Objective to present a critical reflection upon the current and different interpretative models of the Social Determinants of Health and inequalities hindering access and the right to health. Method theoretical study using critical hermeneutics to acquire reconstructive understanding based on a dialectical relationship between the explanation and understanding of interpretative models of the social determinants of health and inequalities. Results interpretative models concerning the topic under study are classified. Three generations of interpretative models of the social determinants of health were identified and historically contextualized. The third and current generation presents a historical synthesis of the previous generations, including: neo-materialist theory, psychosocial theory, the theory of social capital, cultural-behavioral theory and the life course theory. Conclusion From dialectical reflection and social criticism emerge a discussion concerning the complementarity of the models of the social determinants of health and the need for a more comprehensive conception of the determinants to guide inter-sector actions to eradicate inequalities that hinder access to health.
Objective: To analyze the life condition of families in social vulnerability and their potential relation with well being, mental health and the participation and school performance of children and adolescents. Method: Mixed-method study which used a sociodemographic questionnaire, narrated body maps and semi-structured interviews for data collection. Data was collected at one of the units of the Services for Coexistence and Strengthening of Bonds of the Secretary of Social Assistance of the city of Ribeirão Preto. The children and adolescents attending the service, their teachers, family members and the local coordinator participated in the study. Quantitative statistical analysis was performed with IBM SPSS Statistic version 24.0 program, qualitative assessment was performed through content analysis. Results: It was possible through the interviews and the physical maps to identify emotional suffering on the part of the children and adolescents, however, great difficulty in the perception of such state was noticed, which does not receive due attention from parents and teachers. The study also shows the impairment in the educational performance of children and adolescents due to factors mainly related to the culture of exclusion, lack of family encouragement, and the lack of preparation both from school and teachers to work with such population and their reality. Conclusion: There is a need for greater attention to vulnerable social groups through the formulation and implementation of public policies, social development programs and effective actions by the State and civil society.
Objective: to identify the evidence about the repercussion of intersectoral programs / actions / strategies in the reduction of social inequities experienced by children and adolescents in social vulnerability. Method: integrative review performed in the following databases: National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Latin-American and Caribbean Health Sciences Literature, Web of Science, Scopus, and Scientific Electronic Library Online. Primary studies published between 2005 and 2019, written in English, Portuguese, or Spanish, were included. The Rayyan tool was used during selection. The sample was composed of 27 studies, and Ursi was used to extract data. The studies’ methodological quality was verified with the Mixed Methods Appraisal Tool, and descriptive statistics were used. Results: the main results show that intersectoral actions resulted in improved access to health, improved child nutrition indicators, better mental health care, the adoption of a healthy lifestyle, and improved quality of life. Conclusion: significant advancements found in the development and lives of children and adolescents are assigned to intersectoral actions. The studies report that different strategies were used in different regions worldwide and contributed to improved children’s and adolescents’ quality of life, supporting new intersectoral policies.
Objective: to analyze Therapeutic Follow-Up (TF) and Network Intervention (NI) as devices for social network/Psychosocial Care Center (CAPS - Centro de Atenção Psicossocial) user staff construction. Method: an ethnographic study. Data collection instruments were participant observation, field diary, semi-structured interviews and Sluzki’s Minimal Map of Relationships. The research site was at a CAPS II of the city of São Paulo. Participants were CAPS user, their family network, professionals and other users. Data analysis took place through Minayo’s thematic content analysis framework and Sluzki’s personal maps. Results: TF and NI led to greater social participation, autonomy and reorganization of family roles and treatment in CAPS. Conclusion: the TF associated with NI was potent in strengthening the user’s personal/social network and in including them in community activities.
Objetivo: identificar o impacto das desigualdades sociais na cadeia de progressão da tuberculose no Brasil visando à identificação dos nós críticos à eliminação da doença. Método: realizada revisão de literatura dos artigos disponíveis nas bases de dados Cummulative Index to Nursing and Allied Health Literature, Literatura Internacional em Ciências da Saúde e Literatura Latino-Americana e do Caribe em Ciências da Saúde, nos idiomas português, inglês e espanhol. Como critério de inclusão, selecionou-se artigos publicados na íntegra cujo cenário de investigação é o Brasil, no período de 2005 a 2015. Utilizou-se os descritores do Medical Subject Headings, de acordo com as combinações: Access or accessibility and Tuberculosis; social determinants of health and tuberculosis; social vulnerability and tuberculosis; social inequity or social inequality and tuberculosis. A análise dos estudos selecionados pautou-se no referencial de Melnyk, Fineout-Overholt por meio da análise da qualidade do nível de evidência científica dos artigos selecionados com base na Classificação dos Níveis de Evidências Científicas. Resultados: foram analisados 45 artigos, os quais mostraram os principais determinantes sociais da saúde que representam barreiras à meta End TB, sendo eles: as condições econômicas, seguida pela acessibilidade a serviços, violação de direitos e estilos de vida, fatores estes que impactam na cadeia de progressão da tuberculose. Conclusão: desigualdades sociais são barreiras consideráveis à eliminação da doença, portanto intervenções de amplo espectro devem ser consideradas. Os desafios à sociedade brasileira ainda são substanciais e devem envolver para além do setor da saúde, os setores ligados à gestão pública nas várias esferas governamentais. Palavras-chave: Tuberculose; Determinantes Sociais; Vulnerabilidade Social; Desigualdade Social; Iniquidade Social.
À minha família, em especial, Carlos, Thais e Tiê, por serem apoio, cuidado e motivação de todo dia; Nelson e Maria do Rosário, por serem escuta, incentivo e suporte sempre que necessário. Ao Haroldo, por ser força e leveza nessa caminhada e à sua família, pela generosidade e carinho. À Daniela, por me acompanhar nessa jornada, me lembrando o tempo todo das minhas capacidades e potencialidades e me ajudando a partilhar e contar com o outro. À Prof a. Dr a. Regina Célia Fiorati, pela parceria, confiança, paciência e todo o aprendizado.
RESUMOObjetivo: investigar ações intersetoriais voltadas ao enfrentamento das iniquidades sociais, em nível de Atenção Primária à Saúde, desenvolvidas com vistas à redução das desigualdades em saúde no Brasil. Método: revisão sistemática com busca nas Bases de dados LILACS e MEDLINE. Utilizaram-se, como critérios de elegibilidade, pesquisas desenvolvidas no Brasil, de 2005 a 2015, em português, inglês ou espanhol, com, pelo menos, um descritor em título ou resumo. Para a análise dos dados, utilizaram-se os referenciais teóricos, as variáveis ação intersetorial governamental e ação intersetorial com participação social e o Guia de Diretrizes PRISMA. Resultados: 40% dos estudos trataram sobre ações intersetoriais de nível governamental envolvendo iniciativas do governo federal; 20%, de ações intersetoriais locais envolvendo a sociedade civil; 40%, dos dois tipos; 40%, baseados no referencial da Organização Mundial da Saúde; 20%, no referencial do Capital Social; 20%, nos referenciais da Organização Mundial da Saúde e Curso da Vida e 20%, nos referenciais da Organização Mundial da Saúde e do Capital Social. Conclusão: políticas intersetoriais, em conjunto com a sociedade, aumentam as possibilidades de concretização de equidade social no Brasil. Descritores: Atenção Primária à Saúde; Iniquidade Social; Determinantes Sociais da Saúde; Ação Intersetorial; Políticas Públicas; Equidade em Saúde.ABSTRACT Objective: to investigate intersectoral actions aimed at confronting social inequities, in the level of Primary Health Care, developed with a view to reducing health inequalities in Brazil. Method: systematic review with search in LILACS and MEDLINE databases. As eligibility criteria, research developed in Brazil, from 2005 to 2015, in Portuguese, English or Spanish, with at least one title or summary descriptor was used. For the data analysis, the theoretical references, the variables governmental intersectorial action and intersectorial action with social participation and the PRISMA Guidelines Guide were used. Results: 40% of the studies dealt with intersectorial actions of governmental level involving initiatives of the federal government; 20%, of local intersectoral actions involving civil society; 40% of the two types; 40%, based on the World Health Organization's benchmark; 20%, in the reference of the Capital Stock; 20% in the World Health Organization and Lifetime referral guidelines and 20% in the World Health Organization and Social Capital benchmarks. Conclusion: intersectorial policies, together with society, increase the possibilities of achieving social equity in Brazil. Descriptors: Primary Health Care; Social Inequity; Social Determinants of Health; Intersectoral Action; Public Policies; Health Equity.RESUMEN Objetivo: investigar acciones intersectoriales dirigidas al enfrentamiento de las inequidades sociales, a nivel de Atención Primaria a la Salud, desarrolladas con vistas a la reducción de las desigualdades en salud en Brasil. Método: revisión sistemática con búsqueda en las Bases de datos LILACS y MEDLINE. Fueron utilizados, como criterio de elegibilidad, de investigación desarrollado en Brasil, desde 2005 hasta 2015, en portugués, inglés o español, con, al menos, un descriptor en el título o en el resumen. Para el análisis de los datos se utilizaron los referenciales teóricos, las variables acción intersectorial gubernamental y acción intersectorial con participación social y el Guía de Directrices PRISMA. Resultados: 40% de los estudios trataron sobre acciones intersectoriales de nivel gubernamental involucrando iniciativas del gobierno federal; 20%, de acciones intersectoriales locales involucrando a la sociedad civil; el 40% de los dos tipos; El 40%, basado en el referencial de la Organización Mundial de la Salud; el 20%, en el referencial del Capital Social; y el 20%, en los referenciales de la Organización Mundial de la Salud y el Curso de la Vida y el 20%, en los referentes de la Organización Mundial de la Salud y del Capital Social. Conclusión: políticas intersectoriales, en conjunto con la sociedad, aumentan las posibilidades de concreción de equidad social en Brasil. Descriptores: Atención Primaria a la Salud; Iniquidad Social; Determinantes Sociales de la Salud; Acción Intersectorial; Políticas Públicas; Equidad em Salud.
Trata-se de uma revisão integrativa realizada nos meses de agosto e setembro de 2019, com os artigos publicados entre os anos de 2009 e 2019, a partir das bases de dados: LILACS, CINAHL, PSYCINFO, PUBMED, SCOPUS, WEB OF SCIENCE e EMBASE, com objetivo de identificar e analisar as evidências existentes sobre a utilização da auriculoterapia no cuidado em saúde mental. Considerou-se os descritores: auriculotherapy; ear acupuncture; auricular acupuncture and mental health; depression; e anxiety. Dos 533 artigos encontrados, 34 foram incluídos e deram origem a seis categorias: Auriculoterapia no cuidado às manifestações ansiosas; Auriculoterapia no cuidado às manifestações depressivas; Auriculoterapia no alívio do estresse; Auriculoterapia no cuidado do uso e abuso de substâncias psicoativas; Auriculoterapia no cuidado nas alterações do sono; e Auriculoterapia no cuidado às manifestações psíquicas associadas a questões orgânicas. A auriculoterapia mostrou-se um recurso promissor para manifestações ansiosas, depressivas e no alívio do estresse. Entretanto, para os casos de insônia e dependência de substâncias psicoativas, os resultados foram inconclusivos, tornando-se necessários mais estudos nessas temáticas.
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