ABSTRACT
Objetivo: Analizar la influencia de las instituciones en el funcionamiento de los consejos locales de salud. Diseño: Estudio cualitativo, descriptivo y exploratorio. Emplazamiento: Dos servicios de atención primaria de salud de un municipio del interior del estado de São Paulo, Brasil.Participantes: Veinticuatro miembros de los consejos locales de salud y 4 informantes clave. Método: Basado en el marco teórico y metodológico del análisis institucional. Los datos fueron producidos a través de 28 entrevistas individuales con preguntas semiestructuradas, observación, participación en las actividades de los consejos y registro en el diario de investigación. Los datos fueron organizados por el proceso de transcripción, transposición y reconstitución. Resultados: Las instituciones actúan en los territorios representados por actores sociales que ocupan cargos y funciones dentro de los servicios de atención primaria de salud, evidenciando la perpetuación de la jerarquización con valorización de los discursos de los profesionales y gestores en detrimento de los pacientes y predominio de reuniones burocratizadas. Los actores sociales reproducen los ideales del colectivo al que pertenecen en estos espacios. Conclusión: No siempre los equipos de gestión de salud reconocen las diferentes fuerzas que actúan en el territorio de salud, sin embargo, estas fuerzas interfieren en las actividades desarrolladas y en la atención de la salud. Los grupos actúan tanto en espacios formales a través de representantes oficiales que se reúnen y discuten temas en colegiados como en espacios informales y constituyen fuerzas en disputa en el territorio de salud.(AU)
Objective: To analyze the influences of the institutions in the operation of the Local Health councils. Design: qualitative, descriptive and exploratory study. Study setting: 02 Primary Health Care services of a municipality in the inland of the state of São Paulo, Brazil. Participants: twenty-four members of the Local Health Councils and 4 key informants. Methods: Supported by the theoretical methodological framework of Institutional Analysis. Data were produced through 28 semi-structured interviews, observation and participation in the activities of the councils and recording in the research diary. Data were organized and analyzed by the process of transcription, transposition and reconstitution. Results: The institutions act in the territories represented by social actors who occupy positions and functions within the Primary Health Care services, evidencing the perpetuation of hierarchization with valorization of the speeches of professionals and managers to the detriment of patients and predominance of bureaucratized meetings. The social actors reproduce the ideals of the collective to which they belong in these spaces. Conclusions: The health management teams do not recognize the different forces that act in the health territory, however, these forces interfere in the activities performed and in health care. The groups act both in formal spaces through official representatives who meet and discuss issues in collegiate meetings and in informal spaces, and constitute forces in dispute in the health territory.(AU)
Subject(s)
Humans , Male , Female , Health Councils/organization & administration , Social Participation , Organizations , Unified Health System , Community Participation , Epidemiology, Descriptive , Qualitative Research , Primary Health Care , BrazilABSTRACT
OBJECTIVE: To analyze the influences of the institutions in the operation of the Local Health councils. DESIGN: qualitative, descriptive and exploratory study. STUDY SETTING: 02 Primary Health Care services of a municipality in the inland of the state of São Paulo, Brazil. PARTICIPANTS: twenty-four members of the Local Health Councils and 4 key informants. METHODS: Supported by the theoretical methodological framework of Institutional Analysis. Data were produced through 28 semi-structured interviews, observation and participation in the activities of the councils and recording in the research diary. Data were organized and analyzed by the process of transcription, transposition and reconstitution. RESULTS: The institutions act in the territories represented by social actors who occupy positions and functions within the Primary Health Care services, evidencing the perpetuation of hierarchization with valorization of the speeches of professionals and managers to the detriment of patients and predominance of bureaucratized meetings. The social actors reproduce the ideals of the collective to which they belong in these spaces. CONCLUSIONS: The health management teams do not recognize the different forces that act in the health territory, however, these forces interfere in the activities performed and in health care. The groups act both in formal spaces through official representatives who meet and discuss issues in collegiate meetings and in informal spaces, and constitute forces in dispute in the health territory.
Subject(s)
Community Participation , Health Planning Councils , Humans , Brazil , Delivery of Health CareABSTRACT
Medicinal plants are an alternative for the treatment of infected wounds. The objective of this study was to evaluate the efficacy of Sebastiania hispida in an animal model with a wound infected by Staphylococcus aureus. The crude ethanol extract (ExtEtOH) of S. hispida underwent phytochemical analysis, quantification of metabolites and antibacterial activity analysis performed using S. aureus. Wistar rats were used to test healing activity, and the groups evaluated comprised gels of ExtEtOH at the concentrations 0.2 and 2% compared with control groups. Animals were inoculated with the bacteria S. aureus resistant to methicillin. The treatment periods were of 3 and 21 days. Macroscopic and microscopic analysis were conducted and data were submitted to analysis of variance (pâ¯<â¯0.05). Phytochemical and quantification analysis indicated that phenolic compounds and flavonoids are the major constituents, followed by tyterpenes. ExtEtOH 0.2% was the most effective gel against the growth of strains of S. aureus. Histological wound and regression analysis showed that ExtEtOH gels (0.2% and 2%) were similar and effective in promoting wound healing. In the quantification of collagen fibers, the animals from all groups showed a high amount of thick collagen fibers. Thus, ExtEtOH gels based on the shoots of S. hispida can be used for the treatment of infected wounds as a complementary therapy for infected wound closure and further assays are required with other means. The healing effectiveness may be due to the high content of phenolics, flavonoids and triterpenes.
