Integralidade, formação de saúde, educação em saúde e as propostas do SUS -uma revisão conceitualIntegrality, health professional education, health education and SUS proposals -a conceptual review

In the search for new ways to better reflect on the nursing appointments as an opportunity for prenatal health education, we performed a reflexive study with a qualitative evaluation in which subject participation was a predominant factor. To this end, we used a new paradigm as a methodological reference - the emancipative evaluation that oriented this research and described reality. Besides non-participative observation, we used the interviews with the five nurses who work at the outpatient ward of the University Hospital - chosen site for the research - for data collection. In light of the results found, the educational action accomplished by the nurse during prenatal consultation is characterized as a routine action, with little participation, mainly informative, in spite of the good intention to educate, during which issues regarding the Institution's care, structural and organizational models emerged as obstacles for the accomplishment of education in health as a liberating, transforming and critical-social trend. The research points toward reorienting nursing prenatal care, creating an appropriate physical environment for the nursing consultation and participation of pregnant women in groups.

BackgroundInterventions on adolescents’ lifestyle are important, but the main mechanisms that explain the changes (mediating variables) on lifestyle are unclear. This paper presents the rationale and methods of an intervention program focused on promoting active and healthy lifestyles (especially physical activity [PA] practice and reducing screen time) among Brazilian students-the Fortaleça sua Saúde program (Portuguese for “strengthen your health”).Methods/DesignThis is a school-based cluster-randomized controlled trial. Three intervention and three control (no intervention) full-time public schools were randomly selected in Fortaleza, northeastern Brazil. Students (n = 1,272) from classes in Grades 7–9 were eligible, and 1,085 (548 in the intervention and 537 in control schools) completed the baseline and follow-up measures. The program duration was approximately four months and took place in 2014. Intervention strategies focused on teacher training, activities on health in the curriculum, active opportunities in the school environment (the availability of equipment for PA), and health education (health materials for students and parents). Data collection was undertaken before and immediately after the intervention. The primary variables included the practice of PA (weekly PA volume, PA behavior change stage and preference for PA during leisure-time) and screen time (TV and computer/video games). Potential intrapersonal, interpersonal and environmental mediators of PA and screen time were evaluated by a standardized questionnaire. Other lifestyle components (e.g., eating habits, substance use), psychological (e.g., self-rated health, body satisfaction) and biological (general and abdominal obesity) aspects, as well as academic performance were also evaluated in the total sample. Depressive symptoms, eating disorders, sleep quality, objectively-measured PA, and sedentary time were evaluated in obese students.DiscussionIf effective, this program will contribute to the development of public policies for the promotion of active and healthy lifestyles in youth, especially those from low- and middle-income countries. The main intrapersonal, interpersonal and/or environmental mediators of PA and screen time may also be indicated. Finally, we anticipate that the proposed strategies may be adaptable to public schools and may even be extended to the entire school system.Trial registrationClinicalTrials.Gov: NCT02439827. Registration date: May 3, 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2543-2) contains supplementary material, which is available to authorized users.

O objetivo do trabalho foi descrever o trabalho de promoção da saúde desenvolvido por uma escola de educação infantil que incorpora princípios de promoção da saúde em sua prática pedagógica, investigando seis sujeitos que vivenciaram o processo. A aproximação da realidade deu-se por meio de entrevista semi-estruturada e observação, emergindo categorias empíricas dos discursos, revelando: 1. o cuidado como elemento promotor de saúde; 2. formação de hábitos higiênicos com base na educação; 3. promoção da saúde por meio da pedagogia de projetos, e 4. estabelecimento de vínculo entre profissionais de saúde e alunos. Concluiu-se pela necessidade de se realizar um trabalho sistemático de formação com pedagogos e profissionais de saúde, para que compreendam a importância da efetivação de uma prática interligada e presente da educação em saúde nos diversos âmbitos de atuação da escola.

Compreensão das mudanças comportamentais do usuário no Programa Saúde da Família por meio da participação habilitadoraUnderstanding the user´s health behavior change through their participation in the Family Health Program

Objective: understand the perceptions of adolescent students regarding the use of Facebook social media in sexual and reproductive health learning in the Family Health Strategy. Method: a qualitative, descriptive study developed with 96 adolescents from a public school and a private school in Fortaleza-CE who concluded an educational intervention using Facebook. The information was collected in the online environment itself, as well as in a questionnaire applied in person. For the collection and analysis of this information, netnography was used. Results: Facebook contributed to the sexual and reproductive health education in an interactive, playful and practical way, reducing the embarrassment of some adolescents to converse on the subject, and brought adolescents closer to the health service, by strengthening their bond with Health professionals. Final considerations: health professionals should recognize that such virtual spaces on the Internet offer potential for the production of health care, especially among adolescents. Descriptors: Nursing; Family Health Strategy; Health Education; Adolescent Health; Sexual Health. RESUMO Objetivo: compreender as percepções de adolescentes escolares acerca do uso da mídia social Facebook na aprendizagem em saúde sexual e reprodutiva, na Estratégia Saúde da Família. Método: estudo qualitativo, descritivo, desenvolvido com 96 adolescentes de uma escola pública e outra particular de Fortaleza-CE que concluíram uma intervenção educativa mediada pelo Facebook. As informações foram coletadas no próprio ambiente on-line, bem como em um questionário aplicado presencialmente. Para coleta e análise dessas informações, utilizou-se a netnografi a. Resultados: o Facebook contribuiu para o aprendizado em saúde sexual e reprodutiva, de maneira interativa, lúdica e prática, amenizando a vergonha de alguns adolescentes para dialogar sobre a temática, e aproximou os adolescentes do serviço de saúde, mediante o fortalecimento do vínculo com os profi ssionais de saúde. Considerações fi nais: os profi ssionais de saúde devem reconhecer que esses espaços virtuais na Internet podem ser territórios de produção do cuidado em saúde, especialmente com adolescentes. Descritores: Enfermagem; Estratégia Saúde da Família; Educação em Saúde; Saúde do Adolescente; Saúde Sexual. RESUMENObjetivo: comprender las percepciones de adolescentes en edad escolar acerca del uso del medio de comunicación social Facebook en el aprendizaje en salud sexual y reproductiva, en la Estrategia Salud de la Familia. Método: estudio cualitativo, descriptivo, desarrollado con 96 adolescentes de una escuela pública y otra particular de Fortaleza-CE que concluyeron una intervención educativa mediada por Facebook. Las informaciones fueron colectadas en el propio ambiente on-line, bien como en un cuestionario aplicado presencialmente. Para colecta y análisis de esas informaciones, se utilizó la netnografi a. Resultados: Facebook contribuyó para el aprendizaje en salud sexual y reproductiva, de manera interactiva, lúdica ...

Objectives First, to examine the potential value of maternal ophthalmic artery Doppler at 35–37 weeks' gestation in the prediction of subsequent development of pre‐eclampsia (PE), and, second, to examine the variability between repeat measurements in the same eye and variability in measurements between the two eyes. Methods This was a prospective observational study in women attending for a routine hospital visit at 35 + 0 to 36 + 6 weeks' gestation. The visit included recording of maternal demographic characteristics and medical history and assessment of flow velocity waveforms from the maternal ophthalmic artery. Waveforms were obtained in sequence from the right eye, left eye and again from the right and then left eye. We recorded the average of the four measurements, two from each eye, for the following four indices: first peak of systolic velocity; second peak of systolic velocity; pulsatility index; and the ratio of the second to first peak of systolic velocity (PSV ratio). The measurements of the four indices were standardized to remove the effects of maternal characteristics and elements from the medical history. The competing‐risks model was used to determine the detection rate (DR) of delivery with PE at any time and at < 3 weeks after assessment, at a 10% false‐positive rate (FPR), in screening by maternal factors alone and a combination of maternal factors and the adjusted value of each of the four ophthalmic artery indices. Results The study population of 2287 pregnancies contained 60 (2.6%) that developed PE, including 19 (0.8%) that delivered with PE at < 3 weeks after assessment. The DR, at 10% FPR, of delivery with PE at any time after assessment by maternal factors was 25.0% (95% CI, 14.7–37.9%), and this increased by 25 percentage points to 50.0% (95% CI, 36.8–63.2%) with the addition of the adjusted PSV ratio (P = 0.005); the respective values for delivery with PE at < 3 weeks after assessment were 31.6% (95% CI, 12.6–56.6%) and 57.9% (95% CI, 33.5–79.8%). The other ophthalmic artery indices did not improve the prediction provided by maternal factors alone. There was good correlation between the first and second measurements of PSV ratio from the same eye (right eye r = 0.823, left eye r = 0.840), but poorer correlation in the first and second measurements between the two eyes (first measurement r = 0.690, second measurement r = 0.682). In screening by maternal factors and PSV ratio for PE with delivery at any stage after assessment, the estimated DR, at 10% FPR, was 50.0% when the average of four measurements was used (two from each eye), 49.1% when the average of one measurement from each eye was used, 47.3% when the average of two measurements from the same eye was used, and 45.8% when only one measurement was used. Conclusions Ophthalmic artery PSV ratio at 35–37 weeks' gestation can predict subsequent delivery with PE, especially if this occurs within 3 weeks after assessment. In the assessment of ophthalmic artery Doppler, it is necessary to use the average of one measurement fr...

O objetivo deste estudo é abordar o uso de tecnologias educativas como estratégia de educação em saúde junto a adolescentes no contexto escolar. A coleta de dados ocorreu entre abril e maio de 2007 em uma escola pública municipal na cidade de Fortaleza-CE, por meio de um ciclo de quatro oficinas educativas realizadas com 30 adolescentes. As oficinas tiveram o intuito promover a reflexão/ação junto aos participantes sobre as temáticas: sexualidade, gênero, DST/AIDS e métodos contraceptivos. Estudo do tipo pesquisa-ação, de abordagem qualitativa, apoiado no Modelo Pedagógico de Paulo Freire. Os resultados evidenciaram lacunas no conhecimento quanto às formas de infecção pelas DST e uso adequado de métodos contraceptivos. Outro dado refere-se às questões de gênero que parecem influenciar na qualidade de vida dos jovens do estudo. O uso de tecnologias educativas pôde despertar entre os adolescentes, um repensar sobre a vivência da saúde sexual e reprodutiva a partir das vulnerabilidades percebidas. Recomendamos a partir dos achados, que as atividades de prevenção às DST/AIDS no âmbito da escola, rompam com a visão heterossexista, normativa e biologicista. Nesse contexto, a Enfermeira deve produzir/readequar novas tecnologias educativas que favoreçam o processo educação em saúde, valorizando as habilidades e aspirações dos adolescentes.