Emiko Yoshikawa Egry

Characteristics of violence against children in a Brazilian Capital

The purpose of this exploratory, descriptive and retrospective study with a quantitative approach was to characterize violence against children in Curitiba. Reports of 2004 through 2008 about compulsory denouncements of violence cases were analyzed. The results showed an increase in violence, with home violence as the most frequent type and five to nine-year-olds as the most affected group, and negligence and physical violence as the most denounced forms of violence. Almost 81% of the sexual violence is performed against girls and the father is the main aggressor, showing inequality in gender relations and between generations. The importance of notification as a visibility instrument is highlighted. Other confrontation measures are necessary though, such as the promotion of equitable relationships of gender and generation, and cross-sectional policies that involve the social segments in a praxis that transforms reality.The purpose of this exploratory, descriptive and retrospective study with a quantitative approach was to characterize violence against children in Curitiba. Reports of 2004 through 2008 about compulsory denouncements of violence cases were analyzed. The results showed an increase in violence, with home violence as the most frequent type and five to nine-year-olds as the most affected group, and negligence and physical violence as the most denounced forms of violence. Almost 81% of the sexual violence is performed against girls and the father is the main aggressor, showing inequality in gender relations and between generations. The importance of notification as a visibility instrument is highlighted. Other confrontation measures are necessary though, such as the promotion of equitable relationships of gender and generation, and cross-sectional policies that involve the social segments in a praxis that transforms reality.

Internações por condições sensíveis à atenção primária no estado de São Paulo

Internments suitable for Primary Healthcare constitute a new indicator used in some countries to indirectly measure the resolution capability of Primary Healthcare. The scope of this study is to present the panorama of the internments suitable for primary healthcare in Sao Paulo State. An ecological descriptive study was carried out for the period from 2000 to 2007. The data were generated by patients county of residence and grouped by Regional Health Departments. The Information Systems of the Health Ministry and the population estimates of the Brazilian Institute of Geography and Statistics (IBGE) were used to obtain the data of all patients. The internments suitable for primary healthcare in the state follow a tendency toward reduction suggesting a connection with the adoption of the Family Health Program. A reduction in internments for diabetes was detected and attention was drawn to the increase of internment for illnesses related to prenatal care and childbirth. In light of the recent publication of the Brazilian Diagnostics List, studies that analyze the statistics from it can be very useful for managers involved with primary care, and can serve as benchmarks for quality and contribute to assessment for the implementation of health policies in Brazil.

A historicidade das teorias interpretativas do processo saúde-doença

The interpretative theories of the health-illness process that can be identified through History have as consequence intervention projects upon the reality, in response to social needs. Until the 19 century, they could be synthesized in two main streams: ontologic and dynamic. In the ontologic conception, illness assumes the character of a natural or supernatural entity, external to the human body, that shows itself when invading it. The dynamic conception sees illness as a product of the disharmony among vital forces, and the re-establishment of the health comes of the restoration of this balance. At the end of the 18 century, the social-environmental paradigms prevailed in Europe as forms of explanation for human illness, linked to the dynamic conception, and the first evidences of the social determination of the health-illness process were formulated. The onset of the Bacteriologic Era made the ontologic conception victorious and its conquests led to the abandon of the social approaches to face the populations health problems. At the present time, one can identify the prevalence of the multicausal theory, with emphasis in the individual conditionings. This paper proposes the articulation of the individual and collective dimensions of the health-illness process, in consonance with the Theory of Nursing Praxical Intervention in Collective Health.The interpretative theories of the health-illness process that can be identified through History have as consequence intervention projects upon the reality, in response to social needs. Until the 19 century, they could be synthesized in two main streams: ontologic and dynamic. In the ontologic conception, illness assumes the character of a natural or supernatural entity, external to the human body, that shows itself when invading it. The dynamic conception sees illness as a product of the disharmony among vital forces, and the re-establishment of the health comes of the restoration of this balance. At the end of the 18 century, the social-environmental paradigms prevailed in Europe as forms of explanation for human illness, linked to the dynamic conception, and the first evidences of the social determination of the health-illness process were formulated. The onset of the Bacteriologic Era made the ontologic conception victorious and its conquests led to the abandon of the social approaches to face the populations health problems. At the present time, one can identify the prevalence of the multicausal theory, with emphasis in the individual conditionings. This paper proposes the articulation of the individual and collective dimensions of the health-illness process, in consonance with the Theory of Nursing Praxical Intervention in Collective Health.The interpretative theories of the health-illness process that can be identified through History have as consequence intervention projects upon the reality, in response to social needs. Until the 19 century, they could be synthesized in two main streams: ontologic and dynamic. In the ontologic conception, illness assumes the character of a natural or supernatural entity, external to the human body, that shows itself when invading it. The dynamic conception sees illness as a product of the disharmony among vital forces, and the re-establishment of the health comes of the restoration of this balance. At the end of the 18 century, the social-environmental paradigms prevailed in Europe as forms of explanation for human illness, linked to the dynamic conception, and the first evidences of the social determination of the health-illness process were formulated. The onset of the Bacteriologic Era made the ontologic conception victorious and its conquests led to the abandon of the social approaches to face the populations health problems. At the present time, one can identify the prevalence of the multicausal theory, with emphasis in the individual conditionings. This paper proposes the articulation of the individual and collective dimensions of the health-illness process, in consonance with the Theory of Nursing Praxical Intervention in Collective Health.

Domestic violence against women from the perspective of the community health agent

This study addresses violence against women from the perspective of Community Health Agents and related care practices developed at the basic care level. It aims to understand their opinions and care practices in daily care delivery in order to support training of workers on this theme. The theoretical-methodological reference was gender violence as a social construct and ideology as a social product and guider of health care practices. Data collection was carried out through a questionnaire with closed questions addressing these professionals’ positions in relation to facts in the care delivery context. The results showed that positions and conceptions are mostly supported by common perceptions, that is, they do not differ from women victims of violence or lay people in general, which leads to the conclusion that it is necessary to broaden the discussion of this problem, introducing the gender perspective in the acknowledgement and care of women.

PROCESSO DE TRABALHO DE GERÊNCIA: INSTRUMENTO POTENTE PARA OPERAR MUDANÇAS NAS PRÁTICAS DE SAÚDE?

Este estudo analisa o modo como o gerenciamento de servicos de saude se articula a organizacao da producao de Unidades Basicas de Saude, tomando como contexto o processo de implantacao do modelo tecnoassistencial de SILOS. Procura-se nesse estudo operar com instrumentos analisadores que permitam compreender o processo de trabalho de gerencia nos seus aspectos micropoliticos, correlacionando-o as questoes macropoliticas que o perpassam. Conclui-se que existe a possibilidade de se identificar terrenos de potencia no trabalho de gerencia que podem produzir transformacoes nos servicos de saude.

Caminhos da formação de enfermagem: continuidade ou ruptura?

Apresentam-se algumas reflexoes sobre as atuais tendencias da formacao em Enfermagem frente as Diretrizes Curriculares para os Cursos de Graduacao em Enfermagem, visando subsidiar as transformacoes no ensino de 3o grau. Volta-se especificamente para a discussao da formacao da enfermeira, enfocando o desenvolvimento de competencias necessarias a transformacao do modelo assistencial vigente e ao trabalho em equipe multiprofissional, visando a consolidacao do SUS.Some reflections are presented about the current trends in Nursing Education in face of Curricular Guidelines for Undergraduate Programs in Nursing, aiming at providing subsidies for changes in Higher Education. It is primarily geared to discussing nurse education, focusing on the development of the competencies needed to change the present health care delivery model and to working in multiprofessional teams, aiming at the consolidation of the Public Health System (SUS--Serviço Unico de Saúde) in Brazil.

Classificação Internacional de Práticas de Enfermagem em Saúde Coletiva - CIPESC®

El proyecto de Clasificacion Internacional de la Practica de Enfermeria en Salud Colectiva - CIPESC fue la contribucion brasilena para incorporar la nocion del colectivo en la Clasificacion Internacional de la Practica de Enfermeria CIPE . El articulo tiene como objetivo analizar la produccion bibliografica acerca de las clasificaciones de enfermeria en bases de informaciones disponibles en la biblioteca virtual en salud desde 1990. Se trata de una investigacion bibliografica acerca de los sistemas clasificatorios y es parte de un proyecto que pretende identificar la faz colectiva del instrumento CIPESC utilizado en la red municipal de salud de Curitiba, capital del estado de Parana. La mayoria de los articulos referentes a los sistemas clasificatorios en general, son los que se asientan en el modelo clinico-individual, sendo una minoria los que se asientan en el modelo epidemiologico social. Aun, la mayoria de los estudios, con enfoque en el colectivo estan siendo divulgados por las publicaciones de la Asociacion Brasilena de Enfermeria, volviendola hegemonica en la diseminacion de los conocimientos a cerca del tema, en su faz colectiva.O projeto da Classificacao Internacional da Pratica de Enfermagem em Saude Coletiva - CIPESC foi a contribuicao brasileira para incorporar a nocao do coletivo na Classificacao Internacional da Pratica de Enfermagem CIPE . O artigo tem como objetivo analisar a producao bibliografica acerca das classificacoes de enfermagem, disponiveis na base de dados da biblioteca virtual em saude, a partir de 1990. Trata-se de uma pesquisa bibliografica sobre os sistemas classificatorios das praticas de enfermagem, e que faz parte de uma pesquisa que pretende identificar a face coletiva do instrumento CIPESC na rede municipal de saude de Curitiba-PR. Constatou-se que, referente aos sistemas classificatorios em geral, a maioria dos textos acessados baseia-se no modelo clinico-individual e os que enfatizam o modelo epidemiologico e social ainda e minoria. Alem disso, a maioria dos estudos, com enfoque no coletivo, e divulgada pelas publicacoes da Associacao Brasileira de Enfermagem, tornando-a hegemonica na disseminacao dos conhecimentos acerca do tema, em sua face coletiva.The project International Classification of the Nursing Practices in Collective Health-CIPESC was the Brazilian contribution for the incorporation of the notion of collectiveness in the International Classification of Nursing Practice-ICNP. This article aims at analyzing the bibliographical production concerning nursing classifications available in the virtual library in health database since 1990. This is a bibliographical survey of nursing practice classification systems and is part of a larger research that intends to identify the collective face of the CIPESC instrument in the municipal health network of the city of Curitiba, in the State of Parana. The result shows that the majority of the texts are based on the clinical-individual model, and those that emphasize the social-epidemiologic model are still a minority. In addition, most studies focused on the collective were disseminated through the publications of the Brazilian Nursing Association, which has the hegemony in the diffusion of the knowledge about the collective face of classification systems.

A formação da enfermeira na perspectiva da educação: reflexões e desafios para o futuro

The present article proposes to show a reflection in the nurses formation on the point of view of educators, philosophers and contemporary researchers. Moacir Gadotti, Edgar Morin e Philippe Perrenouds theories and reflections were used, as well as the four pillars of the contemporary education, presented in the Delors Account. The adoption of tools like learning to know, learning to do, learning to be and learning to live together as well as the competences abording, are indispensable devices in the formation of professionals in the modern world. It is believed that in incorporating these new dimensions to the nurses formation, it will be possible to untie the notts that are to be overcome in the conformation of critic nursing professionals, competent and agents of social transformation.The present article proposes to show a reflection in the nurses formation on the point of view of educators, philosophers and contemporary researchers. Moacir Gadotti, Edgar Morin e Philippe Perrenouds theories and reflections were used, as well as the four pillars of the contemporary education, presented in the Delors Account. The adoption of tools like learning to know, learning to do, learning to be and learning to live together as well as the competences abording, are indispensable devices in the formation of professionals in the modern world. It is believed that in incorporating these new dimensions to the nurses formation, it will be possible to untie the notts that are to be overcome in the conformation of critic nursing professionals, competent and agents of social transformation.

[The evaluative limits and possibilities in the family health strategy for gender-based violence].

The study aimed to understand the evaluative limits and possibilities of the Family Health Strategy (FHS) in acknowledging and confronting the health needs of women experiencing gender-based violence. This was a case study with a qualitative approach, conducted in a Basic Health Unit that operated under the FHS in São Paulo (SP). Data were collected through interviews with health professionals of the multidisciplinary teams, and women users of the service who experienced gender-based violence. The results were analyzed according to the analytical categories: gender, gender-based violence and health needs. Medicalization was seen as the most significant limitation of professional practice. Moreover, there were opportunities related to the bond afforded by the logic of attention brought by the FHS. Such possibilities, however, were still curtailed by the limitations of the biomedical model and the absence of specific technologies to deal with violence.The study aimed to understand the evaluative limits and possibilities of the Family Health Strategy (FHS) in acknowledging and confronting the health needs of women experiencing gender-based violence. This was a case study with a qualitative approach, conducted in a Basic Health Unit that operated under the FHS in Sao Paulo (SP). Data were collected through interviews with health professionals of the multidisciplinary teams, and women users of the service who experienced gender-based violence. The results were analyzed according to the analytical categories: gender, gender-based violence and health needs. Medicalization was seen as the most significant limitation of professional practice. Moreover, there were opportunities related to the bond afforded by the logic of attention brought by the FHS. Such possibilities, however, were still curtailed by the limitations of the biomedical model and the absence of specific technologies to deal with violence.

Limites e possibilidades avaliativas da estratégia saúde da família para a violência de gênero

The study aimed to understand the evaluative limits and possibilities of the Family Health Strategy (FHS) in acknowledging and confronting the health needs of women experiencing gender-based violence. This was a case study with a qualitative approach, conducted in a Basic Health Unit that operated under the FHS in São Paulo (SP). Data were collected through interviews with health professionals of the multidisciplinary teams, and women users of the service who experienced gender-based violence. The results were analyzed according to the analytical categories: gender, gender-based violence and health needs. Medicalization was seen as the most significant limitation of professional practice. Moreover, there were opportunities related to the bond afforded by the logic of attention brought by the FHS. Such possibilities, however, were still curtailed by the limitations of the biomedical model and the absence of specific technologies to deal with violence.The study aimed to understand the evaluative limits and possibilities of the Family Health Strategy (FHS) in acknowledging and confronting the health needs of women experiencing gender-based violence. This was a case study with a qualitative approach, conducted in a Basic Health Unit that operated under the FHS in Sao Paulo (SP). Data were collected through interviews with health professionals of the multidisciplinary teams, and women users of the service who experienced gender-based violence. The results were analyzed according to the analytical categories: gender, gender-based violence and health needs. Medicalization was seen as the most significant limitation of professional practice. Moreover, there were opportunities related to the bond afforded by the logic of attention brought by the FHS. Such possibilities, however, were still curtailed by the limitations of the biomedical model and the absence of specific technologies to deal with violence.