Práticas coletivas de educação em saúde na atenção primária à saúde em Contagem - MG

Introduction: Education in health represents an important knowledge field and practice for professionals who work on Health Primary Attention, a core activity for peoples` health promotion. In the theoretical field, the intense diffusion that the collective practices in health education in Family Health Strategy must be conducted in a dialogue and participating way,arising in the individual a critical reflection, enabling them to interpret and react to health reality and the environment, because systematized educative actions and or focused directly on informing people rules on a healthy living still prevail. Objective: To analyze Health Education Practices by Family Health Teams in the city of Contagem, Minas Gerais.Methods: A statistically significant amount of 166 professionals who work on the Family Health Strategy participated in the study. Data were collected by means of a questionnaire which is auto-applicable, containing semi-structured questions that address the perception ofthe participants about aspects related to health education as the objectives of this action, the motivations and barriers to their achievement within the Health Primary Attention, selfreported level of knowledge, pedagogical concepts and report of a significant experience ofhealth educations collective practices, as well as factors that are associated with the accession of the collective community health education. Results: A low percentage (28%) of Family Health Teams professionals who reported having adequate knowledge in health education was observed. Health education collective practices, mostly, are performed in a reproductive way or as a continuity of existing groups (35%), in 23,3% of the answers there was mentioning to the use of books on group working techniques and 21,4% reported lack of reference and the use of only their insight to perform education health. The Paulo Freire Method was mentioned in only 4% of the answers. Terms and expressions reported by the participants as descriptive in health education such as affectionateness, behavior and communication through expressions like "feeling", "ethics" and "know how to listen" presented different aspects to the educating performance. Predominance was observed on the assumptions and on the frequency of the health education collective practices realization, strongly limited by the Health Ministry program approaches to the Health Primary Attention as well as to groups targeted for people with diabetes mellitus and arterial hypertension. In smaller numbers, other initiatives in a lessinformative way were identified such as living groups and handicrafts groups, which presented signs of changes in the health education developed at the Family Health Teams, which is attempting to be more active, and presenting approaches in other dimensions liketenderness and commitment. Reports on educative processes to strengthen social control were not reported. The difficulties reported by the participants of the study came together with a non-recognition of the collective educative practices as a central activity to Health Attentionby the management, professionals and the community as well. Health education development was described by means of its own potential to raise empowerment, support experiences exchange and better entailment and access to health. Conclusion: A necessity to create apolicy on health education in the city was noticed, due to its importance for the Health Primary Attention programs and actions, as well as bigger investments in the formation and permanent education in the health education area. Investigative initiatives on the other professional categories working in the Health Primary Attention were suggested and also on the ones which were not included in this investigation.Introdução: A educação em saúde representa um importante campo de conhecimento e de prática para os profissionais que atuam na Atenção Primária à Saúde, sendo uma atividade central para a promoção da saúde das populações. Parece não ter sido suficiente a intensadifusão no campo teórico de que as práticas coletivas de educação em saúde na Estratégia Saúde da Família devem ser conduzidas de forma dialógica, participativa, suscitando no sujeito a reflexão crítica, capacitando-os para interpretar e agir sobre a realidade de saúde eambiente, pois as ações educativas assistematizadas e/ou pautadas unicamente em informar as pessoas regras para um viver saudável ainda prevalecem. Objetivo: Analisar as práticas coletivas de educação em saúde das Equipes de Saúde da Família do município de Contagem, Minas Gerais. Métodos: Participou do estudo uma amostra estatisticamente significante de 166 profissionais que atuam na Estratégia Saúde da Família. Os dados foram coletados por meio de um questionário, autoaplicável, com questões semiestruturadas que abordaram a percepção dos participantes sobre aspectos referentes à educação em saúde como os objetivos dessa ação, as barreiras e as motivações para a sua realização no âmbito da Atenção Primáriaa Saúde (APS), o autorrelato do nível de conhecimento, concepções metodológicas e de uma experiência significativa de prática coletiva de educação em saúde, além de fatores que estão associados a adesão da comunidade às práticas coletivas de educação em saúde. Resultados: Observou-se um baixo percentual (28,2%) de profissionais das Equipes de Saúde da Família que relataram possuir adequado conhecimento na área de educação em saúde. As práticas coletivas de educação em saúde, em sua maioria, acontecem de forma reprodutiva ou como continuidade de grupos já existentes (35,5%), em 22,3% das repostas houve menção da utilização de livros de técnicas para trabalho em grupo e 21,4% reportaram ausência de um referencial e a utilização da intuição para realizar a educação em saúde. O método PauloFreire foi mencionado em apenas 4,7% das repostas. Os termos e expressões reportados pelos participantes como descritivos da educação em saúde apresentaram aspectos diversos ao atode educar como afetividade, comportamento e comunicação em expressões como sentimento, ética e saber ouvir. Observou-se uma predominância nos temas e na periodicidade de realização das práticas coletivas de educação em saúde, fortemente delimitadas pelas temáticas de programas definidos pelo Ministério da Saúde para a Atenção Primária à Saúde como grupos direcionados para pessoas com diabetes mellitus e/ou hipertensão arterial. Em menor número, identificaram-se outras iniciativas de caráter menos informativo como os grupos de convivência e de artesanatos, que demonstraram ser indíciosde mudanças na educação em saúde desenvolvidas nas Equipes de Saúde da Família, que buscam ser mais participativas, dialógicas e com abordagem de outras dimensões como afetividade e vínculo. Não foi observado relato de processos educativos para o fortalecimentodo controle social. As dificuldades relatadas pelos participantes do estudo se aglutinaram em torno de um não reconhecimento das práticas educativas coletivas como uma atividade central para a Atenção à Saúde, tanto por parte da gestão, profissionais e comunidade. As motivações para o desenvolvimento da educação em saúde foram descritas por meio do seu potencial de aumentar o empoderamento, favorecer a troca de experiência e melhorar o vínculo e o acessoem saúde. Conclusão: Verificou-se que há necessidade de criação de uma política municipal de educação em saúde, dada a sua importância para os programas e ações da Atenção Primária à Saúde, assim como de maiores investimentos na formação e educação permanentena área de educação em saúde. Sugerem-se novas iniciativas investigativas com uma abordagem voltada para outras categorias profissionais que atuam na Atenção Primária à Saúde e que não foram contempladas nessa investigação

Long-Term Soil Structure Observatory for Monitoring Post-Compaction Evolution of Soil Structure

The projected intensification of agriculture to meet food targets of a rapidly growing world population are likely to accentuate already acute problems of soil compaction and deteriorating soil structure in many regions of the world. The key role of soil structure for soil functions, the sensitivity of soil structure to agronomic management practices, and the lack of reliable observations and metrics for soil structure recovery rates after compaction motivated the establishment of a long-term Soil Structure Observatory (SSO) at the Agroscope research institute in Zürich, Switzerland. The primary objective of the SSO is to provide long-term observation data on soil structure evolution after disturbance by compaction, enabling quantification of compaction recovery rates and times. The SSO was designed to provide information on recovery of compacted soil under different post-compaction soil management regimes, including natural recovery of bare and vegetated soil as well as recovery with and without soil tillage. This study focused on the design of the SSO and the characterization of the pre- and post-compaction state of the field. We deployed a monitoring network for continuous observation of soil state variables related to hydrologic and biophysical functions (soil water content, matric potential, temperature, soil air O2 and CO2 concentrations, O2 diffusion rates, and redox states) as well as periodic sampling and in situ measurements of infiltration, mechanical impedance, soil porosity, gas and water transport properties, crop yields, earthworm populations, and plot-scale geophysical measurements. Besides enabling quantification of recovery rates of compacted soil, we expect that data provided by the SSO will help improve our general understanding of soil structure dynamics

Qualification of the health community workers in the context of the dengue: a document analysis of the health policies

Dengue is an arbovirus of great public health impact. Based on the importance of community health workers (CHW) in the prevention and control of dengue, this article aims to analyze the professional qualification of CHW in public health policies related to dengue; using a qualitative descriptive document analysis of the primary sources of electronic documents of the Ministry of Health and the Ministry of Education, available online until February 2016. In total, 14 documents were analyzed based on content analysis. The results show few publications about training policies in the context of the dengue. Even though there is an incipient policy for CHW qualification, there is no regulation of their technical work. It is necessary to discuss who are these workers and the reasons why the regulation of CHW training does not appear in the agenda of dengue control policies and its vectors

Automated, 3-D and Sub-Micron Accurate Ablation-Volume Determination by Inverse Molding and X-Ray Computed Tomography.

Ablation of materials in combination with element-specific analysis of the matter released is a widely used method to accurately determine a material's chemical composition. Among other methods, repetitive ablation using femto-second pulsed laser systems provides excellent spatial resolution through its incremental removal of nanometer thick layers. The method can be combined with high-resolution mass spectrometry, for example, laser ablation ionization mass spectrometry, to simultaneously analyze chemically the material released. With increasing depth of the volume ablated, however, secondary effects start to play an important role and the ablation geometry deviates substantially from the desired cylindrical shape. Consequently, primarily conical but sometimes even more complex, rather than cylindrical, craters are created. Their dimensions need to be analyzed to enable a direct correlation with the element-specific analytical signals. Here, a post-ablation analysis method is presented that combines generic polydimethylsiloxane-based molding of craters with the volumetric reconstruction of the crater's inverse using X-ray computed tomography. Automated analysis yields the full, sub-micron accurate anatomy of the craters, thereby a scalable and generic method to better understand the fundamentals underlying ablation processes applicable to a wide range of materials. Furthermore, it may serve toward a more accurate determination of heterogeneous material's composition for a variety of applications without requiring time- and labor-intensive analyses of individual craters

Quantitative laser–matter interaction: a 3D study of UV-fs-laser ablation on single crystalline Ru(0001)

Laser ablation is nowadays an extensively applied technology to probe the chemical composition of solid materials. It allows for precise targeting of micrometer objects on and in samples, and enables chemical depth profiling with nanometer resolution. An in-depth understanding of the 3D geometry of the ablation craters is crucial for precise calibration of the depth scale in chemical depth profiles. Herein we present a comprehensive study on laser ablation processes using a Gaussian-shaped UV-femtosecond irradiation source and present how the combination of three different imaging methods (scanning electron microscopy, interferometric microscopy, and X-ray computed tomography) can provide accurate information on the crater’s shapes. Crater analysis by applying X-ray computed tomography is of considerable interest because it allows the imaging of an array of craters in one step with sub-µm accuracy and is not limited to the aspect ratio of the crater. X-ray computed tomography thereby complements the analysis of laser ablation craters. The study investigates the effect of laser pulse energy and laser burst count on a single crystal Ru(0001) sample. Single crystals ensure that there is no dependence on the grain orientations during the laser ablation process. An array of 156 craters of different dimensions ranging from <20 nm to ∼40 µm in depth were created. For each individually applied laser pulse, we measured the number of ions generated in the ablation plume with our laser ablation ionization mass spectrometer. We show to which extent the combination of these four techniques reveals valuable information on the ablation threshold, the ablation rate, and the limiting ablation depth. The latter is expected to be a consequence of decreasing irradiance upon increasing crater surface area. The ion signal generated was found to be proportional to the volume ablated up to the certain depth, which enables in-situ depth calibration during the measurement

New insights into the lifestyle of Allosaurus (Dinosauria: Theropoda) based on another specimen with multiple pathologies

Adult large-bodied theropods are often found with numerous pathologies. A large, almost complete, probably adult Allosaurus specimen from the Howe Stephens Quarry, Morrison Formation (Late Kimmeridgian–Early Tithonian), Wyoming, exhibits multiple pathologies. Pathologic bones include the left dentary, two cervical vertebrae, one cervical and several dorsal ribs, the left scapula, the left humerus, the right ischium, and two left pedal phalanges. These pathologies can be classified as follows: the fifth cervical vertebra, the scapula, several ribs and the ischium are probably traumatic, and a callus on the shaft of the left pedal phalanx II-2 is probably traumatic-infectious. Traumatically fractured elements exposed to frequent movement (e.g., the scapula and the ribs) show a tendency to develop pseudarthroses instead of a callus. The pathologies in the lower jaw and a reduced extensor tubercle of the left pedal phalanx II-2 are most likely traumatic or developmental in origin. The pathologies on the fourth cervical are most likely developmental in origin or idiopathic, that on the left humerus could be traumatic, developmental, infectious or idiopathic, whereas the left pedal phalanx IV-1 is classified as idiopathic. With exception of the ischium, all as traumatic/traumatic-infectious classified pathologic elements show unambiguous evidences of healing, indicating that the respective pathologies did not cause the death of this individual. Alignment of the scapula and rib pathologies from the left side suggests that all may have been caused by a single traumatic event. The ischial fracture may have been fatal. The occurrence of multiple lesions interpreted as traumatic pathologies again underlines that large-bodied theropods experienced frequent injuries during life, indicating an active predatory lifestyle, and their survival perhaps supports a gregarious behavior for Allosaurus. Alternatively, the frequent survival of traumatic events could be also related to the presence of non-endothermic metabolic rates that allow survival based on sporadic food consumption or scavenging behavior. Signs of pathologies consistent with infections are scarce and locally restricted, indicating a successful prevention of the spread of pathogens, as it is the case in extant reptiles (including birds)

Perfil epidemiológico da AIDS em contagem, Minas Gerais, Brasil, entre 2007 e 2011

Background and Objectives: Bucking the trend worldwide, in Brazil there is a tendency of increase in the number of AIDS cases, justifying the holding of local epidemiological studies providing subsidies for solving them. This study aimed to analyze the epidemiological profile of AIDS in Contagem, Minas Gerais, between 2007 and 2011, with reflections on educational practices for its prevention and control. Methods: This is a descriptive epidemiological study of historical time series. For the 651 new AIDS cases reported in SINAN from 2007 to 2011, it was calculated incidence rate and average rates and performed stratified analysis by gender, education, age and year of occurrence. Results: The mean annual incidence rate of AIDS and the average annual death rate per 100,000 population was 21.0 and 4.0 cases, respectively. The sex ratio (2.16: 1) remained significant (p ≤ 0.05) for the entire series. The feminization of the disease has been verified. Regarding education, 11 people (3.7%) were illiterate, 162 (54.0%) had up to elementary school, 84 (28.0%) had through high school and 43 (14.3%) had to higher education (p = 0.05). Conclusions: In the investigated municipality, AIDS showed an oscillatory pattern, with increased number of cases and may present a strong social determination. This indicated the need to intensify prevention and control of disease, which can be done with the use of educational approaches within the APS and educational institutions. KEYWORDs: Epidemiology. Health Education. Primary Health Care. Communicable diseases. Acquired Immunodeficiency Syndrome.Justificativa e Objetivos: Contrariando as tendências em âmbito mundial, no Brasil há uma tendência de aumento do número de casos de aids, justificando a realização de estudos epidemiológicos locais que forneçam subsídios para o seu enfrentamento. Objetivou-se analisar o perfil epidemiológico da aids, em Contagem, Minas Gerais, no período de 2007 a 2011, apresentando reflexões sobre práticas educativas para sua prevenção e controle. Métodos: Trata-se de um estudo epidemiológico descritivo, de série temporal histórica. Para os 651 novos casos de aids notificados no SINAN, entre 2007 e 2011, foram calculados coeficiente de incidência e taxas médias e realizada análise estratificada por sexo, escolaridade, idade e ano de ocorrência. Resultados: A taxa média anual de incidência de aids e a taxa média anual de óbitos para cada 100.000 habitantes foi de 21,0 e 4,0 casos, respectivamente. A razão de masculinidade (2,16:1) permaneceu significativa (p≤0,05) durante toda a série histórica. Foi verificada a feminilização da doença. Em relação à escolaridade, 11 pessoas (3,7%) eram analfabetos, 162 (54,0%) possuíam até o ensino fundamental, 84 (28,0%) apresentavam até o ensino médio e 43 (14,3%) possuíam até o ensino superior (p≤0,05). Conclusão: No município investigado, a aids apresentou um padrão oscilatório, com aumento do número de casos, relacionado com determinantes sociais. Isso indicou a necessidade de intensificação das ações de prevenção e controle da doença, o que pode ser feito com emprego de abordagens educativas, no âmbito da APS e em instituições de ensino. DESCRITORES: Epidemiologia. Educação em Saúde. Atenção Primária à Saúde. Doenças transmissíveis. Síndrome de Imunodeficiência Adquirida