adopted theoretical reference, showed that aids, for the studied women\'s group, is not constituted in concern, when the approach relapses in the sexual transmission itself, fact that alerts to the need of educational action planning culturally based on the infection by HIV in that segment.

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Trata-se de um estudo de natureza histórico-social, cujo objeto são as lutas simbólicas para criação e implantação da Casa de Parto David Capistrano Filho. A delimitação temporal do estudo abrange o período de 2002 a 2004. Os objetivos da pesquisa são: descrever as circunstâncias que determinaram a criação e implantação da Casa de Parto David Capistrano Filho (CPDCF) no Rio de Janeiro; analisar as lutas empreendidas pelos diferentes agentes para a criação e implantação da Casa de Parto David Capistrano Filho; e discutir os efeitos simbólicos das lutas para as enfermeiras no campo da obstetrícia. A pesquisa teve como suporte teórico os conceitos do sociólogo francês Pierre Bourdieu e utilizou o método da história oral temática. O estudo contou com treze agentes, cujas entrevistas foram gravadas e transcritas, respeitando-se os aspectos éticos da Resolução 196/96. As fontes primárias do estudo foram os depoimentos, legislações, decisões judiciais, projetos, atas e artigos. Os resultados revelam que as concepções do Movimento Feminista, os pressupostos teóricos do movimento de humanização do parto e nascimento, a posição política liderada pela OMS e pelo Ministério da Saúde e as condições sociais e políticas no município do Rio de Janeiro se constituíram em estímulos para a criação da CPDCF. Diante disso, agentes do campo obstétrico se envolveram em lutas simbólicas, e associações da classe médica passaram a lutar contra a criação e implantação da CPDCF. Nessa luta, as enfermeiras foram instigadas a transformar em práticas as disposições incorporadas (habitus) durante sua trajetória social e profissional, quando fizeram alianças com diversos segmentos sociais, buscando implantar a CPDCF e, posteriormente, manter essa unidade de saúde como um espaço da enfermagem obstétrica. Com a implantação da CPDCF, as enfermeiras obstétricas aumentaram seu capital global, conquistando autonomia, o que lhes proporcionou ocupação de posição em uma estrutura hierarquizada e hegemonicamente médica, gerando prestígio para essas profissionais e publicidade para os resultados de seus trabalhos, embora isso seja limitado a alguns espaços da SMS/RJ. A falta de articulação da enfermagem foi considerada um dificultador para a expansão do trabalho das enfermeiras obstétricas e desse modelo assistencial, corroborando o modelo medicalizado de assistência a mulher em processo de parturição, predominante nas unidades de saúde do município. Face às questões levantadas no estudo, dá-se como sugestão que os gestores da saúde estimulem a criação de ambientes favoráveis ao parto e nascimento saudáveis, e que as associações de classe da enfermagem se articulem para desenvolver estratégias de apoio ao trabalho das enfermeiras obstétricas. / It is a historical-social study, whose object is the symbolic fights for creation and implantation of the David Capistrano Filho Childbirth House (CPDCF). The temporary delimitation of the study includes the period from 2002 to 2004. The aims of the research are: to describe the circumstances that determined the creation and implantation of the David Capistrano Filho Childbirth House in Rio de Janeiro; to analyze the fights undertaken by the different agents for the creation and implantation of the David Capistrano Filho Childbirth House; and to discuss the symbolic effects of the fights for the nurses in the field of obstetrics. The research has as theoretical support the concepts of the french sociologist Pierre Bourdieu and uses the method of thematic oral history. The study counted on thirteen agents, whose interviews were recorded and transcribed, being respected the ethical aspects of the Resolution 196/96. The primary sources of the study were interviews, legislations, judgments, projects, minutes and articles. The results revealed that conceptions of the Feminist Movement, theoretical assumptions of the movement of humanizing delivery, political position led by WHO and Brazils Health Ministry and social and political conditions in the district of Rio de Janeiro constituted in incentives for the creation of the CPDCF. Agents of the obstetric field engaged themselves in symbolical fights. Therefore, associations of the medical class started to struggle against the creation and implantation of CPDCF. Thereby, nurses were stimulated to transform in practices their habitus during their social and professional path, making alliances with several social segments, looking for implant CPDCF and, later on, maintain that unit of health as a space of the obstetric nursing. With the implantation of CPDCF, the obstetric nurses increased their global capital, earned autonomy and occupied positions at the field structure, achieving prestige for those professionals and publicity for the results of their work, although that is limited in some spaces of the Health Department of Rio de Janeiro City. The lack of articulation of nursing professionals was considered the problem to expand the obstetric nurses' work and care model, corroborating to the medical model, predominant in the Rio de Janeiros health units. To sum up, it`s suggested that health managers stimulate the creation of favorable places to the healthy childbirth and, that professionals of nursing associations pronounce to develop support strategies to the obstetric nurses' work.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Trata-se de um estudo de natureza histórico-social do tempo presente. O objeto é a implantação do modelo humanizado de assistência ao parto em Juiz de Fora, Minas Gerais, no período de 1998 a 2001. Os objetivos do estudo são: descrever as circunstâncias de criação da Comissão Interinstitucional para Redução da Cesariana e Proteção ao Parto Normal; analisar as estratégias da Comissão Interinstitucional para Redução da Cesariana e Proteção ao Parto Normal e a implantação do modelo humanizado de assistência ao parto na cidade de Juiz de Fora; analisar os efeitos da participação das enfermeiras obstétricas no campo obstétrico. O estudo apoia-se nas noções teóricas de campo, habitus, poder simbólico, luta simbólica e capital do sociólogo Pierre Bourdieu. Na análise foi realizada a triangulação de dados, através da articulação da documentação oral e escrita à luz das noções teóricas. A criação da Comissão Interinstitucional para Redução da Cesariana e Proteção ao Parto Normal foi uma estratégia elaborada na esfera da gestão pública da cidade. Teve início no dia 26 de fevereiro de 1998 no Departamento de Programação e Acompanhamento SMS/JF. As estratégias utilizadas pela Comissão para implantar o modelo humanizado de assistência ao parto foram: a elaboração e a implantação de um Plano de Ação com ações de informações e sensibilização dos médicos e da população; formação de Recursos Humanos para implantar as práticas obstétricas humanizadas, com a criação do Curso de Especialização em Enfermagem Obstétrica; e a reconfiguração do campo obstétrico com o projeto de criação da Casa de Parto. Como efeitos da implantação do modelo humanizado de assistência ao parto foi evidenciado que, a partir de 2001, enfermeiras obstétricas, egressas do Curso de Especialização em Enfermagem Obstétrica/Universidade Federal de Juiz de Fora (UFJF), começaram a ocupar espaços nas salas de partos de duas Maternidades da cidade, e em 2005, foi criada a Lei Municipal do Acompanhante. / This is a study of historical social nature of the present time. The object is the implementation of the humanized labor care model in Juiz de Fora, State of Minas Gerais, in the period 1998 - 2001. The aims of the study are: to describe the context of the establishment of the Inter-institutional Committee on Reduction of Cesarean Section Rate and Protection of Natural Birth; to analyze the strategies of the Inter-institutional Committee on Reduction of Cesarean Section Rate and Protection of Natural Birth and the implementation of the humanized labor care model in the city of Juiz de Fora; to analyze the effects of the obstetric nurses practice in the obstetric field. The study is based on the theoretical concepts of field, habitus, symbolic power, symbolic violence and capital of sociologist Pierre Bourdieu. The analysis comprised data triangulation through the articulation of the primary oral sources and documents written in accordance with the theoretical concepts. The establishment of the Inter-institutional Committee on Reduction of Cesarean Section Rate and Protection of Natural Birth was a strategy designed at the citys public management level. It started on February 26, 1998 at the Planning and Monitoring Department of the Juiz de Fora/JF Municipal Secretariat. The strategies used by the Committee to implement the humanized labor care model: design and implementation of an Action Plan on physicians and populations information and awareness-raising actions; training of Human Resources to implement humanized obstetric practices, with the establishment of the Specialization Course on Obstetric Nursing; and the redesign of the obstetric field with the project to establish the Casa de Parto (Birth Center). As effects of the implementation of the humanized labor care model, we observed that, as from 2001, obstetric nurses graduated from the Specialization Course on Obstetric Nursing at the Federal University of Juiz de Fora (UFJF) started occupying positions at labor rooms from two Maternity Hospitals in the city and, in 2005, the Labor Coach Municipal Law was enacted.

O objetivo deste estudo é o de conhecer e analisar a atenção em saúde de mulheres trabalhadoras com câncer do colo do útero avançado em tratamento no Hospital do Câncer II, no município do Rio de Janeiro. O estudo voltou-se para decifrar os diferentes momentos das trajetórias de vida e de trabalho dessas mulheres e relacioná-los com a procura dos serviços de saúde, estabelecendo relações com o acesso e a atenção à saúde. Constitui-se em um estudo exploratório, de natureza qualitativa, assentado em entrevistas e revisão teórico-bibliográfica. O aprofundamento teórico-empírico acerca deste tema buscou problematizar um objeto de estudo essencialmente relevante para o universo feminino, tendo em vista as altas taxas de incidência e mortalidade deste tipo de câncer no Brasil e no mundo sendo considerado, portanto, um problema de Saúde Pública. Os resultados apontam que o desconhecimento sobre o HPV e sobre a importância da realização do exame preventivo ainda é significativo entre as mulheres entrevistadas, o que aponta para a necessidade em priorizar o acesso à informação e a educação em saúde para o alcance de avanços no diagnóstico precoce. Também foram identificados como obstáculos na atenção em saúde, a sobrecarga de afazeres no cotidiano das mulheres, tendo em vista suas condições de vida e de trabalho e as dificuldades no acesso aos serviços de saúde. / The aim of this study is to understand and analyze the health care of working women with advanced cancer of the cervix in treatment at the Hospital of Cancer II, in Rio de Janeiro city. The study turned to decipher the different moments of life and work courses of these women and relate them with the search for health services, establishing connections between the access to health care and the attention given to it. It constitutes an exploratory study, of qualitative nature, grounded in interviews and theoretical-bibliographic review. The theoretical and empirical development about this theme sought to problematize an object of study relevant to the essentially feminine universe, in view of the high incidence and mortality rates of this type of cancer in Brazil and in the world being therefore, a public health problem. The results indicate that the lack of knowledge about HPV and the importance of completing the screening test is still significant among interviewed women, pointing to the need to prioritize access to information and health education for achieving advances in early diagnosis. The overcharge of women daily chores, considering their life and work conditions and the difficulties in accessing health services, also have been identified as barriers in health care.