Group medical visits after heart failure hospitalization: Study protocol for a randomized-controlled trial.

A primary goal of this research project is to better understand how shared medical appointments (SMAs) can improve the health status and decrease hospitalization and death for patients recently discharged with heart failure (HF) by providing education, disease state monitoring, medication titration, and social support to patients and their caregivers. We propose a 3-site randomized-controlled efficacy trial with mixed methods to test a SMA intervention, versus usual care. Patients within 12 weeks of a HF hospitalization will be randomized to receive either HF-SMA (intervention arm) with optional co-participation with their caregivers, versus usual care (control arm). The HF-SMA will be provided by a non-physician team composed of a nurse, a nutritionist, a health psychologist, a nurse practitioner and/or a clinical pharmacist and will consist of four sessions of 2-h duration that occur every other week for 8 weeks. Each session will start with an assessment of patient needs followed by theme-based disease self-management education, followed by patient-initiated disease management discussion, and conclude with break-out sessions of individualized disease monitoring and medication case management. The study duration will be 180 days for all patients from the day of randomization. The primary study hypothesis is that, compared with usual care, patients randomized to HF-SMA will experience better cardiac health status at 90 and 180 days follow-up. The secondary hypotheses are that, compared to usual care, patients randomized to HF-SMA will experience better overall health status, a combined endpoint of hospitalization and death, better HF self-care behavior, and lower B-type natriuretic peptide levels.

What the Desirable Collaboration between Care Workers in Nursing Homes and Phamacists Should Be: An Approach for Security and Safe Medication for Residents in Nursing Homes.

In our previous research, there was no collaboration between care workers and pharmacists, for the most part. As a result, it was discovered that in some cases, problems concerning medication of nursing home residents had not been resolved. To solve this issue, we brought together care workers and pharmacists for a workshop we conducted. We assigned 12 care workers with at least two years of experience and 12 pharmacists to four mixed groups and guided them in the management of in-home long-term medical care and conducted small group discussions (SGD) using the KJ method. In the pre-survey before the workshop, all 12 care workers replied "yes" to having experienced "concerns over medication" and nine (75%) replied "no" to having experienced "discussions (consultations) with pharmacists regarding the medication of residents". As a result of the SGD, "information sharing among professionals" was revealed as a problem common to all groups. Furthermore, common countermeasures for this issue included communication notes and holding collaborative meetings. In the post-survey after the workshop, 67% of the participants replied that their thoughts concerning countermeasures were "coherent", and everyone replied that their "awareness was increased". In a follow-up survey after the workshop, 82% of the participants replied that they were using some form of what they had learned and discovered in the workshop in their actual work.

Grupos educativos em saúde nas unidades básicas de saúde: concepções de quem faz / Health education groups in basic health units: conceptions of who does

Este estudo contribui para o Projeto de pesquisa do Ministério da Saúde: Observatório Nacional da Produção de Cuidado em diferentes modalidades à luz do processo de implantação das Redes Temáticas de Atenção à Saúde no Sistema Único de Saúde: Avalia quem pede, quem faz e quem usa (RAC). Possui como tema os grupos de educação em saúde nas unidades de Estratégia Saúde da Família. Objetivo geral: analisar os diversos processos de constituição de grupalidade nos grupos de educação em saúde em unidades básicas. Objetivos específicos: Identificar as ferramentas empregadas na constituição de grupos de educação em saúde e relatar o manejo das estratégias de grupalidade presentes nos grupos estudados. Foi utilizado Referencial conceitual fundamentado em autores da área da psicologia. Caminho metodológico: abordagem qualitativa, do tipo descritivo, que se deu por meio da Pesquisa ­ Interferência e outros referenciais, me valendo também do movimento cartográfico. Coleta de dados: observação participante, construção do Diário de Campo e narrativas de três grupos de educação em saúde numa unidade básica no bairro da Rocinha/RJ. Resultados e discussão: Usuários e profissionais identificam os grupos como instrumento fundamental de prática coletiva. Dentre alguns recolhimentos que deixaram impressão, destaco: o local para realização dos grupos; o grupo como local de criação da rede viva; grupo como local de experimentação de novas formas de viver; o uso de tecnologias; o modo como os diálogos são tecidos e como o pertencimento se faz. Considerações finais: Podemos afirmar que os elementos que compõem a grupalidade são combustível para se promover a vida, devido aos dispositivos empregados na construção de processos de pertencimento. O grupo como aposta do cuidado na Atenção Básica aparece como instrumento a ser mais bem entendido e explorado, pois se apresenta como um dispositivo disparador do cuidado na rede e para o cuidado de si

This study contributes to the Research Project of the Ministry of Health: National Observatory of Care Production in different approaches in the view of the implementation process of the Thematic Networks of Health Care in the Unified Federal Health System: "Evaluates who asks, who does and who uses" (RAC). It has as its theme the health education groups in the Family Health Strategy units. The general objective is to analyze the diverse processes of constitution of grouping in the health education groups in basic units. As specific objectives the Identification of the tools used in the constitution of health education groups and report the management of group strategies present in the groups studied. The methodology employed occurred in two ways: an exploratory - bringing evidence of studies on the proposed theme and a descriptive - using Research Interference and the cartographic movement. This second obtained as a scenario a basic health unit in the city of Rio de Janeiro. The data was collected through observation of participants, construction of a field diary and narratives of three groups of health education in a basic unit in the neighborhood of Rocinha, in Rio de Janeiro city. As results, it could be pointed that health care users and professionals identified groups as a fundamental instrument of collective practice. Among some collections that left impression ­ "what is in the skin", the place where the groups are formed is emphasized by the author. the group as the place of creation of the living network and experiment with new ways of living; the use of light technologies and the rationality of praxis; the way the dialogues are woven and how becoming a part of the group is done. Such impressions are those that promote the grouping. We can affirm that the elements that make up the grouping are the fuel to promote life due to the devices employed in the construction of processes of belonging. The group as a resource of care in Primary Care appears as an instrument to be better understood and explored as it presents itself as a trigger device for care in the network and for care of itself

[Health and justice coordination in prisons]. / Articulation santé et justice en milieu carcéral.

The question of health-justice coordination has been present since the law of 18th January 1994. Since then, professional relations between prison staff and health carers have been regularly questioned in terms of their aims. The texts structuring this interinstitutional health-justice coordination constitutes a framework which the various professionals must appropriate and implement by drawing on specific knowledge and skills. It is an invitation to work together around the same population, on their respective and different missions. The implementation of a structured therapeutic group with sex offenders constitutes a positive experience.

Group structure predicts variation in proximity relationships between male-female and male-infant pairs of mountain gorillas (Gorilla beringei beringei).

Relationships between conspecifics are influenced by both ecological factors and the social organization they live in. Systematic variation of both--consistent with predictions derived from socioecology models--is well documented, but there is considerable variation within species and populations that is poorly understood. The mountain gorilla (Gorilla beringei) is unusual because, despite possessing morphology associated with male contest competition (e.g., extreme sexual dimorphism), they are regularly observed in both single-male and multimale groups. Both male-female and male-infant bonds are strong because males provide protection against infanticide and/or predation. Risk of these threats varies with social structure, which may influence the strength of social relationships among group members (including females and offspring, if females with lower infant mortality risk are less protective of infants). Here, we investigate the relationship between group structure and the strength of proximity relationships between males and females, males and infants, and females and offspring. Data come from 10 social groups containing 1-7 adult males, monitored by the Dian Fossey Gorilla Fund's Karisoke Research Center in Volcanoes National Park, Rwanda. After controlling for group size and infant age, association strength was similar for male-female pairs across group types with both dominant and nondominant males, but male-infant relationships were strongest in single-male groups where paternity certainty was high and animals had fewer social partners to choose from. The male:female and male:infant ratios better predicted both male-female and male-infant associations than the absolute number of males, females, or infants did. The fewer the number of males per female or infant, the more both pair types associated. Dominant males in groups containing fewer males had higher eigenvector centrality (a measure of importance in a social network) than dominant males in groups with more males. Results indicate that nondominant males are an important influence on relationships between dominant males and females/infants despite their peripheral social positions, and that relationships between males and infants must be considered an important foundation of gorilla social structure.

Evidências métricas da adaptação da Escala de Dominância Social numa amostra portuguesa / Metric Evidences of the adaptation of the Social Dominance Scale in a portuguese sample / Evidencias de validez da la adaptación de la escala de dominancia social en una muestra portuguesa

Este estudo tem como objetivo apresentar evidências de validação da escala de Orientação para a Dominância Social para a população portuguesa. Participaram 910 pessoas, sendo a maioria do sexo feminino (58,7%), com idades variando de 18 a 81 anos (M=34,09; DP=11,57). Foram realizadas análises de consistência interna, fatorial exploratória (n=455) e fatorial confirmatória (n=455). Os resultados mostram o modelo de dois fatores como mais adequado do que o modelo original e com bom valores de consistência interna. Concluiu-se que esse é um instrumento psicometricamente adequado. Reitera-se a premência de continuar a estudar a da análise da validade de critério em relação ao sexismo ambivalente, neossexismo e personalidade autoritária...

This study aims to present evidences of the validity of the social dominance orientation scale for Portuguese population. Participants were 910 Portuguese people. Most of them were women (58.7%), with ages ranging from 18 to 81 years (M=34.09; SD=11.57). Reliability analysis, exploratory factor analysis (n=455) and confirmatory factor analysis (n=455) were carried out. Results supported a two-component model for the SDO scale, which displayed a better fit than the original one-factorial structure. The scale showed good psychometric properties. In conclusion, the SDO is a psychometrically adequate instrument, being better represented by a two-component model. Future studies should examine the criterion validity through the analysis of the relationship of social dominance with ambivalent sexism, neosexism and authoritarian personality, among others...

El objetivo de este estudio es presentar evidencias de validez de la adaptación de la escala de orientación a la dominancia social en una muestra portuguesa. Participaron 910 personas de varios puntos de Portugal, siendo la mayoría de los participantes mujeres (58,7%) con edades comprendidas entre los 18 y los 81 años (M=34,09; DP=11,57). Se realizaron análisis de consistencia interna, análisis factorial exploratoria (n=455) y análisis factorial confirmatoria (n=455). Los resultados mostraron que el modelo de dos factores tuvo un mejor ajuste que el modelo unidimensional original, mostrando buenos valores de consistencia interna. Considerado una estructura de dos factores, la escala demuestra ser un instrumento psicométricamente adecuado. Futuros estudios deberán analizar la validez de criterio a través de las relaciones con el sexismo ambivalente, el neosexismo y la personalidad autoritaria, entre otras...

Why are all the white (Asian) kids sitting together in the cafeteria? Resegregation and the role of intergroup attributions and norms.

Over three studies, we identified the phenomenon of ethnic 'resegregation' and assessed the extent to which it was predicted by attributions and norms, among other variables. Study 1, an observational study, showed extensive resegregation between White and Asian students in the cafeteria of a highly mixed school. In Study 2, we found evidence of attributional correspondence for White students, who attributed both their own and the outgroup's contact avoidance more to a lack of interest than fear of rejection, whereas Asian students attributed the outgroup's contact avoidance more to lack of interest, but preferred neither explanation of their own avoidance. In Study 3, we observed a pattern of attributional correspondence among both White and Asian students who attributed both their own and the outgroup's inaction in a hypothetical intergroup cafeteria scenario more to a lack of interest than fear of rejection. Study 3 also demonstrated longitudinally, for both groups, that own lack of interest in the outgroup reduced likelihood of cafeteria contact, whereas having outgroup friends and perceiving positive ingroup norms promoted it. In addition, positive outgroup norms promoted likelihood of cafeteria contact only for Asian students. We discuss how an understanding of the factors driving resegregation is critical to effectively realizing the potential of desegregated settings.

The effects of single-sex compared with coeducational schooling on students' performance and attitudes: a meta-analysis.

Proponents of single-sex (SS) education believe that separating boys and girls, by classrooms or schools, increases students' achievement and academic interest. In this article, we use meta-analysis to analyze studies that have tested the effects on students of SS compared with coeducational (CE) schooling. We meta-analyzed data from 184 studies, representing the testing of 1.6 million students in Grades K-12 from 21 nations, for multiple outcomes (e.g., mathematics performance, mathematics attitudes, science performance, educational aspirations, self-concept, gender stereotyping). To address concerns about the quality of research designs, we categorized studies as uncontrolled (no controls for selection effects, no random assignment) or controlled (random assignment or controls for selection effects). Based on mixed-effects analyses, uncontrolled studies showed some modest advantages for single-sex schooling, for both girls and boys, for outcomes such as mathematics performance but not for science performance. Controlled studies, however, showed only trivial differences between students in SS versus CE, for mathematics performance (g = 0.10 for girls, 0.06 for boys) and science performance (g = 0.06 for girls, 0.04 for boys), and in some cases showed small differences favoring CE schooling (e.g., for girls' educational aspirations, g = -0.26). Separate analyses of U.S. studies yielded similar findings (e.g., for mathematics performance g = 0.14 for girls and 0.14 for boys). Results from the highest quality studies, then, do not support the view that SS schooling provides benefits compared with CE schooling. Claims that SS schooling is particularly effective for U.S. ethnic minority boys could not be tested due to the lack of controlled studies on this question.

Comunicação nas práticas de coordenação de grupos socioeducativos na saúde da família / Comunicacion en las practicas de coordinacion de grupos socioeducativos en la salud de la familia / Communication in the coordination practices of socioeducational groups in family health

Este estudo objetivou desvelar a forma da comunicação do coordenador de grupos socioeducativos na Saúde da Família. Pesquisa qualitativa, descritiva e exploratória desenvolvida com 25 coordenadores de grupos distribuídos em oito unidades básicas de saúde de Belo Horizonte, Brasil. Para coleta de dados, utilizou-se a observação não participante e a entrevista semiestruturada com os coordenadores. O estudo teve como marco teórico as concepções de Bakhtin e referenciais sobre comunicação e saúde. As informações coletadas mostram que a tríade corpo, saúde e doença é comunicada nos grupos por diferentes canais e em níveis diversificados de discurso. Conclui-se que há necessidade do coordenador valer-se de uma abordagem que valoriza a expressão do participante, não estritamente da saúde em sua dimensão física, mas da vida de cada um, buscando diferentes formas de comunicação para efetivar a ação educativa dialógica e os espaços de interação nos grupos.

Se objetivó revelar la forma de comunicación del coordinador de grupos socioeducativos en la Salud de la Familia. Investigación cualitativa, descriptiva, exploratoria, desarrollada con 25 coordinadores de grupos distribuidos en ocho unidades básicas de salud de Belo Horizonte-Brasil. Datos recolectados por intervención no participante y entrevista semiestructurada con los coordinadores. Se utilizaron como marco teórico las concepciones de Bakhtin y referenciales sobre comunicación y salud. Las informaciones muestran que la tríada cuerpo, salud y enfermedad es comunicada en los grupos por diferentes canales y en tres niveles diversificados de discurso. Se concluye en que hay necesidad de que el coordinador de valga de un abordaje que valorice la expresión del participante, no estrictamente de la salud en su dimensión física, y sí de la vida de cada uno, buscando diferentes formas de comunicación para hacer efectiva la acción educativa dialógica y los espacios de interacción en los grupos.

The purpose of this study was to assess the forms of communication used by coordinators in socioeducational groups in family health programmes. This qualitative, descriptive and exploratory study was conducted with 25 coordinators of groups in eight basic health units from Belo Horizonte, Brazil. Data collection comprised non-participant observation and semi-structured interviews with the coordinators.The theoretical basis for research was Bakhtin's formulations and references on communication and health. The gathered information showed that the body, health and disease triad was communicated in groups through different channels and at different levels of discourse. Our conclusion is that coordinators must adopt an approach that values the expression of participants, not just regarding the physical dimensions of health, but also the life of each participant, and should use various forms of communication to foster dialogical educational actions and means for interaction in groups.

Multidisciplinarity and medical decision, impact for patients with cancer: sociological assessment of two tumour committees' organization.

PURPOSE: Medical practices in oncology are expected to be multidisciplinary, yet few articles studied how this may be concretely applied. In the present study, we evaluated the organization of two multidisciplinary committees, one for breast cancer and one for sarcoma, in a French Comprehensive Cancer Centre. METHODS: Both tumours were specifically chosen so as to emphasise substantial differences in relation with incidence, histological subtypes, management strategy, and scientific evidence. Between 2003 and 2004, 404 decision processes were observed, 210 for sarcoma (26 meetings) and 194 for breast cancer (10 meetings). The number of physicians who took part in the discussions and their medical specialties were systematically noted as well as the number of contradictory discussions, medical specialties represented in these contradictory discussions and the topics of contradiction. The last measured data was whether the final committee's decision was in conformity with the referent preferences or not. All these measures were related to the referent's medical speciality and working place, to the stage of the disease and to the disease management stage. RESULTS: Committees' specificities concerned their organization, referent's medical specialties, the number of participants in discussions and their medical specialties. Discussions in the sarcoma committee tended to be more multidisciplinary, involving more specialties. Initial strategy proposal for one patient was modified during the discussions for 86 patients out of 210 (41%) and for 62 out of 194 (32%) respectively for sarcoma and breast cancer. However, there was no significant difference in the rate of contradictory discussions between breast cancer and sarcoma committees (32% versus 41% respectively; P = 0.08). The rates of contradictory discussions were similar for localized cancers, local relapse and metastasis disease (37%, 41% and 34% respectively; P = 0.86). CONCLUSIONS: The present study reports more than 30% of changes concerning strategy for patient with cancer due to multidisciplinary discussions. This indicates that, providing tumour committees are adapted to the pathologies' characteristics, they can promote a collective and multidisciplinary approach to oncology.

Limites e possibilidades do desenvolvimento de grupos criativos na Estratégia Saúde da Família / Limits and possibilities of creative development groups in the Family Health Strategy / Limites y posibilidades de desarrollo de grupos creativos de la Estrategia de Salud de la Familia

Objetivou-se identificar as limitações e possibilidades para o desenvolvimento de grupos criativos comunitários, na concepção dos trabalhadores da Saúde da Família. Trata-se de uma pesquisa qualitativa, realizada em três equipes da Saúde da Família que desenvolvem grupos criativos em um município do extremo sul do Brasil. Foram entrevistados onze trabalhadores. Utilizou-se análise de conteúdo - modalidade temática para examinar o conteúdo das entrevistas. Os resultados mostraram persistir limitações estruturais para o desenvolvimento de atividades que envolvam a participação da comunidade em grupos criativos. Constatou-se também, que a utilização de espaços comunitários, a cultura e as características comunitárias, constituem possibilidades de implantação e desenvolvimento desses grupos. Tais possibilidades podem desencadear nos trabalhadores sentimentos de impotência e dependência, devido às dificuldades encontradas no interior das comunidades, que se contrapõem às possibilidades avistadas. Conclui-se que um melhor aproveitamento do trabalho articulado com a comunidade fortaleceria o eixo promotor das potencialidades comunitárias.

Aimed to identify limitations and possibilities for the development of creative community groups in the design of the employees working at the Family Health. This is a qualitative study conducted in three staff who woks in the Family Health to develop creative groups in a city of extreme southern Brazil. Eleven workers were interviewed. Used content analysis - thematic modality to examine the contents of the interviews. The results showed that remain, in practice, structural constraints to the development of activities that involve community participation in creative groups. It was also found that the use of community spaces, culture and community characteristics are possibilities for development and deployment of these groups.These possibilities may trigger the workers feelings of helplessness and dependence, due to difficulties within the communities, that opposes the possibilities seen. It was found that a better use of joint work with the community strengthens the axis of the potential developer community.

Elobjetivo de esto estudio fue identificar las limitaciones y posibilidades para el desarrollo de grupos en la comunidad, en la concepción de los trabajadores en Salud de la Familia. Estudio cualitativo realizado en tres equipos de Salud de la Familia que desarrollan grupos creativos en una ciudad en el sur de Brasil. Once trabajadores fueron entrevistados.Se utilizó el análisis de contenido - modalidad temática para examinar el contenido de las entrevistas. Los resultados mostraron que en la práctica siguen siendo las limitaciones estructurales para el desarrollo de las actividades que implican la participación comunitaria en grupos creativos. También se constató que el uso de espacios comunitarios, cultura y características de la comunidad son las posibilidades de desarrollo y despliegue de estos grupos. Estas posibilidades pueden activar los trabajadores sentimientos de impotencia y de dependencia, debido a las dificultades dentro de las comunidades, que se opone a las posibilidades de visita. Se encontró que un mejor uso de trabajo conjunto con la comunidad de reforzar el eje de la comunidad de desarrolladores potenciales.

Reflexões sobre cidadania e os entraves para a participação popular no SUS / Reflections on citizenship and barriers to popular participation in the Unified Health System

Este trabalho apresenta as contradições do conceito de cidadania encontradas em pesquisas realizadas junto a usuários de uma unidade de saúde da zona leste de São Paulo e os consequentes entraves para a participação popular no SUS. A coleta dos dados foi organizada em dois encontros, sendo abordado o conceito de cidadania e participação popular com oito sujeitos não pertencentes ao conselho gestor da unidade. Utilizou-se a técnica de grupo focal. Como resultado, verificou-se uma imprecisão de significados aplicados ao conceito de cidadania. Os sujeitos da pesquisa apontaram uma série de limites para a execução deste conceito, como a legislação do próprio Estado, a repressão sofrida pelos indivíduos, a descrença na democracia representativa e no voto como práticas de cidadania e o questionamento da igualdade de direitos em nossa sociedade; e a participação popular como forma de movimento coletivo em busca de soluções aos problemas da comunidade. Portanto, a participação popular dentro dos espaços institucionais do SUS com esta concepção de cidadania pode levar os usuários à não resolutividade de suas demandas junto ao Estado nos conselhos gestores. Somente com outras formas de pressão e mobilização nãoinstitucionais, podemos ter uma participação popular mais efetiva e resolutiva, atendendo aos anseios da população e dos militantes em saúde que primam por uma saúde pública e de qualidade.

This paper presents the contradictions of the concept of citizenship found in research conducted with users of a health unit in the East Zone of Sao Paulo and the resulting barriers to popular participation in the SUS. Data collection was organized into two meetings, discussing the concept of citizenship and popular participation with eight subjects outside the unit's management council. We used the focus group technique. As a result, there was a vagueness of meanings applied to the concept of citizenship. The subjects mentioned a number of limitations to the implementation of this concept, as State's law, the repression suffered by the people, the disbelief in representative democracy and voting as citizenship practices, and the question of equal rights in our society; and popular participation as a form of collective movement in search of solutions to community problems. Therefore, popular participation within the institutional spaces of the SUS with this concept of citizenship can lead users to leaving their demands unsolved by the State in the the management councils. Only with other forms of pressure and non-institutional mobilization one can have a more effective popular participation and problem-solving view of the concerns of the population and health activists, who struggle for a public health and quality.

Redes acadêmicas para pesquisa e capacitação em meio ambiente e desenvolvimento sustentável / Academic networks for environmental and sustainable development research and training

A Agenda 21 Global atenta para o importante papel da academia enquanto produtora do conhecimento científico sugere, entre seus objetivos, o aumento do número de programas interdisciplinares de pesquisa e a expansão de redes de informação científica e tecnológicas regionais e mundiais. Assim, em um mundo extremamente globalizado a estruturação de grupos de pesquisa e redes torna-se necessária, surgindo como um espaço institucional, tendo como objetivos o ensino e a pesquisa para o aprofundamento das ciências, fortalecendo a ligação entre a academia e a sociedade. O Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), que é uma agência de fomento à pesquisa Científica e Tecnológica e à formação de recursos humanos do Ministério da Ciência e Tecnologia (MCT), acreditando no espaço que os grupos de pesquisa ocupam no país, desenvolveu, a partir de 1992, um Diretório dos Grupos de Pesquisa existentes no Brasil. Alguns destes grupos de pesquisa possuem, embora não formalmente, modelo de rede, abrangendo várias instituições de pesquisa ou pesquisadores voltados para um objetivo comum. Este cenário enseja a reflexão acerca da importância de avaliar o potencial destes grupos cadastrados no DGP/CNPq em influenciar na formulação e implementação de políticas públicas ambientais. Para isso foi utilizada pesquisa exploratória que envolveu revisão bibliográfica, lições aprendidas pela prática empírica da autora na coordenação da rede SIADES e um aprofundamento da investigação tendo por objeto os grupos de pesquisa cadastrados no DGP/CNPq. Entre os resultados permite-se afirmar que foi possível, a partir da literatura e da pesquisa com os grupos, identificar-se fatores chave para fortalecimento de influência em políticas públicas. Entre esses se destacam, de forma positiva, avanços no fortalecimento da discussão política, interação entre os membros dos grupos e abordagens mais interdisciplinares. Porém, os grupos ainda possuem dificuldades na utilização de ferramentas de comunicação mais eficientes para o trabalho em rede e para atingir o formulador de políticas públicas; no acesso a fundos de financiamento das agências de fomento e nos critérios para se integrar os grupos.

Comunicação nas práticas de coordenação de grupos socioeducativos na Estratégia de Saúde da Família / Communication in the coordination practices of socioeducational groups in Family Health Strategy

O presente estudo teve como objetivo desvelar o conteúdo e a forma dacomunicação do coordenador de grupos socioeducativos na Estratégia de Saúde daFamília. Trata-se de uma pesquisa qualitativa, descritiva e exploratória, desenvolvidajunto a vinte e cinco coordenadores de grupos socioeducativos que assistem àpopulação idosa, distribuídos em oito unidades básicas de saúde de dois DistritosSanitários de Belo Horizonte, Brasil. A coleta de dados foi realizada de março a julhode 2009 e constou de observação não participante e de entrevista em profundidadesemiaberta. Na interpretação dos dados, empregou-se a Análise de Conteúdoproposta por Bardin e o Modelo Teórico de Forrest. As informações coletadas foramorganizadas em sete núcleos temáticos: Atmosfera grupal como fator determinantepara a comunicação entre coordenador e membros; A diversidade de canais decomunicação veiculadores de mensagens nos grupos socioeducativos; Adinamicidade dos conteúdos discutidos nos grupos socioeducativos; A comunicaçãoverbal do coordenador segundo os pressupostos de Forrest; “Eu quis saber o que apessoa está me mostrando”: a leitura do grupo a partir da comunicação não verbal;O grupo enquanto espaço de escuta; Aspectos comunicacionais dificultadores efacilitadores na interação entre coordenador e grupo. A análise desses núcleostemáticos revelou que, apesar do grande incentivo à adoção de hábitos de vidasaudáveis, a prática discursiva dos coordenadores é prescritiva ecomportamentalista, pouco sintonizada com o arcabouço filosófico-conceitual dapromoção da saúde. Nesse sentido, houve predomínio da subcategoria dandoinformação que aparece associada às orientações dos profissionais de saúde sobre aadoção de comportamentos para prevenção de doenças, fundamentada natransmissão de conhecimentos de forma verticalizada. É necessário que sedesenvolvam vários processos de escuta do grupo, levando-se em conta suadimensão sociocultural para...

Reflexões sobre o uso de atividades grupais na atenção aportadores de doenças crônicas / Reflexiones sobre el uso de actividades grupales en la atención a portadores de enfermedades crónicas / Thinking about the group activities for caring chronic diseasespatients

As doenças crônicas não transmissíveis constituem a principal causa de mortalidade em todo o mundo, sendotidas como reflexo das profundas mudanças nos hábitos de vida da população mundial. Entre essas se destacamas doenças cardiovasculares, o diabetes, a obesidade, o câncer, a insuficiência renal crônica e as doençasrespiratórias. Uma das intervenções possíveis no acompanhamento da evolução dessas doenças ou de suaprevenção tem sido o uso da tecnologia de grupo para educação em saúde, prevenção de agravos, treino de habilidades, entre outras ações. O presente artigo de reflexão tem como objetivo discutir caminhos que apontem possibilidades para tornar as atividades grupais mais assertivas e adequadas às necessidades de portadores dessas doenças nos serviços de saúde. O texto aborda aspectos conceituais relacionados ao manejo grupal, formas adequadas de enquadrar os diferentes grupos e ainda a importância da avaliação das intervenções como forma de indicar aos profissionais de saúde caminhos para melhorar seu desempenho na coordenação desse tipo de grupo.

Las enfermedades crónicas no transmisibles constituyen la principal causa de mortalidad en todo el mundo,siendo tenidas como reflejo de los profundos cambios en los hábitos de vida de la población mundial. Entre esasse destacan las enfermedades cardiovasculares, el diabetes, la obesidad, el cáncer, la insuficiencia renal crónicay las enfermedades respiratorias. Una de las intervenciones posibles en el acompañamiento de la evolución deesas enfermedades o de su prevención ha sido el uso de la tecnología de grupo para educación en salud,prevención de agravios, entreno de habilidades, entre otras acciones. El presente artículo de reflexión tiene comoobjetivo discutir caminos que apunten posibilidades para tornar las actividades grupales más asertivas yadecuadas a las necesidades de portadores de esas enfermedades en los servicios de salud. El texto abarcaaspectos conceptuales relacionados al manejo grupal, formas adecuadas de encuadrar los diferentes grupos yaun la importancia de la evaluación de las intervenciones como forma de indicar a los profesionales de saludcaminos para mejorar su desempeño en la coordinación de ese tipo de grupo.

The non-transmissible chronic diseases are the main cause of mortality worldwide, being regarded as a reflectionof the extensive changes in the people living habits in the world. Among these diseases we highlight thecardiovascular, diabetes, obesity, cancer, chronic renal failure and respiratory diseases. One of the possibleinterventions in monitoring the evolution of these diseases and their prevention has been the use of grouptechnology for activities in health education, diseases prevention, skills training, among other ones. This reflexivearticle aims discussing ways that points to possibilities to make these activities more assertive and appropriatesfor patients caring needs in health services. This paper addresses conceptual issues related to the groupmanagement, appropriate ways of getting the fit of the different groups and the interventions evaluationimportance in order to indicate ways for health professionals to improve their performance in groups coordination.

Coevolutionary cycling of host sociality and pathogen virulence in contact networks.

Infectious diseases may place strong selection on the social organization of animals. Conversely, the structure of social systems can influence the evolutionary trajectories of pathogens. While much attention has focused on the evolution of host sociality or pathogen virulence separately, few studies have looked at their coevolution. Here we use an agent-based simulation to explore host-pathogen coevolution in social contact networks. Our results indicate that under certain conditions, both host sociality and pathogen virulence exhibit continuous cycling. The way pathogens move through the network (e.g., their interhost transmission and probability of superinfection) and the structure of the network can influence the existence and form of cycling.

The more (and the more compatible) the merrier: multiple group memberships and identity compatibility as predictors of adjustment after life transitions.

Two longitudinal studies considered the role of social identity factors in predicting well-being after students' transition to university. The transition (assessed before starting university and after 2 months at university) had a detrimental effect on well-being, but identification as a university student improved well-being. Both studies showed that the social context in which the change occurred either facilitated or hindered university identification. Specifically, perceived compatibility between old and new identities and having multiple group memberships (which were each influenced by social class background, Study 2) both increased likelihood of identification with the new group. These predictive relationships remained statistically reliable when controlling for other factors relevant to the transition. The results suggest that life transitions are difficult partly because they entail changes in group membership. Both studies also demonstrate that identification with a new group can help buffer individuals from the negative well-being consequences of change.

Illustration of some limits of the Markov assumption for transition between groups in models of spread of an infectious pathogen in a structured herd.

In epidemic models concerning a structured population, sojourn times in a group are usually described by an exponential distribution. For livestock populations, realistic distributions may be preferred for group changes (e.g. depending on sojourn time). We illustrated the effect on pathogen spread of the use of an exponential distribution, instead of the true distribution of the transition time, between groups for a population separated into two groups (youngstock, adults) when this true distribution is a triangular one. Concerning the epidemic process, two assumptions were defined: one type of excreting animal (SIR model), and two types of excreting animals (transiently or persistently infected animals). The study was conducted with two indirect-transmission levels between groups. Among the adults, the epidemic size and the last infection time were significantly different. For persistence, epidemic sizes (in the entire population and in youngstock) and first infection time, results varied according to models (excretion assumption, indirect-transmission level).

Habilidades e atributos do enfermeiro como coordenador de grupos / Nurses’ skills and abilities as group coordinators

Coordenar grupos é uma atividade cada vez mais freqüente para enfermeiros, que devem ter conhecimento específico para atingir os objetivos propostos e aproveitar o potencial das pessoas envolvidas. Trata-se de um estudo teórico que tem como objetivo discutir e refletir sobre alguns atributos desejáveis para enfermeiros como coordenadores de grupos, baseado no estudo de Godoy, literatura clássica da Dinâmica de Grupo, e artigos contemporâneos publicados em periódicos nacionais e internacionais especializados. O artigo está organizado em dois momentos, sendo no primeiro apresentadas algumas bases teóricas da coordenação de grupos e, no segundo, os atributos desejáveis ao coordenador. Estes elementos são discutidos como ferramentas para os enfermeiros na condução de grupos com o propósito de realizar atividades de assistência, formação de recursos humanos ou desenvolvimento de pesquisas. A praxis da coordenação envolve um conjunto de habilidades técnicas e científicas, amplo conhecimento das relações interpessoais, autoconhecimento, sensibilidade e criatividade para que a performance dos enfermeiros, de fato, promova o atendimento das demandas em saúde.

Social organization of black-and-white snub-nosed monkeys (Rhinopithecus bieti) at Deqin, China.

Data on social organization of two bands of black-and-white snub-nosed monkeys (Rhinopithecus bieti) were collected when the monkeys were crossing an open spot at Nanren and Bamei (northwest of Yunnan, China) using a sampling rule where individuals within one social unit are spatially closer to each other than individuals between social units. The typical pattern of social organization in this sample was multiple adult females (AFs) and their offspring with one adult male (AM) in a one-male unit (OMU), similar to that of many other colobines. In such units, on average one male is associated with 4.0 AFs and 2.5 of their offspring. Moreover, there are multimale/multifemale units and monogamous units besides OMUs. All bisexual units traveled together with at least one all-male unit as a cohesive band. In two bands of monkeys, 87% of AMs in bisexual units were within OMUs, 7.8% within monogamous units and 5.2% within multimale, multifemale units. In the Bamei band, 6.7% of AMs were in the all-male unit. The size of OMUs in the Nanren band was larger than that of the Bamei band, with more AFs and juveniles, which may be related to better conservation in the Nanren band's habitat. For the Nanren band, the average number of AFs in OMUs varied across time, increasing from 4.3 in 1994 to 5.1 in 2001, and then decreasing to 3.8 in 2005. This article suggests three possible explanations for this variation, but more data are needed for these hypotheses to be tested.