Planning and building Health Care Networks in Brazil's Federal District. / O Planejamento e a construção das Redes de Atenção à Saúde no DF, Brasil.

This article reports on the experience of implementing Health Care Planning (HCP) in the territories of Itapoã, Paranoá and São Sebastião in the East Region of Brazil's Federal District. HCP began at the end of 2016 with Itapoã and was expanded to the other territories in 2018. The results point to a better organised health care network, specifically as regards care for chronic conditions, hypertension and diabetes. The activities involved a series of thematic theory workshops and tutoring workshops carried out in Primary Health Care (PHC) and Specialised Ambulatory Care (SAC) facilities. In PHC, macro-processes (territorialisation, family registration, risk stratification, family risk classification, local diagnosis, care by block of hours, elimination of waiting times, and others) were organised to support meeting certain of the population's demands. In SAC, an Ambulatory Specialities Clinic was set up using the technology of continuous care provided by a multi-professional team to high- and very high-risk hypertensive and diabetic patients stratified in PHC, and care provision is shared. One of the strong points in the integration of PHC and SAC was matrix support provided by SAC professionals in "laboratory units". HCP has been an important management tool for organising health care in the East Region.

O artigo objetiva descrever o planejamento e a construção das Redes de Atenção à Saúde (RAS), por meio da Planificação da Atenção à Saúde (PAS), na Região Leste, Distrito Federal. Trata-se de um relato de experiência sobre a PAS, realizada de 2016 a 2018. As atividades foram desenvolvidas a partir de um conjunto de oficinas teóricas temáticas, de tutorias realizadas na Atenção Primária à Saúde (APS) e na Atenção Ambulatorial Especializada (AAE). Os resultados apontam uma melhor organização da RAS, especificamente para a linha de cuidado das condições crônicas, hipertensão e diabetes. Na APS foram organizados os macroprocessos: territorialização, cadastramento das famílias, estratificação de risco, classificação de riscos familiares, diagnóstico local, atendimento por bloco de horas, eliminando filas, dentre outros. Na AAE foi implantado o Ambulatório de Especialidades com a tecnologia de atenção continua, realizada por equipe multiprofissional para hipertensos e diabéticos de alto e muito risco, estratificados na APS, compartilhando o cuidado. Uma das potencialidades da integração da APS e AAE foi o matriciamento realizado por profissionais da AAE, nas unidades laboratórios. A PAS configurou-se como um importante instrumento de gestão das RAS.

O Planejamento e a construção das Redes de Atenção à Saúde no DF, Brasil / Planning and building Health Care Networks in Brazil's Federal District

Resumo O artigo objetiva descrever o planejamento e a construção das Redes de Atenção à Saúde (RAS), por meio da Planificação da Atenção à Saúde (PAS), na Região Leste, Distrito Federal. Trata-se de um relato de experiência sobre a PAS, realizada de 2016 a 2018. As atividades foram desenvolvidas a partir de um conjunto de oficinas teóricas temáticas, de tutorias realizadas na Atenção Primária à Saúde (APS) e na Atenção Ambulatorial Especializada (AAE). Os resultados apontam uma melhor organização da RAS, especificamente para a linha de cuidado das condições crônicas, hipertensão e diabetes. Na APS foram organizados os macroprocessos: territorialização, cadastramento das famílias, estratificação de risco, classificação de riscos familiares, diagnóstico local, atendimento por bloco de horas, eliminando filas, dentre outros. Na AAE foi implantado o Ambulatório de Especialidades com a tecnologia de atenção continua, realizada por equipe multiprofissional para hipertensos e diabéticos de alto e muito risco, estratificados na APS, compartilhando o cuidado. Uma das potencialidades da integração da APS e AAE foi o matriciamento realizado por profissionais da AAE, nas unidades laboratórios. A PAS configurou-se como um importante instrumento de gestão das RAS.

Abstract This article reports on the experience of implementing Health Care Planning (HCP) in the territories of Itapoã, Paranoá and São Sebastião in the East Region of Brazil's Federal District. HCP began at the end of 2016 with Itapoã and was expanded to the other territories in 2018. The results point to a better organised health care network, specifically as regards care for chronic conditions, hypertension and diabetes. The activities involved a series of thematic theory workshops and tutoring workshops carried out in Primary Health Care (PHC) and Specialised Ambulatory Care (SAC) facilities. In PHC, macro-processes (territorialisation, family registration, risk stratification, family risk classification, local diagnosis, care by block of hours, elimination of waiting times, and others) were organised to support meeting certain of the population's demands. In SAC, an Ambulatory Specialities Clinic was set up using the technology of continuous care provided by a multi-professional team to high- and very high-risk hypertensive and diabetic patients stratified in PHC, and care provision is shared. One of the strong points in the integration of PHC and SAC was matrix support provided by SAC professionals in "laboratory units". HCP has been an important management tool for organising health care in the East Region.

Educação em saúde e dispositivos metodológicos aplicados na assistência ao Diabetes Mellitus / Health education and methodological devices applied in the care of Diabetes Mellitus

RESUMO O objetivo deste estudo foi identificar o uso de dispositivos metodológicos para mudanças de comportamento e a prática de educação em saúde aos indivíduos com Diabetes Mellitus (DM). Estudo descritivo, exploratório, de abordagem transversal, desenvolvido no município de Aracaju, Sergipe, com 138 profissionais, médicos e enfermeiros da Estratégia Saúde da Família, utilizando entrevista estruturada, tendo como referencial teórico-metodológico o Modelo de Atenção à Condição Crônica. Os resultados mostraram que a maioria dos profissionais referiu desenvolver atividades de educação em saúde, sendo os temas mais referidos: alimentação saudável e exercício físico. Com relação ao uso de abordagens para mudança de comportamento dos usuários, a mais utilizada foi a entrevista motivacional, seguida do Modelo Transteórico de Mudança (MTT). Todos os profissionais que utilizam o MTT concordam com sua aplicabilidade. Conclui-se que a prática de educação em saúde para pessoas com DM é desenvolvida, enquanto o uso de dispositivos metodológicos para mudanças de comportamento ainda é subutilizado, sobretudo o Grupo Operativo.

ABSTRACT The objective of this study was to identify the use of methodological devices for behavioral changes and practice of health education for individuals with Diabetes Mellitus (DM). A descriptive, exploratory, cross-sectional study developed in the city of Aracaju, Sergipe, Brazil, with 138 professionals, doctors and nurses of the Family Health Strategy, using a structured interview, having as a theoretical-methodological reference the Model of Care to Chronic Conditions. The results showed that most of the professionals referred to developing health education activities, with the most mentioned themes being: healthy eating and physical exercise. Regarding the use of approaches to change the behavior of users, the most used was the motivational interview, followed by the Transtheoretical Model of Change (MTT). All professionals who use MTT agree with its applicability. It is concluded that the practice of health education for people with DM is developed, while the use of methodological devices for behavior changes is still underutilized, especially the Operative Group.

Fetal and neonatal deaths of children of patients classified as near miss. / Óbitos fetais e neonatais de filhos de pacientes classificadas com near miss.

OBJECTIVE:: identify the epidemiological aspects of early fetal and neonatal deaths in children of patients classified with near miss and the factors associated with this outcome. METHOD:: a cross-sectional study of 79 women identified with near miss and their newborns. The variables were analyzed using Fisher's exact test. Risk factors were estimated based on unadjusted and adjusted odds ratios, and by means of multiple correspondence analysis, with significance for p <0.05. RESULTS:: hypertensive disorders totaled 40.5%; Of these, 58.3% had adverse fetal and neonatal outcome. The newborns admitted to the Neonatal Intensive Care Unit proved to be significant for the outcome (70.8%), gestational age <32 weeks (41.6%), birth weight <2500 (66.7%), neonatal asphyxia (50%) and early respiratory discomfort (72.2%). CONCLUSION:: prematurity, neonatal asphyxia, and early respiratory distress were significant characteristics for the outcome among newborns.

Óbitos fetais e neonatais de filhos de pacientes classificadas com near miss / Óbitos fetales y neonatales de hijos de pacientes clasificados con near miss / Fetal and neonatal deaths of children of patients classified as near miss

RESUMO Objetivo: identificar os aspectos epidemiológicos dos óbitos fetais e neonatais precoces em filhos de pacientes classificadas com near miss e os fatores associados a este desfecho. Método: estudo transversal realizado com 79 mulheres identificadas com near miss e seus recém-nascidos. As variáveis foram analisadas utilizando-se o teste Exato de Fisher. Os fatores de risco foram estimados com base nas razões de chances não ajustadas e ajustadas, e por meio de análise de correspondência múltipla, com significância para p < 0,05. Resultados: as desordens hipertensivas totalizaram 40,5%; destas, 58,3% tiveram desfecho fetal e neonatal adverso. Mostraram-se significantes para o desfecho os recém-nascidos admitidos na Unidade Terapia Intensiva Neonatal (70,8%), idade gestacional < 32 semanas (41,6%), peso ao nascer < 2500 (66,7%), asfixia neonatal (50%) e desconforto respiratório precoce (72,2%). Conclusão: prematuridade, asfixia neonatal e desconforto respiratório precoce constituíram características significantes para o desfecho entre os recém-nascidos.

RESUMEN Objetivo: identificar los aspectos epidemiológicos de los óbitos fetales y neonatales precoces en hijos de pacientes clasificados con near miss y los factores asociados a este desenlace. Método: estudio transversal realizado con 79 mujeres identificadas con near miss y sus recién nacidos. Las variables fueron analizadas utilizando la prueba Exacta de Fisher. Los factores de riesgo fueron estimados con base en las razones de posibilidades no ajustadas y ajustadas, y por intermedio de análisis de correspondencia múltiple, con significación para p < 0,05. Resultados: los desórdenes hipertensivos totalizaron el 40,5%; de los cuales el 58,3% tuvieron desenlace fetal y neonatal adverso. Se han mostrado significativos para el desenlace los recién nacidos admitidos en la Unidad de Terapia Intensiva Neonatal (70,8%), edad gestacional < 32 semanas (41,6%), peso al nacer < 2500 (66,7%), asfixia neonatal (50%) y dificultad respiratoria de inicio precoz (72,2%). Conclusión: prematuridad, asfixia neonatal y dificultad respiratoria de inicio precoz constituyeron características significativas para el desenlace entre los recién nacidos.

ABSTRACT Objective: identify the epidemiological aspects of early fetal and neonatal deaths in children of patients classified with near miss and the factors associated with this outcome. Method: a cross-sectional study of 79 women identified with near miss and their newborns. The variables were analyzed using Fisher’s exact test. Risk factors were estimated based on unadjusted and adjusted odds ratios, and by means of multiple correspondence analysis, with significance for p <0.05. Results: hypertensive disorders totaled 40.5%; Of these, 58.3% had adverse fetal and neonatal outcome. The newborns admitted to the Neonatal Intensive Care Unit proved to be significant for the outcome (70.8%), gestational age <32 weeks (41.6%), birth weight <2500 (66.7%), neonatal asphyxia (50%) and early respiratory discomfort (72.2%). Conclusion: prematurity, neonatal asphyxia, and early respiratory distress were significant characteristics for the outcome among newborns.

Stomatognathic evaluation at five years of age in children born premature and at term.

BACKGROUND: The high frequency of alterations of the stomatognathic system associated with premature birth may suggest that prematurity is an important risk factor in the development of this system. Prematurity has an incidence between 6-11% of births and is associated with factors such as genetic, maternal conditions (obstetric problems, nutritional status, infections) and antenatal care. In addition, undesirable situations, such as changes in enamel and the development of the skeletal structure, also appears to be associated with prematurity. This study aimed to look for changes in the stomatognathic system at five years of age associated with premature birth. METHODS: We estimated the prevalence of developmental disorders of the stomatognathic system in the primary dentition of preschool children at five years of age. Changes in preterm infants (n = 32) compared with term born (n = 381) were evaluated . Clinical examinations and questionnaire with sociodemographic and health of mothers and children information. Gestational age, birth weight, head circumference, Apgar score and mechanical ventilation, were collected from the medical records to birth records. The explanatory variable was preterm (<37 weeks gestational age). RESULTS: Prevalence of 7.7% of preterm infants was found. Of these, 40.6% had atresic palate, 56.2% malocclusion and 21.8% enamel hypoplasia. Forty (9.6%) children were not breastfed at the breast, and 26 (65.0%) had some type of malocclusion, showing association between not breastfeeding with an abnormal development of the stomatognathic system. The group of preterm infants showed five times more changes in head circumference and three times more mechanical ventilation use at birth. Change in head circumference at birth and mechanical ventilation has a significant association between groups of preterm and term infants. CONCLUSIONS: Mechanical ventilation at birth directly contributed to an increased risk of developmental disorders of the stomatognathic system in preterm infants, especially dental hypoplasia. Non-breastfed children had a higher risk of developing malocclusion. Alterations in head circumference were related effective on dental malocclusion. The results suggest that changes in the stomatognathic system are influenced by premature birth and points to the imperative need of using methods of preventive.

[Barriers in health care to breast cancer: perception of women]. / Barreiras na atenção em saúde ao câncer de mama: percepção de mulheres.

OBJECTIVE: Identifying the barriers in the access to health care to breast cancer perceived by women undergoing chemotherapy. METHOD: An exploratory descriptive study. The sample consisted of 58 women with breast cancer receiving chemotherapy and registered in the public oncology ambulatory of Aracaju-Sergipe. Data collection was carried out between October 2011 and March 2012 by semistructured interviews, and data were processed using the SPSS, version 17. RESULTS: Among the interviewed women, 37 (63.8%) reported at least a barrier in the trajectory of care for breast cancer. The organizational and health services barriers were the most reported in the periods of investigation and treatment of breast cancer. CONCLUSION: In face of these findings, the barriers should be considered in public health policies and programs for the control of breast cancer in Sergipe.

Barriers in health care to breast cancer: perception of women / Barreiras na atenção em saúde ao câncer de mama: percepção de mulheres / Barreras en la atención en salud en casos de cáncer de mama: percepción de las mujeres

Identifying the barriers in the access to health care to breast cancer perceived by women undergoing chemotherapy.Method: An exploratory descriptive study. The sample consisted of 58 women with breast cancer receiving chemotherapy and registered in the public oncology ambulatory of Aracaju-Sergipe. Data collection was carried out between October 2011 and March 2012 by semistructured interviews, and data were processed using the SPSS, version 17.Results: Among the interviewed women, 37 (63.8%) reported at least a barrier in the trajectory of care for breast cancer. The organizational and health services barriers were the most reported in the periods of investigation and treatment of breast cancer.Conclusion: In face of these findings, the barriers should be considered in public health policies and programs for the control of breast cancer in Sergipe.

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Identifying the barriers in the access to health care to breast cancer perceived by women undergoing chemotherapy.Method: An exploratory descriptive study. The sample consisted of 58 women with breast cancer receiving chemotherapy and registered in the public oncology ambulatory of Aracaju-Sergipe. Data collection was carried out between October 2011 and March 2012 by semistructured interviews, and data were processed using the SPSS, version 17. Results: Among the interviewed women, 37 (63.8%) reported at least a barrier in the trajectory of care for breast cancer. The organizational and health services barriers were the most reported in the periods of investigation and treatment of breast cancer.Conclusion: In face of these findings, the barriers should be considered in public health policies and programs for the control of breast cancer in Sergipe.
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Identificar las barreras en el acceso a la atención en salud percibidos por mujeres con cáncer de mama en tratamiento quimioterapéutico.Método: Estudio descriptivo- exploratorio, cuya muestra estuvo constituida por 58 mujeres con cáncer de mama en quimioterapia inscritas en el servicio ambulatorio público de oncología de Aracaju-Sergipe. La recolección de datos fue realizada entre octubre de 2011 a marzo de 2012, por medio de entrevistas semi-estructuradas. Los datos fueron procesados en el software SPSS, versión 17.Resultados: Entre las entrevistadas, 37 mu­jeres (63,8%) relataron haber enfrentado por lo menos una barrera en la trayectoria de cuidado del cáncer de mama. Las barreras organizacionales o de los servicios de salud fueron las más citadas en los periodos de investigación y tratamiento del cáncer de mama.Conclusión: Las barreras deben ser consideradas en las políticas públicas de salud y de los programas de control del cáncer de mama en Sergipe.
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Visita domiciliar: validação de um instrumento para registro e acompanhamento dos indivíduos e das famílias / Home visit: validation of an instrument for recording and monitoring individuals and families

Objetivo: elaborar e validar um instrumento para visita domiciliar (ficha B-VD) visando ao acompanhamento das visitas domiciliares pelas equipes de Saúde da Família (eSF) na Rede de Atenção Primária à Saúde do município de Aracaju, estado de Sergipe, Brasil. Métodos: a validação da ficha B-VD foi realizada pelos profissionais das equipes de saúde utilizando-se da técnica de Delphi e da escala de Likert; os itens da ficha foram agrupados em três dimensões; a consistência interna dos itens da ficha foi investigada mediante o coeficiente alfa de Cronbach. Resultados: na análise de consistência interna das 17 variáveis investigadas, obteve-se coeficiente alfa de Cronbach de 0,95; na dimensão I (identificação do usuário), esse coeficiente foi de 0,94, na dimensão II (aspectos do território), 0,93, e na dimensão III, (visita domiciliar) 0,82. Conclusão: a ficha B-VD foi validada pelos profissionais das eSF de Aracaju-SE, confirmando-se um instrumento útil para acompanhamento das famílias.

Objective: to develop and validate an instrument for home visits (B-VD Form) aimed at monitoring visits made by Primary Health Care network Family Health teams in the city of Aracaju, State of Sergipe, Brazil. Methods: B-VD Form validation was conducted by health professionals using the Delphi technique and Likert scale. The data items were also grouped into three dimensions. Cronbach's alpha was used to investigate the internal consistency of the form’s items. Results: a Cronbach's alpha coefficient of 0.95 was obtained for the internal consistency of the 17 variables analyzed. The coefficient was 0.94 for dimension I (user identification); 0.93 for dimension II (aspects of the territory) and 0.82 for dimension III (home visit). Conclusion: the B-VD form was validated by the Family Health teams in the city of Aracaju, proving to be a useful tool for monitoring families.

Is adolescent pregnancy a risk factor for low birth weight?

OBJECTIVE: The objective of this study was to evaluate whether adolescent pregnancy is a risk factor for low birth weight (LBW) babies. METHODS: This was a cross-sectional study of mothers and their newborns from a birth cohort in Aracaju, Northeastern Brazil. Data were collected consecutively from March to July 2005. Information collected included socioeconomic, biological and reproductive aspects of the mothers, using a standardized questionnaire. The impact of early pregnancy on birth weight was evaluated by multiple logistic regression. RESULTS: We studied 4,746 pairs of mothers and their babies. Of these, 20.6% were adolescents (< 20 years of age). Adolescent mothers had worse socioeconomic and reproductive conditions and perinatal outcomes when compared to other age groups. Having no prenatal care and smoking during pregnancy were the risk factors associated with low birth weight. Adolescent pregnancy, when linked to marital status "without partner", was associated with an increased proportion of low birth weight babies. CONCLUSIONS: Adolescence was a risk factor for LBW only for mothers without partners. Smoking during pregnancy and lack of prenatal care were considered to be independent risk factors for LBW.

Is adolescent pregnancy a risk factor for low birth weight? / Gravidez na adolescência é fator de risco para o baixo peso ao nascer? / Embarazo en la adolescencia es factor de riesgo para el bajo peso al nacer?

OBJECTIVE: The objective of this study was to evaluate whether adolescent pregnancy is a risk factor for low birth weight (LBW) babies. METHODS: This was a cross-sectional study of mothers and their newborns from a birth cohort in Aracaju, Northeastern Brazil. Data were collected consecutively from March to July 2005. Information collected included socioeconomic, biological and reproductive aspects of the mothers, using a standardized questionnaire. The impact of early pregnancy on birth weight was evaluated by multiple logistic regression. RESULTS: We studied 4,746 pairs of mothers and their babies. Of these, 20.6% were adolescents (< 20 years of age). Adolescent mothers had worse socioeconomic and reproductive conditions and perinatal outcomes when compared to other age groups. Having no prenatal care and smoking during pregnancy were the risk factors associated with low birth weight. Adolescent pregnancy, when linked to marital status "without partner", was associated with an increased proportion of low birth weight babies. CONCLUSIONS: Adolescence was a risk factor for LBW only for mothers without partners. Smoking during pregnancy and lack of prenatal care were considered to be independent risk factors for LBW.

OBJETIVO: Avaliar a gravidez na adolescência como fator de risco para baixo peso ao nascer. MÉTODOS: Estudo transversal incluído numa coorte de puérperas e seus respectivos recém-nascidos, nas quatro maternidades de Aracaju, SE, de março a julho de 2005. Os dados foram coletados consecutivamente durante quatro meses. Variáveis sociais, biológicas e assistenciais foram obtidas por meio de questionário padronizado. Foi realizada regressão logística múltipla, com controle de fatores de confusão e de modificação. RESULTADOS: Foram estudados 4.746 pares de mães/recém-nascidos. Dessas, 20,6% eram adolescentes (< 20 anos). As mães adolescentes apresentaram piores condições socioeconômicas, reprodutivas e resultados perinatais mais adversos, quando comparadas com outros grupos etários. Foram identificados como fatores de risco associados ao baixo peso ao nascer a ausência de assistência no pré-natal e tabagismo na gestação. Identificou-se interação da idade materna com a situação conjugal: mães adolescentes sem companheiro tiveram maiores proporções de baixo peso ao nascer. CONCLUSÕES: A adolescência mostrou-se fator de risco para baixo peso ao nascer entre as mães sem companheiro. Tabagismo durante a gestação e ausência de assistência pré-natal associam-se ao baixo peso ao nascer.

OBJETIVO: Evaluar el embarazo en la adolescencia como factor de riesgo para bajo peso al nacer. MÉTODOS: Estudio transversal incluido en una cohorte de puérperas y sus respectivos recién nacidos, en las cuatro maternidades de Aracaju, SE (Brasil), de marzo a julio de 2005. Se estudiaron 4.646 pares de madres/recién nacidos. Los datos se colectaron consecutivamente durante cuatro meses. Variables sociales, biológicas y asistenciales se obtuvieron por medio de cuestionario estandarizado. Se realizó regresión logística múltiple, con control de factores de confusión y de modificación. RESULTADOS: Del total analizadas, 20,6% eran adolescentes (<20 años). Las madres adolescentes presentaron peores condiciones socioeconómicas, reproductivas y resultados perinatales más adversos, al compararse con otros grupos etarios. Se identificaron como factores de riesgo asociados al bajo peso al nacer, la ausencia de asistencia en el prenatal y tabaquismo en la gestación. Se identificó interacción de la edad materna con la situación conyugal: madres adolescentes sin compañero tuvieron mayores proporciones de bajo peso al nacer. CONCLUSIONES: La adolescencia se mostró como factor de riesgo para bajo peso al nacer entre las madres sin compañero. Tabaquismo durante la gestación y ausencia de asistencia prenatal se asocian al bajo peso al nacer.

Vivências dos estudantes de pré-grau com as matérias de administração de enfermagem / Vivencias de los estudiantes de pregrado con las asignaturas de administración de enfermería / Nursing undergraduates experiences with nursing management subjects

Objetivo. Explorar a percepção dos alunos de enfermagem com respeito a suas vivências com as matérias de administração. Metodologia. Estudo de caso no que se utilizou a análise de conteúdo e a matriz de Fortalezas e Oportunidades, Debilidades e Ameaças. De dezembro de 2009 a agosto de 2010 se realizou a investigação na que participaram 18 estudantes de enfermagem do 6º e 7º semestre de uma universidade federal brasileira. Resultados. Dos núcleos identificados surgiram as seguintes categorias: 1) o aluno de enfermagem e sua recepção nas instituições de saúde, 2) a conexão entre a teoria e a prática, 3) o papel do professor e a organização da matéria, e 4) o papel do aluno na matéria. Surgiram possibilidades e limitações a respeito do processo de ensino analisado. Conclusão. O processo ensino-aprendizagem desta matéria não é adequado, pelo que se requerem estratégias de ação que equilibre os conteúdos acadêmicos dados com o contexto local.

Objetivo. Explorar la percepción de los alumnos de enfermería con respecto a sus vivencias con las asignaturas de administración. Metodología. Estudio de caso en el cual se utilizó el análisis de contenido y la matriz de Fortalezas y Oportunidades, Debilidades y Amenazas. De diciembre de 2009 a agosto de 2010 se realizó la investigación en la que participaron 18 estudiantes de enfermería del 6º y 7º semestre de una universidad federal brasileña. Resultados. De los núcleos identificados surgieron las siguientes categorías: 1) el alumno de enfermería y su recepción en las instituciones de salud, 2) la conexión entre la teoría y la práctica, 3) el rol del profesor y la organización dela asignatura, y 4) el rol del alumno en la asignatura. Surgieron posibilidades y limitaciones acerca del proceso de enseñanza analizado. Conclusión. El proceso enseñanzaaprendizaje de esta asignatura no es adecuado, por consiguiente, el componente pedagógico y metodológico de esta asignatura requiere estrategias de acción que equilibren los contenidos académicos impartidos con el contexto local.

Objective. To explore the perception nursing students have towards their experiences with management subjects. Methodology. Case study, in which, content analysis and the Strengths Opportunities Weaknesses and Threats matrix were used. The research was carried out from December 2009 to August 2010. 18 nursing students from the 6th and 7th semesters of the Federal Brasileña University participated Results.From the nucleus identified the following categories emerged: 1) Nursing student and their reception in health institutions, 2) theory and practice connection, 3) professor’s role and subject organization, 4) student’s role in the subject. Possibilities and limitations about the analyzed teaching process emerged. Conclusion. The subject’s teaching-learning process is not appropriate, reason why action strategies are required to balance academic contents with local contexts.

Asthma and pregnancy: repercussions for neonates.

OBJECTIVE: To describe socioeconomic and behavioral aspects of pregnant women with asthma and to analyze the effects of maternal asthma on certain perinatal parameters in a birth cohort. METHODS: An observational crosssectional analytical study using data regarding the mothers of a birth cohort at maternity hospitals in the greater metropolitan area of Aracaju, Brazil, between the 8th of March and the 15th of July of 2005. In the pregnant women, asthma was self-reported, based on previous medical diagnosis. Epidemiological, obstetric and perinatal variables were studied. RESULTS: Of the 4,757 mothers included in the study, 299 (6.3%) had asthma. The mothers with asthma had lower family incomes and more frequently made use of the public health care system (for prenatal care and delivery) than did those without asthma. Although only 9.4% of the mothers with asthma smoked and only 27.6% consumed alcoholic beverages, these proportions were higher than were those observed for the control group. Asthma was not found to be associated with obstetric problems or with problems involving the neonates. Nor did we find asthma to be associated with cesarean delivery, prematurity or small-for-gestational-age neonates. CONCLUSIONS: Low socioeconomic level seems to be a risk factor for asthma.

Asma e gravidez: repercussões no recém-nascido / Asthma and pregnancy: repercussions for neonates

OBJETIVO: Descrever, numa coorte de nascimentos, aspectos socioeconômicos e comportamentais de gestantes com asma e analisar as repercussões desta sobre alguns parâmetros perinatais. MÉTODOS: Estudo observacional, transversal e analítico a partir de informações de parturientes da coorte de nascimentos ocorridos no período entre 8 de março e 15 de julho de 2005 nas maternidades da Grande Aracaju (SE). A identificação de asma nas gestantes foi obtida segundo informação destas a partir do diagnóstico emitido anteriormente por um médico. Foram analisadas variáveis epidemiológicas, obstétricas e perinatais. RESULTADOS: Das 4.757 parturientes incluídas no estudo, 299 (6,3 por cento) eram asmáticas. As mães asmáticas tinham menor renda familiar e mais frequentemente procuraram assistência no pré-natal e no parto em serviços públicos que as mães sem asma. Embora somente 9,4 por cento das gestantes asmáticas fumaram, e 27,6 por cento ingeriram bebidas alcoólicas, as proporções em relação ao grupo controle foram significativamente maiores. Não se detectou associação entre asma e problemas obstétricos ou do recém-nascido. Não foi encontrada associação entre asma e parto cesariano, prematuridade ou recém-nascido sendo pequeno para a idade gestacional. CONCLUSÕES: O nível socioeconômico inferior parece ser um fator de risco para a asma.

OBJECTIVE: To describe socioeconomic and behavioral aspects of pregnant women with asthma and to analyze the effects of maternal asthma on certain perinatal parameters in a birth cohort. METHODS: An observational crosssectional analytical study using data regarding the mothers of a birth cohort at maternity hospitals in the greater metropolitan area of Aracaju, Brazil, between the 8th of March and the 15th of July of 2005. In the pregnant women, asthma was self-reported, based on previous medical diagnosis. Epidemiological, obstetric and perinatal variables were studied. RESULTS: Of the 4,757 mothers included in the study, 299 (6.3 percent) had asthma. The mothers with asthma had lower family incomes and more frequently made use of the public health care system (for prenatal care and delivery) than did those without asthma. Although only 9.4 percent of the mothers with asthma smoked and only 27.6 percent consumed alcoholic beverages, these proportions were higher than were those observed for the control group. Asthma was not found to be associated with obstetric problems or with problems involving the neonates. Nor did we find asthma to be associated with cesarean delivery, prematurity or small-for-gestational-age neonates. CONCLUSIONS: Low socioeconomic level seems to be a risk factor for asthma.

[Teenagers' information about anticonceptive methods]. / Informações dos adolescentes sobre métodos anticoncepcionais.

A transversal study was realized in order to identify information about anticonceptive methods in high school students. The sample included 816 adolescents of both genders from public schools in Aracaju, Sergipe. With respect to this information, demographic, pedagogical, behavioral and reproductive aspects were also analyzed. It was verified that 59.0% of the teenagers have an active sexual life and 57.7% affirmed that they do not receive information about anticonceptive methods in school. Magazines, books and newspapers obtained 28% as sources of information and the male condom (84.5%) was the best known method. The analysis made it possible to identify the need for further discussion in school and the insertion of the parents in this process.

Informacões dos adolescentes sobre métodos anticoncepcionais / Teenagers' information about anticonceptive methods

Realizou-se estudo de corte transversal, com o objetivo de identificar, em escolares do ensino médio, informacões relativas aos métodos anticoncepcionais. A amostra compreendeu 816 adolescentes de ambos os sexos de escolas públicas de Aracaju, Sergipe. Em relacão a essas informacões, foram investigados também aspectos demográficos, pedagógicos, comportamentais e reprodutivos. Verificou-se que 59 por cento dos adolescentes possuíam vida sexual ativa e 57,7 por cento afirmaram não receber informacões sobre métodos anticoncepcionais nas escolas. As fontes de informacões, revistas, livros e jornais, alcancaram o percentual de 28 por cento e o condon masculino (84,5 por cento) foi o método mais conhecido. A análise possibilitou identificar a necessidade de maior discussão na escola e a insercão dos pais nesse processo.

Diagnóstico de saúde das mulheres em idade fértil de Sergipe / Women's health during fertility - Sergipe

Relato parcial de uma pesquisa realizada pela Secretaria de Estado da Saúde em parceria com o UNICEF, intitulado de Diagnóstico Materno-Infantil do Estado de Sergipe. Nesta pesquisa as autoras realizam uma abordagem parcial sobre a saúde das mulheres em idade fértil. Objetivo: Medir por amostragem a nível estadual os indicadores: estado civil, idade da menarca, início da vida sexual, gravidez, abortos, prevençäo do câncer cérvico-uterino e mama, anticoncepçäo e utilizaçäo dos serviços de saúde. Os resultados foram coletados através da aplicaçäo de um formulário estruturado, abrangendo variáveis pré-concepcionais, biológicas e sociais. Os dados obtidos fornecem subsídos para ampla discussäo sobre a saúde das mulheres em Sergipe.

Experiência de implantaçäo da terapia de reidrataçäo oral na secretaria de Estado de Saúde de Sergipe / Improvement experience in oral rehydration therapy at Secretaria de Estado de Saúde de Sergipe

O Programa Nacional de Controle das Doenças com sais reidratantes, preconizados pela OMS - Organizaçäo Mundial da Saúde - foi integrado a Coordenadoria de Serviçoss Básicos de Saúde de Sergipe, para implantaçäo e controle de execuçäo. A partir daí, a TRO (terapia de reidrataçäo oral) foi implantada paulatinamente, em unidades de saúde. Relatam-se as estratégias utilizadas para capacitaçäo de pessoal, abrangência, a evoluçäo do programa, a operacionalizaçäo e dificuldades identificadas no decorrer da implantaçäo e execuçäo