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Copyright of Ciencia, Cuidado e Saude is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Revista de Atencao Primaria a Saude is the property of Revista de Atencao Primaria a Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Atencao Primaria a Saude is the property of Revista de Atencao Primaria a Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Atencao Primaria a Saude is the property of Revista de Atencao Primaria a Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ciencia, Cuidado e Saude is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a research conducted for analyzing the influence of alcoholism on public health. Various topics discussed include analysis of alcoholic beverages consumption by Family Health Unit's users in São Paulo, Brazil, use of Alcohol Use Disorder Identification Test (AUDIT) in the research and health promotion programs in the region.

Copyright of Brazilian Journal of Applied Economics / Economía Aplicada is the property of FEA-RP, Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Scientiarum: Health Sciences is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Portuguese Journal of Public Health / Revista Portuguesa de Saúde Pública is the property of Revista Portuguesa de Saúde Pública - Escola Nacional de Saúde Pública and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To describe the educational views and practices of family health teams to people with arterial hypertension and their relatives. Method: This is a qualitative study performed with 12 medical and nursing professionals from a municipality located in the Brazilian state of Parana. The data was collected in May 2011, with a semi-structured instrument and submitted to the analysis of content. Results: The professionals believe that education in health is an action to promote health and prevent diseases, but they have a narrow perspective regarding the disease and the individual, despite the fact they recognize the importance of the family in the process; the views about working conditions and technical-scientific preparedness reinforces this view. Discussion: The educational practice must empower families to be able to transform their reality, which does not happen based on reductionist and traditional educational practices. Conclusion: These professionals must search for further information that can open their minds regarding educational views and practices, empowering the families to emancipate the care and the control over the illness. [ABSTRACT FROM AUTHOR]

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: To assess factors associated with low adherence to pharmacotherapy in older adults. METHODS: Cross-sectional population-based study, with a representative sample of 1,593 individuals aged 60 or older, living in the urban area of Bagé, RS, Southern Brazil, in 2008. A multiple stage sampling model was used. The data were collected through individual household interviews. The analyses of the association between low adherence regarding pharmacotherapy, measured using the Brief Medication Questionnaire (BMQ), and demographic, socioeconomic, behavioral, health, assistance and prescription factors were carried out applying Poisson regression model to assess crude and adjusted prevalence ratios, their respective 95% confidence intervals and p-value (Wald test). RESULTS: Around 78.0% of individuals reported have taken at least one medication in the seven days prior to the interview. Of these, approximately one third (28.7%) were considered to have low adherence to the treatment. The factors significantly associated to low adherence to treatment were: age (65 to 74 years old), not having health insurance, having to purchase (totally or partially) their own medicines, having three or more morbidities, having functional disabilities and using three or more medicines. CONCLUSIONS: The increased use of medicines by older adults, because of the high prevalence of non-communicable diseases in this group, and the access to the treatment need to be considered by health care professionals regarding fostering adherence to treatment, which increases therapeutic solutions and quality of life among older people. [ABSTRACT FROM AUTHOR]

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

O estudo teve como objetivo analisar o processo de trabalho das equipes de saúde bucal no Estado de Pernambuco, Brasil, segundo porte populacional, enfocando a articulação junto à comunidade e a organização do atendimento clínico. Foram aplicados questionários estruturados a 121 equipes de saúde bucal de 29 municípios. Para verificar a associação entre as ações realizadas e o porte populacional dos municípios, utilizou-se o teste qui-quadrado. Na integração das equipes com a comunidade, observou-se o maior foco nas escolas (81,2%), entretanto a integração com igrejas (p = 0,000) e creches (p = 0,000) demonstrou associação com os municípios de grande porte. A forma de organização do atendimento clínico evidenciou a atenção aos grupos prioritários (82,3%), sendo ainda bastante presente a marcação por demanda espontânea, principalmente nos municípios de pequeno porte. Assim, é necessário investir em educação permanente para a adequação dos processos de trabalho realizados pelas equipes e a redução das diferenças entre as práticas realizadas nos diversos municípios de Pernambuco.This study aimed to analyze the work process in oral health teams in Pernambuco State, Brazil, according to population size in the various municipalities (counties), focusing on the relationship with the community and organization of clinical care. Structured questionnaires were applied to 121 oral health teams in 29 cities. The chi-square test was used to verify the association between the actions and the municipalities' population size. In the integration of the oral health teams with the community, there was a greater focus on schools (81.2%), while integration with churches (p = 0.000) and daycare centers (p = 0.000) was associated with larger municipalities. Organization of clinical care showed attention to priority groups (82.3%), while dental visits were still largely scheduled by spontaneous demand, especially in the smaller municipalities. It is thus necessary to invest in continuing education to adjust the work processes by the team and reduce the differences between practices in the various municipalities in Pernambuco State.

Considerando nossas percepções, enquanto supervisores de unidades primárias de saúde, no Ceará, de que há baixa oferta das ações de educação em saúde, como parte das atividades do Programa Saúde da Família (PSF), buscou-se investigar suas causas, bem como identificar as falhas no desenvolvimento dessas ações. Aplicou-se a entrevista e a observação participante como método de pesquisa. Detectou-se como causas do déficit das práticas educativas, a desorganização da demanda, a insuficiciente cobertura da população por equipes de PSF, a resistência dos profissionais e da população às ações educativas, a ausência de área física adequada para a realização das ações e escassez de material de apoio. Quanto às falhas no decorrer das atividades, identificou-se: pouca troca de experiências entre os participantes; orientação pouco direcionada às necessidades do grupo; uso freqüente de linguagem científica; repasse de informações desatualizadas e utilização inadequada do material de apoio. Conclui-se ser necessária a atualização dos profissionais de saúde, assim como uma disponibilização maior de recursos físicos e de material de apoio, para que a educação em saúde reprodutiva seja uma realidade no PSF.As supervisors of primary health care units in the State of Ceará, Brazil, we have observed a low supply of health education services. As part of the activities under the Family Health Program (FHP), we attempted to investigate the causes of this short supply and identify flaws in the development of such activities. Interviews and participatory observation were adopted as the research method. The following causes were defined in the lack of health education practices: disorganization of demand, insufficient coverage of the population by FHP teams, resistance by both health professionals and the population to educational activities, absence of adequate floor space for conducting such activities, and lack of support materials. The following flaws were identified in the implementation of activities: limited exchange of experiences among participants; limited focus on the group's needs; frequent use of scientific language; transfer of outdated information; and inadequate utilization of teaching materials. The conclusion is that there is a need to retrain health professionals and to improve the availability of physical resources and teaching materials in order for education in reproductive health to become a reality in the FHP.

OBJETIVOS: avaliar a conformidade da estrutura de sete unidades de saúde da família do município do Rio de Janeiro para a oferta da assistência nutricional no pré-natal. MÉTODOS: um estudo transversal foi desenvolvido no ano de 2008. Foram selecionadas sete unidades de saúde da família, nas quais foi realizada a observação direta da estrutura. Nessas unidades, foram entrevistados sete profissionais de saúde e 230 gestantes. A estrutura das unidades foi avaliada segundo critérios de planta física, recursos materiais, sistema de referência, recursos humanos e normas e rotinas. RESULTADOS: todas as unidades apresentaram conformidade para os critérios de planta física e recursos materiais avaliados, segundo observação direta e entrevista com os profissionais. A norma com menor conformidade foi o registro de manutenção preventiva das balanças. O modelo atual do cartão de pré-natal do Ministério da Saúde só foi encontrado com 45% das gestantes. O acesso ao sulfato ferroso e ao ácido fólico foi relatado por cerca de 70% das gestantes. Foram observadas carências de recursos humanos e de referência das gestantes para nutricionistas. CONCLUSÕES: destaca-se a importância da dimensão correta da equipe mínima e da implantação dos Núcleos de Apoio à Saúde da Família, na ampliação da abrangência e da integralidade da assistência pré-natal.OBJECTIVES: to evaluate the extent to which seven family health units in the municipality of Rio de Janeiro are equipped to provide prenatal care on nutrition. METHODS: a cross-sectional study was carried out in 2008. Seven family health units were selected and their structure was observed directly. Seven health workers and 230 pregnant women were interviewed at these units. The building structure, material resources, referral system, human resources and norms and routines were examined at each unit. RESULTS: direct observation and the interviews with the health workers ascertained that all the units had a suitable building structure and material resources. The norm that was least commonly complied with was the preventive maintenance of scales. The Ministry of Health's current prenatal card was found to have been implemented for 45% of the pregnant women. Access to ferrous sulfate and folic acid were reported by around 70% of pregnant women. There was found to be a shortfall in human resources and in referral of pregnant women to nutritionists. CONCLUSIONS: the study points out the importance of ensuring the minimum team size and installing Family Health Support Unites, when expanding the scope and improving the integration of prenatal care.

OBJETIVOS: avaliar a acessibilidade geográfica à atenção primária à saúde da população coberta pelos Programa de Agentes Comunitários de Saúde (PACS) e Programa de Saúde da Família (PSF) de um distrito sanitário de Salvador. MÉTODOS: estudo avaliativo transversal. Os dados foram coletados a partir de entrevistas realizadas junto aos profissionais das onze equipes de PACS e PSF. A análise dos dados contemplou duas dimensões: acesso da população e lógica de territorialização. RESULTADOS: o distrito apresentava relevo bastante acidentado e todas as equipes informaram a existência de barreiras geográficas na área, em especial escadarias, morros e ladeiras. Não foi observada diferença significativa na acessibilidade às equipes de PACS e PSF. O processo de territorialização esteve dissociado da concepção de território-processo. Algumas áreas de abrangência das equipes situavam-se em locais afastados das UBS, constituindo-se em importante barreira ao acesso da população. CONCLUSÕES: o processo de implantação da estratégia PACS/PSF no distrito e o modelo de territorialização adotado não atenderam aos princípios que devem nortear a organização da atenção primária à saúde, resultando em restrições na acessibilidade geográfica da população coberta. Recomenda-se que seja realizada uma revisão do desenho atual da territorialização, visando uma melhor adequação às diretrizes do PSF e à promoção de uma maior acessibilidade à atenção primária.OBJECTIVES: to assess the geographical accessibility of primary health care for the population served by the Community Health Agents Program (PACS) and the Family Health Program (PSF) in one sanitary district in the city of Salvador, Brazil. METHODS: a evaluative cross-sectional study was carried out. The data were collected using interviews with health workers from the eleven PACS and PSF teams. Analysis of the data took two factors into account: access of the population and the logic of territorialization. RESULTS: the district has a relatively rugged landscape and all the teams reported the existence of geographical barriers in the area, in particular steps and steep hills. There was no difference in accessibility between the PACS and the PSF. The process of territorialization was unrelated to the concept of territory as a process. Some areas covered by the teams were located some distance from the UBS and this constituted a significant obstacle to access. CONCLUSIONS: the implantation of the PACS/PSF strategy in the district and the model of territorialization were not in line with the principles that should guide primary health care, resulting in geographical restrictions on access for the population served. It is recommended that the current territorial design be reviewed to ensure that it is more line with PSF guidelines and to enable better access to primary care.

. Introduction: Type 1 diabetes mellitus is one of the most important endocrine-metabolic diseases in children and the management of its complications is a priority to world health care. Objective: The aim of this study was to acknowledge the resources used by the families to assist their type 1 diabetic children. Methods: This is a descriptive, exploratory and qualitative study, developed with seven resident families in Maringá-PR, whose children were younger than 14 years and enrolled in the municipal Basic Health Units database as diabetic. Data was collected in May 2007 by semi structured interviews carried out in families’ homes. Results showed the families believe that diabetic children need differentiated assistance which is not offered by the public health services, what forces the families to contract health care coverage provided by Health Maintenance Organizations despite the fact that they cannot afford it. Families complain that it takes too long to make appointments and exams/tests with specialist doctors in public health services. They also highlight the distance/absence of the family nurse in the Family Health Conclusions: Team while performing home visits, which hinders the families´ education process. To provide integrated care it is important to rethink the Family Health Team’s actions, mostly the nurses’, in order to plan specific actions towards diabetic children to minimize the impact and suffering due to this disease.

Este artigo apresenta parte dos resultados referentes à pesquisa avaliativa Estudos de Linha de Base, desenvolvida em 21 municípios com mais de 100 mil habitantes em três estados do Nordeste do Brasil. O objetivo geral foi avaliar experiências de implementação do Programa Saúde da Família (PSF), com foco nas induções do PROESF. Foi realizada Análise de Implantação utilizando-se como método o estudo de caso. Na análise utilizaram-se as dimensões: político-institucional, organização da atenção e cuidado integral. Como avanços destacam-se: priorização do PSF em áreas de risco; aprendizado institucional, qualificação dos gestores e equipes; centrais de regulação, vínculo e percepção positiva sobre PSF. Em relação aos desafios observaram-se: fortalecimento da capacidade formuladora local, alocação dos recursos na Atenção Básica, desprecarização do trabalho, efetivação de rede de atenção, fortalecimento da participação social, qualificação do monitoramento e avaliação para tomada de decisão; acolhimento; filas para exames, consultas e internação; implementação do trabalho em equipe e atividades promocionais e intersetoriais.This article presents part of the results from the Baseline Studies, an evaluative research conducted in 21 municipalities with more than 100,000 inhabitants each, in three States of Northeast Brazil. The overall objective was to assess experiences in the implementation of the Family Health Program (FHP), with a focus on inductions in the PROESF. An implementation analysis was performed, using the case study method. The analysis focused on these dimensions: political-institutional, health organization, and comprehensive care. Outstanding advances included: prioritize the FHP in high-risk areas; institutional learning, with qualification of managers and teams; definition of institutional levels for regulating the FHP; and health team-user bonds and positive perceptions concerning the program. Challenges included: strengthening of local policy and decision-making capacity; allocation of primary care resources; greater employment security for human resources; effective implementation of the health care network; strengthening of social participation; upgrading of monitoring and evaluation for decision-making; receptivity; waiting lines for tests, appointments, and hospital admissions; implementation of teamwork; health promotion and inter-sector activities.

O artigo analisa a configuração da Atenção Básica e do Programa Saúde da Família (PSF) nos 22 municípios com mais de 100 mil habitantes do Rio de Janeiro em 2005. A metodologia compreendeu visitas aos municípios, entrevistas com dirigentes da saúde e análise de bases de dados nacionais. Foram definidas quatro variáveis-síntese para a caracterização da Atenção Básica nos municípios: modelo de Atenção Básica e inserção do PSF; institucionalização do PSF; organização da Atenção Básica e organização do PSF. A classificação dos municípios nas quatro variáveis revelou uma grande diversidade de situações, predominando o modelo paralelo de configuração da Atenção Básica e inserção do PSF. Observou-se que os municípios em melhores condições de estruturação da Atenção Básica são pólos do interior do estado, que possuem PSF implantado há mais de seis anos e várias modalidades de organização da Atenção Básica. A maioria dos municípios do grupo em pior situação se situa na região metropolitana. À luz dos resultados, são discutidos os desafios do PSF como estratégia estruturante da Atenção Básica em saúde em municípios de grande porte populacional, particularmente nas regiões metropolitanas.This article analyzes the organization of traditional Primary Health Care and the Family Health Program (FHP) in the 22 municipalities of Rio de Janeiro State, Brazil, with more than 100,000 inhabitants each in 2005. The methodology included visits to the municipalities, interviews with health managers, and analysis of national databases. Four summary variables were defined: the Primary Health Care model and inclusion of the FHP; institutionalization of the FHP; organization of traditional primary care; and organization of the FHP. Classification of the municipalities according to the four variables showed widely diverse situations and the predominance of a parallel model for inclusion of the FHP. The municipalities with the best structural conditions for primary care are located in the interior of the State, besides those that have had the FHP implemented for more than six years and that practice various modalities of Primary Health Care organization. The majority of the municipalities with the worst situation in relation to the FHP are located in Greater Metropolitan Rio de Janeiro. In light of the results, the article discusses the challenges facing the FHP as a strategy for structuring primary health care in large cities, particularly in metropolitan areas.

A expansão da estratégia do Programa Saúde da Família no Brasil torna necessária a construção de indicadores que avaliem a coerência da abordagem efetivamente realizada e os princípios que regem o programa. Associado ao prontuário familiar, o familiograma (genograma) possibilita melhoria no acompanhamento da saúde da clientela e na qualidade da atenção prestada. A pesquisa utiliza o prontuário familiar com base na avaliação externa (acreditação) das equipes de saúde da família e dos gestores. Os resultados mostram uma variação da conformidade do prontuário com o padrão de acreditação segundo a natureza da função avaliada. O estudo revela a importância da avaliação externa como sinalizadora do nível de conformidade aos padrões requeridos, sugerindo a necessidade de operar um indicador combinado entre a avaliação interna e externa das informações familiares como instrumento de gestão.Expansion of the Family Health Program in Brazil requires indicators to evaluate the consistency of the approach actually adopted and the program's underlying principles. Together with the family health chart, the family health history (medical genealogy) allows improved follow-up of the clientele's health and the quality of care provided. This study used the family health chart based on external evaluation (accreditation) of family health teams and managers. The results showed variation in the health charts' conformity to the accreditation standard according to the nature of the function evaluated. The study showed the importance of external evaluation to signal the level of conformity to the required standards, suggesting the need to operate with a combined indicator, including internal and external evaluation of family health data as a management instrument.

Este artigo relata a trajetória metodológica utilizada pela equipe de pesquisa da Universidade Estadual de Maringá no Estudo de Linha de Base, em vinte municípios com mais de 100 mil habitantes dos Estados do Paraná e Santa Catarina, Brasil na implantação do Projeto de Expansão e Consolidação do Saúde da Família (PROESF). Foram realizadas oficinas para a discussão de estudos de avaliação de programas, construção e aplicação de instrumentos de pesquisa, visitas técnicas aos municípios para supervisão das atividades de dispersão e construção de um banco de dados com a produção científica locorregional. Foi possível verificar responsabilidade e compromisso dos representantes municipais e estaduais, visto que a maior parte respondeu prontamente às atividades acordadas, além de interesse no aprendizado e na institucionalização da avaliação. Quatorze municípios incorporaram outros atores para a constituição de rede de apoio para a avaliação da atenção básica, e as estratégias contribuíram para que a avaliação fosse incorporada ao planejamento, indicando que a capacitação pode ser estruturante e potencializadora do processo de institucionalização da avaliação.This article reports on the methodology used by the research team of the State University in Maringá in the Baseline Study in 20 municipalities in the States of Paraná and Santa Catarina, Brazil, with more than 100,000 inhabitants each, in the implementation of the Project for Expansion and Consolidation of the Family Health Strategy. Workshops to discuss the evaluation of programs, construction and application of research instruments, site visits to supervise activities in disseminating the program, and development of a database with the local and regional scientific output were carried out. There was an obvious sense of responsibility and commitment on the part of municipal and State representatives, the majority of whom immediately agreed to the activities. They also showed interest in both the learning process and institutionalization of the evaluation. Fourteen municipalities incorporated other actors to build a support network for the evaluation of the primary health care system. The strategies contributed to the incorporation of evaluation into the planning process, indicating that training can be a constructive and powerful mechanism for institutionalizing evaluation.

Este trabalho engloba parte dos resultados do Estudo de Linhas de Base, Projeto de Consolidação e Expansão do Saúde da Família (PROESF). Seu objetivo é avaliar a Atenção Básica dos municípios de Cuiabá, Várzea Grande e Rondonópolis, Estado de Mato Grosso, Brasil, o que será feito segundo as relações de intersubjetividade que lhes são próprias - entre os profissionais de saúde, entre estes e os usuários, entre os cidadãos em geral e dentro das instâncias institucionalizadas de controle social. É um estudo quali-quantitativo, composto de entrevistas com informantes-chave, miniconvenções com gerentes, grupos focais com gerentes, entrevistas com usuários e profissionais das unidades de saúde selecionadas. Foram atribuídos escores para os quesitos indicativos de processos participativos e para as funções da Atenção Básica. Constatou-se, apesar da identidade geopolítica dos municípios e do acesso deles às mesmas políticas públicas, diferença significativa quanto ao desempenho das funções relativas à organização da Atenção Básica e do Programa Saúde da Família: porta de entrada, longitudinalidade, integralidade e coordenação. Constataram-se ainda diferenças referentes ao tipo de relações estabelecidas, participativas ou não, em correspondência com a diferença anterior.This article presents part of the results from the Baseline Study on the PROESF. The objective was to evaluate primary health care in the cities of Cuiabá, Várzea Grande, and Rondonópolis, Mato Grosso State, Brazil, based on the inter-subjectivity in human relations (among health workers, users of health services, and the public at large and within institutionalized levels of social control). A qualitative and quantitative methodology was used, including interviews with key informants; short meetings with managers; focal groups with managers; and interviews with users and health professionals from pre-selected health units. Scores were assigned to all the questions that indicated participatory processes in primary care practices in the various municipalities. Despite the geopolitical identity among the municipalities and their similar access to the same public policies, there was a significant difference in their performance of the functions pertaining to the organization of primary care and the Family Health Program, in terms of portal of entry into the system, longitudinality, comprehensiveness, and coordination. Differences were observed in the type of relations that were established (participatory versus non-participatory), corresponding to the previous difference.

Os Estudos de Linha de Base do Projeto de Expansão e Consolidação do Saúde da Família construíram indicadores e modelos de atenção básica para os 62 municípios paulistas com mais de 100 mil habitantes, e apontaram uma diversidade de comportamento destes indicadores e modelos em relação às diferentes dinâmicas urbanas do estado. Nesse sentido, houve a necessidade de realizar uma reflexão sobre saúde e uso urbano do território. O principal objetivo desta reflexão foi compreender melhor sobre como a dinâmica urbana tem influência no perfil, na organização e no funcionamento do sistema de saúde. A partir daí, foi possível extrair algumas hipóteses e discussões sobre como a urbanização paulista impõe desafios à expansão e consolidação da atenção básica e do Programa Saúde da Família nos municípios estudados.The Baseline Studies on the Project for Expansion and Consolidation of the Family Health Strategy created primary health care indicators and models for the 62 municipalities with more than 100,000 inhabitants in São Paulo State, Brazil, and identified varying patterns for these indicators and models in relation to different urban dynamics in the State. The studies showed the need to reflect on health in relation to urban land use. The main objective was to gain a better understanding of how urban dynamics influence the health system's profile, organization, and operation, based on which it was possible to extract some hypotheses and discussions regarding how urbanization in São Paulo State creates challenges for the expansion and consolidation of primary health care and the Family Health Program in these municipalities.

O artigo apresenta uma adaptação do índice de desenvolvimento da família, e detalha os resultados de sua aplicação em 21 municípios do Estado do Rio de Janeiro, Brasil no ano 2000. O estudo insere-se na pesquisa de linha de base do Projeto de Expansão e Consolidação do Saúde da Família, e foi proposto como um instrumento para acompanhamento e análise da realidade municipal no contexto de discussão de uma política pública que tem a família como eixo central. Os resultados mostram uma situação muito grave ou grave das famílias no Estado do Rio de Janeiro. As dimensões mais críticas são aquelas relativas às desigualdades de resultado, nos aspectos de disponibilidade de recursos e acesso ao mercado de trabalho; além de uma dimensão relativa à desigualdade de oportunidade, qual seja o acesso ao conhecimento. Os grupos mais vulneráveis são aqueles formados por famílias cujo chefe tem mais do que 65 anos de idade e por famílias cujos chefes são mulheres.This article presents an adaptation of the family development index, with a detailed description of the results of its application in 21 municipalities in the State of Rio de Janeiro, Brazil, in 2000. The research is part of the Baseline Study on the Project for Expansion and Consolidation of the Family Health Strategy and was proposed as an instrument for monitoring and analyzing the municipal reality in the context of a family-centered public policy. The results show a serious-to-severe situation for families in the State of Rio de Janeiro. The most critical dimensions relate to inequalities in results, availability of resources, and labor market access, in addition to a key aspect involving inequality of opportunities, namely access to knowledge. The most vulnerable groups consist of families headed by individuals over 65 years of age and families headed by women.

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Atencao Primaria a Saude is the property of Revista de Atencao Primaria a Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nutritional transition is one of the major challenges for public health policies because it demands a health care model guided by integrality and health promotion, especially in Primary Health Care. Food and nutrition are the basic requirements for health promotion and they enable the achievement of the potential of human development. This paper discusses/examines/brings reflection on the fields of food and nutrition in the context of Primary Care and Health Promotion through a descriptive and reflective methodology, reinforcing the need for a dialogue between these areas, through the interlocution between its challenges and potentials, in order to attain the principles of the National Health System. The analysis made it possible to realize the importance of the Family Health Strategy and Family Health Strategy Support for the revitalization of Primary Care, and how this place is privileged for conducting food and nutrition and health promotion activities. This relationship has potential, but also important challenges such as the need for an interdisciplinary team, which goes beyond the present conformation of family health teams, in sufficient numbers to meet the demand of skills and the development of food and nutrition actions, aiming to the principles of universality, integrality and fairness and the resolutivity of health services. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To analyze the current status of the interventions related to social determinants of health conducted in the context of the brazilian family health program. METHODS: A case study using a mixed method approach based on a sequential explanatory strategy with 171 unit managers in the Family Health Care Program in the municipality of Sao Paulo, SP, Southeastern Brazil, in 2005/2006. Self-administered questionnaires were applied and semi-structured interviews and focus groups were conducted with a purposive sample of professionals involved in initiatives related to social determinants of health. Quantitative data were analyzed using descriptive statistics, multiple correspondence analysis, cluster analysis and correlation tests. Qualitative data were analyzed through content analysis and the creation of thematic categories. RESULTS: Despite the concentration of activities directed at disease care, the Family Health Care Program carries out various activities related to the social determination of health, encompassing the entire spectrum of health promotion approaches (biological, behavioral, psychological, social and structural) and all major social determinants of health described in the literature. There was a significant difference related to the scope of the determinants being worked on in the units according to the area of the city. The description of the activities revealed the fragility of the initiatives and a disconnection with the organizational structure of the Family Health Care Program. CONCLUSIONS: The quantity and variety of initiatives related to social determinants of health attests to the program's potential to deal with the social determination of health. On the other hand, the fluidity of objectives and the 'out of the ordinary/extraordinary' characterization of the described initiatives raises concern about its sustainability as an integral part of the program's current operational model. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Violence is considered a serious public health problem, expressed in several ways and different contexts. In this study, children abuse was highlighted, considering the vulnerability and damage to the health of these individuals. This study aimed to know the role played by nurses at Family Health Units regarding intrafamiliar violence against children in a city in the state of Bahia, Brazil. The approach is qualitative and data were collected through semi-structured interviews. The thematic content analysis was used, resulting in four central themes: "Child abuse: a problem of management?"; "Management and care (inter)acting against violence"; "What was done and what needs to be done in care" and "The 'thousand and none' difficulties". The (in)visibility of child abuse influences the performance of nurses; the unpreparedness of these professionals and their lack of understanding of violence and, consequently, of confrontation, were also identified. [ABSTRACT FROM AUTHOR]