Involvement and fragmentation: a study of parental care of hospitalized children in Brazil.

Parental involvement in the care of children who are hospitalized has been encouraged by the government in Brazil, as it has in the United Kingdom (UK). In this paper, key aspects of the UK, North American, and Latin American literature concerning parental participation are discussed, and implications for hospital care of children in Brazil are considered. A study of the division of work between nurses and the mothers (or other relatives) of 10 children hospitalized with chronic illnesses is reported. Data were collected by participant observation of child care in a Brazilian hospital. The results highlight some of the difficulties that arise in the integration of the work of mothers and nurses in hospital care of children and the fragmentation of care into "manual" and "intellectual" work. The results are considered within the theoretical framework of the model of technologic organization of work (Gonçalves, 1979, 1994). Implications for the organization of child care in the hospital are discussed.

[Certificates of live birth: analysis of completion in the city of Ribeirão Preto, São Paulo, Brazil]. / Declaração de nascidos vivos: análise do seu preenchimento no município de Ribeirão Preto, SP.

The study aims to identify the frequency with which certificates of live birth are filled out and to analyze the data they provide. To gather the data, the authors used a model birth certificate filled out by research assistants based on information obtained from the reports on mothers and newborns. This information was then compared to data contained in the official birth certificates available in the Information Technology Division of the Municipal Health Department. The sample consisted of 911 certificates of live birth from July 1996 in the ten maternity wards of the city of Ribeirão Preto. Data analysis showed that frequency of completion of birth certificates differs by hospital, involving both physicians and administrative personnel. The authors identified a high level of agreement in the data, i.e., over 90% in 13 of 18 variables compared in the birth certificates and in half of the hospitals investigated. The disagreement occurred especially with respect to data on the number of children per mother, number of prenatal visits, mother's schooling, and father's name.

[Care of hospitalized children: reflexions about the participation of parents]. / Assistência à criança hospitalizada: reflexões acerca da participação dos pais.

The care of a child admitted in the hospital is going through meaningful changes and, in a more actual approach, the main strategy seems to stimulate parents or relatives to stay with their children in the hospital. The purpose of this study is to analyse parents' participation in the process of staying in the hospital with their children. We have chosen the qualitative method and used as a theoretic--methodological reference the Model of Technological Work Organization. Based on the process of work, we have pointed out that bringing mothers to the ward is not so simple as it interferes in the reorganization of the work at the theoretical and practical levels. Concepts such as co-operation and partnership are built, however, sharing knowledge, power and room is not a simple action. It implies in changes of values and postures by parents and professionals.

[Qualitative study on integrated care for children and adolescents]. / Estudo da assistência integral à criança e ao adolescente através da pesquisa qualitativa.

This paper presents the theoretical reference and methodology applied by the Group of Study on Children's and Adolescent's Health of the University of São Paulo at Ribeirão Preto College of Nursing, in their qualitative research aiming at the integral assistance to children's and adolescent's health. The authors describe the health sector in current Brazilian society, where the health actions take place, following with the presentation of the Study Group. After that, they develop the theoretical reference and methodology, defining the analytical--politics and social policies, technological organization of work, health services, child and family. To conclude, the authors present an outline of the results of investigations carried out in the last three years (1995 to 1997).

[Prescription for the day: infusion of cheer. Using art as an instrument in the care of hospitalized children]. / Prescrição do dia: infusão de alegria. Utilizando a arte como instrumento na assistência à criança hospitalizada.

The purpose of this study is to report on the experiment of a group of undergraduate students from the University of São Paulo at Ribeirão Preto College of Nursing, who use art (some aspects of the Clown Theatre) as a nursing resource in the care to hospitalized children. Having as basis the job performed by the group of physicians "Joy Doctors", and the theoretical grounding from Psychology and Pediatric and Neonatal Nursing, those students founded the Laugh Company that aims at rescuing laugh within the hospitalized child/family. This experiment has caused some changes in daily care: the hospital space has become more informal and relaxed, laugh can be heard more often and some items, such as, objects, sounds, movements, colours, rooms and people can become toys.

[Organization of neonatal nursing in the region of Ribeirão Preto-SP. Brazil-1992]. / A organização do trabalho na assistência ao recém-nascido em berçários da regional de Ribeirão Preto-SP. Brasil-1992.

The present study analyses the organization of newborn care in different nurseries in the region of Ribeirão Preto as well as how nursing participates in this work. Through observation and interviews in 4 nurseries, we found that the work organization varies according to the hospital size and complexity. Action is centred on the child and in more complex cases, priority is given to the pathology and clinical care. We also observe enlarged actions, involving the binomial mother-child and the family. The quality of care is a result of a complex combination of human resources, material and installation. Bigger and more complex institutions present a diversity of personnel, more bureaucracy and hierarchy, information and technology system, routine procedures by written norms and more sophisticated equipment. The object of action is centred on the child, but there are practices in which the object is enlarged to the binomial mother-child and the family.

[Pediatric nursing knowledge: books edited in Brazil from 1916 to 1988]. / O conhecimento em enfermagem pediátrica: livros editados no Brasil de 1916 a 1988.

From the apprehension of the knowledge in pediatrics nursing in Brazil, a research was done in a Brazilian historical bibliographic work of references. From an historical perspective nursing it is seen as a social articulate practice, as part of a collective process of work. The knowledge in this study is considered as an instrument from which man apprehends his working object. Forty titles were found about how to take care of children, from eight per cent of the a group of five hundred and four. The proportion was considered very small. The production which was found was classified under two aspects: the prescriptive and the analytical. The prescriptive texts are those related to normalize the work in view of the rationality and to the productivity. The analytical opens the possibility and give the means to diversify the nursing assistance particularizing the care and with another aim related to the nursing work.

[Nutritional hygiene in the neonatal period: a review of the literature]. / Higiene alimentar no período neonatal: revisão da literatura.

The present study makes a bibliographic review about the alimentary hygiene of children in the neonatal period. It describes the advantages of maternal milk by attending the basic principles that should govern the children's feeding, the importance of free scheme breast-feeding to emotional development, as well as ventral and right side-lying position and belching to the prevention of accidents.

Flavonoids and alkaloids from Strychnos pseudoquina.

From the leaves of Strychnos pseudoquina (Loganiaceae), isorhamnetin (1) and a new biflavone (2) named strychnobiflavone were isolated together with the alkaloids diaboline and 11-methoxydiaboline.