Marilyn Kay Nations

DESIGNING EDUCATIONAL MESSAGES TO IMPROVE WEANING FOOD HYGIENE PRACTICES OF FAMILIES LIVING IN POVERTY

This paper describes a methodology to design feasible interventions to improve weaning food hygiene practices of families living in extreme poverty. Educational messages to promote specific behavioural changes were defined and tested by utilizing a combination of ethnographic, survey and observational methods, and integrating viewpoints and suggestions of mothers and caretakers into the decision-making process. This new approach culminated in a household trial in which five groups, each of 15 non-practising mothers, were invited to adopt defined behaviours (handwashing before and after defined events, boiling water for reconstituting powdered milk, feeding gruel by spoon rather than bottlefeeding, not storing gruels and milks, and all four together). All initiated the advocated behaviours and most (53-80%) sustained the new behaviours and practised them every time during a one-month period. Of the four advocated behaviours, spoon-feeding was the most difficult to adopt wholly. The methodology was developed in response to the high priority given to reducing weaning food contamination for diarrhoeal disease control, and the lack of any existing methodology for defining appropriate educational interventions in resource-poor regions. This approach, with its combination of qualitative and quantitative methods and community focus, is recommended for future studies to design hygiene and other health education interventions in developing countries.

Etno-avaliação da humanização hospitalar pelo usuário do Sistema Único de Saúde (SUS) e seus mediadores

This study was aimed at evaluating the humanization of hospital care ethnically, as perceived by the hospitalized patients. Data were collected from 13 inpatients from January to July/2005 in a public hospital in Fortaleza, Ceará, Brazil, according to the patients circuit. This analysis yielded the following categories: ethnic evaluation of the hospital structure and dynamics, hospital and professional image, human and technical competence. The subjects used multiple aspects to soften their opinions, unveiling factors named mediators of the ethnical evaluation. Such aspects were categorized into: conditions of the interview, socio-economic status, users personality and religiousness, ironic speech, somber diagnosis and necessities met, and prior hospitalization experiences. The elements revealed by the patients are significant in order to encourage professionals and mediators to mobilize towards humanizing changes, including the user as a social and critical ethnic evaluator.La investigacion tuvo por objetivo etno-evaluar la humanizacion de la asistencia hospitalaria segun la percepcion de los usuarios hospitalizados. Los datos fueron recolectados de enero a julio del 2005, en un hospital publico de Fortaleza-CE, a traves de la opinion del paciente. Participaron 13 usuarios hospitalizados. El analisis fue realizado por analisis de categorias: etno-evaluacion de la estructura y dinamica hospitalaria, la imagen hospitalaria y la competencia profesional humana y tecnica. Los usuarios utilizaron varias formas para suavizar sus opiniones, siendo mostrados factores denominados de mediadores de la etno-evaluacion catalogados como: condiciones de la entrevistas, condicion socioeconomica, personalidad y religiosidad del usuario, narracion ironica, diagnostico sombrio y necesidades atendidas y experiencia anterior a la hospitalizacion. Aspectos mencionados por los pacientes son significativos para movilizar profesionales y gestores para cambios que promuevan la humanizacion e incluyan al usuario como etno-evaluador critico social.

Código dos direitos e deveres da pessoa hospitalizada no SUS: o cotidiano hospitalar na roda de conversa

Os direitos dos pacientes consistem em dispositivo para mudar a atencao e a gestao no Sistema Unico de Saude - SUS. O objetivo deste trabalho e apresentar as rodas de conversa sobre os direitos e deveres dos usuarios do SUS no âmbito das unidades hospitalares. Trata-se de um estudo descritivo e exploratorio, realizado em dois hospitais de Fortaleza, Ceara. Foram promovidas, em cada servico, tres rodas de conversa com 40 trabalhadores de varias profissoes e setores. Utilizou-se para o debate o texto do Codigo de Direitos e Deveres do Paciente no SUS/CE. Os discursos foram analisados segundo a Analise de Conteudo, consoante Lawrence Bardin. Percebeu-se que normas consolidadas dificultam a efetivacao dos direitos, e a roda de conversa ampliou a visao critica, promovendo discernimento. Esta se revelou importante instrumento de educacao para a cidadania e humanizacao do processo de cuidado.

Os saberes e o fazer pedagógico: uma integração entre teoria e prática

O saber-fazer docente desperta o interesse dos educadores que tratam deste tema sob diferentes opticas: competencia do professor; integracao do conhecimento subjacente do aluno; do professor reflexivo-critico; da proposta de educacao libertadora e pratica politica; e reconhecimento da complexidade da educacao e reflexao sobre a fragmentacao das disciplinas, dificultando a interdisciplinaridade. Este estudo descritivo qualitativo trata de um processo de ensino a partir de analises teoricas e empiricas, proposto por Edga Morin, ocorrido na disciplina Didatica, no Mestrado em Educacao·em Saude da UNIFOR, em 2004. Participaram da pesquisa vinte mestrandos de varias categorias profissionais. Os resultados demonstram que a dinâmica empregada propiciou a integracao, maior compreensao dos conceitos e obtencao de clima descontraido para aprendizagem. Concluimos que estrategias tais como jogo; dinâmicas grupais e psicodrama pedagogico favorecem a participacao e a expressao de sentimentos, permitem a interacao, assimilacao e compartilhamento das experiencias na elaboracao coletiva do conhecimento.

Aspectos culturais na compreensão da periodontite crônica: um estudo qualitativo

Abstract This study aimed to analyze the concepts, be-liefs, attitudes, and explanatory models related to chronic periodontitis among individuals with this disease in order to facilitate commu-nications between dentists and patients and foster conscientious treatment adherence. The study sample consisted of 20 patients from the Periodontics Specialization Courses at Fortaleza University and the Brazilian Dental Association in Fortaleza, Ceara State. Data were gathered from October 2004 to January 2005. A qualita-tive methodological framework was used to in-terpret the patients’ subjective expression. Semi-structured interviews were applied to obtain patients’ accounts of their individual experience with the disease condition. Thematic discourse analysis used: empirical categories established within the study itself, simple frequencies and calculated percentages, and refinement of the-matic classifications. According to their reports, patients understand the periodontal heath-dis-ease process through the intermediation of both popular and scientific knowledge, involvement of living and work conditions, and access to quality care, i.e., they do not incorporate only the biomedical discourse.Periodontitis; Self Care; Health Education; Qualitative Research

Stuck in the muck: an eco-idiom of distress from childhood respiratory diseases in an urban mangrove in Northeast Brazil

The aim of this study was to compare the direct costs of implementation of the Kangaroo Method and an Intermediate Neonatal Care Unit, from the perspective of the Brazilian Unified National Health System (SUS) in Rio de Janeiro, Brazil. Newborns were eligible for inclusion if they were clinically stable and were able to receive care in those two modalities. A decision tree model was developed that incorporated baseline variables and costs into a hypothetical cohort of 1,000 newborns, according to the literature and expert opinions. Daily cost was BR

Carne crua e torrada: a experiência do sofrimento de ser queimada em mulheres nordestinas, Brasil

343.53 for the second stage of the Kangaroo Unit and BR

Illness experiences of persons with chronic obstructive pulmonary disease: self-perceived efficacy of home-based pulmonary rehabilitation

394.22 for the Intermediate Neonatal Care Unit. The total cost for the hypothetical cohort was BR

Ethnic evaluation of hospital humanization by the users of the Brazilian Unified Health System and their mediators

5,710,281.66 for the second and third stages of the Kangaroo Unit and R

Code of rights and obligations of hospitalized patients within the Brazilian National Health System (SUS): the daily hospital routine under discussion

7,119,865.61 for the Intermediate Neonatal Care Unit. The Intermediate Neonatal Care Unit cost 25% more than the Kangaroo Unit. The study can contribute to decision-making in health, in addition to providing support for studies related to economic evaluation in neonatal health.The aim of this study was to compare the direct costs of implementation of the Kangaroo Method and an Intermediate Neonatal Care Unit, from the perspective of the Brazilian Unified National Health System (SUS) in Rio de Janeiro, Brazil. Newborns were eligible for inclusion if they were clinically stable and were able to receive care in those two modalities. A decision tree model was developed that incorporated baseline variables and costs into a hypothetical cohort of 1,000 newborns, according to the literature and expert opinions. Daily cost was BR