Marisa Palácios

A finitude humana e a saúde pública

A morte e uma questao implicita na pratica e na formacao dos profissionais da saude. Ha, todavia, uma tendencia dos profissionais de saude de restringir sua discussao aos aspectos meramente tecnicos, seja na assistencia a saude, seja nas acoes de saude publica. Este artigo analisa a importância da adocao do cuidado de qualidade no fim de vida como norteador das praticas assistenciais e a necessidade de que o campo da Saude Publica tome esses cuidados como objeto de reflexao e de pesquisas. Por fim, aponta-se para aspectos relevantes para a formacao de profissionais de saude para que sejam respeitadores das diferencas e comprometidos com o dialogo.

Trabalho e sofrimento psíquico de caixas de agências bancárias na cidade do Rio de Janeiro

The prone sleeping position has been causally linked to sudden infant death syndrome (SIDS). This survey aimed to determine whether maternity hospitals in Brazil were promoting the prone sleeping position for newborns. Information was also collected on SIDS prevention messages. The study adopted a multicenter collaborative approach in hospitals with training in pediatrics, using questionnaires. Correctly completed questionnaires were received from 55 hospitals. The number of deliveries/year varied at the hospitals from 240 to 11,000 (median 2,750). The majority of hospitals encouraged the lateral (side) sleeping position in the normal care nurseries (44.4%) and at discharge (67%). In conclusion, the majority of hospitals surveyed are not promoting the supine sleeping position or any other intervention for SIDS prevention, although verbal information is provided to parents about breastfeeding (100%), immunization (100%), and smoking (85%).

Bioética para profissionais da saúde

BIOÉTICA PARA PROFISSIONAIS DA SAÚDE Lorena Mara Nóbrega de Azevêdo. Aluna do curso de graduação em Enfermagem pela Universidade Federal do Rio Grande do Norte/UFRN. Bolsista de Iniciação científica PIBIC/CNPq do grupo de pesquisa Caleidoscópio da Educação em Enfermagem da UFRN. Natal, Rio Grande do Norte, Brasil. E-mail: lorenanobregaazevedo@yahoo.com.br Aline Galúcio de Oliveira. Aluna do curso de graduação em Enfermagem pela Universidade Federal do Rio Grande do Norte/UFRN. Voluntária de iniciação científica do grupo de pesquisa Caleidoscópio da Educação em Enfermagem da UFRN. Natal, Rio Grande do Norte, Brasil. E-mail: aline_galucio@yahoo.com.br Alane de Medeiros Silva. Enfermeira. Aluna especial do Programa de Pós-Graduação em Enfermagem da Universidade Federal do Rio Grande do Norte/UFRN. Natal, Rio Grande do Norte, Brasil. E-mail: alaninhamedeiros@hotmail.com Raimunda Medeiros Germano. Professora Doutora dos cursos de graduação e pós-graduação em Enfermagem da Universidade Federal do Rio Grande do Norte/UFRN. Coordenadora do grupo de pesquisa Caleidoscópio da Educação em Enfermagem. Natal, Rio Grande do Norte, Brasil. E-mail: rgermano@natal.digi.com.br O livro Bioética para profissionais da saúde, publicado em 2009, com 159 páginas, faz parte da coleção “Temas em saúde” e foi escrito por Sergio Rego, Marisa Palácios e Rodrigo Siqueira-Batista. Os autores são médicos doutores e professores em nível de graduação e pós-graduação de ética e bioética.

Promoção e propaganda de medicamentos em ambientes de ensino: elementos para o debate

A industria farmaceutica utiliza a propaganda para a promocao de seus produtos. Os de uso controlado so podem ter a propaganda dirigida a profissionais habilitados a prescreve-los ou dispensa-los. Este artigo faz uma ampla revisao de artigos cientificos que discutem questoes eticas e legais acerca da promocao e propaganda de medicamentos em ambientes de ensino medico. Conclui-se que nao se justifica a auto-regulamentacao da propaganda de medicamentos e que existem evidencias suficientes de como o poder da industria farmaceutica e capaz de influenciar as decisoes no âmbito da relacao medico-paciente, sendo a promocao e a propaganda um de seus instrumentos. Defende-se sua total proibicao em ambientes de ensino, bem como a incorporacao da tematica na formacao dos estudantes. Como a legislacao vigente permite a propaganda de medicamentos vendidos sob prescricao apenas a medicos e farmaceuticos, destaca-se que tal propaganda e ilegal quando atinge estudantes de medicina e de farmacia.A industria farmaceutica utiliza a propaganda para a promocao de seus produtos. Os de uso controlado so podem ter a propaganda dirigida a profissionais habilitados a prescreve-los ou dispensa-los. Este artigo faz uma ampla revisao de artigos cientificos que discutem questoes eticas e legais acerca da promocao e propaganda de medicamentos em ambientes de ensino medico. Conclui-se que nao se justifica a auto-regulamentacao da propaganda de medicamentos e que existem evidencias suficientes de como o poder da industria farmaceutica e capaz de influenciar as decisoes no âmbito da relacao medico-paciente, sendo a promocao e a propaganda um de seus instrumentos. Defende-se sua total proibicao em ambientes de ensino, bem como a incorporacao da tematica na formacao dos estudantes. Como a legislacao vigente permite a propaganda de medicamentos vendidos sob prescricao apenas a medicos e farmaceuticos, destaca-se que tal propaganda e ilegal quando atinge estudantes de medicina e de farmacia.

Musculoskeletal Disorders Among Brazilian Dentists

ABSTRACT Dentists are exposed to several occupational risks. This study aimed at comparing the prevalence of referred morbidity among Brazilian dentists with that reported by doctors, lawyers, and the general population. Data on referred morbidity were obtained from the Brazilian Household Survey. Stratification by gender was performed, and prevalence rate ratios were calculated. Dentists were more likely to report back pain and arthritis than physicians or lawyers. Dentists also reported tendinitis more frequently than physicians, lawyers, and the general population. Stratification revealed that, when compared to physicians and lawyers, male dentists were more likely to refer to back pain and arthritis than did female dentists. However, female dentists were at higher risk to report tendinitis when compared to all 3 reference populations. This study suggests that Brazilian dentists are at higher risk to develop musculoskeletal disorders.

Assédio moral no trabalho no setor saúde no Rio de Janeiro: algumas características

This article aims at analyzing the magnitude and some characteristics of the workplace moral harassment phenomenon in Rio de Janeiro health sector. Data from a randomized anonymous survey research developed in 2001 as part of the Program “Workplace Violence in the Health Sector” was analyzed. All cases (1569) and their variables related to moral harassment were selected for the bank analysis. The professional group of nurses’ aides presented the highest proportion of moral harassment victims (22.7%) and the most frequent perpetrators were co-workers, supervisors and managers (48.7%). The victims’ most frequent psychological reaction was “becoming super-alert”. Although part of them (38.5%) reported to their bosses they had been morally harrassed, only 20% of them had an action taken. In order to evidence this kind of violence in Brazil, the authors suggest increasing research and surveillance. They also emphasize the need to implement institutional measures to control violence at work and studies that will stimulate the institutional management of this kind of violence.

O modelo bioético principialista para a análise da moralidade da pesquisa científica envolvendo seres humanos ainda é satisfatório

This paper discusses the application of principlism to research involving human subjects, starting from the question of its pertinence in the current situation of the paradigmatic pluralization on science and the multiplication of models of ethical evaluation in the complex societies. Highlights that the development of modern scientific medicine depended strongly on human experimentation and that up to the mid 20th century the good intention of the researcher was, theoretically, enough to justify a research morally, but that with the twofold paradigmatic transition in Science and in Ethics, occurred in the course of the 20th century, a pluralization and complexification took form in both the scientific know-how and the field of ethics applied to scientific research, which on normative level was in the uncomfortable situation of having to deal with a permanent contestation of scientific and ethic paradigms. In the field of ethics, other principles also pass to guide decisions such as the principles of protection, applicable to situations of need as they arise mainly in the case of the populations of the Third World. Finally, principlism is pertinent in its general philosophic posture and methodological value, but insufficient when applied to the moral problems of public health and in particular to research ethics in dependent countries.

Temas éticos e bioéticos que inquietaram a Enfermagem: publicações da REBEn de 1970-2000

Fueran estudiados los temas eticos y/o bioeticos publicados en la Revista Brasilena de Enfermeria (REBEn) que inquietaran la enfermeria en el periodo entre 1970 y 2000. Objectivando: Identificar en los articulos publicados en la REBEn, durante el periodo mencionado, los temas relacionados con la etica/bioetica. Discutir las perspectivas teoricas en las cuales los autores basan sus discusiones. El estudio era cuantitativo y cualitativo, tipo documental o bibliografico. Resultados: en los 30 anos pasados tenia aumento gradual en el numero de los articulos que debatian los cuestionamientos eticos. Despues de 1984 aparezco el primer estudio, con connotacion bioetica, en la cual el autor discurre sobre las intervenciones de la enfermeria delante del paciente en muerte inminente, con el proposito de verificar las relaciones entre los valores personales y profesionales del enfermero. El termino bioetica fue utilizado por la primera vez por Valeria Lunardi en 1998.UNLABELLED It was studied the ethical and/or bioethical issues published in the Revista Brasileira de Enfermagem (Brazilian Nursing Journal-REBEn) that disturbed the nursing in the period between 1970 and 2000. Tha aim was to identify in articles published in the REBEn, during the mentioned period, subjects related to the ethics/bioethics. To discuss the theoretical perspectives in which the authors base their arguments. The study was quantitative and qualitative, documentary or bibliographical type. RESULTS in the last 30 years it had gradual increase in the number of the articles that debates ethical questionings. After 1984 appear the first study, with bioethics connotation, in which the author discourses on the interventions of nursing before the patient in imminent death, with the purpose to verify the relations between the personal and professional values of the nurse. Was Valdria Lunardi who used the bioethics term for the first time in 1998.

The new geography of scientific collaborations

The science ethics melting pot is just heating up; what role will emerging nations play in setting new standards of practice that ensure successful international collaborations?

Brazilian Science and Research Integrity: Where are We? What Next?

Building a world-class scientific community requires first-class ingredients at many different levels: funding, training, management, international collaborations, creativity, ethics, and an understanding of research integrity practices. All over the world, addressing these practices has been high on the science policy agenda of major research systems. Universities have a central role in fostering a culture of research integrity, which has posed additional challenges for faculty, students and administrators - but also opportunities. In Brazil, the leading universities and governmental funding agencies are collaborating on this project, but much remains to be done.