Survival analysis of Chagas disease patients, beneficiaries of social security and social assistance in Brazil, 1942-2016 / Análise de sobrevida de portadores da doença de Chagas, beneficiários da previdência e da assistência social no Brasil, 1942-2016

ABSTRACT Objective To analyze the survival of patients with Chagas disease, beneficiaries of social security and social assistance, in Brazil, from 1942 to 2016. Methods This is a retrospective cohort study with data from the Brazilian Ministry of Social Security. The event of interest was death, and the survival functions were estimated by the Kaplan-Meier and Cox regression methods. Results In the period "onset of the disease until death", women (HR=0.54; 95%CI 0.43-0.53) and receiving social security benefits (HR=0.13; 95%CI 0.11-0.23) were associated with longer survival. Lower survival was associated with the cardiac form of the disease (HR=2.64; 95%CI 2.23-3.12), living in a rural area (HR=1.23; 95%CI 1.14-1.21), and manifestation of the disease between the years 2000 and 2016 (HR=5.32; 95%CI 4.74-5.93). Likewise, in the period "work disability until death", women (HR=0.51; 95%CI 0.41-0.52) and receiving social security benefits (HR=0.24; 95%CI 0,14-0.45) were associated with longer survival, as well as the cardiac form of the disease (HR=1.95; 95%CI 1.83-2.13), living in a rural area (HR=1.31; 95%CI 1.21-1.54), and manifestation of the disease between 2000 and 2016 (HR=1.53; 95%CI 1.33-1.71) were associated with lower survival. Conclusion The main predictors of mortality and survival of patients with Chagas disease who receive social security and assistance benefits in Brazil were presented. These findings can guide the definition of priorities for follow-up actions by Primary Health Care, currently recommended for the longitudinal management of the disease.

RESUMO Objetivo Analisar a sobrevida de portadores da doença de Chagas, beneficiários da previdência e da assistência social no Brasil, 1942-2016. Métodos Estudo de coorte retrospectivo com dados do Ministério da Previdência Social. O evento de interesse foi o óbito, e as funções de sobrevida foram estimadas pelos métodos Kaplan-Meier e de regressão de Cox. Resultados No período "início da doença até o óbito", o sexo feminino (HR=0,54; IC95% 0,43-0,53) e recebimento de benefícios previdenciários (HR=0,13; IC95% 0,11-0,23) foram associados a maior sobrevida. A menor sobrevida esteve associada à forma cardíaca da doença (HR=2,64; IC95% 2,23-3,12), residência em zona rural (HR=1,23; IC95% 1,14-1,21) e manifestação da doença entre os anos de 2000 e 2016 (HR=5,32; IC95% 4,74-5,93). Da mesma forma, no período "incapacidade laboral até o óbito", o sexo feminino (HR=0,51; IC95% 0,41-0,52) e o recebimento de benefícios previdenciários (HR=0,24; IC95% 0,14-0,45) foram associados a maior sobrevida, assim como forma cardíaca da doença (HR=1,95; IC95% 1,83-2,13), residência em zona rural (HR=1,31; IC95% 1,21-1,54) e manifestação da doença entre os anos de 2000 e 2016 (HR=1,53; IC95% 1,33-1,71) associaram-se a menor sobrevida. Conclusão Os principais preditores de mortalidade e sobrevida de portadores de doença de Chagas que recebem benefícios previdenciários e assistenciais no Brasil foram apresentados. Estes achados podem nortear a definição de prioridades de ações de acompanhamento pela atenção primária à saúde, preconizada atualmente para o manejo longitudinal da doença.

Concessão dos benefícios assistenciais para pessoas com paralisia cerebral no Brasil: tendência temporal e análise espacial / Continuous cash benefit for people with cerebral palsy in Brazil: temporal trend and spatial analysis

Objetivo: Analisar a tendência temporal e distribuição espacial dos benefícios concedidos para as pessoas com Paralisia Cerebral. Método: Estudo ecológico em que foram incluídos os benefícios concedidos às pessoas com Paralisia Cerebral, nos períodos de 2004 a 2016, no Brasil. Os dados foram coletados do Instituto Nacional de Seguridade Social e Instituto Brasileiro de Geografia Estatística. Utilizou-se o software Join Point Regression, 4.5.0.1, sendo as tendências classificadas em decrescente; crescente e estacionária. Na distribuição espacial foi realizada Análise Exploratória de Dados Espaciais com o software QGIS versão 3.18. Resultados: Observou-se uma tendência decrescente do BPC do ano de 2004 até o ano de 2016, no Brasil. Na região Norte o número de concessões aumentou de 2004-2010, mas, após isso, houve um decréscimo. Já as regiões Sudeste, Sul e Centro Oeste apresentaram tendência decrescente em todo o período analisado. Na análise espacial, as regiões Norte e Nordeste apresentaram maior frequência de BPC proporcionalmente à população com pessoas até 19 anos, aos domicílios e às famílias com até um salário mínimo nas unidades federativas do Brasil. Conclusão: Foi possível observar a diminuição de concessões do BPC em todas as regiões do país no período de 2004 a 2016. As regiões que possuem os índices mais elevados de distribuição do BPC são Nordeste e Norte, reconhecidamente, as que possuem os maiores indicadores de pobreza e extrema pobreza do país

Objective: To analyze the temporal trend and spatial distribution of benefits granted to people with Cerebral Palsy. Method: An ecological study that included the benefits granted to people with Cerebral Palsy, from 2004 to 2016, in Brazil. Data were recorded from the National Institute of Social Security and the Brazilian Institute of Geography. The software Join Point Regression, 4.5.0.1 was used and the trends were classified as increasing; growing and stationary. In the spatial distribution, Exploratory Spatial Data Analysis was performed with the QGIS software version 3.18. Results: There is a downward trend in BPC from 2004 to 2016 in Brazil. In the North region, the number of concessions increased from 2004-2010, but after that, there was a decline. The regions and Center West, on the other hand, show a decreasing trend throughout the Southeast and South period. In the spatial analysis, the most frequent North and Northeast regions of BPC in proportion to the population with people aged 19 years, to families with units up to one minimum wage in the federative units of Brazil. Conclusion: A decrease in BPC extensions was observed in all regions of the country in the period 2016. Poverty and extreme poverty in the country

Sistema Único de Assistência Social e a inserção da terapia ocupacional / Unified social assistance system and the occupational therapist insertion

Resumo Introdução A terapia ocupacional é uma profissão com mais visibilidade histórica na área da saúde. No âmbito da política pública da assistência social, sua inserção passou a ser oficialmente prevista a partir de 2011, embora atue neste setor desde o início de suas ações no Brasil. Objetivo Neste estudo, objetivou-se traçar o perfil dos terapeutas ocupacionais inseridos nos serviços e/ou programas do Sistema Único de Assistência Social (SUAS) no estado de Minas Gerais (MG). Método Realizou-se pesquisa documental, tendo como fonte de informações o Censo SUAS. Foram mapeados os dados quantitativos de municípios com terapeutas ocupacionais por ano, por equipamentos, serviços e função entre os anos de 2012 e 2019. Os dados foram tratados por meio de estatística simples e os resultados foram organizados em categorias analíticas, as quais integraram a discussão dos resultados. Resultados Foram encontrados dados dos terapeutas ocupacionais em equipamentos do SUAS da Proteção Social Básica e da Proteção Social Especial e no nível da gestão. Destacou-se quantitativo relevante de terapeutas ocupacionais em serviços para pessoas com deficiência. Conclusão A constituição da terapia ocupacional social, o reconhecimento da especialização da profissão em contextos sociais e a previsão deste profissional no SUAS tem ampliado o debate e as possibilidades de atuação com foco na proteção social. Sugere-se outros estudos acerca do perfil desses profissionais, bem como das práticas desenvolvidas por eles visando compreender suas atuações, aplicação dos conhecimentos teórico-práticos e contribuição da especificidade da terapia ocupacional neste contexto.

Abstract Introduction Occupational therapy is the profession with more historical visibility related to the health field. Within the scope of the public policy of social assistance, its insertion started to be officially foreseen from 2011, however its action has been developed in the beginning of occupational therapists' action in Brazil. Objective To present the profile of occupational therapists inserted in the services and/or programs of the Unified Social Assistance System (SUAS) in Minas Gerais (MG) state, Brazil. Method Documentary research was carried out, using the SUAS Census as a source of information. Quantitative data from municipalities with occupational therapists per year, by equipment, services, and role between the years 2012 to 2019 were mapped. The data were treated using simple statistics, and the results were organized into analytical categories, which were part of the discussion of the results. Results Data from occupational therapists were found in SUAS equipment for Basic Social Protection, Special Social Protection, and at the management level. A relevant number of occupational therapists in services for people with disabilities stood out. Conclusion The constitution of social occupational therapy, the recognition of the profession's specialization in social contexts, and the provision of this professional in the SUAS has expanded the debate and the possibilities of action with a focus on social protection. Other studies are suggested about the professionals' profile, as well as the practices developed by them, aiming to understand their actions, application of theoretical-practical knowledge and contribution of the specificity of occupational therapy in this context.

Benefícios previdenciários de pescadores artesanais e marisqueiras em comunidade quilombola no Nordeste do Brasil / Social security benefits for small-scale fisherman in a quilombola community in northeastern Brazil

Resumo Introdução: a pesca artesanal e a mariscagem são consideradas atividades especiais, para fins de benefícios, no âmbito do Regime Geral de Previdência Social do Brasil. Objetivo: descrever o acesso aos benefícios previdenciários por uma população quilombola tradicional pesqueira no Nordeste do Brasil, cuja principal atividade ocupacional é a extração e beneficiamento de mariscos. Métodos: estudo transversal, descritivo, em uma comunidade da Ilha da Maré, em Salvador, Bahia, Brasil. Os dados foram coletados por meio de entrevistas, utilizando questionários padronizados. Resultados: participaram 213 pescadores artesanais e marisqueiras, 76,5% do sexo feminino. Dentre os participantes, 62,9% não recebem nenhum tipo de benefício previdenciário. Apesar de se submeter a uma jornada de trabalho exaustiva (90,9%), com exposição a substâncias químicas (83,9%), ruído (69,9%) e radiação solar (88,2%), a maioria não obtém rendimentos que garantam a subsistência familiar (79,6%). Conclusão: há um importante déficit no recebimento de benefícios previdenciários em uma população quilombola tradicional que atende aos critérios de segurados especiais. Sugere-se adequação da legislação, de forma que o acesso aos benefícios se torne mais justo para as comunidades tradicionais.

Abstract Introduction: artisanal fishing and shellfish gathering are considered special activities under the Brazilian general social security system for the purposes of social security benefits. Objective: to describe the access to social security benefits for a traditional fishing quilombola community in northeastern Brazil, whose main occupational activity is shellfish extraction and processing. Methods: a cross-sectional descriptive study conducted in a community from Ilha da Maré, Salvador, Bahia, Brazil. Results: 213 fishermen (76.5% female) participated in the study, of which 62.9% did not receive social benefits. Although most participants undergoing an exhausting working hours (90.9%), with exposure to chemicals (83.9%), noise (69.9%) and solar radiation (88.2%), the majority of them do not earn an income that guarantees their family's subsistence (79.6%). Conclusion: there is an important deficit in social security benefits access for a traditional quilombola population that meets the criteria for special insurance. Legislation must be adapted to ensure fairer access to social benefits for this population.

Relación entre los sistemas políticos y el índice COP en 62 países durante el periodo 1970-2010 / Relationship between the political regime and the DMTF index in 62 countries in the period 1970-2010

Objetivo: determinar la relación de los sistemas políticos y sus trayectorias, según la clasificación de Navarro y Shi, con el índice COP en 62 países durante el periodo 1970-2010. Métodos: se utilizó un diseño ecológico retrospectivo. Para ello, fueron seleccionados países que cumplieran con al menos tres registros de los clasificados en el índice C.O.P a los 12 años de edad en el periodo 1970-2010. Una vez definida la muestra de países, se buscó información sobre las trayectorias políticas de cada país para caracterizar el sistema político y las condiciones de salud oral. El análisis de la información se realizó a partir de cruzar y triangular los datos de la presencia de caries en los países con cada categoría del sistema o régimen político. Resultados: los determinantes sociales y políticos macroestructurales que organizan los sistemas sanitarios influyen en el bienestar de la población de un país. De ahí que, el índice de C.O.P esté relacionado con los contextos políticos, apreciándose que, a mayor democracia, mejores resultados en salud oral. Conclusiones: la forma cómo los diferentes modelos políticos (socialdemócratas, conservadores, liberales y dictatoriales) organizan los sistemas sanitarios en cada Estado, en los 62 países analizados, ha influenciado sobre la experiencia de caries dental de la población (índice COP).

Objective: To determine the influence of political trajectories according to the classification of Navarro and Shi, with the DMTF index in 62 countries during the period 1970-2010. Methods: A retrospective ecological design was used. Countries that met at least three records of the national DMTF indices at 12 years of age in the period 1970-2010 were selected. Once the country sample was defined, information was sought on the political tradition of each country to characterize the political model and oral health conditions. The analysis of the information crossed and triangulated the caries data in the countries according to each category of political model, according to the perspective of the political parties in government. Results: The macro-structural social determinants that organize the health systems influence the well-being of the population in a country and the DMTF index is related to the political regimes, appreciating that the more democratic, the better results they present in oral health. Conclusions: There is an influence of political trajectories (Social Democrats, Conservatives, Liberals and Dictatorials) in the 62 countries analyzed on the experience of dental caries (DMTF index), which is mediated by the way in which political models organize health systems in each country.

Empobrecimento, fome e pandemia: o Auxílio Emergencial, o fim do Programa Bolsa Família e o Auxílio Brasil, 2019-2022 / Impoverishment, hunger, and pandemic: Emergency Aid, the end of the Bolsa Família Benefit, and its replacement, Auxílio Brasil, 2019-2022

Resumo O artigo aborda as escolhas políticas do governo brasileiro relacionadas aos programas sociais de transferência condicionada de renda feitas em meio à pandemia de covid-19. O objetivo é analisar como a implementação do Auxílio Emergencial, o fim do Programa Bolsa Família e a implementação do Auxílio Brasil estão relacionados ao rearranjo e ao desmanche da rede de proteção social brasileira diante da conjuntura de generalizado empobrecimento dos trabalhadores brasileiros. Espera-se não só apresentar um registro dessas ações, mas estabelecer chaves de leitura que, contextualizadas historicamente, permitam explicar a análise de tais ações em meio ao aprofundamento das políticas neoliberais no país.

Abstract This article addresses the political choices made by the Brazilian government concerning conditional cash transfer programs during the covid-19 pandemic. The aim is to analyze how the covid-related Emergency Aid (Auxílio Emergencial), the extinction of the Bolsa Família Program, and the implementation of its replacement, Auxílio Brasil, interacted in the rearrangement and dismantling of Brazil's social protection network in a broader context of a generalized impoverishment of Brazilian workers. The article not only presents a record of these actions, but also offers an interpretative approach that, historically contextualized, can shed light on these actions, which ran parallel to the deepening entrenchment of neoliberal policies in the country.

Detection and Quantification of Gastrointestinal Parasites among Inmates of Social Welfare Homes and Low Socio-economic Areas in Metropolitan Port Harcourt

Background: Detection and quantification of gastrointestinal parasitic infections (GIPIs) causing public health problems among poorer layers of the society are still one of the Neglected Tropical Diseases (NTDs) in developing countries. Objective: The aim of the study was to detect gastrointestinal parasites among inmates of Social Welfare Homes and Low Socioeconomic Areas in Metropolitan Port Harcourt. Methods: A cross-sectional survey was carried out for the evaluation of all the 1500 participants for GIPs among residents of social welfare homes and low socioeconomic areas in Rivers State, Nigeria for a period of one year (July 2019- June 2020). Stool samples were collected from each participant for isolation of GIPs in stool sample. Formol-ether concentration methods and Modified Ziehl-Neelson Staining techniques was used for the isolation and identification of gastrointestinal parasites. Descriptive and Chi square statistical analysis was applied. Results: Out of 1500, 1,381 (92.1%) participants showed negative report, while 119(7.9%) participants were positive for GIPs. Females account for 839 (55.9%) while males were 661 (44.1%). Positivity in males accounted for 9.8% (65/661) and the females had 6.4% (54/839). Age group with high prevalence occurred among 11-15yrs (13.5%)/340. Both variables were statistically significant (p<0.05). Seasonal distribution of GIPs was high during the wet season (p<0.05). Overall, A. lumbricoides was the most predominant gastrointestinal parasites, accounting for 35.3% of the total identified. Others were as follows; T. Trichiura 26.1%, hookworm 21.9%, C. sinensis and S. mansoni 2.5%, tapeworm 1.7%, while H. nana and H. diminuta had 0.8% each. Co-infection of A. lumbricoides + hookworm and hookworm + T. Trichiura recorded 4.2% each. Protozoa species were not identified. Risk factor of the use of toilet papers was found to be statistically significant (p<0.05) among others. Conclusion: We recommend that knowledge of epidemiology and transmission routes of C. sinensis and H. diminuta needs to be improved and effective health education on personal hygiene and mass treatment should be sustainable to control the spread of gastrointestinal parasites.

Espaços potentes para a democracia: um olhar sobre os CRAS em um município do Sul do Brasil / Powerful spaces for equality, emancipation and democracy: a look at the CRAS in a southern Brazilian City / Espacios poderosos de igualdad, emancipación y democracia: una mirada a los CRAS de un municipio del sur de Brasil

Este artigo compõe uma ampla pesquisa, cujo objetivo foi investigar trabalhadores de Centros de Referência de Assistência Social (CRAS) no que se refere a seus fazeres com grupos e coletivos, e experiências de subjetivação política, em municípios do Brasil. Este artigo foca a compreensão dos trabalhadores acerca dos usuários dos CRAS em um município da região Sul. Por meio de entrevistas semiestruturadas, videogravadas e realizadas coletivamente com as equipes dos CRAS, buscamos uma análise voltada ao discurso dos sujeitos, tomando como base o pensamento de Jacques Rancière e dialogando com as diretrizes da PNAS. Os resultados apontam para discursos nos quais se identificam, em grande parte, por relações com os usuários orientadas pelo princípio da igualdade, indicando práticas voltadas à emancipação. Considerando que os CRAS possibilitam uma ampliação do exercício político das comunidades onde se encontram, aponta-se a necessidade de intenso investimento nesses serviços.

This article is part of an extensive research project whose objective was to research the workers from Centros de Referência de Assistência Social (CRAS) regarding their doings with groups and collectives, and experiences of political subjectivation, in Brazilian counties. This article focuses on workers' understanding of CRAS users, in a county of the southern region. Through semi-structured interviews, videorecorded and conducted collectively with the CRAS teams, we seek an analysis focused on the subjects' discourse, based on Jacques Rancière's thinking and dialoguing with the PNAS guidelines. The results point to discourses in which are identified, in most of it, by relationships with users guided by the principle of equality, indicating practices towards the emancipation. Considering that the CRAS enables an expansion of the political exercise of the communities where they are located, there is a need for maintenance and investment in these services.

Este artículo forma parte de un amplio proyecto de investigación cuyo objetivo fue investigar los trabajadores de los Centros de Referência de Assistência Social (CRAS) en relación con su trabajo con grupos y colectivos y sus experiencias de subjetivación política en los municipios de Brasil. Este artículo se centra en la comprensión que tienen los trabajadores de los usuarios del CRAS en un municipio del sur de Brasil. A través de entrevistas semiestructuradas, grabadas en vídeo y realizadas colectivamente con los equipos del CRAS, buscamos un análisis centrado en el discurso de los sujetos, basándonos en el pensamiento de Jacques Rancière y dialogando con las directrices del PNAS. Los resultados señalan que los discursos se identifican, en gran medida, por las relaciones con los usuarios guiadas por el principio de igualdad, lo que indica prácticas volcadas a la emancipación. Teniendo en cuenta que los CRAS permiten ampliar el ejercicio político de las comunidades donde se encuentran, es necesario invertir intensamente en estos servicios.

Doença de Chagas e a seguridade social: caracterização da doença no sistema previdenciário e assistencial brasileiro, 2004-2016 / Enfermedad de Chagas y la seguridad social: caracterización de la enfermedad en el sistema de seguridad y asistencia social brasileño, 2004-2016 / Chagas disease and social welfare: characterization of the disease in the Brazilian social security and social assistance, 2004-2016

Objetivo: Caracterizar o perfil sociodemográfico de beneficiários da seguridade social brasileira com doença de Chagas e identificar fatores associados à concessão de benefícios assistenciais, 2004-2016. Métodos: Estudo transversal, com dados secundários do Ministério do Trabalho e Previdência Social. Empregou-se regressão logística para estimar as razões de chances (OR: odds ratios), brutas e ajustadas, e intervalos de confiança de 95% (IC95%). Resultados: Foram concedidos 36.023 benefícios: 62,5% a pessoas do sexo masculino; 67,0% para residentes de áreas urbanas; 46,7% para moradores da macrorregião Sudeste; 56,7% para pessoas com forma cardíaca crônica; e 42,7% para a faixa etária de 50-59 anos. Residir em áreas urbanas (OR = 134,9; IC95% 78,0;233,2), residir no Nordeste (OR = 2,9; IC95% 2,5;3,1), ser do sexo feminino (OR = 2,0; IC95% 1,8;2,1) e ter idade de 60 anos ou mais (OR = 1,6; IC95% 1,3;1,7) estiveram associados aos benefícios assistenciais. Conclusão: Fatores relacionados a zona de residência, macrorregião, sexo e faixa etária aumentaram a chance de concessão de benefícios assistenciais.

Objetivo: Caracterizar el perfil sociodemográfico de los beneficiarios de la seguridad social brasileña con enfermedad de Chagas e identificar los factores asociados a la concesión de beneficios asistenciales, de 2004 a 2016. Métodos: Estudio transversal con datos del Ministerio de Trabajo y Seguridad Social. Se utilizó la regresión logística para estimar las razones de probabilidad (OR) brutas y ajustadas. Resultados: Se otorgaron 36.023 beneficios; 62,5% para el sexo masculino; 67,0% para residentes en áreas urbanas; 46,7% residentes del Sudeste; 56,7% para personas con insuficiencia cardiaca crónica; y 42,7% para personas de 50-59 años. Residir en áreas urbanas (OR = 134,9; IC95% 78,0;233,2), en el Nordeste (OR = 2,9; IC95% 2,5;3,1), ser de sexo femenino (OR = 2,0; IC95% 1,8;2,1) y tener de 60 años o más (OR = 1,6; IC95% 1,3;1,7) fueron factores asociados a las prestaciones asistenciales. Conclusión: Los factores relacionados con el local de residencia, sexo y grupo de edad aumentaron la posibilidad de otorgar beneficios asistenciales.

Objective: To characterize the sociodemographic profile of beneficiaries of Brazilian social welfare affected by Chagas disease and identify factors associated with the granting of assistance benefits, 2004 to 2016. Methods: Cross-sectional study based on secondary data from the Ministry of Labor and Social Security. Logistical regression was performed to estimate crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI). Results: 36,023 benefits were granted; 62.5% were to male; 67.0% to residents of urban areas; 46.7% to residents of Southeast region; 56.7% to people with chronic cardiac form; and 42.7% to the 50-59 age group. Residents of urban areas (OR = 134.9; 95%CI 78.0;233.2), Northeast macro-region (OR = 2.9; 95%CI 2.5;3.1), female (OR = 2.0; 95%CI 1.8;2.1) and age group 60 years or older (OR = 1.6; 95%CI 1,3;1,7) were factors associated with assistance benefits. Conclusion: Factors related to the area of residence, macro-region, sex and age group increased the chance of granting assistance benefits.

El colegio como lugar de sanación social: una reflexión en tiempos del Covid-19 / The school as a place of Social Healing: a reflection in times of Covid-19

Con el presente artículo pretendemos ahondar en lo que se puede denominar como una concepción y visión sanadora de la sociedad desde el ámbito que como maestros nos ocupa, que es el educativo. Para ello, tomamos como referencia la más reciente literatura científica relativa al docente y a la didáctica como elementos curativos en potencia y la relacionamos con los colegios como espacios donde se produce el proceso de enseñanza-aprendizaje. Así, unimos las reflexiones previas sobre esta temática con aquellas surgidas en España durante los meses de pandemia, ya que nuestra forma de vida ha cambiado considerablemente y hay aspectos que deben visibilizarse en las aulas. A lo largo del texto ponemos también el foco en los futuros docentes, es decir, en los alumnos que se están formando para ser maestros y que, a lo largo de su formación, dedicarán tiempo a las prácticas pedagógicas en centros educativos. Estos alumnos que se encuentran realizando el prácticum son el futuro de la educación, por lo que es fundamental que vayan desarrollando determinadas competencias docentes y que lleguen a amar el proceso de enseñanza-aprendizaje a través de un aprendizaje lúcido y lúdico.

With this article we aim to delve into what can be called as a healing conception and vision of society from the field that we are dealing with as teachers, which is the educational. For this, we take as a reference the most recent scientific literature related to teaching and didactics as potential curative elements and we relate it to the schools like places where this teaching-learning process occurs. Thus, we join the previous reflections on this issue with those that emerged in Spain during the months of the pandemic, since our way of life has changed considerably and there are aspects that must be visible in the classroom. Throughout the text, we also focus on future teachers, that is, students who are being trained to be teachers and who, throughout their training, will spend time on their practices in educational centers. These students who are doing the practicum are the future of education, so it is essential that they develop certain teaching skills and that they come to love teaching-learning process through ludic and lucid learning.

Bienestar Social, Autoestima y Reconocimiento: Estudio Empírico sobre Crimen y Exclusión Basado en la Categoría de Menosprecio de Axel Honneth / Social welfare, Self-esteem and Recognition: Empirical Study on Crime and Exclusion Based on the Category of Contempt of Axel Honneth

Resumen Este trabajo estriba en un primer acercamiento empírico a la categoría de menosprecio de Axel Honneth, para quien la lucha por reconocimiento consiste en una negociación intersubjetiva con pretensiones de reivindicación identitaria. Según este autor, el reconocimiento desplaza la concepción de justicia desde su acepción tradicional de redistribución material hacia la noción de vida satisfactoria. Este artículo examinará especialmente la hipótesis de que el crimen, en su interconexión con la exclusión social, sería consecuencia de la negación de reconocimiento. Así, se armó un estudio cuantitativo con sujetos residentes en España, agrupados en presos (n = 117), personas en situación de riesgo social (n = 131) e individuos fuera de ambas condiciones (n = 294). Las variables utilizadas fueron autoestima, bienestar social subjetivo, fatalismo y autoeficacia. Los resultados de los análisis estadísticos sobre diferencias de medias entre grupos, correlaciones y regresiones múltiples indicaron la validez de la categoría de menosprecio de Honneth y confirmaron la hipótesis planteada

Abstract The work is based on a first empirical approach to the category of contempt of Axel Honneth, for whom the struggle for recognition consists of an intersubjective negotiation that the subjects establish among themselves to achieve the consideration of their identity claims . According to this author, recognition displaces the conception of justice from its traditional meaning of material redistribution to the notion of a satisfactory life. This article will examine in particular the hypothesis that crime, in its interconnection with social exclusion, would be a consequence of the denial of recognition. Thus, a quantitative study was set up with subjects residing in Spain, grouped into: prisoners (n=117), people at social risk (n=131) and individuals who were not in the previous conditions (n=294). The variables used were: self-esteem, subjective social welfare, fatalism, and self-efficacy. The results of the statistical analyzes indicated the validity of Honneth's category of contempt and confirmed the hypothesis investigated.

2．Response to COVID-19 from a Social Welfare Policy Perspective / 薬剤疫学

Novel coronavirus infection（COVID-19）is having a significant impact on diverse areas of society. We investigated the features of Japan's policies from the perspective of analogies used in social welfare policy and policy science. The results revealed that Japan's statistics do not represent reality； the government is unable to respond with world-class policies； the system is maintained through excessive workloads in the workplace； local governments adopt different directions to national policy； non-experts are confusing society； and other areas are affected due to the inability to implement concentrated investment and support. If we apply these findings to the current COVID-19 response, there are problems including statistical issues, an inability to respond with world-class policies, confusion of policy objectives and means of implementation, increased public opinion guidance that disregards human life, and the inability to adopt optimal measures due to a lack of resources, which worsened the situation and affected other areas. Therefore, it is presumed that insufficient care and compensation to individuals adversely affected by the social effects of COVID-19 would delay economic and social recovery. Accordingly, as a future response, we will present policies including establishment of a crisis management organization, accumulation of experience, and implementation of suitable statistical information to deal with infectious diseases that exceed a certain disaster level. We also recommend that preparations be implemented during normal times, rather than waiting until a crisis has occurred, and a system for finding and supporting people who have suffered due to these events should also be considered. All these issues can be resolved by politics. In other words, all of Japan's problems can be said to converge on the political arena； hence, it is predicted that the current society that excessively burdens its citizens will persist for a long time unless suitable policies are implemented through the political process.

Guarantee of the social rights of children with chronic conditions: reinventing care towards civil rights / Garantía de los derechos sociales de los niños en condiciones crónicas: reinventando el cuidado para la ciudadanía / Garantia dos direitos sociais das crianças com condições crônicas: reinventando o cuidado para a cidadania

ABSTRACT Objective: To analyze the experiences of families in the exercise of the rights of children with chronic conditions in public health, education and social assistance institutions. Method: ethnographic multiple case study, with qualitative approach, following the theoretical approach of Boaventura Santos. Experiences of the families of these children in a city were studied through interviews with family members, managers and professionals from social institutions (35), participant observations in social spaces (13) and creation of eco-maps (3). Critical Discourse Analysis was performed. Results: the offer of services is lower than the demand, and exclusion processes persist. Given the hegemony of neoliberal and normality ideologies, meetings between family members and professionals revealed obstacles to civil rights; however, when these ideologies were challenged, the realization of their rights was enhanced. Final considerations: the care to promote civil rights requires family members, managers and professionals to develop subjectivities that overcome neoliberal and normality ideologies, recognizing these children as subjects of law.

RESUMEN Objetivo: analizar las experiencias de las familias en cuanto el ejercicio de los derechos de los niños en condiciones crónicas de las instituciones públicas de salud, educación y asistencia social. Método: se trata de una investigación etnográfica de casos múltiples, de enfoque cualitativo y referencial de Boaventura Santos, realizada en un municipio con entrevistas a familiares, gestores y profesionales de las instituciones (35), observación de los participantes en los espacios sociales (13) y elaboración de Ecomapas (3); se llevó a cabo el Análisis Crítico del Discurso. Resultados: la oferta del cuidado es inferior a la demanda y persisten los procesos de exclusión. Frente a la hegemonía de las ideologías neoliberales y la normalización, los encuentros entre familiares y profesionales revelaron obstáculos a la ciudadanía; sin embargo, al cuestionarse las ideologías, la efectividad de los derechos promulgados se potencializó. Consideraciones finales: el cuidado para promover la ciudadanía exige construcción de subjetividades en las prácticas de familiares, gestores y profesionales que rompan con las ideologías neoliberales y de normalización y, en consecuencia, reconozcan a esos niños como sujetos de derechos.

RESUMO Objetivo: analisar as experiências das famílias para exercício dos direitos das crianças com condições crônicas nas instituições públicas de saúde, educação e assistência social. Método: estudo de casos múltiplos etnográfico, com abordagem qualitativa e referencial de Boaventura Santos. Foram estudadas experiências das famílias dessas crianças em um município, por meio de entrevistas com familiares, gestores e profissionais das instituições sociais (35), bem como por observações participante nos espaços sociais (13) e elaboração de ecomapas (3). Realizou-se Análise Crítica do Discurso. Resultados: a oferta de atendimento é menor que a demanda e persistem processos de exclusão. Diante da hegemonia das ideologias neoliberal e de normalização, os encontros entre familiares e profissionais revelaram obstáculos à cidadania, porém quando essas ideologias foram contestadas potencializou-se a efetivação dos direitos promulgados. Considerações finais: o cuidado para promover a cidadania exige construção de subjetividades nas práticas de familiares, gestores e profissionais que rompam com as ideologias neoliberal e de normalização, por consequência reconheçam essas crianças como sujeitos de direitos.

Características e demandas da população em situação de vulnerabilidade social acompanhadas em Belford Roxo (RJ) / Characteristics and demands of the population in a situation of social vulnerability attended in Belford Roxo (RJ)

RESUMO O objetivo deste estudo foi o descrever as características e demandas das famílias em acompanhamento no Centro de Referência de Assistência Social (Cras) de Santa Marta, município de Belford Roxo (RJ), no período de 2006 a 2017. Trata-se de estudo transversal descritivo com dados extraídos das fichas de acompanhamento. Um total de 87 famílias foi acompanhada no período. A maioria dos responsáveis familiares era do sexo feminino (92,0%), menor de 40 anos (59,8%), solteira (92,0%) e com ensino fundamental incompleto (89,7%). As principais demandas se referiram ao descumprimento de condicionalidade do Programa Bolsa Família (28,7%) e evasão escolar (26,4%). O serviço de saúde (33,3%) apresentou o maior encaminhamento intersetorial. A mediana do tempo de acompanhamento foi de 53 meses. Não houve diferença no tempo de acompanhamento em função do grupo etário, sexo, vínculo de trabalho informal ou precário, para recebimento de benefício, forma de acesso, tipo de demanda e registro de plano de acompanhamento (p≥0,272). A demanda espontânea foi a razão de a maioria das famílias estar em acompanhamento (86,2%), mas não havia registro sobre sua situação de vulnerabilidade. A identificação das famílias que necessitam de acompanhamento é importante para garantir acesso aos direitos socioassistenciais, além de contribuir para superar as desigualdades sociais existentes.

ABSTRACT The objective of this study was to describe the characteristics and demands of the families under follow-up at Social Assistance Referral Center (Cras) of Santa Marta, municipality of Belford Roxo, State of Rio de Janeiro, from 2006 to 2017. This is a descriptive cross-sectional study whose data were retrieved from the families' accompanying records. A total of 87 families were followed up within the study period. Most of the family heads were female (92.0%), under 40 (59.8%), single (92.0%) and incomplete elementary school (89.7%). Main demands referred to noncompliance with the Bolsa Família Program (28.7%) and school dropout (26.4%) conditionalities. Health service (33.3%) showed the greatest intersectoral referral. The median following-up time was 53 months. There was no difference in the following-up time due to the age group, gender, informal or precarious employment relationship, benefit payment, access type, demand type, and follow-up plan registration (p≥0,272). Spontaneous demand was the reason for most of the families to be under follow-up (86.2%), although no record existed on their vulnerability situation. The identification of the families in the need to be followed is important to guarantee access to social and care rights, besides contributing to overcome the existing social inequalities.

O espírito de um sobrevivente / The survivor's spirit / El espíritu de un sobreviviente

Em 2018, o Sistema Único de Saúde (SUS) completou 30 anos de sua criação no Brasil. Embora reúna muitas conquistas nessas três décadas, o SUS hoje enfrenta novos desafios, impostos pela agenda liberal e conservadora em curso no país. Nesse contexto, o documentário O Espírito de 45 (2013), dirigido por Ken Loach, que destaca a criação do Serviço Nacional de Saúde (National Health Service - NHS), no Reino Unido, é um filme salutar. Tendo a cidadania e o bem comum como grandes temas, a obra mostra como é possível, revisitando o passado, despertar o espírito combativo em defesa de uma sociedade mais justa e solidária, que privilegie o bem-estar da população em lugar do lucro e que aponte caminhos para a defesa do SUS, enquanto uma conquista do povo brasileiro.

In 2018, the SUS ­ Sistema Unificado de Saúde (Unified Health System) celebrated the 30th anniversary of its setting up in Brazil. Despite its many achievements in these three decades, nowadays SUS faces new challenges which were imposed by a liberal and conservative agenda ongoing in the country. In this context, the documentary The Spirit of '45 (2013), directed by Ken Loach, which highlights the creation of the National Health Service (NHS) in the United Kingdom, is a very important film. Addressing citizenship and the common good as major themes, the movie shows how it is possible by revisiting the past to awaken the combative spirit in favour of a fairer and more solidary society, in order to prioritize the population's wellbeing instead of the profit and to point out ways to defend SUS as an achievement of the Brazilian people.

En 2018, el SUS ­ Sistema Único de Saúde (Sistema Único de Salud) completó 30 años de su creación en Brasil. Aunque haya tenido muchos logros en estas tres décadas, el SUS enfrenta hoy nuevos desafíos, impuestos por la agenda liberal y conservadora en curso en el país. En este contexto, la película documental The Spirit of '45 (2013), en la versión brasileña, O Espírito de 45, de Ken Loach, que destaca la creación del Servicio Nacional de Salud (National Health Service ­ NHS); en el Reino Unido, es un buen ejemplo. Con la ciudadanía y el bien común como temas principales, la producción muestra como es posible, reviviendo el pasado, despertar el espíritu combativo en defensa de una sociedad más justa y solidaria, que privilegie el bienestar de la población en lugar de losbeneficios lucrativos, y señale formas de defender el SUS, como un logro del pueblo brasileño.

Saúde e migração em Roraima: rede social migratória e impactos psicossociais na vida do migrante venezuelano enquanto trabalhador informal / Health and migration in Roraima: migratory social network and psychosocial impacts on life of the venezuelan migrant as an informal worker

Objetivo geral: caracterizar as condições do trabalho informal e seus impactos psicossociais na vida do migrante venezuelano. Métodos: trata­-se de um estudo descritivo de abordagem qualitativa e etnográfica. Resultados: A partir do levantamento sociodemográfico e da situação laboral, constatou-se a predominância de indivíduos jovens, exercendo atividade de vendedor ambulante no país de destino. A partir dos relatos, quanto a constituição da rede social migratória, apurou-se a participação familiar. Identificou-se ainda o sentimento de bem-estar e conformidade ao trabalhar no Brasil. Conclusão: a procura por trabalho tem sido um dos maiores motivos para se efetuar a travessia de fronteiras. Todavia, as escassas oportunidades de emprego induzem o migrante ao trabalho informal.

General objective: to characterize the conditions of informal work and their psychosocial impacts on the life of the Venezuelan migrant. Methods: This is a descriptive study of qualitative ethnographic approach. Results: From the sociodemographic survey and the employment situation, it was found the predominance of young individuals, working as a street vendor in the destination country. From the reports, regarding the constitution of the migratory social network, i t was found the family participation. The feeling of well­being and compliance is evident when working in Brazil. Conclusion: the search for work has been one of the biggest reasons for crossing borders. However, scarce employment opportunities induce migrants to work informally.

Educación interprofesional y vivencias de los estudiantes en la ejecución de proyectos de desarrollo social / Interprofessional Education and Life Experience of Students in the Implementation of Social Development Projects

Introducción: La educación terciaria tiene el reto de formar profesionales de salud idóneos para desempeñarse como agentes proactivos de cambio. La participación en proyectos sociales es una estrategia para integrar la educación interprofesional en sus competencias. Objetivo: Comprender las vivencias de los estudiantes que participan en proyectos de desarrollo social, en el marco de la educación interprofesional. Métodos: Estudio cualitativo con enfoque fenomenológico. La muestra se obtuvo por saturación teórica, conformada por 11 estudiantes que participaron en proyectos de desarrollo social. La colecta de datos se realizó con una entrevista en profundidad a los estudiantes que otorgaron su consentimiento informado. Se utilizó el análisis fenomenológico de Coalizzi identificando significados, categorías y subcategorías. Resultados: Del análisis de los discursos emergieron 4 categorías: trabajo en equipo, colaboración interprofesional, toma de decisiones y resolución de conflictos, adquisición de nuevos conocimientos y habilidades. Conclusiones: Los estudiantes participantes fortalecieron el trabajo en equipo ya que conocieron mejor su rol. La comunicación interprofesional fue base para consolidar su participación en los roles de liderazgo y les permitió visualizar su actuar ulterior como profesionales de la salud en la búsqueda de la atención centrada en el paciente con una práctica colaborativa. Frente a dificultades surgidas aprendieron a tomar decisiones en equipo para resolver los conflictos a través del reconocimiento de las líneas de autoridad. Han adquirido nuevos conocimientos y habilidades lo que permite que su formación sea más sólida al asumir un compromiso con la sociedad para dar una atención centrada en el paciente, interprofesionalmente y con calidad(AU)

Introduction: Tertiary education is challenged to train health professionals qualified to act as proactive agents of change. Participation in social projects is a strategy to integrate interprofessional education into its competences. Objective: To understand the experiences of the students who participate in social development projects, within the framework of interprofessional education. Methods: Qualitative study with a phenomenological approach. The sample was obtained by theoretical saturation, made up of 11 students who participated in social development projects. The data collection was carried out with an in-depth interview with the students who gave their informed consent. Colaizzi's phenomenological analysis was used, and meanings, categories and subcategories were identified. Results: From the analysis of the discourses, four categories emerged: teamwork, interprofessional collaboration, decision making and conflict resolution, acquisition of new knowledge and skills. Conclusions: The participating students strengthened teamwork, as they knew their role better. Interprofessional communication was the basis to consolidate their participation in leadership roles and allowed them to visualize their subsequent actions as health professionals in the search for patient-centered care with collaborative practice. Before the difficulties that appeared, they learned to make team decisions to resolve conflicts through the recognition of lines of authority. They have acquired new knowledge and skills, which makes their training more solid by assuming a commitment to society and to provide quality patient-centered care interprofessionally(AU)

A Comissão Nacional de Bem-estar Social: planejamento estatal e política social, 1951-1954 / The National Commission of Social Welfare: State planning and social policy, 1951-1954

Resumo O artigo analisa a criação da Comissão Nacional de Bem-estar Social no segundo governo Vargas (1951-1954). A partir das mensagens presidenciais e do acervo privado de Alzira Vargas do Amaral Peixoto, contextualiza o momento de fundação do órgão e suas conexões com órgãos internacionais de planejamento da política de assistência social.

Abstract The article analyzes the creation of the National Commission of Social Welfare (Comissão Nacional de Bem-Estar Social) during the second Vargas administration (1951-1954). Presidential communiqués and the private archive of Alzira do Amaral Peixoto Vargas are used to characterize the context of the founding of the commission and its liaison with international entities involved in the planning of social welfare policies.

A study on nutritional status and environmental conditions of school children residing in social welfare hostels in urban area of a South Indian city

Background: Nutrition plays a vital role, as inadequate nutrition during childhood may lead to malnutrition, growth retardation, reduced work capacity and poor mental and social development. The school age period is nutritionally significant so this study aims is to evaluate the present scenario of nutritional status and environmental conditions of schedule caste school children residing in social welfare hostels.Methods: A community-based cross sectional study was taken up in 9 social welfare hostels in urban Vijayawada city. 312 students were studied in a period of one year, from October 2012 to October 2013. Nutritional status of children was assessed by anthropometric measurements viz BMI, Hb levels. Environmental conditions of the hostel were assessed after thorough inspection of all the environmental conditions. Data was analysed using SPSSv20.Results: Prevalence of underweight was more in boys compared to girls with (27.9%) of boys with grade III thiness as compared to (11.50%) of girls and overall prevalence of underweight of 39.1% in boys as compared to 31.1% girls. Overall prevalence of anaemia was found out to be 97.7% with girls 53.5% and 44.2% in boys. Overcrowding is seen in all the hostels studied. All the rooms are adequately ventilated, and lighting was adequate. Sanitation is found to be satisfactory.Conclusions: This study found out that prevalence of anaemia (97.7%) and malnourishment was high in majority of school children in social welfare hostels.

O direito constitucional ao Benefício de Prestação Continuada (BPC): o penoso caminho para o acesso / The Constitutional Right to the Continued Payment Benefit (BPC): the arduous path to its access

Resumo: O BPC é o único benefício da Assistência Social garantido pela Constituição Federal de 1988 no valor de um salário mínimo mensal. Apesar de ser imprescindível na vida dos beneficiários e de suas famílias, tendo mais de 4,5 milhões de benefícios mantidos, a materialização do BPC em dois espaços (Assistência Social e INSS), a burocracia estatal, a falta de informações e, principalmente, a (i)lógica perversa dos critérios tornam penoso o caminho percorrido pelos usuários.

Abstract: The BPC is the only benefit from Social Assistance guaranteed by the Federal Constitution of 1988 in the amount of one minimum monthly salary. It was found that, despite of being indispensable in the lives of its more than 4,5 million recipients and their families, BPC's materialization in two spaces (Social Assistance and INSS), the bureaucracy, the absence of information, and especially the perverse (i)logic of its criteria make an arduous path for its users to go through.