"Somos a terra lutando para sobreviver": histórias de vida de mulheres agroecologistas / "We are the earth struggling to survive": life stories of female agroecologists / "Somos la tierra luchando por sobrevivir": historias de vida de mujeres agroecólogas

A luta pela terra e seu uso incide na forma como as subjetividades têm sido produzidas no Brasil. No contexto capitalista, patriarcal e machista, vive-se um processo de exploração da mão de obra de mulheres e de recursos naturais da Terra. Este estudo objetivou conhecer histórias de vida de mulheres agricultoras rurais que participam de movimentos sociais agroecológicos no Rio Grande do Sul. Participaram do estudo três mulheres agricultoras, com idades entre 21 e 53 anos, residentes e trabalhadoras em zonas rurais das cidades de Viamão e Rolante, escolhidas por conveniência. Os instrumentos utilizados foram: questionário sociodemográfico, entrevista de história de vida e observação participante, os quais foram, posteriormente, submetidos à análise temática. Os resultados demonstram que as histórias de vida das mulheres relatadas são marcadas por lutas e formas de resistência. Para além das situações de conflitos e falta de recursos, avistam-se questões próprias de gênero, como a invisibilidade feminina e a desigualdade no acesso à terra por mulheres. A construção de base e o fortalecimento do papel político das mulheres nos movimentos sociais permite inferir que existem melhorias significativas nas desigualdades e injustiças no meio rural. Contudo, pontua-se a necessidade de se promover o diálogo entre os movimentos sociais, as mulheres e a sociedade política sobre os modelos atuais de políticas públicas existentes, possibilitando, assim, avançar nas discussões a respeito da promoção da equidade de gênero nos espaços rurais, bem como potencializar o avanço das práticas agroecológicas em direção à superação do capitalismo.(AU)

The struggle for land and its use affects the way subjectivities have been produced in Brazil. In the capitalist, patriarchal, and male-chauvinist context, women's labor and the Earth's natural resources are strongly exploited. This study aimed to know the life stories of female farmers who participate in agroecological social movements in the state of Rio Grande do Sul. Three female farmers, aged from 21 to 53, residents and workers in rural areas of the municipalities of Viamão and Rolante, chosen by convenience, participated in the study. The instruments used were: sociodemographic questionnaire, a life story interview, and participant observation, which were later subjected to thematic analysis. The results show that the participants' life stories are marked by struggles and means of resistance. In addition to conflicts and lack of resources, there are specific gender issues, such as female invisibility and inequality in women's access to land. The grassroots construction and the strengthening of the political role of women in social movements allow us to infer that there are significant improvements in inequalities and injustices in rural areas. However, it is necessary to promote dialogue between social movements, women, and political society about the current models of existing public policies, thus making it possible to advance in discussions about gender equity in rural spaces, as well as to enhance the advancement of agroecological practices to overcoming capitalism.(AU)

La lucha por la tierra y su uso afecta a la forma en que se han producido las subjetividades en Brasil. En el contexto capitalista, patriarcal y machista, hay un proceso de explotación del trabajo de las mujeres y de los recursos naturales de la tierra. Este estudio tuvo como objetivo conocer las historias de vida de agricultoras rurales que participan en movimientos sociales agroecológicos en Rio Grande do Sul (Brasil). Participaron en el estudio tres agricultoras, de entre 21 y 53 años, residentes y trabajadoras en áreas rurales de las ciudades de Viamão y Rolante, elegidas por conveniencia. Los instrumentos utilizados fueron: cuestionario sociodemográfico, entrevista de historia de vida y observación participante, cuyos datos posteriormente se sometieron a análisis temático. Los resultados muestran que las historias de vida de las mujeres relatadas están marcadas por luchas y formas de resistencia. A las situaciones de conflicto y falta de recursos se suman cuestiones específicas de género, como la invisibilidad femenina y la desigualdad en el acceso de las mujeres a la tierra. La construcción popular y el fortalecimiento del papel político de las mujeres en los movimientos sociales permiten inferir que hay mejoras significativas en las desigualdades e injusticias en las zonas rurales. Sin embargo, es necesario promover el diálogo entre los movimientos sociales, las mujeres y la sociedad sobre los modelos actuales de las políticas públicas existentes, para posibilitar avances en las discusiones sobre la promoción de la equidad de género en los espacios rurales y potenciar el avance de las prácticas agroecológicas hacia la superación del capitalismo.(AU)

Violência contra a pessoa idosa no contexto rural em tempos de COVID-19: velhas e novas emergências / Violencia contra los adultos mayores en el contexto rural en tiempos de COVID-19: viejas y nuevas emergencias / Elder abuse in the rural context in times of COVID-19: old and new emergencies

RESUMO Objetivo ampliar o debate sobre os fatores presentes no cotidiano da população idosa rural do Brasil, que contribuem para o aumento da violência contra a pessoa idosa (VCPI) na pandemia. Método estudo teórico-reflexivo, que apresenta como referenciais a Política Nacional de Saúde Integral das Populações do Campo e da Floresta e a Teoria da Vulnerabilidade, proposta por Ayres, que buscam compreender a exposição dos indivíduos a desfechos agravantes à saúde. O desenvolvimento se pautou na literatura nacional e internacional, e foi organizado pelo eixo condutor "as vulnerabilidades, redes formais e informais de proteção contra VCPI: reflexões em tempos de pandemia de COVID-19 em contexto de ruralidades". Resultados o distanciamento social necessário para a mitigação da pandemia de COVID-19 pode estar impactando negativamente os idosos da zona rural a enfrentarem a VCPI. Acredita-se que o conjunto de estratégias das redes formais e informais não tem atingido adequadamente as necessidades dos idosos da área rural. Considerações finais e implicações para a prática é de fundamental importância que, em meio à pandemia do coronavírus, haja implantação de estratégias para a manutenção e ampliação dos equipamentos sociais da rede formal e informal de proteção contra VCPI, levando em consideração as necessidades da área rural.

RESUMEN Objetivo ampliar el debate sobre los factores presentes en el cotidiano de la población anciana rural en Brasil, que contribuyen al aumento de la violencia contra los ancianos (VCA) en la pandemia. Método estudio teórico-reflexivo que presenta como referencias la Política Nacional de Salud Integral de las Poblaciones Rurales y Forestales y la Teoría de la Vulnerabilidad, propuesta por Ayres, que buscan comprender la exposición de los individuos a resultados agravantes de salud. El desarrollo se basó en la literatura nacional e internacional, y fue organizado por el eje rector "las vulnerabilidades, redes formales e informales de protección a las VCA: reflexiones en tiempos de la pandemia del COVID-19 en el contexto de las ruralidades". Resultados el distanciamiento social necesario para mitigar la pandemia de COVID-19 puede estar impactando negativamente a las personas mayores rurales que enfrentan la VCA. Se cree que el conjunto de estrategias de las redes formales e informales no han atendido adecuadamente las necesidades de los adultos mayores en las zonas rurales. Consideraciones finales e implicaciones para la práctica es de fundamental importancia que, en medio de la pandemia del coronavirus, se implementen estrategias para el mantenimiento y ampliación de los equipamientos sociales en la red formal e informal de protección contra la VCA, teniendo en cuenta las necesidades de la zona rural.

ABSTRACT Objective to expand the debate on factors present in the daily life of rural older adults in Brazil, which contribute to the increase in elder abuse (EA) in the pandemic. Method a theoretical-reflective study, which presents the Brazilian National Comprehensive Health Policy for Rural and Forest Populations and the Vulnerability Theory as frameworks, proposed by Ayres, that seek to understand the exposure of individuals to aggravating health outcomes. The development was based on national and international literature, and was organized by the guiding axis "vulnerabilities, formal and informal networks of protection against EA: reflections in times of the COVID-19 pandemic in a context of rurality". Results the social distancing necessary for mitigating the COVID-19 pandemic may be negatively impacting rural older adults facing EA. It is believed that the set of strategies of formal and informal networks has not adequately met older adults' needs in rural areas. Final considerations and implications for practice it is of fundamental importance that, amidst the coronavirus pandemic, strategies are implemented for maintenance and expansion of the formal and informal network social equipment of protection against EA, taking into account rural people's needs.

Influence of family smoking on children’s exposure to second-hand smoke in rural Taizhou City / 上海预防医学

Objective:To analyze the household smoking behavior of smokers in rural Taizhou City of Zhejiang Province， and to provide the basis for the intervention measures to reduce children's second-hand smoke （SHS） exposure. Methods:The investigation started in May 2018. A total of 418 smoking families in Luqiao and Linhai were included. Field face-to-face questionnaire survey was conducted and cotinine level in children's urine was measured. Kernel density estimation was used for curve fitting. The results were analyzed by Wilcoxon rank sum test and chi square test. Results:The age distribution of smokers in the family was bimodal. The younger smoker group was mainly the parents. The older group was mainly the other relatives such as grandfather. The age started smoking in the parent group was younger than that in relative group， but the average number of cigarettes smoked per day in relative group was higher than that in parent group （P<0.05）. The parent group had higher proportion than the relative group in having family smoking regulations or agreeing not to smoke in the room in the presence of children （P<0.001）.The proportion of the parent group who has heard about third hand smoke and electronic cigarette was higher than that of the relative group （P<0.001）.The detection rates of cotinine in urine of children were 91.05% and 86.96% in parent group and relative group， respectively. The urine cotinine level of the children in the parent group was higher than that in the grandfather group （P=0.049）. Conclusion:Children are more exposed to SHS when the smoker in the household are parents. In order to reduce children's SHS exposure， we should pay more attention to educate the parents with a family based tobacco control program.

Iniciativas de organização comunitária e Covid-19: esboços para uma vigilância popular da saúde e do ambiente / Communitary organization initiatives and COVID-19: sketches for popular surveillance of health and environment / Iniciativas de organización comunitaria y COVID-19: esbozos para la vigilancia popular de la salud y del ambiente

Resumo O contexto da pandemia da Covid-19 está relacionado à interação dos seres humanos com a natureza, na medida em que invadimos e destruímos nichos ecológicos importantes, criando modelos de produção animal e de trocas comerciais não sustentáveis. Lavar as mãos é uma das ações mais eficazes de prevenção à Covid-19. Mas como seguir este procedimento onde a água não é garantida com a frequência necessária? Outro aspecto importante da vigilância é a exposição crônica à contaminação do ar, favorecendo as altas taxas de mortalidade pela Covid-19. As populações do campo, da floresta e das águas são também um dos grupos mais vulneráveis e, ao mesmo tempo, possuem modos de vida determinantes para a sustentabilidade socioambiental do planeta. Gabinetes de crise, comitês populares, articulações solidárias, plataformas, observatórios acadêmico-populares, barreiras sanitárias populares, portais na internet de monitoramento participativo são algumas das formas que, espontaneamente, têm surgido nas favelas e nos territórios de povos tradicionais para dar conta de enfrentar a Covid-19, dada a ausência de políticas efetivas, principalmente no âmbito federal. Temos que criar métodos, estratégias e iniciativas que possibilitem que a vigilância sobre a saúde e o ambiente possa contribuir para resolver problemas e necessidades de forma horizontal, participativa, democrática e cientificamente qualificada.

Abstract The COVID-19 pandemic context is related to the interaction of human beings with the environment, as we invade and destroy important ecological niches, creating unsustainable models of animal production and trade. Washing your hands is one of the most effective actions to prevent COVID-19. But how to follow this procedure where water is not guaranteed as often as necessary? Another important aspect of surveillance is chronic exposure to air contamination, favoring high mortality rates from COVID-19. The populations of the countryside, the forest and the waters are also one of the most vulnerable groups and, at the same time, have ways of life that are decisive for the socio-environmental sustainability of the planet. Crisis offices, popular committees, solidarity articulations, platforms, academic-popular observatories, popular health barriers, internet portals for participatory monitoring are some of the ways that, spontaneously, have emerged in the favelas and in the territories of traditional peoples to cope with facing COVID-19, given the absence of effective policies, mainly at the federal level. We have to create methods, strategies and initiatives that enable health and environmental surveillance to contribute to solving problems and needs in a horizontal, participatory, democratic and scientifically qualified way.

Resumen El contexto de la pandemia del COVID-19 está relacionado a la interacción de los seres humanos con la naturaleza, en la medida en que invadimos y destruimos nichos ecológicos importantes, creando modelos de producción animal y de intercambio comercial que no son sustentables. Lavarse las manos es una de las acciones más eficaces de prevención al COVID-19. Pero, ¿cómo seguir este procedimiento donde el agua no está garantizada con la frecuencia debida? Otro aspecto importante de la vigilancia es la exposición crónica a la contaminación del aire, que favorece a las altas tasas de mortalidad por COVID-19. Los pobladores del campo, de los bosques y de las orillas de las aguas también son de los grupos más vulnerables y, al mismo tiempo, tienen modos de vida determinantes para la sustentabilidad socioambiental del planeta. Gabinetes de crisis, comités populares, articulaciones solidarias, plataformas, observatorios académico populares, barreras sanitarias populares, portales en la internet de monitoramiento participativo son algunas de las formas que, espontáneamente, han surgido en las favelas y en los territorios de los pueblos tradicionales para intentar enfrentar al COVID-19, dada la ausencia de políticas efectivas, principalmente en el ámbito federal. Tenemos que crear métodos, estrategias e iniciativas que posibiliten que la vigilancia sobre la salud y el ambiente pueda contribuir para resolver problemas y necesidades de forma horizontal, participativa, democrática y científicamente calificada.

Transtornos mentais comuns em mulheres de cidades rurais: prevalência e variáveis correlatas / Common mental disorders in females from rural towns: prevalence and co-related variables

Analisar a prevalência dos Transtornos Mentais Comuns (TMC) em mulheres residentes em cidades rurais do Estado da Paraíba/Brasil e a associação dos TMC com os aspectos socioeconômicos, vivência de violência doméstica e cuidados em saúde mental. Participaram 608 mulheres entre 18 e 83 anos de idade (43 ± 14,640). Utilizou-se um questionário sociodemográfico e o Self-Reporting Questionnaire-20. Os dados foram analisados através de análises estatísticas descritivas e bivariadas. A prevalência de TMC foi de 31,6%, com maior índice em mulheres acima dos 50 anos, separadas/divorciadas, com baixa escolaridade e renda. As variáveis preditoras para o TMC foram: ser vítima de violência doméstica, vivência de situação estressora; e a inter-relação entre variáveis como ter mais de 50 anos, ter antecedentes familiares com sofrimento psíquico e renda entre um e dois salários mínimos. Elementos socioculturais significativos no que tange à saúde mental ligados às relações de gênero predizem o aparecimento de TMC nesta população

Current analysis deals with the prevalence of Common Mental Disorders (CMD) in females living in rural towns in the state of Paraíba, Brazil, and the association of CMDs with socio-economic factors, experience in domestic violence and mental health care. Six hundred and eight females, aged between 18 and 83 years (43 ± 14.640) participated. The sociodemographic questionnaire and the Self-Reporting Questionnaire-20 were used. Data were assessed by descriptive and bivariate statistical analysis. CMD prevalence reached 31.6%, with highest rates in females over 50 years old, divorced, low schooling and low income. Predictor variables for CMDs were: victim of domestic violence, experience of stressing conditions, and inter-relation between variables comprised people over 50 years old, family antecedents of psychic sufferings and income between one or two minimum wages. Significant sociocultural factors with regard to mental health linked to gender predict CMD in the population

Evolução, distribuição e expansão dos cursos de medicina no brasil (1808-2018) / Evolution, distribution and expansion of medicine courses in brazil (1808-2018)

Resumo O estudo identificou o padrão de evolução, distribuição e expansão dos cursos de medicina no Brasil e descreveu os processos governamentais relacionados à ampliação da oferta de vagas. Trata-se de estudo descritivo, baseado em dados disponíveis no sistema do Ministério da Educação sobre escolas médicas. Com as informações sobre os cursos, desde os primeiros implantados, estabelecem-se seis períodos de governo para análise: de 1808 a 1963 (monarquia e governos republicanos iniciais), de 1964 a 1988 (governos militares - José Sarney), de 1989 a 1994 (Fernando Collor - Itamar Franco), de 1995 a 2002 (Fernando Henrique Cardoso), de 2003 a 2010 (Lula) e 2011 a 2018 (Dilma Rousseff - Michel Temer). Observou-se relevante expansão de escolas a partir dos governos militares, com pico em 2014 (Dilma Rousseff), frente à implementação do Programa Mais Médicos. Ao longo dos períodos analisados, o ensino médico tornou-se progressivamente privatizado e parcialmente deslocado para as Regiões Norte, Nordeste e Centro-Oeste e para cidades de médio e pequeno portes populacionais no interior dos estados. Os resultados apontam que a combinação de gestão governamental das políticas de saúde e educação e de desenvolvimento socioeconômico influenciaram a expansão dos cursos de medicina e as marcadas diferenças intra e interregionais.

Abstract The study identified the pattern of evolution, distribution and expansion of the undergraduate medicine courses in Brazil and described the governmental processes related to the increase in the capacity of the courses. It is a descriptive study based on data available in the system of the Brazilian Ministry of Education about medical schools. With information about the courses dating back to the first that were implemented in the country, we could establish six periods of government for the analysis: from 1808 to 1963 (from the Monarchy to the first republican governments); from 1964 to 1988 (from the military dictatorship to the government of José Sarney); From 1989 to 1994 (Fernando Collor - Itamar Franco); from 1995 to 2002 (Fernando Henrique Cardoso); from 2003 to 2010 (Lula); and from 2011 to 2018 (Dilma Rousseff - Michel Temer). We observed a significant expansion of the schools starting with the military dictatorship and peaking in 2014 (Dilma Rousseff), and the implementation of the More Doctors Program (Programa Mais Médicos, in Portuguese). Throughout the analyzed periods, the teaching of Medicine became ever more privatized, and was partially shifted to the Northern, Northeastern and Midwestern regions of Brazil, and to medium-sized and small municipalities in the countryside of the states. The results indicate that the combination of the management by the government of the health, education and socioeconomic development policies had an influence on the expansion of the Medicine undergraduate courses and the marked intra- and interregional differences.

Resumen El estudio identificó el patrón de evolución, distribución y expansión de las carreras de Medicina en Brasil y describió los procesos gubernamentales relacionados al aumento de la oferta de vacantes. Se trata de un estudio descriptivo, con base en datos disponibles en el sistema del Ministerio de Educación sobre escuelas de medicina. Con la información sobre las carreras, desde las primeras implantadas, se establecen seis períodos de gobierno para análisis: desde 1808 hasta 1963 (monarquía y gobiernos republicanos iniciales), desde 1964 hasta 1988 (gobiernos militares - José Sarney), desde 1989 hasta 1994 (Fernando Collor - Itamar Franco), desde 1995 hasta 2002 (Fernando Henrique Cardoso), desde 2003 hasta 2010 (Lula) y desde 2011 hasta 2018 (Dilma Rousseff - Michel Temer). Se observó una importante aumento de las escuelas a partir de los gobiernos militares, con un pico en el 2014 (Dilma Rousseff), frente a la implementación del Programa Más Médicos. A lo largo de los períodos analizados la educación médica se ha ido privatizando progresivamente y se trasladó parcialmente hacia las Regiones Norte, Nordeste y Centro-Oeste, y a ciudades de tamaño medio y pequeño en el interior de los estados. Los resultados indican que la combinación de la gestión gubernamental de las políticas de salud y educación y de desarrollo socioeconómico influyeron en la expansión de las carreras de medicina y las marcadas diferencias intra e interregionales.

Investigation on the epidemic characteristics of injuries among left-behind children in rural areas in Qingyuan city, Guangdong Province / 中华疾病控制杂志

Objective To investigate the epidemic character of injuries among rural left-behind children, so as to provide evidence for strategies and processes on preventing injuries. Methods Using stratified cluster sampling, a town was randomly selected from each of the two layers with different economic development levels in Qingxin district, Qingyuan city, Guangdong Province. The local left-behind children of 3-9 grades from 3 elementary schools and 3 middle schools were randomly selected from the local area. The student self-administered questionnaire was used to investigate the occurrence of injuries, personal circumstances, family environment and school situation in the past year. Data of injury situation, personal situation, family situation and school situation during last year were analysed by Chi-square and multiple logistic analysis. Results Injuries were reported to occur in 440 left-behind children, with an injury rate of 17.5%. Significant difference of injury rate was observed between groups divided by grades, being only-child in family, health conditions, anxiety, getting along with other students, teacher’s attitude to students, emphasizing security by teachers, knowledge level about injury, and injury-relative behaviors (all P<0.05). Multivariate logistic regression model results suggested that middle school, physical health, behavioral level, and relationship with classmates are protective factors, anxiety is a risk factor (OR=1.262,95%CI:1.009~1.577,P=0.041). Conclusions We have to take some comprehensive methods to prevent injuries that are influenced by all kinds of factors. While constructing an advantage circumstance to left-behind children, their awareness of security should also be improved to reduce the occurrence of injuries.

Impact of food processing on antioxidants inadults living in rural areas / Impacto do processamento de alimentos sobreantioxidantes em adultos moradores da zona rural

Currently, it is widely recognized that in natura or minimally-processed foods are being substituted by processed and ultraprocessedproducts. The objective of this study was to evaluate the relationship between the degree of food processing andantioxidant consumption in adults living in the rural area of the city of Viçosa, MG. A total of 64 adults from 11 rural censustracts were evaluated. Data collection was performed immediately through the measurement of blood pressure and theapplication of a survey on eating habits to evaluate food intake. The foods consumed were grouped for analysis accordingto the NOVA classification and the total antioxidant capacity of the diet was evaluated using existing databases of FerricReducing Antioxidant Power (FRAP) values. There was a positive correlation between the consumption of antioxidants andcalories from in natura foods (r = 0.289, p = 0.021), and between the consumption of calories from processed foods andcalories from butter (r = 0.371, p = 0.003). In addition, a difference was observed in the consumption of calories from ultraprocessedfoods between the sexes, being higher in the females (p = 0.02). Therefore, the results found reinforce the currentrecommendation of the Food Guidelines for the Brazilian Population: "Always prefer in natura or minimally-processedfoods and culinary preparations to ultra-processed foods"

Atualmente é notória a substituição de alimentos in natura ou minimamente processados por produtos processados eultraprocessados. O objetivo deste estudo foi avaliar a relação entre o grau de processamentos de alimentos e o consumode antioxidante em adultos moradores da zona rural do município de Viçosa-MG. Avaliou-se 64 adultos de 11 setorescensitários da área rural. A coleta de dados foi realizada em um único momento através da aferição da pressão arteriale aplicação de recordatório habitual para avaliação do consumo alimentar. Os alimentos consumidos foram agrupadospara análise segundo a classificação NOVA e a Capacidade Antioxidante Total da Dieta foi avaliada pelos valores doPoder Antioxidante de Redução Férrica (FRAP), utilizando bancos de dados existentes. Houve correlação positiva entreconsumo de antioxidantes e de calorias provenientes de alimentos in natura (r=0,289, p=0,021), e entre consumo decalorias provenientes de alimentos processados e calorias provenientes de manteiga (r=0,371, p=0,003). Além disso,observou-se diferença no consumo de calorias provenientes dos alimentos ultraprocessados, entre os sexos, sendo maiorno sexo feminino (p=0,02). Portanto, os resultados encontrados reforçam a atual recomendação do Guia Alimentar paraa População Brasileira: "Prefira sempre alimentos in natura ou minimamente processados e preparações culinárias aalimentos ultraprocessados"

Relative workload measurement based on RBRVS theory on village level basic public health service projects / 中华医院管理杂志

Objective To scientifically measure the workload of basic public health services project on village level .Methods 257 village doctors and 24 public health administrators that work in rural health clinics in Qianjiang city ,Hubei province and Qianjiang distrcit ,Chongqing city were sampled ,with questionnaire survey and key informant in-depth interview methods used to screen basic public health service projects affordable on village level ,for workload measurement .Results 35 basic public health service projects were chosen as the measurement projects regarding their relative workload. Hypertension follow-up workload 100 was set as the benchmark ,finding the rest relative workload of other projects range from11～936 .Conclusions It is reasonable to use the relative value measurement based on RBRVS theory on village level basic public health service projects. Results of this study can offer support for the pricing and further dynamic modification of the basic public health service projects .

Investigation on the Utilization of Essential Drugs in 23 Rural Primary Medical Institutions from Poverty-stricken Areas of Chongzuo City / 中国药房

OBJECTIVE:To provide reference for promoting the rational use of essential drugs in primary medical institutions. METHODS:Twenty-three rural primary medical institutions(8 township health centers,15 village clinics)were randomly selected from 2 poverty-stricken counties in Chongzuo city of Guangxi Zhuang Autonomous Region. The utilization of essential drugs was investigated and analyzed statistically through exporting hospital information system data and on-site interviews. RESULTS:The utilization rate of essential drugs in sample township health centers was 72.4％,and the amount of essential drugs accounted for 78.3％. The utilization rate of variety from National List of Essential Drug was 36.9％,which in the Autonomous Regions Essential Drug List Supplement was 47.2％(utilization rate of chemical drugs was 53.9％,and that of Chinese patent drugs was 39.7％). The utilization rate of essential drugs in sample village clinics was 64.4％;utilization rate of variety from National List of Essential Drug was 18.3％, which in the Autonomous Regions Essential Drug List Supplement was 10.5％. The amount of 5 major categories accounted for 47.9％ of total amount of chemical agents,among which that of antimicrobial agents took up the highest proportion,being 35.9％. Among top 10 drugs in the list of amount,there were 8 national essential drugs and 4 antimicrobial agents. There were 2.90 kinds of drugs in each outpatient prescription averagely in sample township health centers;the average proportion of antibiotic prescription was 43.0％;the cost of each prescription was 33.12 yuan in average. CONCLUSIONS:The utilization rate of essential drugs in primary medical institutions is lower than the requirements of policy. There are great difference in utilization rate between chemical agents and Chinese patent drugs of township hospital in Autonomous Regions Essential Drug List Supplement. The cost proportion of antimicrobial agents is high. The rationality of prescription drug use still needs to be improved. It is suggested to guarantee essential drugs supply,adjust Autonomous Regions Essential Drug List Supplement in time,control the price of main categories and strengthen antimicrobial agent use monitoring so as to further promote rational drug use.

Investigation on the Utilization of Essential Medicines in 26 Rural Primary Medical Institutions from Poverty-stricken Areas of Huanggang City / 中国药房

OBJECTIVE:To provide reference for promoting the rational use of essential medicines in primary medical institutions.METHODS:Twenty six rural primary medical institutions (13 township health centers,13 village clinics) were randomly selected from 2 poverty-stricken county (city) in Huanggang city of Hubei province.The utilization of essential medicine was investigated and analyzed statistically through exporting hospital information system data and on-site interviews.RESULTS:The utilization rate of essential medicine in sample township health centers was 76.9％,and the amount of essential medicine accounted for 93.0％;the utilization rate of essential medicine in sample village clinics was 89.7％.The utilization rate of variety from essential medicine list was 53.6％ in sample township health centers and 25.0％ in sample village clinics;the utilization rate of variety from National Essential Medicine List was higher than that of Provincial Essential Medicine List Supplement.The amount of 5 major categories as antimicrobial agents,cardiovascular agent in sample primary medical institutions accounted for 64.7％ of chemical agents.The top ten medicines in the list of amount were all essential medicine,9 of which were national essential medicines.There were 2.8 kinds of medicines in each outpatient prescription averagely in sample township health centers.The proportion of antibiotic prescription was 44.2％.CONCLUSIONS:The utilization rate of essential medicines in township health centers of this area is lower than WHO recommended value,and the ratio of amount meets the policy requirements.The utilization rate of variety from Provincial Essential Medicine List Supplement is in low level in primary medical institutions;the amount of anti-microbial drugs is in high level;the rationality of medicine use in prescriptions needs to be improved.It is suggested to adjust the type of provincial supplement list dynamically according to actual situation and control the price and amount of main categories strictly,the rationality of prescription.

Crianças do Campo: da invisibilidade ao reconhecimento como sujeito de direito / Country Children: from invisibility to recognition as a subject of law / Niños Campesinos: la invisibilidad al reconocimiento de un sujeto de derecho / Enfants Paysans: invisibilité à la reconnaissance en tant que sujet de droit

O objetivo deste artigo é analisar como processos de silenciamento e de invisibilização que caracterizaram historicamente a construção das culturas infantis das crianças do campo, impuseram-lhe formas subalternas de existência, mediante revisão do conceito de socialização. À luz da sociologia da infância e dos estudos pós-coloniais, partimos do pressuposto de que a infância enquanto categoria social é uma construção que implica uma condição de vida não apenas biológica, mas cultural. Com base em abordagens críticas da perspectiva teórica intercultural, examinamos a existência de uma pluralidade de culturas infantis nas quais as crianças do campo constroem-se e são construídas nas relações estabelecidas com os seus pares, os adultos e o mundo rural ao qual pertencem, considerando o tensionamento entre o rural e o urbano. Após análises desenvolvidas a partir das reflexões teóricas efetuadas, concluímos que as tensões e contradições que permeiam a invisibilidade das crianças do campo, ainda que marcados pela subalternização, expressam também a busca por novos caminhos e referenciais para dar visibilidade a este sujeito social.

The aim of this article is to analyze how processes of silencing and invisibilization that historically characterized a construction of the children 's cultures of the rural children, imposed, subaltern forms of existence, by reviewing the concept of socialization. In light of the sociology of childhood and post-colonial studies, we start from the assumption of a childhood as a social category is a construction that implies a condition of life not only biological but cultural. Based on critical approaches from the intercultural theoretical perspective, it examines the existence of a plurality of child cultures in which as rural children are constructed and built in the relationships established with their peers, adults and the rural world to which they belong, considering the tension between rural and urban. After analysis developed from theoretical reflections made, we conclude that as tensions and contradictions that permeate the invisibility of rural children, even if marked by subalternization, also express the search for new ways and referential to the vision of a social subject.

El objetivo de este artículo es analizar como procesos de silenciamiento y de invisibilización que caracterizaron históricamente la construcción de las culturas infantiles de los niños del campo, impusieron formas subalternas de existencia, mediante la revisión del concepto de socialización. A la luz de la sociología de la infancia y de los estudios postcoloniales, partimos del supuesto de que la infancia como categoría social es una construcción que implica una condición de vida no sólo biológica, sino cultural. Sobre la base de enfoques críticos de la perspectiva teórica intercultural, examinamos la existencia de una pluralidad de culturas infantiles en las que los niños del campo se construyen y se construyen en las relaciones establecidas con sus pares, los adultos y el mundo rural al que pertenecen, la tensión entre lo rural y lo urbano. Después de análisis desarrollados a partir de las reflexiones teóricas efectuadas, concluimos que las tensiones y contradicciones que permean la invisibilidad de los niños del campo, aunque marcados por la subalternización, expresan también la búsqueda de nuevos caminos y referencias para dar visibilidad a este sujeto social.

L'objectif de cet article est d'analyser comment les processus de silence et d'invisibilisation qui caractérisent historiquement la construction des cultures infantiles des enfants ruraux lui imposent des formes subalternes d'existence, par la révision de la notion de socialisation. À la lumière de la sociologie de l'enfance et des études post-coloniales, nous partons de l'hypothèse que l'enfance en tant que catégorie sociale est une construction qui implique une condition de vie non seulement biologique mais culturelle. Basé sur des approches critiques du point de vue théorique interculturel, nous examinons l'existence d'une pluralité de cultures infantiles dans lesquelles les enfants ruraux sont construits et construits dans les relations établies avec leurs pairs, les adultes et le monde rural auquel ils appartiennent, compte tenu la tension entre rural et urbain. Après une analyse développée à partir des réflexions théoriques réalisées, nous concluons que les tensions et les contradictions qui imprègnent l'invisibilité des enfants ruraux, même si elles sont marquées par la subalternisation, expriment également la recherche de nouvelles voies et références pour donner une visibilité à cette sujet sociale.

Representaciones sociales en el proceso de integración del campo a la ciudad Colquencha-La Paz¹

La presente investigación identifica las representaciones sociales sobre la integración campo-ciudad en dos poblaciones de adultos, una en el área rural en Colquencha y la otra en la ciudad de La Paz. Los resultados nos muestran en ambas áreas geográficas que la representación social es "caminos", lo que significa que el pensamiento colectivo se encuentra asentado en la infraestructura. Otras categorías de la representación social es "unión", palabra que comprueba que hay puntos de encuentro entre estas dos áreas geográficas, en este caso relacionadas a procesos económicos, como son el "trabajo" y a la "población", semejantes representaciones se encuentran vinculadas según los análisis realizados en base a las entrevistas, a procesos migratorios que se dan frecuentemente entre el campo y la ciudad.

The present investigation identifies the social representations on the country side city integration in in two populations of adults, one in the rural area in Colquencha and other in the city of La Paz. The result is that we are geographically speaking that the social representation is "ways", which means that collective thinking is based on the infrastructure. The social representation is "unión", in this case, related to economic processes, such as "work" and "population", similar representations are linked according to the analyzes made based on the interviews, to migratory processes that frequently occur from the countryside to the city.

A presente pesquisa identifica as representações sociais sobre a integração campo-cidade em duas populações de adultos, uma na área rural de Colquencha e a outra na cidade de La Paz. Os resultados mostramnos em ambas as áreas geográficas que a representação social é "caminhos", o que significa que o pensamento coletivo é baseado em infraestrutura. A representação social é "união", uma palavra que comprova que existem pontos de contato entre essas duas áreas geográficas, neste caso relacionadas a processos econômicos, como "trabalho" e "população", tais representações estão ligadas de acordo com a análise, conduzido com base em entrevistas, processos migratórios que freqüentemente ocorrem do campo para a cidade.

Contradições do cotidiano nos homicídios por motivo fútil no baixo São Francisco: pistas para pensar a interiorização da violência / Contradictions of everyday life at futilely motivated homicides in the baixo São Francisco: indications to think the increasing of violence in the countryside / Contradicciones del cotidiano en homicidios por moivo trivial en el baixo São Francisco: pistas para pensar el desplazamiento de la violencia para nucleos urbanos periféricos

O estudo dos homicídios por motivo fútil serve como base analítica para refletir acerca do tema da interiorização da violência, fenômeno que se faz presente em recentes estudos sobre criminalidade e violência no Brasil. O aspecto deste tipo de homicídio que permite a análise pretendida é sua íntima vinculação com o cotidiano da vida social e suas contradições, condição que, por sua vez, favorece uma visão da segurança pública não focada no controle da penalidade criminal. Para tal intento, recorre-se a uma pesquisa sobre homicídios por motivos fúteis ocorridos no período de 2008 a 2011 na região do Baixo São Francisco em Sergipe, cuja análise de 48 ocorrências homicidas se fez no campo de tensões entre ‘lógica desenvolvimentista’ e ‘modos de vida tradicionais’, mais precisamente nos conflitos de práticas entre Estado, corporações e comunidades locais.

The study of futilely motivated homicides (a brazilian penalty typification category) serves as an analytic basis to ponder the subject of the increasing of violence in the countryside, a phenomenon that is shown in recent studies on violence and criminality in Brazil. The aspect of this kind of homicide that allows the intended analysis is its intimate bonding with the everyday social life and its contradictions, conditions that support a vision of public security that is not focused on the controlling of criminal penalties. In order to accomplish that, the analysis relies upon a research on futilely motivated homicides that occurred between 2008 and 2011 at the Baixo São Francisco region of the state of Sergipe in which the analysis of 48 homicidal occurrences was build up among the strain between the ‘developmentalism’s way’ of operating and the ‘traditional ways of living’, precisely in the conflicts between practices of the State, corporations and local communities.

El estudio de los homicidios por motivo trivial sirve como base analítica para reflexionar sobre el crescimiento de la violencia en los nucleos urbanos perifericos, fenómeno presente en recientes estudios acerca de criminalidad y violencia en Brasil. El aspecto de este tipo de homicidio que permite la análisis pretendida es su íntima vinculación con el cotidiano de la vida social y sus contradiciones, condición que, por su vez, favorece una visión de la seguridad publica que no se centra en el control de sanción penal. Para este propósito, se recurre a una investigación acerca de homicidios por motivo trivial ocurridos en el periodo de 2008 a 2011 en la región de lo Baixo São Francisco en Sergipe, cuya análisis de 48 ocurrencias homicidas se hice en el campo de tensiones ideológicas entre la ‘lógica desarrollista’ y ‘los modos de vida tradicionales’, mas precisamente en los conflitos de las prácticas entre el Estado, corporaciones y comunidades locales.

How reproductive history of married women influencing the mortality rate of their children under 5 years in rural areas of Shaanxi province / 中华流行病学杂志

Objective To investigate the current status of reproductive history among married women and the mortality rate of children under 5 years.Influence of reproductive history among married women on mortality rate of their children under 5 years in rural areas in Shaanxi province was also studied.Methods A cross-sectional survey was conducted on reproductive history and mortality rate of their children under 5 years of age in five Fourth National-Level Poverty-Stricken counties in Shaanxi province.Sample under study was chosen according to the three-stage stratified random sampling technique.Results A total number of 4 732 married women were studied,with the average age of first birth as 23.65 years,the average parity as 1.49,the average spacing between first and second child birth as 6.96 years and the average spacing between second and third child birth as 3.98years.In children under 5 years of age among the surveyed women in 2007-2010,32.19％ of the deaths in children under 5 years of age occurred during infancy while 70.21％ of the infant deaths occurred during neonatal period.The mortality rates (1/1000) for newborns,infants and children under 5 years were 6.71‰,9.55‰,29.67‰ respectively.Infant mortality rate of mother with multiple births was higher than the singletons (x2=6.057,P=0.014).Parity differences in mortality rate of children under 5 years were significant (x2=17.469,P＜0.001) and interval differences of births on infant mortality rate were also significant (x2=13.137,P=0.001).Conclusion Fertility of rural women in Shaanxi was in good condition.The proportion that infant death was accounted for the total deaths of children under 5 years had declined,but the neonatal deaths still accounted for a big proportion of infant deaths.Infant mortality rate and mortality rate of children under 5 years old had declined,when compared to the national level in 2000,however,it was still higher than the city level.In terms of the fertility characteristics in women as multiple births,more parity and short spacing of births etc,were important factors of death of their children under 5 years of age.

Políticas de desenvolvimento territorial no meio rural brasileiro: novas institucionalidades e protagonismo dos atores / Territorial development policies in the brazilian countryside: new institutional arrangements and key protagonists / Politiques de développement du territoire en milieu rural au Brésil: les nouvelles pratiques institutionnelles et le rôle des acteurs

This article analyzes the implementation of two policies for territorial development of the Brazilian countryside in the first decade of the 21st century: the Program for the SustainableDevelopment of Rural Territories (Pronat) and the Program for Territories of Citizenship (PTC). Examining the new institutional arrangements, the programs' socialmanagement and governance structures, and the protagonist role of the various stakeholders, the article concludes that to a certain extent the programs represent a unique strategy for political action and development in the respective geographic areas.However, they still face enormous challenges for effective consolidation of their results.

Dans cet article, on examine lamise en place de deux politiques orientées vers le développement du territoire en milieu rural au Brésil dans les années 2000: le Programme de Développement Durable des Territoires Ruraux (Pronat) et le Programme Territoires de la Citoyenneté (PTC). D'après l'examen des nouvelles pratiques institutionnelles en cours, de la gestion sociale des programmes et de leurs structures de gouvernance, ainsi que du rôle des acteurs engagés, on conclut que ces derniers ont suivi, d'une certaine façon, une stratégie singulière d'action politique pour le développement des régions concernées, malgré les immenses enjeux à venir, afin d'aboutir à des résultats vraiment solides.

Establishment of the curriculum system for fostering practical medical talents / 中华医学教育探索杂志

For the employment orientation of graduates in clinical medical major from three-year medical eduction,a curriculum system,which will be used to foster practical medical talented person for urban and rural communities,has been proposed in this paper.We will take measures,which not only further defines training target and requirement for the practical medical person from the short school system and guides students to alterate their ideological concept but also reconstructures new curriculum system and reforms teaching methods,to ensure the implementation of the training objectives

Heidegger Na Cidade De Benjamin / Heidegger in Benjamin's City

O lugar comum, no que tange à imagem de Heidegger, é a de um filósofo firmemente enraizado, não na cidade de Freiburg, na qual passou grande parte de sua vida, mas na região rural alemânico-suábia, nos arredores do povoado de Messkirch, onde nasceu. Poderia parecer que a distância entre Heidegger e Benjamin, entre Messkirch e Berlim, ou Paris, não poderia ser maior. Mas até que ponto estão as predileções pessoais de Heidegger pelo provinciano e o bauerlich (camponês) de fato ligadas às posições filosóficas que ele desenvolveu? Poderia ser este o caso, de que a cidade, talvez ainda mais do que o campo, devesse desempenhar um papel central em qualquer tentativa séria de se pensar até o fim as implicações do pensamento de Heidegger sobre o ser? Esta apresentação investigará como Heidegger se sentiria na cidade de Benjamin, bem como o lugar da cidade no pensamento do próprio Heidegger, com o propósito de lançar luz não apenas sobre o pensamento de Heidegger, mas também sobre o do próprio Benjamin.

The commonplace image of Heidegger is of a philosopher firmly rooted, not in the city of Freiburg in which much of his life was spent, but in the Alemannic-Schwabian countryside around the village of Messkirch in which he was born. It would seem that the distance between Heidegger and Benjamin, between Messkirch and Berlin or Paris could not be greater. But to what extent are Heidegger's own personal predilections for the provincial and the bauerlich actually tied to the philosophical positions that he developed? Might it be the case that the city, perhaps even more than the countryside, has to play a central role in any serious attempt to think through the implications of Heidegger's thought of being? This presentation will explore how Heidegger might find himself in Benjamin's city, and of the place of the city in Heidegger's own thought, with the aim of shedding light, not only on Heidegger's thought, but also on that of Benjamin himself.

A Study of the Intervention of Children with Bilateral Severe Hearing Loss in Countryside of China / 听力学及言语疾病杂志

Objective To investigate the effects of the intervention,rehabilitation and speech development of children with severe hearing loss in some rural areas.Methods 61 children,including 35 males and 26 females,were diagnosed as severe hearing loss with ABR and 40 Hz-AERP from June 2004 to July 2008.All the children failed hearing screening or visited the hospital as outpatients.The ages ranged from 2 to 72 months with the average age of 17.59 months.During telephone follow-up,the questionnaire was used to gather the data regarding the usage of hearing aids,hearing and speech rehabilitation,speech development,and communication abilities.Results 33 (54.10%) children were fitted with hearing aids,and 2 (3.28%) received cochlear implants,while 26(42.62 %) neither had hearing aids nor cochlear implants.10 cases with hearing aids also had speech training,whereas 23 children with hearing aids did not receive the training.2 cases with cochlear implants and 2 cases with hearing aids were found to have good speech development and communication ability,while 31 cases with hearing aids had delayed speech development.26 cases without any devices had to rely on sign language for their commumication.Conclusion Children in rural area with severe hearing loss experience greater speech and communication difficulties because many of them have no access to intervention and speech training.The results suggest that it would be very important to increase public awareness and educate parents to have their children wear hearing aids and receive speech training.

Percepção das barreiras e prática de atividade física em adolescentes residentes em regiões metropolitana e interiorana do Estado de São Paulo / Barriers perception and physical activity practice in adolescents living at metropolitan and countryside areas from São Paulo State

Experiências nacionais e internacionais apontam que barreiras pessoais (BP) e ambientais (BA) interferem no estilo de vida ativo. Objetivo: comparar as BA e BP em adolescentes de ambos os sexos residentes em região metropolitana (RM-Santo André) e interiorana (RI-São Bento do Sapucaí) do Estado de São Paulo. Métodos: Avaliamos 198 adolescentes: 98 residentes em RM e 100 em RI com média de idade (15,6 + 0,7 (RM) e 16,0 + 1,6 anos (RI). Os avaliados responderam o questionário do Programa Agita São Paulo (2006), sobre BA e BP. As BA e BP foram analisadas pelos critérios: nunca interferem (1); (2) raramente; (3) algumas vezes; (4) freqüentemente; (5) quase sempre interferem. As respostas a BA e BP dos adolescentes foram agrupadas em três categorias: raramente interferem (1+2) (RR), algumas vezes (3) (AV) e frequentemente (4+5) (FR) . O teste Qui-quadrado foi utilizado para comparação das proporções com nível de significância de p<0,05. Resultados: Adolescentes AT da RM citaram falta de equipamento (68,7%) e diversão em se exercitar (85,8%) como as BA mais freqüentes. Na RI falta de local (45,7%) e companhia (41,3%) como BA. Nas BP os AT apresentaram falta de conhecimento como se exercitar (64,6%) e falta de tempo (58,9%). Na RI falta de tempo (51,5%) e de conhecimento como se exercitar (32,1%). Grupos IA da RM mostraram falta de energia (38,8%) e autodisciplina (46,9%) e na RI falta de interesse (34,5%) e de energia (44,6%). Conclusão: fatores culturais podem interferir similarmente nas BA e distintamente nas BP em adolescentes.

National and international experiences show that personal (PB) and environmental barriers (EB) interfere on lifestyle. Purpose: analyze the EB e PB in both sexes adolescents living at metropolitan region (MR – Santo André) and countryside (CR – São Bento do Sapucaí) in São Paulo State. Methods: 198 adolescents were evaluated: 98 from MR and 100 CR, with mean of age (15.6 + 0.7 (MR) and 16.0 + 1.6 years old (CR). The subjects answered the Agita São Paulo Survey (2006), about EB and PB. The EB and PB were analyzed by never interfere (1); (2) rarely; (3) sometimes; (4) frequently; (5) always interfere criteria. We set the answers on 1+2; 3 e 4+5. The physical activity level was shared in insufficient (IA) and active (AT) and Chii-square test (p<.05) as statistics analysis. The analysis was determined by frequently criteria. Results: AT Adolescents from MR reported lack of equipment (68.7%) and fun to exercise (85.8%) as the most important EB. Adolescents from CR presented lack of place (45.7%) and friendship (41.3%) as EB. PB the AT presented lack of knowledge how to exercise (64.6%) and lack of time (58.9%). Lack of time was reported by 51.5% from CR and lack of knowledge to exercise in (32.1%). The groups IA from MR showed lack of energy (38.8%) and self-discipline (46.9%) and from CR lack of interest (34.5%) and energy (44.6%). Conclusion: cultural factors may contribute to similar results in EB and differently on PB for adolescents’ subjects.