Factors related to transmission of and infection with Schistosoma mansoni in a village in the South-eastern Region of Brazil.

In this transversal study, factors related to infection with and transmission of Schistosoma mansoni were explored. Based on stool examinations of two Kato-Katz smears of a single sample, the prevalences of schistosomiasis and geohelminths were established. In a multivariable analysis, sets of demographic, socio-economic and water contact pattern variables were tested for strength of relation with infection. Males presented a 3.39-times higher risk for infection than females. The age groups between 10-19 years and 20-30 years showed risks of infection 7.1- and 7.5-times higher, respectively, than the control age group between 0-10 years. Individuals practicing leisure activities had a 1.96-times higher risk than those without these activities. The malacological survey identified snails of the species Biomphalaria glabrata, Biomphalaria straminea and Biomphalaria tenagophila. Two exemplars of B. glabrata (0.53%) proved positive for S. mansoni. The socio-economic improvements observed in the locality suggest a protective and preventive effect towards infection with schistosomiasis, which requires further investigation with a longitudinal and more detailed study design. Considering our findings, a proposal for an integrated control program should be based on two pillars: one horizontal, which involves social empowerment and health education, and another more vertical, which delivers treatment and infrastructure improvements.

[Hortênsia de Hollanda: the art of health education to prevent and control epidemics in Brazil]. / Hortênsia de Hollanda: a arte da educação em saúde para prevenção e controle das endemias no Brasil.

The article presents the transcription of a class given by Brazilian educator Hortênsia Hurpia de Hollanda entitled: "Educação sanitária na profilaxia das endemias rurais" [Sanitary education in the prophylaxis of rural epidemics], in a refresher course on rural epidemics and included in the Anais da Faculdade Fluminense de Medicina in December 1956. The annotated publication of the manuscript seeks to prove the pioneering efforts of Hollanda, whose work has been seldom investigated, considering the dimension of her role in the area of health education in Brazil. Sensitivity to social problems, the importance of the population's participation and an experimental attitude are some of the aspects presented in the educator's text, revealing an advanced theoretical grounding for her times and an original and pioneering practice that remains to this day as an ideal to be achieved.

Development of a natural molluscicide prototype kit (MoluSchall) for the control of schistosomiasis mansoni transmission.

INTRODUCTION: In Brazil, Biomphalaria glabrata, B. tenagophila, and B. straminea are intermediate hosts of Schistosoma mansoni, the etiological agent of schistosomiasis mansoni. Molluscicide use is recommended by the WHO for controlling the transmission of this parasite. Euphorbia milii latex has shown promising results as an alternative molluscicide. Thus, a natural molluscicide prototype kit based on freeze-dried E. milii latex was developed and evaluated against Biomphalaria spp. METHODS: E. milii latex was collected, processed, and lyophilized. Two diluents were defined for freeze-dried latex rehydration, and a prototype kit, called MoluSchall, was produced. A stability test was conducted using prototype kits stored at different temperatures, and a toxicity assay was performed using Danio rerio. Additionally, MoluSchall was tested against B. glabrata under semi-natural conditions according to defined conditions in the laboratory. RESULTS: MoluSchall was lethal to three Brazilian snail species while exhibiting low toxicity to D. rerio. Regardless of storage temperature, MoluSchall was stable for 24 months and was effective against B. glabrata under semi-natural conditions, with the same LD100 as observed under laboratory conditions. CONCLUSIONS: MoluSchall is a natural, effective, and inexpensive molluscicide with lower environmental toxicity than existing molluscicides. Its production offers a possible alternative strategy for controlling S. mansoni transmission.

A combined strategy to improve the control of Schistosoma mansoni in areas of low prevalence in Brazil.

Results of stool examinations for infections with Schistosoma mansoni among schoolchildren, living in a village of Minas Gerais State, Brazil, were used as an indicator to identify schistosomiasis-positive individuals within the entire population. This new approach is based on dividing the community into schoolchildren, members of households of schistosomiasis-positive and -negative schoolchildren, and members of households without schoolchildren. Each subgroup was evaluated comparing different sampling efforts with the predetermined "gold standard" to find the best relationship between detection rate and sampling effort. Consequently these results were combined, and a proposal for a new strategy, valid for an entire community, was elaborated. This alternative approach during the screening process permits to treat a similar proportion of positives as detected with 6 Kato-Katz slides of 3 stool samples, with 3-fold reduced sampling effort, enhancing the efficiency of schistosomiasis control programs in low-endemic areas.

[Aesthetics of the grotesque and audiovisual production for health education: segregation or empathy? The case of leishmaniasis in Brazil]. / A estética do grotesco e a produção audiovisual para a educação em saúde: segregação ou empatia? O caso das leishmanioses no Brasil.

In order to understand audiovisual production on health and disease and the pedagogical effects of health education mediated by educational videos, this article analyzes the audiovisual production on leishmaniasis in Brazil. Fourteen educational videos showed the hegemony of TV aesthetics, particularly a journalistic paradigm with constant use of voice-over, inducing the fixation of meanings. Rather than stimulating critical reflection on the social circumstances of leishmaniasis, the videos' discourse and images promote a banal, non-critical, stigmatized representation of the disease. Individuals with the disease are subjected to visual exposure rather than being involved critically and sensitively as protagonists in prevention and treatment. The article thus presents approaches based on studies of visual and health anthropology, arguing in favor of an innovative approach to the production and utilization of educational videos in health education, mediated through audiovisuals. Health education should respect and engage in dialogue with various cultures, subjectivity, and citizenship, developing an audiovisual aesthetics (in terms of narrative and image) that fosters an educational praxis in the field of collective health.

Development of a natural molluscicide prototype kit (MoluSchall) for the control of schistosomiasis mansoni transmission

Abstract INTRODUCTION In Brazil, Biomphalaria glabrata, B. tenagophila, and B. straminea are intermediate hosts of Schistosoma mansoni, the etiological agent of schistosomiasis mansoni. Molluscicide use is recommended by the WHO for controlling the transmission of this parasite. Euphorbia milii latex has shown promising results as an alternative molluscicide. Thus, a natural molluscicide prototype kit based on freeze-dried E. milii latex was developed and evaluated against Biomphalaria spp. METHODS E. milii latex was collected, processed, and lyophilized. Two diluents were defined for freeze-dried latex rehydration, and a prototype kit, called MoluSchall, was produced. A stability test was conducted using prototype kits stored at different temperatures, and a toxicity assay was performed using Danio rerio. Additionally, MoluSchall was tested against B. glabrata under semi-natural conditions according to defined conditions in the laboratory. RESULTS MoluSchall was lethal to three Brazilian snail species while exhibiting low toxicity to D. rerio. Regardless of storage temperature, MoluSchall was stable for 24 months and was effective against B. glabrata under semi-natural conditions, with the same LD100 as observed under laboratory conditions. CONCLUSIONS MoluSchall is a natural, effective, and inexpensive molluscicide with lower environmental toxicity than existing molluscicides. Its production offers a possible alternative strategy for controlling S. mansoni transmission.

Effect of a participatory educational program on primary school teachers' knowledge of malaria.

OBJECTIVE: To describe a participatory educational program for building up knowledge on malaria among primary school teachers in a highly endemic city. METHODS: An observational study was conducted. A 40-hour course with a multidisciplinary and problematizing approach was held in 2008, including 46 teachers mainly from rural areas of the city of Barcelos, Northern Brazil. The participatory educational process was comprised of workshops and practical classes. A previously validated questionnaire was applied before and after the course to assess teachers' knowledge and subsequently analyzed using qualitative and quantitative approaches and open-response thematic analysis. RESULTS: Prior to the course, teachers had little information about the transmission mechanisms, means of prevention, and the association between malaria and its vectors, and their health concepts were limited. After the course, teachers' knowledge of malaria increased and they reflected on their role in society. CONCLUSIONS: The effect of the educational program on the construction of contextualized knowledge of malaria and health indicates the potential of the strategy developed. Continuing education processes are required for the maintenance of new knowledge and practices directed towards health promotion.

A abstração do risco e a concretude dos sujeitos: uma reflexão sobre os comportamentos de risco no contexto da adolescência / The abstraction of risk and the concreteness of the subject: a reflection of risk behaviors in the context of adolescence

Resumo Em tempos em que se multiplicam as enfermidades decorrentes de hábitos de vida poucos saudáveis, característicos do estilo de vida moderno, a noção de comportamento de risco faz-se cada vez mais presente no discurso e nas práticas em saúde. No contexto da adolescência, esse tema vem sendo estudado através de investigações relacionadas ao consumo de álcool e outras drogas, ao tabagismo, à alimentação inadequada, ao sedentarismo, à atividade sexual desprotegida, entre outros comportamentos que, observados entre os adolescentes, somam-se ao risco atribuído a essa fase do desenvolvimento. Este artigo objetiva discutir criticamente a construção do risco e da adolescência enquanto objetos de investigação e intervenção na área da saúde, a partir de um estudo qualitativo realizado por meio de entrevistas em profundidade com 12 adolescentes de Lagoa Santa, Minas Gerais. Os resultados apontam para diferentes aspectos pessoais e emocionais geralmente não contemplados nas pesquisas na área, que, no entanto, influenciam sobremaneira as condutas dos adolescentes. Conclui-se que, para o aprimoramento e a resolutividade das políticas públicas e ações voltadas para a temática dos comportamentos de risco, torna-se necessário ampliar o escopo de investigações sobre os riscos e as perspectivas teóricas que lhes dão sustentação.

Abstract In times when a diversity of conditions resulting from unhealthy lifestyles and habits, characteristic of modern lifestyle, the notion of risk behavior becomes more and more present in the discourse and in health practices. In the context of adolescence studies, this issue has been analyzes by a series of investigations related to alcohol and other drugs use, smoking, inadequate diet, sedentary lifestyle, unprotected sexual activity and other behaviors that, when observed among young people, increase the risk to this particular phase of development. This article aims to critically discuss the construction of risk and adolescence as a concept and as an object of investigation in intervention and health care. It is structured as a qualitative study with individual and in depth interviews with 12 adolescents from Lagoa Santa city in Minas Gerais state, Brazil. The results point to different personal and emotional aspects raised by the youth usually not included in the research in the area, which nevertheless greatly influences the behavior of adolescents. We conclude that for the improvement and the resolution of public policies and actions towards the theme of risk behaviors, it is necessary to expand the scope of research on the concept of risks and theoretical perspectives that give them support.

Relações de gênero e a atuação de psicólogos na oncologia: subsídios para a saúde masculina / Relationship between gender and the action of psychologists in oncology: subsidies to the masculine healthcare / Relaciones de género y la práctica de los psicólogos en la oncología: subsidios para la salud masculina

O câncer vem sendo considerado um problema de saúde pública com maior índice de mortalidade entre a população masculina. Este estudo tem como objetivo identificar e analisar os relatos de psicólogos sobre a assistência voltada ao público masculino no âmbito da oncologia. Na perspectiva da Pesquisa Descritiva e Exploratória e dos Estudos de Gênero, foi elaborado um questionário semiestruturado respondido por 113 psicólogos de diferentes regiões do Brasil. Observou-se a incipiência de ações voltadas para o público masculino e um maior reconhecimento das necessidades específicas das mulheres. Os entrevistados apontaram para dificuldades de adesão dos homens às atividades dos serviços de psicologia e ao tratamento oncológico, revelando implicações dos aspectos socioculturais e institucionais. Os dados apontam para o processo de genderificação das instituições de saúde e a necessidade de inclusão do tema das masculinidades no âmbito do SUS.

Cancer has been considered a problem of public health with the highest mortality ratings among the male population. This paper aims to identify and analyze the report of psychologists about the specialized attention towards the male public in the field of oncology. According to the Descriptive and Exploratory Research and the Gender Studies’ perspective, a semi-structured questionnaire was elaborated and it was answered by 113 Brazilian psychologists. Through the answers, the lack of specific actions to the male public was observed in comparison to the recognition of the specific women’s necessity. The interviewed ones pointed out the difficulties that men have to join the psychology services with the oncological treatment, exposing implications from the social-cultural and institutional aspects. The results points to the process of genderization of the health institutions and the necessity to include the theme of masculinity in the ambit of SUS.

El cáncer ha sido considerado un problema de salud pública con tasas de mortalidad más elevadas entre los hombres. Este estudio buscó identificar y analizar las opiniones de psicólogos sobre la asistencia dirigida al público masculino en la oncología. A la vista de la investigación descriptiva y exploratoria y de los estudios de género, fue criado un cuestionario semi-estructurado, respondido por 113 psicólogos del Brasil. Se observó una escasez de acciones dirigidas al público masculino y un mayor reconocimiento de las necesidades de las mujeres. Los entrevistados informaron las dificultades en la adhesión de los hombres a las actividades de los servicios de psicología y al tratamiento oncológico, revelando implicaciones de los aspectos socioculturales e institucionales. Los resultados relevan el proceso de genderificación de las instituciones de salud y la necesidad de inclusión de la cuestión de las masculinidades en él SUS.

Dengue prevention at the household level: preliminary evaluation of a mesh cover for flowerpot saucers.

The effectiveness of a polyester mesh cover (evidengue), aimed at preventing the access of female Aedes aegypti mosquitoes to flowerpot saucers, was evaluated in laboratory. Two saucers of flowerpot with water were individually wrapped with the cover was placed with their respective pots in two entomological cages. One identical set of flowerpot and saucer was placed in a third cage. In each cage, 20 gravid females, fed on mouse blood, were released. Results show that the cover was effective to prevent access of females. Further tests are necessary to assess cover effectiveness as a device to prevent saucer oviposition.

Women's perceptions and practices regarding prevention and health promotion in primary healthcare.

OBJECTIVE: To analyze the perceptions and participation of female basic health unit users with regard to prevention and health promotion. METHODOLOGICAL PROCEDURES: Qualitative study with 20 users of a family health unit in the municipality of Belo Horizonte, Southeastern Brazil, in 2007. The interview script included questions about the health-disease process and prevention and health promotion. The content analysis technique was used to analyze the reports. RESULTS ANALYSIS: The perception of disease prevention was influenced by Leavell & Clark's theory, which is expressed as actions that avoid the appearance, progression or worsening of disease. Health promotion was regarded as a level of prevention and associated with the individual responsibility and the positive concept of health. Prevention and health promotion practices were influenced by the positive health concept, the possibility of causing pleasure/displeasure, the way in which they might interfere in daily life, by the concept of will-power and the value attributed to life. CONCLUSIONS: The discourse about disease prevention and health promotion is marked by traditional concepts. However, the inclusion of the positive health concept, allied to pleasure and will-power, are the main behavior determinants. Strategies based on a more comprehensive approach to the health-disease process are needed, thus reflecting the modern principles of health promotion.

[Evaluation of group and individual strategies in a diabetes education program]. / Avaliação estratégica de educação em grupo e individual no programa educativo em diabetes.

OBJECTIVE: To compare the effectiveness of individual and group strategies in a diabetes education program. METHODS: A total of 104 type-2 diabetes outpatients enrolled in an education program of a teaching hospital in Belo Horizonte, Southeastern Brazil, were randomly selected and assigned to two different education strategies: group education (54 subjects) and individual education (50 subjects). Group education comprised three monthly sessions, which involved play and interactive dynamics. In parallel, a second group received individual education. Subjects were follow up for six months during 2006 and they were evaluated using specific questionnaires: knowledge of diabetes, psychological attitudes, change in behavior, quality of life. Clinical evaluation was performed at baseline, three and six months of intervention. RESULTS: Mean age was 60.6 years. The results of group and individual education were similar in the assessment tests of attitude, change of behavior and quality of life. A reduction in HbA1c levels was seen in both groups, but a statistically significant difference (p=0.012) was found only in the group education. CONCLUSIONS: Both strategies of diabetes education were effective, however, group education was more effective than individual education for blood glucose control.

Como os profissionais da atenção primária percebem e desenvolvem a Educação Popular em Saúde? / How do primary care professionals perceive and develop Popular Health Education?

O objetivo do estudo foi analisar percepções e experiências em Educação em Saúde de 166 profissionais de equipes de Saúde da Família de Contagem (MG, Brasil), que responderam um questionário sobre práticas de Educação em Saúde. Os participantes consideraram aspectos além da finalidade informativa, ao relatar práticas voltadas à qualidade de vida e à formação humana. Todas as categorias profissionais mencionaram uma maior participação em grupos de controle da hipertensão arterial sistêmica e diabetes mellitus. Utilizam a pedagogia de Paulo Freire 4,7% dos entrevistados. Termos que demonstram a intencionalidade política, como “controle social” e “Educação Popular em Saúde” não foram mencionados. Foi constatada a necessidade de processos de educação permanente para os profissionais e implementação da política nacional de Educação Popular em Saúde...

The aim of this study was to analyze the perceptions and experiences of Health Education amongst 166 professionals of Family Health teams in the city of Contagem, State of Minas Gerais, Southeastern Brazil. Participants answered a questionnaire about Health Education practices. When reporting practices aimed at quality of life and human education, they considered issues beyond the informational purpose. All professional categories mentioned greater participation in groups for controlling hypertension and diabetes mellitus. Use of Paulo Freire’s pedagogy was reported by 4.7% of the respondents. Terms indicating political intentionality, such as “social control” and “Popular Health Education”, were not mentioned. It was noticed that continuing education processes need to be offered to Family Health professionals and that a national policy for popular Health Education must be implemented...

El objetivo del estudio fue analizar percepciones y experiencias en Educación en Salud de 166 profesionales de equipos de Salud de la Familia de Contagem (Estado de Minas Gerais) que respondieron un cuestionario sobre prácticas de Educación en Salud. Los participantes consideraron aspectos más allá de la finalidad informativa, al relatar prácticas enfocadas en la calidad de vida y en la formación humana. Todas las categorías profesionales mencionaron una mayor participación en grupos de control de la hipertensión arterial sistémica y diabetes mellitus. El 4,7 % de los entrevistados utilizan la pedagogía de Paulo Freire. No se mencionaron términos que demuestran la intencionalidad política, tales como “control social” y “Educación Popular en Salud”. Se constató la necesidad de procesos de educación permanente para los profesionales e implementación de la política nacional de Educación Popular en Salud...

Saúde sexual e reprodutiva de adolescentes: interlocuções com a Pesquisa Nacional de Saúde do Escolar (PeNSE) / Sexual and reproductive health: a dialogue with the National Students' Health Survey

Este artigo analisa a saúde sexual e reprodutiva de adolescentes, com base em resultados da PeNSE, a partir de três variáveis comparativas: a) dependência administrativa (escolas públicas e privadas); b) sexo; c) localidade (Brasil e Belo Horizonte), utilizando proporções e intervalos de confiança de 95% (IC95%). A proporção de escolares que já tiveram relação sexual (30,5%) é maior nas escolas públicas do que nas privadas, ocorrendo mais cedo e em dobro para o sexo masculino. Entre os entrevistados, o preservativo não foi utilizado por 24,1% na ultima relação sexual, sem diferenças entre sexos e tipo de escola. Constata-se, assim, a necessidade de políticas públicas e compromisso com a promoção da saúde sexual e reprodutiva na adolescência.

This article analyzes the sexual and reproductive health of adolescents, based on the results of a national survey and three comparative parameters: a) administrative dependence (public and private schools), b) gender c) location (Brazil and Belo Horizonte), using proportions and confidence intervals of 95%. The proportion of students who have had sexual intercourse (30.5%) is higher in public schools than in private, occurring earlier and twice as frequently for males. Among the survey sample, a condom was not used by 24.1% in their last sexual intercourse, with no differences between gender and type of school. The data suggested the need for public policies and commitment to the promotion of sexual and reproductive health in adolescence.

The effect of the number of stool samples on the observed prevalence and the infection intensity with Schistosoma mansoni among a population in an area of low transmission.

Examination of faecal material by Kato Katz (KK) technique is a widely used approach for the diagnosis of intestinal schistosomiasis, particularly in epidemiological surveys. However, this technique lacks diagnostic sensitivity in individuals with low infection intensity or in low endemic areas. In the total population (TP) of 1265 individuals prevalence and infection intensity were established by examining two KK slides. A representative subset of 305 individuals, denominated experimental group (EG), was defined to assess the comparative advantage of an increased sampling effort using the KK technique. In addition stools of the participants of the EG were examined by the formol ether centrifugation technique. The proportion of all positive stool examinations detected by both methods among the experimental group served as reference value for prevalence (diagnostic 'gold' standard). Prevalence of schistosomiasis among TP based on two KK slides was 12.5%. Prevalence among the EG varied from 13.8%, based on one KK slide, over 27.2 based on 10 KK slides of three stool samples to 35.4% as value for the diagnostic 'gold' standard. The comparison of values for prevalence, stratified by age, revealed significant elevated numbers for all age groups, and interestingly, an extension of the highest prevalence levels until an age of 50 years. The overall infection intensity in eggs per gram (epg), calculated as geometric mean, was 83 epg for the TP based on one KK slide, 78 epg for the GE based on one KK slide and 28 epg based on 10 KK slides of three stool samples. In summary our data demonstrate that control programmes based on the examination of a single KK slide, as it is the case in Brazil, tend to underestimate significantly the prevalence and overestimate infection intensity. This applies especially for low endemic areas, where the efficacy and cost-effectiveness of such programmes become questionable. Our data also indicate that the possible solution of this problem lies in targeted mass treatment including age groups with the highest proportions of those infected. This will give high sensitivity together with sustainability and suitability under field conditions.

Formação e atuação de psicólogos da Rede de Atenção Oncológica de Belo Horizonte, MG / Education and practice of the psychologist's network of oncological care in Belo Horizonte, Minas Gerais: challenges and prospets

A incidência do câncer e as novas formas de assistência e tratamento da doença convocam o psicólogo, enquanto profissional da saúde, a desenvolver estratégias que deem suporte à escuta do processo saúde-doença, na sua singularidade em diferentes contextos. Assim, foi objetivo deste estudo conhecer a formação e a atuação dos psicólogos da rede de atenção oncológica de Belo Horizonte Minas Gerais. Foram entrevistados 13 profissionais de instituições públicas e privadas. Os resultados apresentam a necessidade de uma formação que contemple a realidade dos serviços de saúde conforme proposto pelas políticas públicas numa perspectiva coletiva e social. Os discursos dos sujeitos apontam para os limites e possibilidades na construção de novos saberes e fazeres nas intervenções no contexto hospitalar

The incidence of cancer and new forms of care and treatment of this disease invite the psychologist asa health professional to develop strategies that support the listening of the health-disease process in itsuniqueness in different contexts. Thus, the aim of this study was to investigate the formation and theperformance of the psychologists' oncology network in Belo Horizonte - Minas Gerais. Weinterviewed 13 professionals from public and private institutions. The results pointed to the need for aformation that addresses the reality of health services as proposed by public policies, in a social andcollective perspective. The speech of the participants point to the limits and possibilities for theconstruction of new knowledge and practices in interventions at the hospital context.

Sentidos do cuidado: a perspectiva de cuidadores de homens com câncer / Senses of care: the perspective of caregivers of people with cancer / Sentidos de la atención: la perspectiva de los cuidadores de las personas con cáncer

Há, na atualidade, uma tendência para que os cuidados aos pacientes com câncer sejam realizados no âmbito familiar. Nesse sentido, o presente estudo buscou compreender como os cuidadores de homens em tratamento oncológico significam a experiência do cuidado. Foram realizadas entrevistas narrativas com 10 cuidadores de homens com câncer em um hospital público, especializado em oncologia, na cidade de Belo Horizonte-MG. Na análise, realizada à luz do referencial fenomenológico heideggeriano, pode-se conhecer o sentido que os cuidadores atribuem ao câncer, o significado atribuído à experiência de ser cuidador e os sentidos do cuidar. Considera-se que conhecer os sentidos que os cuidadores atribuem ao seu fazer possibilita pensar em intervenções direcionadas às necessidades desses sujeitos, visando melhorar sua qualidade de vida...

There is currently a tendency for the care of patients with cancer to be performed within the family. In that sense, this study aimed to understand how caregivers of men in Oncology treatment mean the experience of care. Narrative interviews were conducted with 10 caregivers of men's with cancer in a public hospital specializing in Oncology in the city of Belo Horizonte-MG-Brasil. The analysis conducted through the Heideggerian phenomenological pointed to the meaning that caregivers attribute to cancer, the meaning attributed to the experience of being a caregiver and the meaning of care. To understand the meanings that the caregivers attribute to their activities allow interventions directed to the needs of these subjects, favoring their quality of life...

Actualmente, hay una tendencia a que el cuidado de pacientes con cáncer se realize en suyas familias. Este estudio buscó comprender cómo los cuidadores de los hombres sometidos a tratamiento contra el cáncer significan la experiencia del Cuidado. Se realizaron entrevistas narrativas con los 10 cuidadores en un hospital público especializado en oncología, en la ciudad de Belo Horizonte -MG-Brasil. Por el análisis realizado, en la perspectiva de la fenomenología heideggeriana, se puedo conocer el significado que los cuidadores atribuyen al cáncer, el significado atribuido a la experiencia de ser un cuidador y los sentidos de cuidado. Se considera que conocer los sentidos que los cuidadores atribuyen a su actividad permite que intervenciones dirigidas a las necesidades de estas personas sean posibles, para mejorar su calidad de vida...

A produção científica brasileira sobre o câncer masculino: estado da arte / The Brazilian Scientific Production about Male Cancer: State of the Art

Introdução: Embora apresente taxas de incidência semelhantes entre homens e mulheres, estudos apontam paramaior letalidade dos diferentes tipos de câncer entre a população masculina. Entretanto, ainda observa-se uma maiorprodução científica voltada para a compreensão do processo de adoecimento das mulheres e crianças com câncer, em detrimento dos homens com essa enfermidade. Objetivo: Identificar e analisar a produção científica brasileira sobre o câncer masculino, buscando evidenciar lacunas e dimensões abordadas ou privilegiadas quanto ao tema. Método: Na perspectiva dos estudos de Estado da Arte, foram consultadas as bases de dados SciELO, PePSIC e CAPES, sem recorte temporal, utilizando os descritores câncer, neoplasias e tumores. Para inclusão dos artigos, foram considerados aqueles que tratassem da doença “câncer” e que possuíam amostra/população composta exclusivamente por homens. Para análise dos dados, foi realizada uma caracterização dos trabalhos e autores de cada estudo selecionado. Resultados:Das 16.972 publicações encontradas, apenas 543 atenderam aos critérios de seleção. Constatou-se a maior produçãorealizada por homens, graduados em medicina pertencentes a grupos de pesquisa de universidades públicas localizadas na região Sudeste do Brasil. Observou-se uma maior ênfase desses estudos nas neoplasias da próstata, pênis e testículo, e a necessidade de maior investimento em trabalhos que considerem os aspectos psicossociais que perpassam o adoecimento e tratamento oncológico. Conclusão: Os resultados apontam para a incipiente produção científica brasileira acercado câncer masculino. Faz-se necessário investir na produção de conhecimento científico sobre o tema, contribuindoassim para a efetividade da Política Nacional de Atenção Integral à Saúde do Homem.

O abandono do tratamento da tuberculose sob a perspectiva dos gerentes de diferentes centros de saúde de Belo Horizonte-MG, Brasil / Abandonment of tuberculosis treatment in the perspective of health centers managers in Belo Horizonte-MG, Brazil / El abandono del tratamiento de tuberculosis en la perspectiva de directores de centros de salud de Belo Horizonte-MG, Brasil

O Programa Nacional de Controle da Tuberculose requer a organização e adequado funcionamento dos serviços de saúde para o cumprimento do princípio de integralidade do Sistema Único de Saúde, um dos pilares para o controle da doença. Este estudo qualitativo objetivou investigar, sob a perspectiva de gerentes de Centros de Saúde de Belo Horizonte-Minas Gerais, aspectos relativos ao funcionamento dos serviços que coordenam face ao abandono do tratamento da tuberculose e a viabilidade de cumprir as diretrizes do Programa de Controle da doença. Os dados foram coletados através de entrevistas semiestruturadas e interpretados pela Análise Temática de Conteúdo. Os relatos indicam que os serviços ainda não cumprem a perspectiva da integralidade, requerendo melhor organização e processos de educação permanente das equipes para enfrentar o abandono e elaborar novas alternativas para ampliar a adesão e conclusão do tratamento.

The Brazilian National Tuberculosis Control Program requires the organization and proper functioning of health services to meet the principle of intregality, one of the pillars of the Brazilian Unified Health System and the most important orientation for tuberculosis control. This study aims to investigate, in the perspective of nine managers of health centers in Belo Horizonte, MG, Brazil, aspects concerning the functioning of the services they coordinated, associated to noncompliance with tuberculosis treatment and the feasibility of meeting Program guidelines. Data were collected through semi-structured interviews and interpreted by means of thematic content analysis. Reports indicate that health services did not comply with the integrality orientation, requiring better organization and continuing education processes of health professionals to deal with abandonment and to develop new alternatives to improve treatment adherence and compliance.

El Programa Nacional de Control de la Tuberculosis en Brasil requiere la organización y funcionamiento de los servicios de salud para cumplir con el principio de la integralidad del Sistema Único de Salud, uno de los pilares para el control de la enfermedad. Este estudio tuvo como objetivo investigar desde la perspectiva de nueve administradores de centros de salud en Belo Horizonte, Minas Gerais, Brasil los aspectos relativos al funcionamiento de los servicios que coordinan asociados con el abandono del tratamiento de la tuberculosis y la viabilidad para cumplir con las directrices del Programa. Los datos fueron recolectados a través de entrevistas semi-estructuradas e interpretados por análisis de contenido temático. Los informes indican que los servicios no cumplen con la perspectiva de la integralidad y requieren una mejor organización así como de procesos de formación permanente de profesionales de la salud para hacer frente al abandono y desarrollar nuevas alternativas para aumentar la adherencia y la finalización del tratamiento.

Maternidade e hanseníase: as vivências de separação devido ao isolamento compulsório / Being a mother with leprosy: the experiences of separation due to compulsory isolation

As mulheres portadoras de hanseníase, durante grande parte do século XX, não puderam exercer a maternidade devido à política de isolamento compulsório dos doentes adotada para controlar a doença. Os filhos ao nascerem eram levados para os preventórios e o contato com estes era realizado pelo olhar. Visando compreender a experiência da maternidade no hospital colônia foi realizada pesquisa narrativa com três mães que viveram o período de internação compulsória. Os discursos revelam dois momentos distintos da vivência de maternidade: a separação dos filhos com sua posterior volta para casa e a adoção de crianças para realizar a maternidade. Considera-se que a adoção promoveu o encontro com o sentido da existência que havia sido rompido e possibilitou a experiência de ser-mãe.

In the twentieth century, women with leprosy could not carry on their maternity because of the statement of compulsory isolation of patients, adopted to control the disease. Their children were taken at birth to prevention centers and the contact of mothers with their babies was only visual. In order to understand the experience of maternity in the leprosaria it was carried out an investigated narrative research with three mothers who lived through the period of compulsory internment. The speeches reveal two distinct moments in the experience of motherhood: the separation of the children with their subsequent return to home and the adoption of other children to achieve motherhood. It is considered that the adoption has promoted the meeting with the meaning of existence that had been broken and allowed the experience of being a parent.