Perspectiva dos funcionamentos: Outra leitura de seus possíveis usos na atenção e cuidado em saúde / Functioning perspective: Another reading of its possible uses in health care and attention

A perspectiva dos funcionamentos é um aporte teórico por meio do qual a filósofa brasileira Maria Clara Dias, fundamentalmente, e outros autores, apresentam seus argumentos acerca da moralidade, redefinindo o escopo de objetos de nossa consideração moral. Nossos autores têm como referência o fato de muitos indivíduos, animados ou não, encontrarem-se fora dessa consideração. Isto se dá em função dos critérios que servem de fundamento para nossas mais correntes teorias morais serem, via de regra, limitadores do rol de concernidos, ou seja, dos objetos da moralidade. Com base na pretensão de universalidade própria dos discursos morais, os autores consideram a necessidade de incluir naquele rol um amplo número de indivíduos indicando que o atributo que identifica um objeto de consideração moral são os "funcionamentos básicos de cada sistema funcional existente" . Estes funcionamentos, mais do que a racionalidade, ou ainda a senciência, ampliam enormemente o escopo acima referido, fazendo da perspectiva dos funcionamentos uma teoria moral mais inclusiva.

Feasibility of describing community strengths relative to Omaha system concepts.

OBJECTIVES: The purpose was to determine the feasibility of using a standardized language, the Omaha System, to describe community-level strengths. The objectives were: (a) to evaluate the feasibility of using the Omaha System at the community level to reflect community strengths and (b) to describe preliminary results of community strengths observations across international settings. DESIGN AND SAMPLE: A descriptive qualitative design was used. The sample was a data set of 284 windshield surveys by nursing students in 5 countries: Mexico, New Zealand, Norway, Turkey, and the United States. MEASURES: An online survey included a checklist and open-ended questions on community strengths for 11 concepts of the Omaha System Problem Classification Scheme: Income, Sanitation, Residence, Neighborhood/workplace safety, Communication with community resources, Social contact, Interpersonal relationship, Spirituality, Nutrition, Substance use, and Health care supervision. Themes were derived through content analysis of responses to the open-ended questions. RESULTS: Feasibility was demonstrated: Students were able to use the Omaha System terms and collect data on strengths. Common themes were described among the five countries. CONCLUSIONS: The Omaha System appears to be useful in documenting community-level strengths. Themes and exemplar quotes provide a first step in developing operational definitions of strengths at a more granular level.

TAxonomy of Self-reported Sedentary behaviour Tools (TASST) framework for development, comparison and evaluation of self-report tools: content analysis and systematic review.

OBJECTIVE: Sedentary behaviour (SB) has distinct deleterious health outcomes, yet there is no consensus on best practice for measurement. This study aimed to identify the optimal self-report tool for population surveillance of SB, using a systematic framework. DESIGN: A framework, TAxonomy of Self-reported Sedentary behaviour Tools (TASST), consisting of four domains (type of assessment, recall period, temporal unit and assessment period), was developed based on a systematic inventory of existing tools. The inventory was achieved through a systematic review of studies reporting SB and tracing back to the original description. A systematic review of the accuracy and sensitivity to change of these tools was then mapped against TASST domains. DATA SOURCES: Systematic searches were conducted via EBSCO, reference lists and expert opinion. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: The inventory included tools measuring SB in adults that could be self-completed at one sitting, and excluded tools measuring SB in specific populations or contexts. The systematic review included studies reporting on the accuracy against an objective measure of SB and/or sensitivity to change of a tool in the inventory. RESULTS: The systematic review initially identified 32 distinct tools (141 questions), which were used to develop the TASST framework. Twenty-two studies evaluated accuracy and/or sensitivity to change representing only eight taxa. Assessing SB as a sum of behaviours and using a previous day recall were the most promising features of existing tools. Accuracy was poor for all existing tools, with underestimation and overestimation of SB. There was a lack of evidence about sensitivity to change. CONCLUSIONS: Despite the limited evidence, mapping existing SB tools onto the TASST framework has enabled informed recommendations to be made about the most promising features for a surveillance tool, identified aspects on which future research and development of SB surveillance tools should focus. TRIAL REGISTRATION NUMBER: International prospective register of systematic reviews (PROPSPERO)/CRD42014009851.

[Development of valorization of physical activity: the role of HIV associations]. / La construction de la valorisation de l'activité physique : le rôle des associations VIH.

With the arrival of triple combination therapy in 1996-1997, HIV infection, considered up until then to be a life-threatening condition, changed statuses within the realm of public health actions Progressively likened to a "chronic illness", the discourse on HIV prevention targeting people living with HIV (PLHIV) began to evolve. A review of the scientific literature and the journals of four national HIV associations published between 1990 and 2010 shows that physical activities, previously discouraged because considered to be dangerous, have become increasingly presented as a means of improving quality of life and are increasingly recommended for PLHIV. This article studies this reconfiguration of the discourse on HIV prevention, as well as its effects on the discourse conveyed by HIV associations. The article shows how the new classification of HIV as a "chronic illness", on the basis of scientific expertise, has led to a modified discourse on prevention, including the recommendation of regular and controlled physical activity. This new orientation has contributed to the restructuring of HIV associations which relay this discourse and modify their organization and services, increasingly offering access to physical activities. However, this raises the question of the effects of this new representation of physical activities, as there has been little conside-ration of the difficulties encountered by PLHIV to respond to these repeated encouragements to modify their lifestyles in order to be "good" chronically ill patients. .

Health literacy and online educational resources: an opportunity to educate patients.

OBJECTIVE: Given the increasing accessibility of material on the Internet and the use of these materials by patients as a source of health care information, the purpose of this study was to quantitatively evaluate the level of readability of resources made available on the European Society of Radiology website to determine whether these materials meet the health literacy needs of the general public as set forth by guidelines of the U.S. National Institutes of Health (NIH) and the American Medical Association (AMA). MATERIALS AND METHODS: All 41 patient education articles created by the European Society of Radiology (ESR) were downloaded and analyzed with the following 10 quantitative readability scales: the Coleman-Liau Index, Flesch-Kincaid Grade Level, Flesch Reading Ease, FORCAST Formula, Fry Graph, Gunning Fog Index, New Dale-Chall, New Fog Count, Raygor Reading Estimate, and the Simple Measure of Gobbledygook. RESULTS: The 41 articles were written collectively at a mean grade level of 13.0 ± 1.6 with a range from 10.8 to 17.2. For full understanding of the material, 73.2% of the articles required the reading comprehension level of, at minimum, a high school graduate (12th grade). CONCLUSION: The patient education resources on the ESR website are written at a comprehension level well above that of the average Internet viewer. The resources fail to meet the NIH and AMA guidelines that patient education material be written between the third and seventh grade levels. Recasting these resources in a simpler format would probably lead to greater comprehension by ESR website viewers.

Prevalence of health promotion programs in primary health care units in Brazil.

OBJECTIVE: Assessment of prevalence of health promotion programs in primary health care units within Brazil's health system. METHODS: We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS: Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS: Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil.

Prevalence of health promotion programs in primary health care units in Brazil / Prevalência de programas de promoção da saúde em unidades básicas de saúde no Brasil

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. .

OBJETIVO Estimar a prevalência de programas de promoção da saúde nas unidades básicas de saúde no Brasil. MÉTODOS Estudo transversal descritivo realizado por meio de entrevistas telefônicas com coordenadores de unidades básicas de saúde. Do total de 42.486 unidades básicas de saúde cadastradas pelo Ministério da Saúde, 1.600 foram aleatoriamente selecionadas. As unidades foram amostradas nas cinco regiões do País de acordo com a proporção de unidades em cada região. Foi analisada a presença ou não de cinco programas de promoção da saúde: promoção de atividade física, cessação de tabagismo, cessação de uso de álcool e drogas ilícitas, alimentação saudável e ambiente saudável. Foram coletados dados sobre o tipo de ações desenvolvidas nos programas e a presença ou não da Estratégia de Saúde da Família na unidade. RESULTADOS A maioria das unidades básicas de saúde (62,0%) referiu ter pelo menos três programas de promoção da saúde e apenas 3,0% não tinha nenhum. A promoção do ambiente saudável e da alimentação saudável foram os programas mais prevalentes (77,0% e 72,0%, respectivamente), enquanto o controle do tabaco e do álcool foram referidos em 54,0% e 42,0% das unidades de saúde, respectivamente. A promoção de atividade física foi referida em menos de 40,0% das unidades e teve grande variação regional, com prevalência de 51,0% nas unidades do Sudeste e apenas 21,0% nas do Norte. A maioria das unidades de saúde (61,0%) oferecia Estratégia de Saúde da Família, porém não foi verificada maior prevalência de programas de promoção da saúde nessas unidades em relação ...

Faith community/parish nurse literature: exciting interventions, unclear outcomes.

Faith community/parish nurses provide a variety of services thought to yield positive health outcomes. An integrative literature review was conducted to identify interventions most commonly used by parish nurses in the United States and determine the value of the parish nurse in health promotion and disease prevention. A review of 22 articles published 2008 to 2013 revealed that parish nurses are providing a wealth of interventions to diverse populations but are not successfully evaluating outcomes.

[Are German information materials on colorectal cancer screening understandable or do they fail? Rating of health information by users with different educational backgrounds]. / Sind Informationsmaterialien zur Darmkrebsfrüherkennung in Deutschland verständlich oder verfehlen sie ihre Wirkung? : Bewertung von Gesundheitsinformationen durch Nutzerinnen und Nutzer mit unterschiedlichem Bildungshintergrund.

Evidence-based patient information is an essential part of decision making in health issues. A qualitative study was conducted to examine whether consumers consider the health information on colorectal cancer screening in Germany helpful in supporting their decision making. In this study, eight texts from different German authors about colorectal cancer screening were evaluated with a criteria-based selection. The texts were tested for understandability, structure, design, and effect on readers. Thirteen semi-structured focus groups were formed including 59 higher-educated and 15 lower-educated testers, 46 % of them being male with a mean age of 62.9 years. The transcripts were analyzed by content-analytic assessment. The testers provided detailed comments on the content and design of the texts. They revealed inaccuracies and suggested improvements of the texts. The testers differed from each other in terms of the intensity of their participation in the discussions and comprehension of the material. The reception of the flyers and brochures varied according to the educational level of the testers. Lower-educated testers often skipped passages of texts about risks as well as passages containing numbers and graphics. The texts had different effects on the testers, regardless of the level of education. If adverse effects were presented, some testers became scared while others were reassured because they felt informed. Most of the testers appreciated a call for participation as a central message of the text. Sometimes, if there was no clear appeal to attend the screening, the testers even asked for it. The recently introduced political strategy of promoting an informed choice is applied to an unprepared population who was used to getting a clear yes-or-no recommendation. Thus, at first, the population has to learn how to make an informed choice. This topic must be addressed and taken into account in the process of developing health information. Since this is not always the case, we conclude that current materials are limited in their contribution toward the decision of attending CRC screening.

Educação em saúde: relato de experiência com pré-escolares / Health education: an experience report with preschoolers

Health education encompasses knowledge and practices aimed at disease prevention and health promotion, relying on scientific and popular knowledge, promoting autonomy of the individuals involved, making them active and transformers of their lives or their social environment. The goal of this study was to share experiences in health education for children, aimed at health prevention and promotion. It reports the experiences that took place in the second half of 2010 with 20 preschool children between three and five years old enrolled in a day care center belonging to the Family Health Unit (FHU) Nova Esperança, in the neighborhood of Mangabeira, Joao Pessoa, state of Paraiba. In the first visit to day care center, activities were planed according to local needs, with the usual children issues, establishing the ?Healthy Eating?. The activity took place in a moment of integration between the children from the center and students from the Program of Education through Work for Health (PET ?Saude), using music, mutual construction of cardstock illustrative material, thematic group talk, proposal of an illustrative activity for the center, finalizing with music. It was a laidback, productive and questionable time, which allowed consideration on the issue involved, specifically nutritional transition in Brazil, as well as on the difficulties and advantages of carrying out public health practices broadly, articulated to the health care system, applying the knowledge acquired. Considering the local singularity with essential dialogue between the actors involved, helping transform reality into integrality.

La educación para la salud comprende el conocimiento y las prácticas dirigidos a la prevención de enfermedades y promoción de la salud, con base en el conocimiento científico y popular, promoviendo la autonomía de las personas implicadas, lo que los hace sujetos activos y ransformadores de su vida o de su entorno social. El objetivo de este trabajo es compartir experiencias sobre el enfoque de educación para la salud de los niños, dirigidas a la prevención y promoción de la salud. Se trata de un relato de las experiencias vividas en el segundo semestre de 2010, con 20 niños en edad preescolar, entre 3 y 5 años de edad, inscritos en una guardería en el área de cobertura de la Unidad de Salud Familiar (USF) Nova Esperança, en el barrio de Mangabeira, en la ciudad de João Pessoa, estado de Paraíba, Brasil. En principio se realizó una primera visita a la guardería con el fin de planificar las actividades de acuerdo a las necesidades locales, con las temáticas habituales de los niños, estableciéndose ?Alimentación Sana? como un asunto a ser tratado. La actividad tuvo lugar en el momento de integración entre los niños y los estudiantes del Programa de Educación para la Salud en el Trabajo (PET - Salud), utilizando la música, confección de materiales ilustrativos en cartulina, sesiones temáticas de conversación, propuesta de tarea ilustrativa y finalización con música. El momento fue relajado, productivo y con debate, lo que permitió reflexionar sobre el asunto en cuestión, específicamente sobre la transición nutricional en Brasil y también las dificultades y ventajas de la realización de las prácticas de salud colectiva de forma amplia, articuladas al sistema de salud, aplicando los conocimientos adquiridos. Teniéndose en cuenta también la particularidad local, haciéndose imprescindible el diálogo entre los actores participantes y ayudando a transformar la realidad hacia la integridad.

A educação em saúde abrange saberes e práticas voltados à prevenção de doenças e à promoção da saúde, baseando-se em conhecimento científico e popular, promovendo autonomia dos sujeitos envolvidos, tornando-os ativos e transformadores de sua vida e/ou de seu meio social. O objetivo deste trabalho é compartilhar experiências no enfoque da educação em saúde para crianças, voltadas à prevenção e à promoção da saúde. Trata-se de um relato de experiência vivenciada no segundo semestre de 2010, com 20 pré-escolares, entre 3 e 5 anos de idade, matriculados em uma creche na área de cobertura da Unidade de Saúde da Familia (USF) Nova Esperança, no bairro de Mangabeira, João Pessoa-PB. Inicialmente, foi realizada visita à creche, a fim de planejar a atividade conforme a necessidade local, com assuntos habituais das crianças, estabelecendo-se ?Alimentação saudável?. A atividade realizou-se em momento de integração das crianças com os estudantes do Programa de Educação pelo Trabalho na Saúde (PET ? Saúde), utilizando-se música, confecção mútua de materiais ilustrativos em cartolina, roda de conversa temática, proposta de atividade ilustrativa para casa e encerramento com música. O momento foi descontraído, produtivo e instigativo, o qual possibilitou reflexão sobre a temática envolvida, especificamente a transição nutricional no Brasil e ainda as dificuldades e vantagens de realizar práticas em saúde coletiva de forma ampla, articuladas ao sistema de saúde, aplicando-se os conhecimentos adquiridos. Considerando-se, ainda, a singularidade local, mostrou-se imprescindível o diálogo entre os atores envolvidos, contribuindo, dessa forma, para transformar a realidade em direção à integralidade.

Bite size oral health promotion.

UNLABELLED: Improving health is part of the Government's wider public health agenda and central to this theme is the requirement to help patients make informed healthy choices. The aim of the article is to review the basis of oral health promotion in primary dental care, explain why it is necessary and to give some practical tips on behaviour change in practice. CLINICAL RELEVANCE: Understanding and relating well to your patients can make oral health promotion more successful, with communication skills being paramount in achieving this goal, along with the creation of a supportive health-orientated practice environment.

[New European model for cross-sectorial health initiatives]. / Ny europaeisk model til tvaersektorielt sundhedsarbejde.

Over the last years EU have been working on the development of a common classification system for health indicators. In connection with prevention and health promotion, a classification system has now been developed: the European Health Promotion Indicator Development, EUHPID. The purpose has been to establish a system of indicators to advance the focus on health promotion. Furthermore, the EUHPID can be used as a planning tool to generate higher consistency between different health promotion initiatives and other policy initiatives. This article discusses the model and its relevance in a Danish context.

Classifying health questions asked by the public using the ICPC-2 classification and a taxonomy of generic clinical questions: an empirical exploration of the feasibility.

In case of an overload of information, structure is needed to make the content of the information accessible and the information flow well-ordered. If we wish to gain insight into the health information needs of the public, a specific research tool is needed. The aim of this study was to investigate the feasibility of using two professional classification structures for medical information to classify health questions asked by the public: one classification for the subject of the question, the International Classification of Primary Care (ICPC-2), and one classification for the nature and type of the question, the Taxonomy for Generic Clinical Questions (TGCQ). Health questions asked during online consultations with health care providers were retrieved (452 subjects for coding) and were given two codes: one code according to the ICPC-2 and one according to the TGCQ. The problems encountered during coding were recorded and analyzed. Nine different clusters of problems arose during classification with the ICPC-2, including issues regarding specificity, lay versus professional terminology, a combination of diverse complaints not complying with a clinical syndrome, and preclinical issues. Nine types of problems were encountered during the classification with the TGCQ: questions about preclinical issues, preventive procedures, name finding, health promotion, where to go for a diagnostic test or therapy, justification of the choice of a test or treatment, and common knowledge. The results of this study are promising, and further investigation of the validity, reliability, and use of these two classification systems to classify health questions asked by the public is desirable. The problems that were encountered should be solved before these professional systems can be used to classify the health information needs of the general public.

A tag based recommendation engine to suggest information resources in an online community for health promotion.

WEB 2.0 or the "social web" has created a new paradigm of collaborative information creation, organization and consumption. Among these, the social process of "tagging" has emerged as a bottom-up user-driven method to index content. We describe the use of tags as a way to connect users to resources in an online community that we are developing which utilizes social content creation and collaboration to promote health. Such connections are the basis of a recommendation engine that will suggest users a) other users who have similar health profiles, b) relevant information resources such as articles or blogs on health promotion and c) community resources such as local health facilities.

Implementar programas de promoción y prevención en el servicio de odontología para mejorar la salud oral de niños de 0 a 12 años de edad asegurados AI Policlinico Manco Kápac de la Caja Nacional de Salud en la gestión 2005 / Implement programs for promotion and prevention in the service of dentistry in order to improve the oral health of children from 0 to 12 years old ensured AI One-armed Polyclinic Kapac de la Caja Nacional Health in the management 2005

La autora del presente trabajo de investigación es odontóloga del servicio de odontologia del policlinico Manco Kapac. En la consulta odontológica diaria ha podido observar que los pacientes que acuden a la consulta diaria tienen mala salud oral, lo que nos ha llevado a hacernos la siguiente pregunta de investigación. ¿Al implementar un programa de promoción, educación y prevención en el servicio de odontológia del policlinico Manco Kapac, de la Caja Nacional de Salud, años 2005, se lograra mejorar la salud oral de los niños de 0 a 12 años de edad, asegurados al centro. Planteamos como objetivo general, Establecer la implementación de programas de promoción, educación y prevención en el servicio de odontologia para mejorar la salud oral de niños de 0 a 12 años de edad asegurados a la caja nacional de salud en la gestión 2005...

WHO Health Promotion Glossary: new terms.

The WHO Health Promotion Glossary was written to facilitate understanding, communication and cooperation among those engaged in health promotion at the local, regional, national and global levels. Two editions of the Glossary have been released, the first in 1986 and the second in 1998, and continued revision of the document is necessary to promote consensus regarding meanings and to take account of developments in thinking and practice. In this update 10 new terms that are to be included in the Glossary are presented. Criteria for the inclusion of terms in the Glossary are that they differentiate health promotion from other health concepts, or have a specific application or meaning when used in relation to health promotion. The terms defined here are: burden of disease; capacity building; evidence-based health promotion; global health; health impact assessment; needs assessment; self-efficacy; social marketing; sustainable health promotion strategies, and; wellness. WHO will continue to periodically update the Health Promotion Glossary to ensure its relevance to the international health promotion community.

The EUHPID Health Development Model for the classification of public health indicators.

The European Community Health Promotion Indicator Development Model has been developed as the basis for establishing a European set of indicators for monitoring health promotion interventions. This paper offers the model more generally as a common frame of reference for broader public health practice and indicator development. The model builds around the physical, mental and social health of individuals and shows how health develops by interaction between individual and environmental health determinants. It demonstrates that health development can be analysed from a salutogenic and a pathogenic perspective and explains how the differing starting points of different intervention approaches such as health promotion and health care are related to these two perspectives. Finally, a classification system for pathogenic and salutogenic public health outcome indicators is derived from the model and has been applied to the current core list of the European Community Health Indicator system. The model and its application highlight the need for systematic salutogenic indicator development in the field of public health and for strengthening the health promotion perspective in the future.

[Reflections about actual understanding of health education as a conceptional category in pedagogical science]. / Refleksje wokól aktualnego rozumieniawychowania zdrowotnego jako kategorii pojeciowej w naukach pedagogicznych.

Health education is area of social reality, in which all less or more purposeful interactions on consciousness, behaviour and conduct of human met. They are meant to be understand as holistic, dynamic and long- term process. Bases of this process are two elemental values: life and health of the human being, which are the source of pedagogical and obligatory norms. In the area of health education we should highline processes of health education and health promotion. From the health pedagogic point of view, which is fulfilling explicational, generalising, communicative, applicational and heuristic function, they become also needed to describing, explaining and estimating the health education process. Example of attaching bigger weight to health educational processes is obligatory entering to the teacher's educational programs terms connected with it's aims, contents, forms, methods and measures.