Showing papers in "Ciencia & Saude Coletiva in 2010"

As redes de atenção à saúde

Abstract: The demographic and epidemiologic transition resulting from aging and the increase of life expectation means an increment related to chronic conditions. The healthcare systems contemporary crisis is characterized by the organization of the focus on fragmented systems turned to the acute conditions care, in spite of the chronic conditions prevalence, and by the hierarchical structure without communication flow among the different health care levels. Brazil health care situation profile is now presenting a triple burden of diseases, due to the concomitant presence of infectious diseases, external causes and chronic diseases. The solution is to restore the consistence between the triple burden of diseases on the health situation and the current system of healthcare practice, with the implantation of health care networks. The conclusion is that there are evidences in the international literature on health care networks that these networks may improve the clinical quality, the sanitation results and the user's satisfaction and the reduction of healthcare systems costs.

Pesquisa Nacional de Saúde do Escolar (PeNSE)

Abstract: Gerson Oliveira Penna - Autor vinculado a Fiocruz Brasilia, mas nao consta a informacao no documento.

Physical activity and quality of life

Abstract: Acredita-se na atividade fisica como uma forma de restaurar a saude dos efeitos nocivos que a rotina estressante do trabalho/estudo traz. O estudo constitui uma pesquisa transversal que objetiva analisar as associacoes da pratica de atividades esportivas na qualidade de vida dos individuos. A amostra foi constituida por 107 professores, 111 funcionarios e 638 estudantes da Universidade Catolica de Pelotas (UCPel), totalizando 863 participantes. Foram utilizados como instrumentos o WHOQOL-breve/OMS para avaliar a qualidade de vida e questionario de atividades fisicas habituais traduzido e modificado por NahasNuPAF/UFSC, 2001. Do total, 394 sao do sexo masculino e 469 do sexo feminino. Destes, 313 sao moderadamente ativos, 210 inativos, 207 ativos e 136 sao muito ativos. Pode-se observar que, em media, quanto mais ativa a pessoa e, melhor sua qualidade de vida. Alem disso, dentre as diferencas na qualidade de vida das pessoas que praticam atividades fisicas comparadas com as que nao praticam, nao estao apenas os aspectos de saude fisica, mas tambem aspectos psicologicos e cognitivos. Estes resultados servem de estimulo a profissionais de diferentes areas para incentivarem e apoiarem a definicao de rotinas de atividades fisicas para seus pacientes.

Food consumption and eating behavior among Brazilian adolescents: National Adolescent School-based Health Survey (PeNSE), 2009

Abstract: The objective of this article is to describe the characteristics of food consumption and eating behavior of adolescents and its association with socio-demographic factors. In 2009, a random sample of students in 9th grade of elementary education at public and private schools from 26 Brazilian state capitals and Federal District was studied. It was applied a self-administered questionnaire with socio-demographic attributes, food consumption and eating behavior, among others. Estimates of the constructed indicators were presented for the total population and by sex. The association of each indicator with socio-demographic variables was examined by logistic regression. The results showed that over half of adolescents presented frequent consumption of beans (62.6%), milk (53.6%) and sweets (50.9%), and held at least lunch or dinner with the mother or responsible (62.6%) and watching television or studying (50.9%). In general, girls were more exposed to undesirable eating habits and higher socioeconomic status was associated with a higher prevalence of the indicators studied. The results revealed regular consumption of unhealthy diet markers and consumption of less than the recommended for a healthy diet, pointing the need for strengthening health promotion activities targeting young people.

Abortion in Brazil: a household survey using the ballot box technique

Abstract: This study presents the first results of the National Abortion Survey (PNA, Pesquisa Nacional de Aborto), a household random sample survey fielded in 2010 covering urban women in Brazil aged 18 to 39 years. The PNA combined two techniques, interviewer-administered questionnaires and self-administered ballot box questionnaires. The results of PNA show that at the end of their reproductive health one in five women has performed an abortion, with abortions being more frequent in the main reproductive ages, that is, from 18 to 29 years old. No relevant differentiation was observed in the practice of abortion among religious groups, but abortion was found to be more common among people with lower education. The use of medical drugs to induce abortion occurred in half of the abortions, and post-abortion hospitalization was observed among approximately half of the women who aborted. Such results lead to conclude that abortion is a priority in the Brazilian public health agenda.

Prevalência de fatores de risco e proteção de doenças crônicas não transmissíveis em adolescentes: resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE), Brasil, 2009

Abstract: A adolescencia e marcada por transformacoes e exposicao a diversas situacoes e riscos para a saude. O estudo atual estima a prevalencia dos principais fatores de risco e protecao a saude dos adolescentes entrevistados em 2009 na Pesquisa Nacional de Saude do Escolar (PeNSE). A PeNSE, parceria do Instituto Brasileiro de Geografia e Estatistica (IBGE) com o Ministerio da Saude, usou questionario autoaplicavel em palmtop coletando informacao de 60.973 estudantes em 1.453 escolas publicas privadas nas 27 capitais. RESULTADOS: consumo de alimentos em cinco dias ou mais na semana: 62,6% comem feijao, apenas 31,5% consomem frutas, 58,3% comem guloseimas e 37% tomam refrigerantes; 43,1% dos alunos sao suficientemente ativos fisicamente e 79,5% gastam mais de duas horas diarias em frente a TV. Em relacao a tabaco e drogas: 6,3% sao fumantes atuais, 71,4% dos alunos disseram ja ter experimentado alguma bebida alcoolica. O consumo atual de bebida alcoolica foi de 27% e as drogas ilicitas foram usadas alguma vez na vida em 8,7%. Esses dados geram evidencias para orientar a implementacao de politicas publicas e realizar acoes para minimizar a exposicao de fatores de risco dos adolescentes brasileiros.

Physical activity practice among brazilian adolescents

Abstract: O objetivo deste estudo e descrever a pratica de atividade fisica em adolescentes, utilizando dados da Pesquisa Nacional de Saude do Escolar (PeNSE), coletados em todas as capitais do Brasil e no Distrito Federal em 2009. A amostra incluiu escolares do 9o ano do ensino fundamental (n=60.973). Foram investigadas a pratica de atividade fisica nos ultimos sete dias, incluindo modo de deslocamento para a escola, pratica de atividade fisica dentro e fora da escola e participacao nas aulas de educacao fisica. Consideraram-se ativos os jovens que acumularam > 300 min/sem de atividade fisica. A proporcao de ativos foi de 43,1%, sendo maior nos meninos (56,2%) em comparacao as meninas (31,3%). Metade dos adolescentes (49,2%) relatou ter tido duas ou mais aulas de educacao fisica na semana anterior a entrevista; 79,2% relataram assistir a duas horas diarias de televisao ou mais. Os dados do PeNSE indicam baixa prevalencia de jovens ativos e com duas ou mais aulas de educacao fisica por semana, alem de elevada prevalencia de comportamento sedentario. Tais dados podem ser utilizados como linha de base para o monitoramento de atividade fisica em escolares brasileiros, mas desde ja sugerem a necessidade de intervencoes para a promocao de atividade fisica em adolescentes brasileiros.

Obesity: a plural perspective

Abstract: Obesity is a disease characterized by the excessive accumulation of corporal fat, which produces deleterious effects to the health. There is consent in the literature that its etiology is multi-factorial, involving biological, historical, ecological, political, social-economical, psychosocial and cultural aspects. In that sense, this article's objective is to talk about the multi-factorial character of obesity, involving the wide variety of environmental and genetic factors implicated in its etiology, starting from secondary studies of literature revision in the main bases of data and specialized libraries. Nowadays, obesity has been considered the most important nutritional disorder in the developed countries and the ones in development, due to the increase of its incidence. The approach of the genetic, metabolic, psychosocial, symbolic, and cultural aspects in addition to the lifestyle allowed to base obesity as a plural illness, and showed the necessity to create public politics with multidiscipline and inter-sectorial actions, that value the partnership between government and civil society, in the prevention and combat of obesity and the promotion of health, making possible the community's participation in that process, through responsibility and self care.

Acolhimento e (des)medicalização social: um desafio para as equipes de saúde da família

Abstract: This article discusses the relation between sheltering practice and social medicalization in the primary care. It begins with a revision about social medicalization and mentions some influences concerning the organization of the Brazilian primary care. It also indicates that the ground of receptivity proposal was provided by those influences. It argues the potentiality to accomplish the sheltering with a demedicalization and interdisciplinary action and its reverse effect, when restricted simply to emergency medic care. There are hereby suggested changes in the management and organization of routines, agendas as well as collective and individuals activities of the professionals with the intention to reduce medicalization. The conclusion favors the expansion of experimentation on sheltering as a strategy in dealing with unexpected events and with primary care spontaneous demand, always watching out for its medicalization potential.

Bullying nas escolas brasileiras: resultados da pesquisa nacional de saúde do escolar (PeNSE), 2009

Abstract: The aim of this study is to identify and describe the occurrence of bullying among students in the 9th year (8th grade) from public and private schools from 26 Brazilian state capitals and the Federal District. It is a cross-sectional study involving 60,973 students and 1,453 public and private schools. Data analysis indicates that 5.4% (IC95%: 5.1%-5.7%) of students reported having suffered bullying almost always or always in the last 30 days, 25.4% (IC95%: 24.8%-26.0%) were rarely or sometimes the victim of bullying and 69.2% (IC95%: 68.5%-69.8%) of students felt no humiliation or provocation at school. The capital with higher frequency of bullying was Belo Horizonte (6.9%; IC95%: 5,9%-7,9%), Minas Gerais, and the lowest was Palmas (3.5%; IC95%: 2.6%-4.5%), Tocantins. Boys reported more bullying (6,0%; IC95%: 5.5%-6.5%) compared with girls (4,8%; IC95%: 4.4%-5.3%). There was no difference between public schools 5.5% (IC95%: 5.1%-5.8%) and private (5.2%) (IC95%: 4.6%-5.8%), except in Aracaju, Sergipe, that show more bullying in private schools. The findings indicate an urgent need for intersectoral action from educational policies and practices that enforce the reduction and prevention of the occurrence of bullying in schools in Brazil.

Physiotherapy and collective health: challenges and new professional responsibilities

Abstract: The physiotherapist is destining its attention almost exclusively on the cure of patients and their rehabilitation However, the new epidemic profile and the new logic of organization of the health system suggest the restructuring of this professional practices and the re-definition of the field of the physiotherapist's performance In this sense, this article aims to discuss the reorientation of the field of the physiotherapy professional performance and the new possibilities of acting at the Unified Health System (SUS) The article starts with a debate about the demographic, epidemiological and nutrition transitions and the new professional demands before the new attendance models Taking as reference the model of health surveillance and the primary attention as a restructuring axis of the health system, it is highlighted the overcome of the rehabilitation as only level of professional performance and showed the collective model of the physiotherapy as an instrument of reorientation of the physiotherapist's performance Finally, it is presented some possibilities of the physiotherapist's performance in the basic attention and in the collective ambit

Nurses and doctors turnover: an impasse in the implementation of the Family Health Strategy

Abstract: The research analyzed the causes for turnover rate of doctors and nurses in family health strategy teams with at least two years of implementation on March 2006 in Vale do Taquari, Rio Grande do Sul State. It is a quantitative and qualitative study identifying 31 teams in 25 towns, and the turnover rate was established by year from 1999 to 2005 by professional category. There was no turnover for doctors and nurses in 1999 and 2000. Doctor turnover was 5.9% in 2002; 32.1% in 2003; 25.8% in 2004; and 64.5% in 2005. Regarding nurses, it was 27.7% in 2001; 47% in 2002; 17.8% in 2003; 41.9% in 2004; and 22.6% in 2005. The analysis of semi-structured interviews with 7 doctors and 7 nurses appointed as main causes for turnover: poor work links, fragmented education, authoritarian way of managing, no links with the community, and poor work conditions. Thus, it is necessary to make changes regarding labor links, work conditions, and education for health workers and managers, seeking for the integrality in health practices.

Capacidade funcional, condições socioeconômicas e de saúde de idosos atendidos por equipes de Saúde da Família de Goiânia (GO, Brasil)

Abstract: O envelhecimento populacional e um desafio para os profissionais de saude. Este estudo objetivou avaliar a capacidade funcional e identificar os fatores associados a dependencia para as atividades de vida diaria (AVD) e instrumentais de vida diaria (AIVD) e descrever o perfil socioeconomico, demografico e de saude de idosos. Trata-se de pesquisa transversal realizada com idosos atendidos pelas equipes de Saude da Familia do Distrito Sanitario Leste de Goiânia (GO). Aplicou-se questionario para obtencao de dados socioeconomicos e demograficos, fatores relacionados a saude e escalas de avaliacao funcional. Para analise, utilizou-se o teste Qui-Quadrado, considerando o nivel de significância de 5%. A amostra foi composta por 388 idosos, sendo 57,5% entre 60 e 69 anos, 58,5% do sexo feminino, 39,7% analfabetos, 77,3% com renda 80 anos. Esses resultados denotam que os idosos estao vivenciando envelhecimento caracterizado por comorbidades e dependencia para realizar as atividades diarias.

Revisão sistemática sobre o conceito de acesso nos serviços de saúde: contribuições do planejamento

Abstract: This article aims to discuss the category access to health services and the Planning contributions to building it on SUS. The central discourse axis refers to the connection between theoretic and practice planning on the Collective Health field related to different analysis dimensions of access: economic, technical-assistential, political and symbolic, described theorists in the field. The dimensions evidence contributions of subjects/authors for greatest approximation to the health reality of country; regarding the understanding of symbolic elements that determinate intervention in health-disease process, as well as regarding the different ways of organization of the Health System and policies, observed in its political, economic, technical-assistential components.

Educação em saúde como estratégia de promoção de saúde bucal em gestantes

Abstract: This literature revision is intended to discuss the importance of health education as a strategy to oral health promotion in the pregnancy period. The most common mouth manifestations during pregnancy have been studied, and the conclusion is that, although pregnancy itself is not responsible for such manifestations in the mouth, e.g. dental decay and periodontal diseases, a dentistry follow-up during prenatal care is necessary, considering that hormonal alterations in pregnancy may aggravate the diseases contracted. The oral health promotion for pregnant women has been focused on mouth health education, considering it an important part of the Program of Attention to Women's Health, as recommended by the current National Politics' Mouth Health Policy. It is considered that, by means of mouth health education activities, implemented during prenatal care by a multiprofessional team, under an oral surgeon, women may be aware of the importance of their role in the attainment and maintenance of positive mouth health habits in family environment and act as an agent to multiply preventive and mouth-health-promotion information.

Monitoring and evaluation of adherence to ARV treatment for HIV/aids: challenges and possibilities

Abstract: The advances in research and treatment regimens have transformed aids into a chronic illness, with a marked increase in the quality of life of those living with HIV/aids. This brings new challenges in understanding and treating the disease and those living with it. From this perspective, adherence to antiretroviral treatment (ART) has been made a priority in the public policy of countries such as Brazil. This article discusses the challenges and potential solutions to the monitoring and evaluation of adherence to ART as well as the advantages and disadvantages of the techniques available for its assessment. Emphasis was given to the work done in countries with scarce resource with patients who have little or no formal education. It is necessary to take into account logistic, conceptual and empirical aspects in the choice of methods to monitor the adherence, examining sociocultural and economic contexts, especially in countries with scarce resource. The conclusion is that identify adequate and effective ways of measuring adherence remains an important challenge for those who work with HIV/aids.

Health care networks: contextualizing the debate

Abstract: The proposal of organization in health services networks has been included in the broad field of integrated health care, a general denomination which includes a wide range of interventions varying in objectives and scope, which have in common the pursuit of integration strategies and tools. Among the main experiences in the field are the American integrated delivery systems and the traditional regionalized networks of the national health systems, especially after the introduction of new cooperation strategies. However, while strategies and organizational arrangements might be similar, context is central to debate. Not considering differences concerning health systems nature may turn it difficult to grasp main distinctions in policy making which are responsible for possibilities and limitations of adopting integration strategies and tools. This article aims to look for references in the literature and international experience that might contribute to the debate on health networks building in the Brazilian Unified Health System (SUS). It discusses context regarding the creation of integrated health services networks in two cases, the British National Health Service and the American Health System, focusing specifically on the health services organization component.

A framework for examining social stress and susceptibility to air pollution in respiratory health

Abstract: There is growing interest in disentangling the health effects of spatially clustered social and physical environmental exposures and in exploring potential synergies among them, with particular attention directed to the combined effects of psychosocial stress and air pollution. Both exposures may be elevated in lower-income urban communities, and it has been hypothesized that stress, which can influence immune function and susceptibility, may potentiate the effects of air pollution in respiratory disease onset and exacerbation. In this paper, we review the existing epidemiologic and toxicologic evidence on synergistic effects of stress and pollution, and describe the physiologic effects of stress and key issues related to measuring and evaluating stress as it relates to physical environmental exposures and susceptibility. Finally, we identify some of the major methodologic challenges ahead as we work toward disentangling the health effects of clustered social and physical exposures and accurately describing the interplay among these exposures. As this research proceeds, we recommend careful attention to the relative temporalities of stress and pollution exposures, to nonlinearities in their independent and combined effects, to physiologic pathways not elucidated by epidemiologic methods, and to the relative spatial distributions of social and physical exposures at multiple geographic scales.

Desafios para gestão do trabalho a partir de experiências exitosas de expansão da Estratégia de Saúde da Família

Abstract: This article discusses the management of the work in Family Health Strategy in four major urban centers. The research includes perspectives from different actors who compose and integrate the network of working relationships in Public Health System through questionnaires with employees of professional categories family health team and interviews with managers and representatives of professional bodies. It is a qualitative-quantitative evaluation study. The dimensions analysed were: insertion and remuneration policies, strategies and qualification of employees. The insertion and remuneration policy highlights the replacement of outsourced frames and hiring by public tender that allows links labor more stable. Other strategies are the establishment of allowance for expertise in areas of greater social vulnerability and the assimilation of specialists in Family and Community Medicine with other experts engaged in secondary services. The political will of municipal Manager to qualify the workforce of family health, maintaining the provision of adequate human resources needs of the health system is a fundamental factor for the consolidation of family health strategy in the face of the low degree of specialization of professionals to work in primary health care.

Assistência Farmacêutica no Sistema Único de Saúde: da Política Nacional de Medicamentos à Atenção Básica à Saúde

Abstract: This study of theoretical revision discuss the Pharmaceutical Assistance in the Basic Units of Health, rescuing briefly the history of the National Drug Policy, the mechanisms of financing in the process of health decentralization and Pharmaceutical Assistance on the Basic Attention to Health The expansion of the population access to the health system has demanded changes on drug distribution in order to increase the coverage and at the same time to reduce costs It was identified advances in legal and institutional structures: the management decentralization of actions on pharmaceutical assistance; the expansion of the population access to essential medicines; and the establishment of the pharmaceutical assistance in some cities However, it still persists priority actions in relation to the financing and population coverage, in detriment of quality processes The conclusion is that, many Brazilian cities has low availability and discontinuity of essential medicine offer; dispensation by workers without qualification; inadequate conditions of storage that compromise the quality of medicines; medicine prescription that does not belong to the National Reference of Essential Medicines; and problems related to the access of users to the pharmacotherapy

Integralidade da saúde: norteando mudanças na graduação dos novos profissionais

Abstract: The strong changes happened in the health sector with the creation of the Brazilian Unified Health System had forced a reflexion about the formation of the new health professionals. However, the substitution of the dominant health care system, centered in the illness, hospital and super specialized assistance, by attention's models that value the integrality, the humanized care and the health's promotion, was not yet conquered and depends, in great measured, on the formation's profile and the practice of the health professionals. It is in the distance between the new professional's formation and the user's necessities of the system that is the great obstacle of the relation of health services and health education. This essay tries to formulate an understanding about the necessity of a more integral formation for a more integral service. It aims to give subsidize to affirm that the integrality of the health actions must be preceded by the integrality of the thought and health education.

A judicialização da saúde e os novos desafios da gestão da assistência farmacêutica

Abstract: Health litigation spurs many challenges in the management of pharmaceutical services. Performance of health managers and decisionmakers must be adjusted to new administrative and legal boundaries. Their actions must also be efficient in responding to ongoing lawsuits, as well as in avoiding additional litigation and in upholding principles and directives of the Brazilian Health System (SUS). This paper proposes to better understand one of the aspects of health litigation, namely the growing use of lawsuits demanding medicines, and the relationship between this phenomenon and pharmaceutical services management in SUS. Through review and analysis of available published research on the subject, from various Brazilian states, the main elements of "medicines litigation" are presented and examined in light of their interference on the activities of the pharmaceutical services cycle. The analysis points to possible mechanisms to be adopted by decision-makers in management and in the Judicial System, since the right to health can only be effectively established when management and Justice are predominantly aware and committed to the safety and the protection of patients and users.

Humanização das práticas do profissional de saúde: contribuições para reflexão

Abstract: Este artigo se propoe a contribuir com subsidios para a reflexao da atuacao clinica contemporânea sob a otica da humanizacao da atencao a saude a partir de revisao da literatura indexada e publicada no Brasil nas bases de dados da biblioteca virtual em saude (BVS) e Scielo entre 1987 e 2007, bem como autores citados nestes estudos e publicados no mesmo periodo, quando considerado essencial para consubstanciar as discussoes apresentadas. Tambem sao discutidas questoes ligadas a humanizacao da saude a partir da concepcao da humanizacao como politica de saude e como pratica profissional, assim como possibilidades de ampliacao da discussao da necessidade de incorporar tais premissas nas diversas etapas da formacao dos alunos de graduacao no que concerne ao tema. Alem disso, sao apresentadas proposicoes para contribuir a formacao do profissional ligado ao setor saude desde a graduacao, bem como subsidios para a reflexao sobre as propostas curriculares e oportunidades oferecidas pelos professores universitarios, os quais podem influir fortemente na formacao profissional e, posteriormente, com o funcionamento e com as praticas vigentes nos servicos de saude.

[Prevalence of enteroparasitosis in the population of Maria Helena, Paraná State].

Abstract: The epidemiological study on intestinal parasites has the purpose of determining the main diseases and their respective etiologic agents, which are endemically or epidemically spread worldwide. The aim of this study was to evaluate the enteroparasitosis infection prevalence, in which age group they prevail, relating the infection with age, gender, and the region in which the person lives, in the city of Maria Helena - PR. Data collection was performed from June of 2004 to May of 2006. 431 samples of feces were analyzed through the spontaneous sedimentation and centrifugal fluctuation methods. The enteroparasitosis prevalence was of 16%, being the most frequent enteroparasitosis: Endolimax nana (6.5%), Entamoeba coli (3.5%), Giardia lamblia (6.3%), Ascaris lumbricoides (1.4%), Strongyloides stercoralis (0.7%), Entrobius vermicularis (0.7%), Anchylostomiasis (0.2%), Entamoeba hystolitica and Taenia sp (0.2%). Poly-parasitism was found in 3.2% of the samples. The age group from 0 to 9 years presented the highest prevalence, however there was no statistical difference among the analyzed factors since p>0.05. From these results, it was possible to conclude that the city presents similar characteristics both in rural and urban zones.

Vivência de violência entre escolares brasileiros: resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE)

Abstract: This article presents the main results of the National Adolescent School-based Health Survey (PeNSE). A questionnaire was applied to a sample of 60,973 students of the 9th year of Junior high school in public and private schools of the Brazilian state capitals and the Federal District, between March and June 2009. The prevalence and confidence interval of 95% (CI 95%) of the violence situations involving adolescents were analyzed. The following situations were identified: lack of safety on the way home-school (6.4%; CI95%: 6.1%-6.8%) and at school (5.5%; CI95%: 5.2%-5.8%); involving fights with physical aggression (12.9%; CI95%: 12.4%-13.4%), with knife (6.1%; CI95%: 5.7%-6.4%) or fire arm (4.0%; CI95%: 3.7%-4.3%); physical aggression by family member (9.5%; CI95%: 9.1%-9.9%). Violence situations were more prevalent among male students. There were great variations among the cities studied. Adolescents are exposed to different violence manifestations in the institutions that supposedly must assure their protection and healthy development: school and the home. These results aim to support health promotion measures and prevention of these risk factors.

Democratic management and new craft: concepts to rethink integration between autonomy and responsibility in health work

Abstract: This article analyses tensions between the dominant management rationality and health work. By means of philosophical concepts and bibliography revision it was found that clinical and public health practices are structured as praxis, a term defined by Aristotle. It does not work automatically, depending on a human being to reflect and decide in most situations, making mediation between established knowledge and singular context. So, it is recommended the adoption of a management model that enables and favors the combination of professional autonomy and sanitary responsibility.

Condições de trabalho e transtornos mentais comuns em trabalhadores da rede básica de saúde de Botucatu (SP)

Abstract: Common mental disorders (CMD) present high prevalence among general populations and workers with important individual and social consequences. This cross-sectional and descriptive study explores the relationship between psychological job demands, job control degree and job support and prevalence of CMD among primary health care workers of Botucatu - SP. The data collection was carried out using an unidentified self-administered questionnaire, with emphasis on items relating to demand-control-support situation and occurrence of CMD (Self Reporting Questionnaire, SRQ-20). The data were stored using the software Excel / Office XP 2003, and the statistical analyses were performed in SAS system. It was evidenced that 42.6% of primary health care workers presented CMD. The observed association - high prevalence of CMD with high-strain job (Karasek model) and low prevalence of CMD with low-strain job - indicates that, in the studied city, primary health care work conditions are contributive factors to workers' illness. The survey reveals the need of interventions aiming at caring the workers and also gets better work conditions and increase social support at work.

Situation of lawsuits concerning the access to medical products by the Health Department of Santa Catarina State, Brazil, during the years 2003 and 2004

Abstract: This study describes the situation of lawsuits concerning the access to medical products by the Health Department of Santa Catarina State (SES/SC), Brazil, during the years of 2003 and 2004 The variables considered were: declared illnesses, medicines demanded, prescription origin, possible alternatives therapeutics in the Santa Catarina State Register of Essential Medicines (Resme), the medicines registration at the National Health Surveillance Agency (Anvisa) and total expenditure 622 lawsuits were filed Total expenditure was R$ 11,333,750,00 (Brazilian Reais) Private health care was the source of 56% of the prescriptions Hepatitis C and rheumatoid arthritis were the most commonly diseases involved About 40% of requested drugs were on the Resme 62% of required drugs were approved in Brazil after 2000 PEG-Interferon and Infliximab were responsible for 46% of total expenditure There were still some cases of drugs or indications not registered at Anvisa These results indicate the need to reassess the list of medicines regularly provided by the SES/SC, and also to improve accessibility to (and information concerning) Programs of medicines distribution These measures may potentially reduce the number of lawsuits filed against the State

Educação em saúde: uma reflexão histórica de suas práticas

Abstract: This text aims to contextualize the transformations occurred in the practice of health education since the political scenario in the end of 19th century, when the first extended initiatives of the Brazilian State in the health field were organized, until the creation of the Brazilian Unified Health System

Yoga in Modern India: the Body Between Science and Philosophy

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