André de Faria Pereira Neto

A internet, o paciente expert e a prática médica: uma análise bibliográfica

El mundo ha presenciado en los ultimos anos una amplia transformacion tecnologica que ha ampliado substancialmente el acceso a la informacion, sobre todo por medio de Internet. En el area de la salud hay cada vez mas informacion disponible. El acceso a la informacion tecnico-cientifica, aliado con el aumento del nivel educacional de las poblaciones ha hecho surgir un paciente que busca informaciones sobre su enfermedad, sintomas, medicamento y costo de internacion y tratameinto: el paciente experto. Este articulo discute de que modo las informaciones obtenidas en Internet modifican o interfieren en la relacion medico-paciente. Se recupera la controversia entre Freidson y Haug sobre la des-profesionalizacion del medico. Metodologicamente se analizan opiniones de los autores que han publicado articulos sobre el tema, entre 1997 y 2005, en dos importantes revistas academicas del sector inglesas. Se concluye que las posiciones encontradas son diferentes e incluso antagonicas; y Brasil, pese a la exclusion digital, necesita analizar esta cuestion.O mundo presenciou nos ultimos anos uma ampla transformacao tecnologica que ampliou substancialmente o acesso a informacao, sobretudo por meio da Internet. Na area da saude ha cada vez mais informacao disponivel. O acesso a informacao tecnico-cientifica, aliado ao aumento do nivel educacional das populacoes tem feito surgir um paciente quebusca informacoes sobre sua doenca, sintomas, medicamento e custo de internacao e tratamento: o paciente expert. Este artigo discute de que modo as informacoes obtidas na internet modificam ou interferem na relacao medico-paciente. Recupera-se a controversia entre Freidson e Haug sobre a desprofissionalizacao do medico. Metodologicamente, foram analisadas opinioes dos autores que publicaram artigos sobre o tema, entre 1997 e 2005, em duas importantes revistas academicas inglesas da area. Conclui-se que as posicoes encontradas sao distintas e ate antagonicas, e o Brasil, apesar da exclusao digital, precisa analisar esta questao.

Reflexão sobre a legitimidade da autonomia da enfermagem no campo das profissões de saúde à luz das ideias de Eliot Freidson

Resumen This study aims to reflect about Nursing as a health profession in the light of Eliot Freidson’s theory of professions. It approaches the necessary credentials for an occupation to be recognized as a profession, relating them to the nursing’s characteristics, with a special focus in Brazil. In Freidson’s approach, exper tise, autonomy and self-regulation are highlighted as professional credentials. Nursing is analyzed by emphasizing its responsibility for a range of tasks whose performance is based on scientific knowledge, on the need of specific professional training, on the knowledge availability and the State recognition of formal credentials for the professional member’s protection. It concludes that Nursing is a health profession with a key role in the health’s reality transformation and that investment is needed to convince society about its usefulness as a profession dedicated to people’s health needs.

The internet, expert patients and medical practice: an analysis of the literature

El mundo ha presenciado en los ultimos anos una amplia transformacion tecnologica que ha ampliado substancialmente el acceso a la informacion, sobre todo por medio de Internet. En el area de la salud hay cada vez mas informacion disponible. El acceso a la informacion tecnico-cientifica, aliado con el aumento del nivel educacional de las poblaciones ha hecho surgir un paciente que busca informaciones sobre su enfermedad, sintomas, medicamento y costo de internacion y tratameinto: el paciente experto. Este articulo discute de que modo las informaciones obtenidas en Internet modifican o interfieren en la relacion medico-paciente. Se recupera la controversia entre Freidson y Haug sobre la des-profesionalizacion del medico. Metodologicamente se analizan opiniones de los autores que han publicado articulos sobre el tema, entre 1997 y 2005, en dos importantes revistas academicas del sector inglesas. Se concluye que las posiciones encontradas son diferentes e incluso antagonicas; y Brasil, pese a la exclusion digital, necesita analizar esta cuestion.O mundo presenciou nos ultimos anos uma ampla transformacao tecnologica que ampliou substancialmente o acesso a informacao, sobretudo por meio da Internet. Na area da saude ha cada vez mais informacao disponivel. O acesso a informacao tecnico-cientifica, aliado ao aumento do nivel educacional das populacoes tem feito surgir um paciente quebusca informacoes sobre sua doenca, sintomas, medicamento e custo de internacao e tratamento: o paciente expert. Este artigo discute de que modo as informacoes obtidas na internet modificam ou interferem na relacao medico-paciente. Recupera-se a controversia entre Freidson e Haug sobre a desprofissionalizacao do medico. Metodologicamente, foram analisadas opinioes dos autores que publicaram artigos sobre o tema, entre 1997 e 2005, em duas importantes revistas academicas inglesas da area. Conclui-se que as posicoes encontradas sao distintas e ate antagonicas, e o Brasil, apesar da exclusao digital, precisa analisar esta questao.

Internet na promoção da saúde: um instrumento para o desenvolvimento de habilidades pessoais e sociais

The development of individual and social skills, in the sense of acquiring greater control and produce empowerment, is considered a very important Health Promotion strategy. Access to information is one of the bases for such process. Much has been said and written about the immense potential of the internet, as studies point it as a special tool to obtain information and develop skills, both individual and communal. This article is based on national and international scientific literature on Health Promotion, Health Information on the internet and Digital Divide, with the aim of discussing the possibility of using the internet as a resource on Health Promotion projects, highlighting strength points and potential barriers, especially the digital divide. The authors believe that the internet may be a great ally in building projects for Health Promotion, however, in developing these projects is essential to consider the potential risks and understand that the strategies and programs in health promotion area need to adapt to the needs and possibilities of each site and take into account social, cultural and economic differences.

Cultura Identitária pró-anorexia: características de um estilo de vida em uma comunidade virtual

Anorexia nervosa is a disease listed in the International Classification of Diseases. However, young pro-anorexics believe they are adopting a “lifestyle”. The aim of this paper is analyze the “cultural identity” of these youth, investigating a Brazilian Virtual Community. Virtual Ethnography was used methodologically in three “units of meaning” found in this community: the tension between anorexia as a disease versus anorexia as a lifestyle, the ideal of perfection and the meaning of belonging to the group. The results suggest that pro-anorexia identity differs from the biomedical model. She admits that the thin body serves as reference for social recognition and economic success. In this sense, the online forums allow construction of identity based on anonymity. We conclude that studies of anorexic practices in Virtual communities should be encouraged because they contribute to understanding the universe of the adolescents and collaborate to promote policies and actions for their health. Key-words: Anorexia; Adolescent Behavior; Webcasts as Topic and Internet.

Participatory evaluation of the quality of health information on the internet: the case of dengue sites

The world has witnessed a powerful and radical transformation of social, economic and cultural relationships promoted by the Internet. The Internet provides opportunities for access, dissemination and production of information worldwide. Health, for example, stands out as one of the main areas with information of interest to a growing number of users. However, this information is often unsatisfactory, incorrect or incomprehensible. This paper analyzes an experiment of evaluation of information on dengue websites developed in a laboratory of the Oswaldo Cruz Foundation. It counted on the participation of a group of Manguinhos dwellers and Public Health PHC physicians, infectious disease specialists and public health physicians in the development of criteria and the evaluation of websites. This paper shows the main results of this experience, which is innovative because its paper and product differ from those proposed by national and foreign agencies and analysts. This experience supports the establishment of an institutional process that issues a quality seal to websites that comply with the suggested criteria and indicators.

Temporal and spatial evolution of maternal and neonatal mortality rates in Brazil, 1997–2012

OBJECTIVE Maternal and neonatal mortality are important public health issues in low-income countries. This study evaluated spatial and temporal maternal and neonatal mortality trends in Brazil between 1997 and 2012. METHODS This study employed spatial analysis techniques using death records from the mortality information system. Maternal mortality rates per 100,000 and neonatal mortality rates (early and late) per 1000 live births were calculated by state, region, and period (1997-2000, 2001-2004, 2005-2008, and 2009-2012). Multivariate negative binomial models were used to explain the risk of death. RESULTS The mean Brazilian maternal mortality rate was 55.63/100,000 for the entire 1997-2012 period. The rate fell 10% from 1997-2000 (58.92/100,000) to 2001-2004 (52.77/100,000), but later increased 11% during 2009-2012 (58.69/100,000). Early and late neonatal mortality rates fell 33% (to 7.36/1000) and 21% (to 2.29/1000), respectively, during the 1997-2012 period. Every Brazilian region witnessed a drop in neonatal mortality rates. However, maternal mortality increased in the Northeast, North, and Southeast regions. CONCLUSION Brazils neonatal mortality rate has improved in recent times, but maternal mortality rates have stagnated, failing to meet the Millennium Development Goals. Public policies and intersectoral efforts may contribute to improvements in these health indicators.

Pro-anorexia cultural Identity: characteristics of a lifestyle in a virtual community

Anorexia nervosa is a disease listed in the International Classification of Diseases. However, young pro-anorexics believe they are adopting a “lifestyle”. The aim of this paper is analyze the “cultural identity” of these youth, investigating a Brazilian Virtual Community. Virtual Ethnography was used methodologically in three “units of meaning” found in this community: the tension between anorexia as a disease versus anorexia as a lifestyle, the ideal of perfection and the meaning of belonging to the group. The results suggest that pro-anorexia identity differs from the biomedical model. She admits that the thin body serves as reference for social recognition and economic success. In this sense, the online forums allow construction of identity based on anonymity. We conclude that studies of anorexic practices in Virtual communities should be encouraged because they contribute to understanding the universe of the adolescents and collaborate to promote policies and actions for their health. Key-words: Anorexia; Adolescent Behavior; Webcasts as Topic and Internet.

Interfaces da história da Enfermagem: uma potencial agenda de pesquisa

During the 20th Century, historical knowledge ceased to present itself solely as a chronological list of dates and facts. Rather, it developed into a critical feature that detaches from problems of the present while attempting to analyze the past. The history of health also suffered from the same transformation. The purpose of this article is to summarize some current elements of the contemporary historiographical debate surrounding the History of Health, Science, Women, and Professions. The choice of these areas is justified because of their potential as a collective medium for writing about the history of nursing. It revitalizes and publicizes its history - indispensable components for the construction of identity of any profession. In this way, we invite scholars of the History of Nursing to take into consideration this controversial historiography and introduce them into the discussion in a conscientious and qualified manner.

The Internet and Health in Brazil: Trends and Challenges

New information and communication technologies are increasingly present in our daily lives. Change occurred very fast. The sensation is that we live in another world. This new digital reality is where all or almost all economic, social, political, and cultural activities develop. They can be everywhere at the same time in people’s everyday lives. However, digital exclusion and privacy on the Internet are some of the challenges that compromise the initial design of new information and communication technologies as universal, free, and secure by their very nature. In the field of health, the presence of the Internet transcends the technological realm. It is an emerging field characterized by the intersection of different spheres, practices, and knowledge (such as medical informatics), public health, and business. It can be considered a state of mind, a way of thinking, and an attitude that can improve health care. This chapter looks at where Brazil stands in this process, especially in the health field. It also presents the parts in which this book is divided.