José Patrício Bispo Júnior

Perfil do consumo de bebidas alcoólicas e fatores associados em um município do Nordeste do Brasil

Estudo transversal que objetivou verificar o perfil do consumo de bebidas alcoolicas de acordo com sexo, idade, renda e escolaridade na populacao urbana de Jequie, Bahia, Brasil. Amostra aleatoria composta por 270 individuos maiores de 14 anos residentes na zona urbana, pesquisados entre janeiro e marco de 2010. Como instrumento utilizou-se o Alcohol Use Disorders Identification Test (AUDIT). Os resultados mostraram que 21,8% consomem quatro ou mais doses em dia tipico; 14,1% admitiram ja terem causado algum prejuizo apos ter bebido; 26,3% relataram que alguem ja sugeriu que parasse de beber; entre os homens 40% bebem mais que quatro doses no dia tipico; 50,5% dos jovens bebem com alguma frequencia. A distribuicao caracteristica das variaveis estudadas e compativel com maior frequencia e quantidade de uso de alcool entre os homens e entre os jovens. A ocorrencia do padrao de consumo pesado episodico de alcool foi marcante. Sao apresentados grupos vulneraveis, ainda nao considerados dependentes e que tambem devem ser alvo de politicas publicas de promocao da saude e prevencao.This cross-sectional study focused on alcohol consumption according to gender, age, income, and schooling in Jequié, Bahia State, Brazil. The random sample consisted of 270 individuals over 14 years of age living in the urban area of Jequié from January to March 2010. Alcohol consumption was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Of the total sample, 21.8% consumed four or more drinks on a typical day, 14.1% admitted having caused any harm after drinking, and 26.3% reported that someone had already suggested they should stop drinking. Forty percent of men had more than four drinks on a typical day, and 50.5% of young people drank frequently. Distribution of the variables was consistent with higher frequency and greater amounts of alcohol among men and young people. There was a large proportion of heavy episodic alcohol consumption. The study identified vulnerable groups that are still not addicted to alcohol, and that should be targeted for public health promotion and prevention policies.

Potencial participativo e função deliberativa: um debate sobre a ampliação da democracia por meio dos conselhos de saúde

This article reflects upon the relation between democracy and health councils. It seeks to analyze the councils as a space for broadening the scope of democracy. First, some characteristics and principles of the liberal democratic regime are presented, with an emphasis on the minimalist and procedural approach of decision-making. The fragilities of the representative model and the establishment of new relations between the Government and society are then discussed in light of the new social grammar and the complexity of the division between governmental and societal responsibilities. The principles of deliberative democracy and the idea of substantive democracy are subsequently presented. Broadening the scope of democracy is understood not only as the guarantee of civil and political rights, but also especially, of social rights. Lastly, based on discussion of the participation and deliberation categories, the health councils are analyzed as potential mechanisms for broadening the scope of democracy.

Prevalência e fatores associados ao consumo abusivo e à dependência de álcool

The scope of this study is to estimate the prevalence of alcohol abuse and alcohol addiction and the respective associated factors in the urban population of a city of northeastern Brazil. It is a population-based cross-sectional study that investigated the consumption of alcohol of 270 people living in the urban area of Jequie, State of Bahia. Alcohol abuse, defined by a score of > 8 from responses to the Alcohol Use Disorders Identification Test (AUDIT). Alcohol addiction was identified by a score > 2 obtained in the application of the Cut down, Annoyed by criticism, Guilty and Eye-opener (CAGE). The analysis used the logistic regression model. The prevalence of alcohol abuse was 18.5%. For alcohol addiction it was 10.4%. After adjusted analysis, the groups with greater alcohol abuse were men (OR = 5.56) and young (OR = 5.41). Professing evangelical belief was inversely associated with alcohol abuse (OR = 0.04). An association between alcohol abuse was established in the young, males, and smoking, whereas the inverse association was observed with those professing evangelical religious beliefs.

Violência doméstica e sexual no âmbito da Estratégia de Saúde da Família: atuação profissional e barreiras para o enfrentamento

A violencia domestica e sexual e um fenomeno complexo, com multiplas determinacoes. A abordagem do problema exige outros saberes alem dos clinicos e biologicos. O estudo objetivou analisar as percepcoes dos profissionais da saude da familia a respeito do enfrentamento da violencia domestica e sexual. Realizou-se pesquisa qualitativa com 18 profissionais de sete equipes de saude em Vitoria da Conquista-BA. Para a analise, utilizou-se o metodo de codificacao e categorizacao tematica. Os resultados evidenciaram duas categorias centrais: atuacao profissional no atendimento aos casos; e barreiras e dificuldades para o enfrentamento da violencia. Os profissionais demonstraram dificuldades em identificar os casos e sua atuacao esta centrada na abordagem sintomatologica. As principais dificuldades percebidas referem-se ao medo e a inseguranca, a sobrecarga de atribuicoes e a formacao inadequada. Considera-se a necessidade de articulacao intersetorial e o desenvolvimento de politicas de educacao permanente.

Envolvimento comunitário na Estratégia de Saúde da Família: dilemas entre institucionalização e efetiva participação

Este artigo analisa o desempenho dos Conselhos Locais de Saude enquanto instrumentos da participacao social no âmbito da Estrategia de Saude da Familia. Trata-se de pesquisa quali-quantitativa com triangulacao de metodos. O campo de estudo foi o municipio de Vitoria da Conquista-BA. Os dados e informacoes foram obtidos por meio de analise da agenda de compromissos, dos formularios de acompanhamento, das atas das reunioes dos conselhos e por entrevistas semiestruturadas com informantes-chave. Os resultados demonstraram que os conselhos locais de saude apresentam desempenho limitado, com baixa frequencia de realizacao de reunioes, agenda de compromissos voltada para o proprio conselho e reunioes pautadas nas dificuldades de acesso aos servicos de saude. Os baixos niveis de mobilizacao social e envolvimento comunitario sao o principal entrave para o bom desempenho desses foruns. Sao apontados problemas sobre representatividade dos conselheiros, desmotivacao em participar de atividades voluntarias e sentimento de despreparo em decorrencia das fragilidades da formacao e capacitacao. Conclui-se que a institucionalizacao dos conselhos locais nao e condicao suficiente para promover a participacao comunitaria. Sao sugeridas algumas iniciativas com potencial de promover a mobilizacao social e despertar as comunidades para a importância da participacao e do envolvimento coletivo.

Qualidade da informação dos óbitos por causas externas em Fortaleza, Ceará, Brasil

The article analyzes the quality of information of deaths from external causes in Fortaleza, in the State of Ceará, Brazil. They analyzed the completeness of the information of the death certificate (DO) and the correlation between the underlying cause of death described in the OF and registered in the Mortality Information System (SIM ).We used all the original statements of deaths from external causes, occurred in 2010, of residents in Fortaleza. The study population was 2109 DO. The statements were individually checked seeking to identify the completion of the fields and the basic cause attested the coding of the underlying cause in this DO and compared with the SIM was held. The fields with the highest completion rates were: name (100%), place of residence (100%), mothers name (99.6%), place of birth (99.1%), and sex (98.8%). The fields with the lowest completion rates were: place of occurrence (55%), race/skin color (38.4%), and schooling (34%). They observed inadequacies in the completion of the underlying cause. In DO are reported injuries found and not the circumstances of the death. There was poor level of concordance between the basic cause of DO and registered on the SIM (kappa 0.07). They suggest awareness strategies and training of medical examiners.

Participação social na Estratégia de Saúde da Família: análise da percepção de conselheiros de saúde

ABSTRACT This study aims to analyze the health counselors’ perceptions with regard to the par-ticipation in Family’s Health Strategy. This is a qualitative research, with the realization of in-terviews with the counselors representatives of the Family’s Health Units. The results have evi-denced that councils are noticed as a tool for the improvement of the assistance and also as a place for health promotion. It has become clear the existence of a community’s lack of interest for the participative practices. Some factors contribute to the few engagement of the population, following the example of the healthcare debilities and the council’s sterility perception in the resolution of community problems. KEYWORDS Social participation; Health councils; Primary Health Care; Family health; Qualitative research. SAUDE DEBATE | RIO DE JANEIRO, V. 38, N. 102, P. 440-451, JUL-SET 2014 440 Participacao social na Estrategia de Saude da Familia: analise da percepcao de conselheiros de saude

Legitimidade da representação em instâncias de participação social: o caso do Conselho Estadual de Saúde da Bahia, Brasil

The electoral representation model is insufficient and inadequate for new participatory roles such as those played by members of health councils. This article analyzes representation and representativeness in the Bahia State Health Council, Brazil. The study included interviews with 20 current or former members of the State Health Council, analysis of the council minutes and bylaws, and observation of plenary meetings. Discourse analysis technique was used to analyze interventions by members. The article discusses the results in four analytical lines: the process by which various organizations name representatives to the Council; the relationship between Council members and their constituencies; interest representation in the Council; and criteria used by the plenary to take positions. The study reveals various problems with the representativeness of the Bahia State Health Council and discusses the peculiarities of representation in social participation forums and the characteristics that give legitimacy to representatives.O modelo de representacao eleitoral demonstrase insuficiente e inadequado para contemplar os novos formatos participativos, como os exercidos pelos conselheiros de saude. O artigo analisa a representacao e a representatividade no Conselho Estadual de Saude (CES/BA) da Bahia, Brasil. O estudo foi realizado por meio de entrevistas com 20 conselheiros ou ex-conselheiros de saude, analise documental das atas e regimentos do CES/BA e observacao das reunioes plenarias. Para analise das falas utilizou-se a Tecnica de Analise do Discurso. Os resultados sao discutidos com base em quatro eixos de analise: processo de escolha do representante pelas entidades; relacao estabelecida entre representantes e representados; conformacao da representacao de interesses no conselho; e criterios utilizados para definicao de posicionamentos no plenario. O estudo evidencia um conjunto de problemas referentes a representatividade no CES/BA. Sao discutidas as peculiaridades da representacao nas instâncias de participacao social e as dimensoes que conferem legitimidade aos representantes.

The legitimacy of representation in forums with social participation: the case of the Bahia State Health Council, Brazil

The electoral representation model is insufficient and inadequate for new participatory roles such as those played by members of health councils. This article analyzes representation and representativeness in the Bahia State Health Council, Brazil. The study included interviews with 20 current or former members of the State Health Council, analysis of the council minutes and bylaws, and observation of plenary meetings. Discourse analysis technique was used to analyze interventions by members. The article discusses the results in four analytical lines: the process by which various organizations name representatives to the Council; the relationship between Council members and their constituencies; interest representation in the Council; and criteria used by the plenary to take positions. The study reveals various problems with the representativeness of the Bahia State Health Council and discusses the peculiarities of representation in social participation forums and the characteristics that give legitimacy to representatives.O modelo de representacao eleitoral demonstrase insuficiente e inadequado para contemplar os novos formatos participativos, como os exercidos pelos conselheiros de saude. O artigo analisa a representacao e a representatividade no Conselho Estadual de Saude (CES/BA) da Bahia, Brasil. O estudo foi realizado por meio de entrevistas com 20 conselheiros ou ex-conselheiros de saude, analise documental das atas e regimentos do CES/BA e observacao das reunioes plenarias. Para analise das falas utilizou-se a Tecnica de Analise do Discurso. Os resultados sao discutidos com base em quatro eixos de analise: processo de escolha do representante pelas entidades; relacao estabelecida entre representantes e representados; conformacao da representacao de interesses no conselho; e criterios utilizados para definicao de posicionamentos no plenario. O estudo evidencia um conjunto de problemas referentes a representatividade no CES/BA. Sao discutidas as peculiaridades da representacao nas instâncias de participacao social e as dimensoes que conferem legitimidade aos representantes.

Legitimidad de la representación en los foros de participación social: el caso del Consejo de Salud de Bahía, Brasil

The electoral representation model is insufficient and inadequate for new participatory roles such as those played by members of health councils. This article analyzes representation and representativeness in the Bahia State Health Council, Brazil. The study included interviews with 20 current or former members of the State Health Council, analysis of the council minutes and bylaws, and observation of plenary meetings. Discourse analysis technique was used to analyze interventions by members. The article discusses the results in four analytical lines: the process by which various organizations name representatives to the Council; the relationship between Council members and their constituencies; interest representation in the Council; and criteria used by the plenary to take positions. The study reveals various problems with the representativeness of the Bahia State Health Council and discusses the peculiarities of representation in social participation forums and the characteristics that give legitimacy to representatives.O modelo de representacao eleitoral demonstrase insuficiente e inadequado para contemplar os novos formatos participativos, como os exercidos pelos conselheiros de saude. O artigo analisa a representacao e a representatividade no Conselho Estadual de Saude (CES/BA) da Bahia, Brasil. O estudo foi realizado por meio de entrevistas com 20 conselheiros ou ex-conselheiros de saude, analise documental das atas e regimentos do CES/BA e observacao das reunioes plenarias. Para analise das falas utilizou-se a Tecnica de Analise do Discurso. Os resultados sao discutidos com base em quatro eixos de analise: processo de escolha do representante pelas entidades; relacao estabelecida entre representantes e representados; conformacao da representacao de interesses no conselho; e criterios utilizados para definicao de posicionamentos no plenario. O estudo evidencia um conjunto de problemas referentes a representatividade no CES/BA. Sao discutidas as peculiaridades da representacao nas instâncias de participacao social e as dimensoes que conferem legitimidade aos representantes.