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This paper aims to identify the perceptions of elderly hypertensive patients about therapy, related or not to adherence to medication. The qualitative sample consisted of 16 elderly of both sexes, aged 60 and older living in two rural districts of the municipality of Governador Valadares, Brazil, who used some medication to control blood pressure and had independent functional status and cognitive function preserved. Data was collected through open interview at depth, with the aid of a digital voice recorder, conducted between June and September 2010. The assessment of information obtained was performed according to the technique of content analysis of Bardin, which found these categories: Practice and knowledge, Hygienic and dietetic Measures (Food, Exercise, Stress and nervousness) and drug treatment. The results showed that older people have adequate knowledge about hypertension and treatment, but are driven, during therapy, to act according to their socially shared opinions and experiences. Moreover, elderly hypertensive non-adherent tend to consider hypertension as an acute, symptomatic and linked to emotional states. We conclude that, because of this misperception, it is necessary to reevaluate the guidance given to hypertensive patients by the health staff, and viable alternatives to promote health must be created, to change attitudes and practices regarding the disease. [ABSTRACT FROM AUTHOR]

When referring to Public Health, literature points to the need for professionals who are able to work in different contexts. In this perspective, the theme of "competency" emerges from the administrative context for health in order to promote debates in the field of human resource development and training. This paper aims to present an overview of the Brazilian scene on professional skills in health for better understanding the construct at the national level and propose future research. The study used data from the Directory of Research Groups of the National Research Council (CNPq), the database of the Department of Science and Technology of the Ministry of Health (Health Research System), Bank of Theses and Dissertations of the Coordination for Higher Education Personnel (CAPES) and SciELO database. We observed inequality in the distribution of scientific researchers and little encouraged production. Thus greater efforts in the field of health management are necessary to build the theme. [ABSTRACT FROM AUTHOR]

In Brazil, it is estimated that 1,443,350 abortions occur annually, leading thousands of women with incomplete abortion, to seek care in public health. In 2005, the Ministry of Health published the Technical Act for Humane Abortion in response to this challenge. This paper discusses whether the Act sets an evaluable program and proposes an evaluation model. The survey, conducted in 2010, is an evaluability study using techniques of document analysis and interviews with key informants. To validate the indicators, we applied the nominal group technique. The results were elaborated and agreed upon the logical model, the matrix of indicators and evaluative questions that reflect the pillars of care: care, quality clinical care with technical, ethical and legal, reproductive planning, integration with network health and collective women. We conclude that the humanized abortion is an assessable program with development of an evaluation model in a timely manner. The preassessment was suitable and better understood by managers and professionals. There was agreement about the explicitness and relevance of goals, actions, and resource needs, ethical questions to guide changes. The study has increased the knowledge of the actors involved with decisive participation of clinical direction. For subsequent evaluations, the study recommends focusing on the structure and processes of the five components of the program with prioritization of subjective aspects of humanization, infrastructure, and the prevalence of abortion in the public health service. [ABSTRACT FROM AUTHOR]

This paper aimed to investigate the opinions, emotions and feelings of sterilized women awaiting assisted human reproduction treatment in a specialized sector of a public hospital. Sixteen sterilized women were interviewed in the health care department of a public hospital in São Paulo, southeastern Brazil, as to their experiences while they had been awaiting treatment. The feelings referred to were: anxiety, the fear of taking up the time of the health personnel, and fear of their dis-attention, experienced during the moments when the women's feelings of loneliness and abandonment became most acute. It is evident from this study that there is a need to create strategies to guarantee that this specific population in the health field receive adequate attention and care, with a view to ensuring their emotional comfort, through a straightforward dialogue among women and healthcare professionals. [ABSTRACT FROM AUTHOR]

The paper discusses the results of a survey on the social representations of citizenship found in speeches issued by senators in the Senate, between years 2003 and 2006. The analyzed material includes speeches of 46 senators, the theme of social politics, and was investigated using the Alceste software. And despite different political parties are represented, we find relative consensus on the key idea of citizenship. The representational field showed the centrality of global awareness and input peripherals issues in political debates, such as the Basic Income and Racial Equality, and also signaled little influence on health sector issues raised by senators, in social politics, in period studied. [ABSTRACT FROM AUTHOR]

With the objective of enabling the broader social life of people with mental disorder, the Psychiatric Reform advocates to disrupt the hospitalization model and subsequent reintegration of these individuals. Whereas the reform is in process of construction, research is needed on the social reintegration to contribute to greater effectiveness of mental health network. This paper aims to analyze the views of users of a mental health service about the social rehabilitation of patients with psychological distress. The study involved the participation of 20 users of a CAPS, who responded to a semistructured interview, data were subjected to discourse analysis. The analysis indicates that the service is perceived as a place of welcome, safe for users, however, patients with psychological distress are still viewed with prejudice by attending a place of psychological assistance. Additionally, users of the service are not included in the labor market. Thus it is considered that the service still does not provide full social reinsertion. It is clear the positive shift in ways of mental health treatment, and the CAPS becomes synonymous with freedom in its various senses. However, the reinsertion not yet reached spaces other than the CAPS itself. [ABSTRACT FROM AUTHOR]

The notion of integral care, established as a principle for actions and policies in the Brazilian Unified Health System (SUS), has guided various discussions in the field of Collective Health. Following the direction of the debate on comprehensiveness-gender, this paper explores the (dis)articulation between sexuality and reproduction in the assistance provided to women and men in facilities of Primary Health Care (PHC). To that end, it makes a double appropriation of the idea of relationship, regarding men-women and sexuality-reproduction as inherently relational. This study is part of a multicentered qualitative survey conducted to investigate the relationship between men and PHC facilities. It uses data from ethnographic observation of four Family Health Units, located in the Brazilian states of Rio Grande do Norte and Pernambuco. The results point to disarticulations in the organizational structure of the facilities, which compromise the effectuation of an integral health care for men and women. Accordingly, the discourses and practices of health professionals (re)produce fragmentations in the assistance, especially on the basis of the association men-sexuality and women-reproduction. Taking the comprehensiveness as a horizon, it points to the need for a (re)articulation between sexuality and reproduction that, instead of subordinating one to another, allows the recognition of the various expressions of those spheres in concrete experiences of men and women, as well as the dialogue between different interventions related to sexual health and reproductive health starting from the possible points of convergence. [ABSTRACT FROM AUTHOR]

In this paper, we address the access of homeless people with severe mental disorder to public mental health care. To this end, we conducted a narrative review on the topic and concluded that Social Welfare services have frequent contact with that portion of the population, providing answers to their needs, such as housing and civil rights of redemption. Mental health services still have difficulty establishing strategies to care for people in mental distress in the street and enter them in CAPS and health units. Thus, the welfare network has often been the gateway of this population to mental health services, indicating that the intersectoral work needs to be further developed to ensure effective access to public health services. [ABSTRACT FROM AUTHOR]

This paper assesses the current conceptual trend in General Medicine / Family, Public and Collective Health regarding quaternary prevention. The goals are to identify and disseminate this type of prevention and reflect on their epistemological and ethical discourses. The methodology is qualitative, of hermeneutic type. We begin by recalling the three dimensions of disease prevention, developing its fourth type, which is a kind of prevention of the above. Then we address the allocation of the urgency of quaternary prevention to some specific groups: doctors, elderly, "pseudo-patients" and psychiatric patients. Next, we assessed whether the basic principles of bioethics are not addressed (and how developed) in this type of prevention. Although we have previously outlined some criticism, we opened a section especially for this, in which we epistemologically and ethically disassembled texts of that lineage, resulting in speeches not always consistent or aligned with effective clinical practice. We emphasize the dualistic discourse that hides behind most texts, and defeats the defending alleged holism. The research result is that the main proponents of this type of prevention using a speech is not always consistent, either epistemologically or ethically. We conclude that, being a very useful expression in clinical practice, the quaternary prevention needs to be theoretically clarified and more widespread among - and dialogued with - health professionals of various specialties. [ABSTRACT FROM AUTHOR]

The paper discusses the complexity of disasters, enhancing risk situations and the importance of support from Biosecurity, as in episodes with fatalities, procedures formulated by this field should be adopted in the handling of corpses, particularly when occurring with search of buried bodies. It contextualizes the magnitude of the disaster characterized by rain and its aftermath (landslides, burying), emphasizing the phenomenon of global warming and climate change and its impacts on communities, especially the poorest, valuing the concept analysis of vulnerability caused by urbanization, environmental degradation by improper management of natural resources, environmental pollution, inefficient public policies, emphasizing low investment in infrastructure. It emphasizes the concept of disaster as unpredictable, sudden and violent, phenomenon causing numerous deaths and destruction; and social, health, legal and operational problems when there is high number deaths at the same time or within a short time. And it analyzes the contribution of Biosafety as guiding emergency plans facing disasters, enhancing the biological risk and the measures required for handling corpses. [ABSTRACT FROM AUTHOR]

Fibromyalgia is a rheumatic syndrome that affects many women in the Brazilian population. There is the current hypothesis that the social labor regime has contributed to increased rates of fibromyalgia, resulting in illness and collective suffering. The unease generated is somatized as chronic pain, anxiety and depression, symptoms typical of fibromyalgia. This paper is a product of ethnographic research with more than 60 women diagnosed with fibromyalgia. The loss of positive directions in relation to work and disenchantment with work activity involves pain and suffering. Fibromyalgia has become, along with RSI and WRMD cases, an effect of the restructuring of capital-labor ratio in recent decades. [ABSTRACT FROM AUTHOR]

This paper aims to examine the relationship between the meanings of male sexuality and how male individuals from two different generations take care of their health. We sought to identify whether there were changes regarding the standing of these men in relation to health care, and whether these changes were influenced by generation gaps. The study is anchored in two theoretical conceptual frameworks: generation and sexual script. We used the narrative analysis methodology, and the sources of this study are part of two surveys conducted in Rio de Janeiro with men of higher education as well as university students, whose sexual initiation occurred during the 1970's and 1990's, respectively. The results show that the subjects are currently facing an inadequate male's social model in conjunction with the new social demands from the females, therefore seeking a new model for themselves. During this study, both permanent and changing patterns of hegemonic masculinity were noted to be related to how men take care of their own health. [ABSTRACT FROM AUTHOR]

This paper analyzes some socio-cultural dimensions of the semantic field and ways of structuring forensic psychiatry discourses in relation to the criminal dangerousness and its connections with mental health. From the results of a research based on content analysis of several handbooks and books in forensic psychiatry, it was possible to examine some meanings and forms of enunciation about the concept of criminal dangerousness as well as the main interpretive strategies that organize the etiological models of criminality prevailing in this area. [ABSTRACT FROM AUTHOR]

This paper analyzes the performance of Local Health Councils as tools for social participation in the Family Health Strategy. It is a quali-quantitative research with triangulation method. The research took place in the city of Vitoria da Conquista, state of Bahia, Brazil. Data and information were gathered through the analysis of the agenda, followup forms, minutes of meetings of the council and semistructured interviews with key informants. The results show that the local health councils have limited performance, with a low frequency of meetings, commitments directed to the council itself and meetings on difficulties to access health care services. Low levels of social mobilization and community engagement are the main draw-backs for the good performance of these forums. Some problems stand out: counselors' representativeness, lack of motivation to perform voluntary tasks and feeling unprepared due to a poor graduation and training program. We conclude that institutionalization of local councils is not enough to promote community participation. It requires actions that can promote social mobilization and inform communities of the importance of group participation and engagement. [ABSTRACT FROM AUTHOR]

The paper analyzes the conditions that interfere with the setting of the physician in the Family Health Strategy. It is a qualitative research involving documentary analysis of human resources policies practiced, application and analysis of questionnaires and focus groups to identify the physicians' perception of their work in the strategy. There was a high turnover of doctors, determined by job dissatisfaction, poor working conditions and heavy workload. Among the characteristics of the human resources local politics stood out distortions in relation to remuneration, and problems with job plans, career and wages for family doctors, which limit and penalize the professional rise. The main reasons identified in the research that promote the continuity were identification with the strategy's philosophy, professional vocation and ability to serve the community. Reflections on human resources management in the strategy and SUS as a whole were presented, pointing out some of its main weaknesses, mostly including: deficiencies in vocational training policy for the specialty, insufficient regulation of the medical profession in Brazil by the State, and excessive political interference in the provision of public health services, particularly in this strategy. [ABSTRACT FROM AUTHOR]

Advances are needed in the implementation of the Unified Health System (SUS) in Brazil. Health workers are instituting agents of change in the practices of the working world. This paper aims to understand some possibilities to ponder on the political dimension in training these workers. The territory of study was a multidisciplinary health residence program in São Paulo. For data production, as well as observation, semistructured interviews were conducted with 14 residents, preceptors, mentors and program coordination. The analysis was divided into powers for the political dimension in teaching practices and management practices of the Residence. Powers were met in educational, management and world of care. Tensions created a process of self-examination in the subjects involved and provided new arrangements in the training process. It was evident that the residences can be devices for the formation of health workers in defense of SUS. [ABSTRACT FROM AUTHOR]

This paper aimed to explore the political and pedagogical views expressed by managers of five Technical Schools from the Brazilian Unified Health System (ETSUS ), in five regions of Brazil. It also focused on understanding how these institutions organize and structure themselves towards their sustainability. The method searched for qualitative aspects. Data were collected from a questionnaire through the internet, and documents such as: certification of establishment, authorization, Political Pedagogical Project (PPP) and school regulations. The semi-structured questionnaire was directed to the participating institutions, to identify their sustainability within the administrative and finance, technical pedagogical and political dimensions. The technique used to organize and store data and content analysis was the document analysis, according to the methodology proposed by Bardin (2007). Results show that there had been fluctuations in the different dimensions, mainly in the finance administrative fields where the managers' governance was rather fragile. Other results pointed that the technical and pedagogical dimension, with its innovative PPP proposal, is the one that gives more sustainability to ETSUS, making them different from the formal educational system, through the incorporation of management principles to the decentralized curricula, centralized administrative processes and multi-professional acting in the field of health. Its pedagogical strength is mainly translated by the existence of the methodological axis on teaching in service integration, suitability of the curriculum to the regional context, pedagogical use of the working spaces, performance evaluation of the students under services with supervision and pedagogical follow-up, teaching in the work field by a pedagogically qualified professional having the guidelines and principles of the SUS as directions for the course plans. The political dimension was the one which provided more visibility to the school work, also capable of favoring more sustainability. The education/qualification in the municipalities has brought benefits to students/workers and allowed a closer performance to the decentralized areas of management and decision. In the conclusions, the difficulties encountered by the schools were analyzed where there is also the need to correct asymmetries in the technical pedagogical and administrative and finance dimensions. [ABSTRACT FROM AUTHOR]

Human development is a dynamic process that occurs throughout life. However, it is during the childhood when external events and internal factors have higher influence. The social inequality stands out among the factors and events because it keeps the unfair distance between the Brazilian children that are vulnerable as a result of the poverty and the opportunities with the ability to change that condition. These opportunities also are related to their families and the possibility to fulfill the role as a promoter of children development, particularly the mother's role. This paper analyzes public policies for early childhood in the city of Rio de Janeiro, in 2011, seeking a favorable relation of building up the children basic abilities, considering the agent status of the woman as a mother. [ABSTRACT FROM AUTHOR]

This paper aims to stimulate the debate on the role the State takes in the development of a more supportive citizenship and health promotion. It proposes to analyze those relationships through the Theory of Donation and analytical categories such as participation and visibility. It is believed that the use of material and immaterial goods in public policies gives visibility and recognition to the users' needs, enabling the participation and the enlargement of partnerships and solidarity between State-society and society-society. This, in turn, would contribute in achieving rights, empowering health programs and materializing health conceived in a broader way. The reflections here presented come from studies of qualitative approach, which have as locus a rural community of Rio Grande do Sul state, Brazil. Data were produced through interviews, participating observations and focus groups; in the assessment of information it was adopted a thematic analysis. It was possible to see that, on one hand, when policies favor visibility and participation they allow the exercise of citizenship, the development of solidarity ties, and coping in the search of health and social needs. On the other, when they are against citizenship they can also favor immobility and clientelism, (re)producing inequalities. Finally, there has been much progress in terms of public policies, but to achieve a more supportive citizenship, the State must overcome its undemocratic practices, and society must overcome its tutored and conformist public spirit. [ABSTRACT FROM AUTHOR]

This paper aimed to analyze the meanings attributed by young men to male sexuality and sexual practices in order to understand any difficulties in adhering to preventive practices in relation to AIDS. Based on the theory of sexual scripts and the concept of habitus, we performed a discourse analysis on a collection of 42 stories, from their youth subsamples differentiated in terms of education and socioeconomic status. Two conflicts seem to influence crucial preventive sexual practices of participants. On the one hand, cognitive elements of a "sexuality informed" oppose the dimension of pleasure related to sexual practices; on the other, these information elements are opposed to the more stable components related to psycho male habitus. The empirical basis on which it worked allows a deeper understanding of the clear limitations of the effectiveness of prevention initiatives in health based on information about risky sexual practices. [ABSTRACT FROM AUTHOR]

By common sense, adolescents with intellectual disabilities have a heightened sexuality or are asexual. To learn how they experience the sexual manifestations of their children, we interviewed 14 parents of adolescents with this deficiency. The analysis of the narratives obtained was based on authors of anthropology. In them, there were prejudices and ignorance on the subject, as well as playing the gender ideology of our society. In the narratives of parents of adolescent males, masturbation, sex and fear of sexual abuse were highlighted, while parents privileged themes such as bodily changes and also the fear that they were sexually abused. The mismatch between physical development and sexual behavior considered socially improper was also the target of narratives. The paper points up the need to expand the discussion with teens, their parents and various sectors of society to minimize biases regarding sexuality of people with intellectual disabilities, providing a guarantee of their sexual rights. [ABSTRACT FROM AUTHOR]

This paper was based on a study that examined the social representations of health-illness process among workers with work-related musculoskeletal disorders (WMSDs), users of the Reference Center of Occupational Health (CEREST ) in the city of Juiz de Fora, state of Minas Gerais. Information was collected through semistructured interviews with 12 workers, aged between 29 and 55 years. Data were subjected to thematic analysis. The themes of analysis called "representation of health" and "representation of illness" set that, for these workers, illnesses and labor disability represent a painful gap and the destruction of life projects. Tables of deterioration of living conditions and work degradation, reflected on the health of workers, refer us to sustain that the prevention of health problems that would find a higher degree of resolution would be the replanning of work process' organization and effective performance of public health policies, through symbolic representations of broader health, illness and healing. [ABSTRACT FROM AUTHOR]

We present and discuss the results of a survey that aimed of develop an information and communication technology in the web in order to promote healthy nutrition, by facilitating access to information on the internet. We sought through interviews, knowing the concepts and identifying demands and needs for information and knowledge on the subject, among NGO's working with health. Besides, mapping information and knowledge about the healthy eating on the web at national sites. From the results, concept maps were prepared, placed in dialogue, mediated by researchers with the knowledge of experts. The paper also describes the methodology used to build navigation maps oriented by concept maps and discusses the challenges of management and access to health information and knowledge on the internet. We highlight the potential to shift the model of supply information for the shared construction of knowledge mediated by information and communication technologies. [ABSTRACT FROM AUTHOR]

The decline of traditions, institutions and paternal authority in present times has been largely discussed in psychoanalytical literature. Heir of Romanticism and Individualism forged in modernity, romantic love as a cultural value and the last subjective refugee, has ruined. Sexuality understood as absolute pleasure and multiplicity of sensations has been more and more considered as a condition for love relationships. Considering this state of affairs, and based on a theoretical discussion and clinical vignettes, we argue that jealousy is "old-fashioned". The absence of jealousy points at a new ideal for love, not so much romantic, but most of all narcissistic, erotic, multiple and excessive. Based on psychoanalytical studies about love and jealousy, in this paper, we intend to reflect about how today's narcissistic cultural model, still permeated by the remains of Romanticism, continues to interfere with contemporary subjectivity. In an ambiguous way, the absence of jealousy and its opposite correlate "primitive jealousy" take turns in the field of contemporary love relationships. [ABSTRACT FROM AUTHOR]

The paper analyzes mental health human resources training in a changing environment of the mental health delivery model in Brazil, a country that was one of the first to adopt a community care model to replace the one based on the asylum. The authors argue that the human resources training is one of the weakest points in the changing process of the mental health care model in Brazil, despite that this difficulty is exclusive of the mental health area. This problem seems to cut across the Brazilian Health Reform. According to the authors, the challenge is to plan co-ordinately the health system and the training policies, linking health and education. The long-term sustainability of the new health policy requires developing appropriate human resources policies, as well as to address the workforce distribution inequality. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the process of regulation of drug advertising by AN VISA (National Health Surveillance Agency) in 2008 and to identify its results on the regulatory model in this area. We analyzed the changes in 2008 with the publication of RDC No. 96/2008, based on three data sources. The first was a comparative analysis with the previous rules, the RDC No. 102/2000. Then, the changes were related to two technical papers in different scopes: the Ethical Criteria for Drug Promotion of the World Health Organization, with global reach; and the Contribution to the Debate and Proposals for Public Consultation 84/2005, nationwide , issued by AN VISA , on drug advertising in Brazil. The analysis of 11 content changes in the legal order established by RDC No. 96/2008 points to a closer relationship with the Ethical Criteria for Promotion of Medicines of the World Health Organization, but a clear separation of proposals for changing the regulatory model currently established. It was concluded that the adoption of measures amending the regulatory model in this field, the regulation of drug advertising, requires more substantial changes in the management model and the regulatory action of AN VISA , especially regarding the role of social regulation. [ABSTRACT FROM AUTHOR]

The paper discusses the emergence of the professional category of cytotechnologists in Brazil and its history from the 1970s and late 1990s. At the beginning of this period, the Pan American Health Organization considered cervix cancer as a serious public health problem, which can be controlled in developing countries. In this context, arose the first campaigns tracking the disease in the country. The institutionalization of these campaigns made the cytotechnologists indispensable for the disease control. With the expansion of demand for its activity and the emergence of the first initiatives for its formation, new issues begin to emerge. How these new professionals could be trained in adequate quantity and quality? What is the appropriate curriculum to their duties and responsibilities? How to monitor the functioning of the courses? In the field of standardization of the new activity, other questions arise: how to secure a monopoly on the activity performed, how to characterize their specificity, which required training to those who will exercise it? These points become topics of debates and negotiations, a typical process of consolidating a new profession. The process of institutionalization of the program of prevention of cancer of the cervix and the consequent need for quality assurance tests performed have made these issues return to the limelight. This study aims to contribute to the expansion of knowledge about the formation of cytotechnologists, and the more general context, the process of health training in Brazil. [ABSTRACT FROM AUTHOR]

Investing in the necessary theoretical relationship between Humanization and Mental Health Policies of the Brazilian health system, this paper argues, through the theoretical dialogue between them, the idea that the proposals set forth in such policies are coherent answers to the main contradictions of the intricate national public health system. So are presented: the theoretical basis of the aforementioned ministerial policies; their relations with the society demanded as public policy; and finally, how the combination of both provide essential contributions to the continuity of the Unified Health System (SUS ). The essay methodology was used, according to updated methodological bibliography, listing authors and their contributions in order to defend the views of the authors. We conclude that the public encouragement of protagonizsm of society undermines the logic of biological training courses for health professionals and flattens human relations within the SUS , fortifying it and giving it essential reason for existence to the Brazilian society. [ABSTRACT FROM AUTHOR]

This paper aims to present and compare the results of the cost-effectiveness of antimeningococcal C conjugate vaccine, which insert new cost data, collected by personal interviews with families of people with sequels, called "family expenditures" for treatment of sequelae, compared to the analytical model presented by De Soarez et al. (2011), resulting from a research project done for the NIP (National immunization Program) on the feasibility of meningococcal C vaccine in routine vaccination. It is shown that as a result of the inclusion of new costs have changed the cost-effectiveness of the vaccine in question, making the vaccine more cost effective. [ABSTRACT FROM AUTHOR]

This paper aims to discuss the relation between individual and collective autonomy and health promotion. In order to do so, it reviews the literature on the conceptual course of health promotion since the Ottawa Charter, emphasizing the amplification of autonomy as a guide for health promotion actions. It also highlights the importance of health promotion strategies in Brazil, which prioritize public policies in order to decrease social inequalities. In particular, Brazilian policies are addressed towards increasing individual and collective autonomy. [ABSTRACT FROM AUTHOR]

This paper analyzes the conduct of the federal primary health care politics in Brazil in the 2000's, seeking to identify elements of continuity and change in the previous period. The research was based on the theoretical framework of historical institutionalism and the concept of path dependence. The methodology included a variety of strategies: literature review, document analysis, analysis of secondary databases, budget analysis and interviews with key stakeholders of the policy. It was possible to identify continuities and changes in the conduct of national policy for federal primary care during the study period. The predominance of continuities, emphasizing the persistence of the Family Health Program as a hegemonic strategy for reorientation of primary care in the country, creates a condition of path-dependence. There were also incremental changes, such as initiatives to strengthen inter-sectoral coordination and important innovations, notably the creation of the Centers for Family Health Support. There are, however, structural problems within primary care, and it is important to overcome them to enable the effective change in the health care model in the country. [ABSTRACT FROM AUTHOR]

This paper aims to discuss advances and challenges of multiprofessional teamwork in child rehabilitation. The study was conducted in a state reference center, in Natal, Brazil, between May and July 2010. This is a case study using semi-structured interviews with a qualitative sample of 20 upper level health professionals. Three categories were considered: conception of teamwork; interaction with the team, family and school; exchange of knowledge and interdisciplinarity; flexibility in division of work; integrality and quality care; work values; professional limits and interpersonal relationships. Content analysis was applied. In relation to advances, professionals underscore common objectives and the search for integrality. The following challenges were cited: lack of assistance programs, protocols and discussions; interaction, integration and professional delimitation difficulties; and strict division of work. Work is organized into an instrumental dimension directed towards integrality and resoluteness, but without interaction and mutual recognition of teamwork. [ABSTRACT FROM AUTHOR]

The main objective of this paper is to contribute to the debate on the legal claims for pharmaceutical drugs in Brazil, as part of the struggle for access to these products. A brief discussion about the pharma industry is made, followed by the state-of-the-art of the so-called process of "health judicialization". These are the basis for the reflections on the relationships between the corporations and patients' associations, which are part of the strategies used by the pharma industry in order to expand the market. These liaisons may be influencing the augmentation of court requests, thus damaging the responsible drug use. The role of commodification of healthcare is discussed. [ABSTRACT FROM AUTHOR]

This paper aims to identify and interprete, in the resultant database of the registers of an Anonymous Telephone Service of support and advisement in the areas of rights and violence against women, the perception and the attribution of meanings of their experiences of intimate violence mainly in the light of contemporary Brazilian feminist literature. This text is aligned to a group of investigators who focused the attention in describing and thinking about the feminine representations about the violence, pointing out the non-universality of the feminine experience in relation to aggressions, valuing singular aspects of the attacked women. In the data analysis the meanings women give to their prolonged hesitations against the expressed desire to separate themselves from their abusive spouses are highlighted. The results support previous researchs on the complexity and morbidity of the phenomenon and also point to the need of the intersection of research fields in order the expansion of their understanding and more effective interventions. [ABSTRACT FROM AUTHOR]

In this paper we present an analysis of the issues concerning the medical-industrial complex (MIC) and medical-financial complex (MFC), inspired by the theoretical framework of the science studies. The discussion about the medical-industrial/financial complex is approached under the aegis of a dychotomic split between economic interests and social values. We intend to draw attention to the need to consider the different angles of the issue, since the mentioned notions seek to nominate a very complex type of phenomenon. In order to attain an evaluation of the problem that is at once broad and deep, we consider necessary to unearth the underlying ideas to both its epistemological and axiological aspects as well. In order to achieve this goal, we begin with a brief contextualization and reassessment of the science studies; this is followed by an equally brief review of the available literature in Portuguese pertaining to the concepts of MIF and MFC, emphasizing the recent attempts to surpass the dychotomy "economic interests versus social values"; after that we attempt to elucidate, based upon the discussion about different modes of knowledge production, the epistemological and economic background underlying the MIC; after that, we bring to the forefront some critical diagnoses of the pharmaceutical industry, drawing on the notions of social medicalization and complementary & alternative medicine (CAM); finally, we point towards an approach as broad and acute possible of a problematic that can no longer be thought of in dychotomic terms. [ABSTRACT FROM AUTHOR]

This paper aims to outline some terms within the scope of a new area of knowledge called "Biosafety". It also intends to point out that these terms relate to several chains of thought among various fields of knowledge. This can lead to barriers in public understanding and implementation of research and communication ability in the scientific community. Research on use of terminology which is being applied in the construction of this field represents a growing concern. [ABSTRACT FROM AUTHOR]

This paper discusses the data of the survey conducted in 2008 in the Manguinhos Slum Complex, Rio de Janeiro, on therapeutic itineraries of the local population. By therapeutic itineraries we mean the paths taken by the individual in search of a solution to his/ her health problems. We aim to identify to what extent these paths are ordered by symbolic schemes or by the availability of resources. A qualitative method focused on the semi-directive interview technique, following an ethnographic script, was used. Three residents of each community of Manguinhos were interviewed, in a total of 26 interviews. The results show that the offer of services is heterogeneously distributed, being itself a generating factor of inequalities in disease. The different strategies show that the knowledge and practices of these individuals are made of, and due to different experiences, given biographic situations and that there is not a single model of Therapeutic Itinerary. The urban "marathons" ran by the local population denounce the urgency of the State to put into practice more fair political policies, with a full access to health care, thus ensuring the respect for the rights. [ABSTRACT FROM AUTHOR]

The paper discusses the current challenges encountered in caring for children with mental health problem in the context of the Family Health Strategy (FHS). Therefore, this study sought to understand how the matrix support (MS) has been used as a tool for care of children with mental health problems in the Family Health Strategy. Interviews were conducted with professionals involved in the work of MS in mental health in the FHS and relatives of children seen by this form of mental health care. The narratives were analyzed by Paul Ricoeur's Hermeneutic- Phenomenology approach. When questioned about cases of child seen at matrix support, it was discussed, even with some controversy, almost no attention to this age group. Therefore, it was realized that not only the issue of child mental health is still poorly studied, but its population is not perceived in the context of the FHS. At the same time, the mother's difficulty in exposing the children's mental health problems in the context of the FHS has also inhibited the care for this population. Moreover, little training in child mental health of health workers has become an obstacle to the effectuation of care for children. Thus, these issues must be discussed and addressed effectively, so that, as recommended to adults, children with mental health problems can be cared for in a comprehensive way, being, however, observed differences in their development and needs. [ABSTRACT FROM AUTHOR]

This paper is part of a research that aims to evaluate the place of motherhood in the constitution of subjectivity in a group of teenagers. It begins with the hypotheses that teenage pregnancy has become a political and social problem, inside a bio-politic targeting the production and reproduction of the social body. In this context, teenage pregnancy becomes a public health problem and the speeches about the subject tend to assume a homogenizing and stigmatizing tone, punctuating its negatives aspects. A research developed with teenagers from poor communities, between 16 and 18 years old, allows us to question these speeches. The research pointed out motherhood as a fundamental event in the constitution of these young women subjectivities. In fact, motherhood makes possible for them to built new ideals, and articulates a plan for the future. [ABSTRACT FROM AUTHOR]

Approaches to, and expressions of, social issues as poverty involve discussing how social fractures connected with the process of capitalist restructuring are shaped and to be addressed in several dimensions (economic, political, cultural and social). This paper aims to review this debate 40 years after Jose Nun's marginality theory turned a fresh eye to Latin American poverty. It highlights singularities over that period in ways of looking at poverty as a social issue in Latin America and the approximation with French theorists of social exclusion. After the 1990's the debate is steered by the theoretical perspective of social exclusion, operationalised as a category capable of revealing the weakening and breakdown of social cohesion in terms of multiple levels and relational dimensions. [ABSTRACT FROM AUTHOR]

This paper presents results of a qualitative research that aimed to apprehend and understand, among middle class women's perception and experience, the disagreement / distance / gap between primary vaginal labor option and a cesarean outcome. Fifteen women who had a private health insurance plan were interviewed about their experiences and perceptions related to their prenatal care and parturition process. Results showed a pervasive or explicit intervention of the obstetrician on women's choice, influencing on the cesarean outcome and suggesting that, for many women, it is still difficult to escape from the "trap" of the mercantilist, intervening and "iatrogenic" biomedical model, which is still firmly institutionalized and legitimated in our society. These results intend to collaborate with actions aimed to promote women's citizenship related to the right to make decisions on their reproductive choices, preserving and undertaking the parturition experience as unique and indefeasible right for all women, their partners and relatives. [ABSTRACT FROM AUTHOR]

This paper aims to understand the mothers' experiences on the care received during the birth process in a public maternity in Feira de Santana, state of Bahia, Brazil. This is a qualitative descriptive exploratory study that complied with the Resolution 196/96 of the National Health Council and was conducted from February to April 2010, through semi-structured interviews with 19 puerperas. The Content Analysis of data showed that the respondents had experienced the birth process with loneliness, fear, pain, suffering and abandonment. The assistance occurred only during the expulsive period or in the postpartum. It is needed to use an approach that encourages women and their companions' participation, which prioritizes the constant presence of professionals with the parturient, proposes the physical and emotional support and the use of new care technologies that provide relief pain and the parturient's comfort. [ABSTRACT FROM AUTHOR]

Maternal mortality is a complex issue and remains a serious public health problem. This paper aims to look at this phenomenon from the perspective of the right to health, noting that the option for bringing the discussion to the field of human rights provided an extension of its explanation and a clearer presentation to society. It presents brief history of the insertion of this theme in the global policy agenda, exploring national and international initiatives. The current situation of maternal mortality in Brazil is just the most visible face of the precariousness of the health care of women. The situation worsens when cases of severe maternal morbidity are considered, which affects a significant number of women. Despite the initiatives for the realization of the right to safe motherhood, there are few advances, and society must require the State to reverse the injustice against women. [ABSTRACT FROM AUTHOR]

This paper seeks to identify and analyze the professionals' perception about mothers who care for children between 0 and 6 years old. Professionals from the Family Health Strategy were interviewed: doctors, nurses and nursing technicians/assistants. The research took place in two districts of Florianópolis/SC. Through content analysis, we identified that, although professionals realize that mothers keep on using public health care, they claim that learning child's basic care in the family subsystem has changed, as familiy life conditions do not encourage home care. This aspect, along with the consequences of implementation of a new design of public health services particularly for basic care and available on a large scale to the population, tend to make women more dependent on health services and children's care more medicalized. [ABSTRACT FROM AUTHOR]

This paper aims to problematize the itinerancy as a way to operationalize care in the territory. With the creation of the Unified Health System, the notion of territory has become an organizing principle of work processes in primary health care and mental health policies. In the delicate field of coordination between these policies, itinerant practices now have a strategic importance in the deinstitutionalization of practices and construction of integral care. We take the deinstitutionalization and the integrality as conceptual operators that make the difference that Psychiatric and Health reforms want to print in the care practices. Warned that by joining in a posture of active search in the life territory of users, the itinerant practices fall in a field of tensions, which can both be called to work as a part of the State apparatus to population control, as in a strategic place for the construction of a contextualized care to users" way of life. We believe that it is possible to resist the social control mandate and build an ethics of care with itinerancy to explore the political power of the movement and transform the users' territory in a laboratory for the invention of life. [ABSTRACT FROM AUTHOR]

This paper focuses on the working conditions of nursing technicians of Neonatal Units, considering the relational dimension of the care activity. Having as main epistemological references Canguilhem's concept of health of and the Ergological perspective, the research was based on the clinical approaches of work, including the following methods: direct (observations) and indirect (talks and meetings about work with the technicians); analysis of documents on the previous norms concerning this work. The analysis dealt basically with the groups' language production. Some results can be highlighted: the development of this care activity implies intense mobilization of workers; the possibility of not assisting the mothers who arrive to have their babies seems to be more noxious to these technicians than to work with an overload of patients; the precarious conditions of work are producers of pathogenic suffering, once the pleasant and well-succeeded realization of this activity is hindered. [ABSTRACT FROM AUTHOR]

This paper aims to analyze the content validity of self-assessment tools that make up the Evaluation for Quality Improvement (EQI) of the Family Health Strategy (FHS). It is a retrospective ecological study on secondary data available from 46 out 64 municipalities participating in the EQI program until December 2007 in Espírito Santo state, Brazil, where 241 family health teams were identified. The average percentage of "yes" responses was calculated from data provided by health teams for each quality standard component of the EQI. There was a nonlinearity between the implementation complexity of work processes suggested by the EQI from the list of quality standards on each quality level and self-assessment of the health teams of municipalities surveyed. The non-linear relation between the quality levels of EQI and complexity of implementation of work processes recommended by the standards of quality shows the need to rearrange the terms of self-assessment, establish new quality standards and to find a more consistent correlation between the difficulty of implementation of work processes in FHP and quality levels. [ABSTRACT FROM AUTHOR]

This paper aims to study the contributions of quantitative and qualitative methods for the construction of knowledge about the social determinants of the weaning process, by comparing the findings of studies published between 2003 and 2009 in LILA CS database system. The social determinants identified in quantitative research were expressed by risk variables, while those identified in the qualitative research gave visibility to inter-subjective and objective factors that shape social action. The realization that the quantity and quality are characteristics that make up the complex phenomena, leads us to the triangulation of methods as a strategy to expand the existing knowledge on social determinants of the weaning process and thereby contribute to the expansion of the breast-feeding period. [ABSTRACT FROM AUTHOR]

The new genetics would point to a new era of metamorphosis of the human, which would be marked by the prominence of that in the selection and improvement of their nature. Thus, the Human Enhancement would become a tangible reality anthropo-technique. This paper, included a research of the field of Ethics Enhancement of Human Beings, intends excogitate a new concept to understand nuances called Genetic Age apparently overlooked by other already available, namely, Biopolitics and Biosociality. Therefore, we refer the review of the bibliography on Human Enhancement and the analysis and critique of these concepts, which focus on the issue mainly of risk management and promotion of healthy living. The objective was to identify the partial relevance of the grid of intelligibility provided by them to understand the new genetics. So, we present an introductory the concept of Biodesign as a complementary alternative, hoping that it permits the apprehension, especially, what the possibilities of artificiality of life to represent beyond a new form of risk management/health promotion. [ABSTRACT FROM AUTHOR]

This paper is a critical review on interventions with male perpetrators of violence against women, grounded in the revision of national and foreign literature on the theme and results from a case study with a qualitative approach of a governmental domestic and family violence prevention and action program from the South of Brazil. Besides working with women victims of violence, this program has been attending male perpetrators of violence against women since 2004, a pioneer service in this state, and at that time, one of the few developed in Brazil by a governmental organization. The results of this study showed that although these interventions with male perpetrators of violence represent an additional challenge to the complex field of prevention, attention and confrontation of domestic and family violence against women, they can, when developed along with activities already directed to women, create new possibilities to this field, contributing to decrease this violence and promote gender equity. [ABSTRACT FROM AUTHOR]