The professional path of postgraduates of a professional master's degree in primary health care in the municipality of Rio de Janeiro, Brazil: an evaluative study.

A four-block exploratory study was conducted with an electronic online, anonymous questionnaire to study the path of postgraduates  from two professional master's degree classes, as follows: personal, current professional activity, course-professional situation relationship, and open-ended questions for positive/negative points. Results: Most of them remained in the primary care area and public services; in health care and as tutors; developed a course-related work activity, and 75% reported a high impact of the course. A lower effect was perceived in the remuneration.

[Similarities and diferences between Academic and Professional Master Programs as Educational Public Policy in the field of Public Health].

In the attempt to find a specificity for the Professional Master Program in Public Health (PM), we asked, what is, from the point of view of its means and purposes, kept or broke from the training models of the Academic (traditional) Masters Program (AM). In the public health field, this discussion possess an extra "flavor", as both program aim, in Brazil, to prepare health professionals to the Brazilian Unified Health System (SUS). Therefore, this research sought to investigate the heuristic and innovative vocation of the PM vis-à-vis the AM as an education public policy.

Traditional Complementary and Integrative Medicine: challenges in constructing an evaluation model of care.

The complexity and diversity of what is proposed in Traditional and Complementary Medicine constitute a challenge for those seeking evidence of its effectiveness. Its growth, offer and, use justify the need to build more complex and more appropriate methodological frameworks to explicit the uniqueness of this approach to healthcare and the diversity of its techniques. Based on a narrative review of the recent literature, this article aims to contribute to the construction of an evaluation model, focused on understanding the uniqueness and diverse dimensions of this specific care, seeking to reflect on the challenges and evidences of successful therapy.

Partnerships in Health Systems: Social Organization as limits and possibilities in the Family Health Strategy Management.

This is a case study in the municipality of Rio de Janeiro about management in the Family Health Strategy based on the Social Organizations model. The aims were to characterize and analyze aspects of the governance system adopted by the Rio de Janeiro Municipal Health Department and identify limits and possibilities of this model as a management option in Brazil's Unified Health System. A qualitative study was performed based on a literature review, document analysisand interviews with key informants.

Social inequality, health policies and the training of physicians, nurses and dentists in Brazil and in Portugal.

This study analyzes the production of scientific knowledge on Health Inequalities (HI) and its use in policies of education of dentists, nurses and physicians in Brazil and Portugal. Documents published between January 2000 and December 2001, in Portuguese, French, English and Spanish, were identified by means of a combination of a manual and intentional electronic database survey of the grey literature. Fifty-three documents were selected from a total of 1,652.

Activators of processes of change: a proposal oriented to the transformation of educational practices and the training of health professionals.

This paper investigates an educational proposal articulated through a policy of the Ministry of Health, which aims to promote changes in the training of health professionals. An inter-institutional partnership promoted the training of specialists as Activators of Processes of Change. This study analyzes the characteristics of a post-graduate semi-distance-learning course, examining the transformation potential of health praxis.

[Contractual arrangements in primary health care: the experience of Portugal and Brazil].

The contractual arrangements adopted in the Family Health Strategy are a topic as yet scantly addressed in studies. It is introduced in Brazil in different models in accordance with the contracting entity and the legal status of the contracted service provider; and in Portugal, it is based on a model of inter-governmental contractual arrangements with the Family Health Units. In this paper, the current status of contractual arrangements in both countries is presented and their attributes of joint planning, accountability with autonomy and performance-based incentive programs are discussed.

[Professional Master's in Public Health: from legal precepts to experience in a research and education institution].

This study is about the discourses that prevailed over the course of time in Brazilian legislation for the Master's Course in Public Health, and how a Brazilian research and education institution in the area of Public Health appropriated these discourses in the creation of its course proposals. Discourse analysis techniques were applied to legal documents and to sixteen master's programs developed in the institution under scrutiny. The results revealed that with respect to legislation, analysis of the historical timeline makes it possible to say that the initial lack of definition progressively gave rise to the understanding that the identity of such post-graduate education presupposes pedagogical practices that promote the strengthening of ties between academia and the workplace.

[Professional paths of alumni from doctorate programs in health and biological sciences].

Objective: To analyze the career path and professional satisfaction of alumni from the doctorate degree programs in health sector.

Methods: Exploratory study with 827 alumni of doctoral programs in public health, biological and health sciences at the , RJ, Southeastern Brazil, from1984 to 2007. The subjects were grouped in three cross-temporal cohorts according to year.

[Integrative and complementary health practices: the supply and production of care in the Unified National Health System and in selected municipalities in Brazil].

The world of Traditional/Complementary and Alternative Medicine has grown and its importance has been emphasized in several studies. In Brazil, the National Policy on Integrative and Complementary Practices encourages their inclusion and empowerment in primary care. This study attempted to identify the provision of services and integrative practices in the Unified National Health System and the production of consultations from 2000 to 2011, contrasting the analysis of available information in national databases with the primary care data collected locally in Campinas (São Paulo State), Florianópolis (Santa Catarina State), and Recife (Pernambuco State).

[Characteristics and limits of Professional Master in the Health area: study with alumni from Oswaldo Cruz Foundation].

This paper discuss findings of a follow-up study with alumni of three graduate courses known as "professional master" oriented toward institutional innovation in management of science and technology, offered by Oswaldo Cruz Foundation to its employees. The study analyzed alumni profile and characteristics, identified evidence of changes in their original workplace and assessed the relationship between the courses proposals, institutional needs and alumni expectations. The paper presents limits and possibilities of this new format of graduate courses, emphasizing its evaluation as strategic for institutional development.

[Interventions to solve overcrowding in hospital emergency services: a systematic review].

This review discusses interventions aimed at solving the problem of overcrowding in hospital emergency services (HES), characteristic of low organizational effectiveness. In free-access and restricted-access databases, the target descriptors were 'overcrowding; emergency; medicine; first aid'. The survey identified 66 citations of interventions, grouped in 47 related interventions.

[Evaluation of group and individual strategies in a diabetes education program].

Objective: To compare the effectiveness of individual and group strategies in a diabetes education program.

Methods: A total of 104 type-2 diabetes outpatients enrolled in an education program of a teaching hospital in Belo Horizonte, Southeastern Brazil, were randomly selected and assigned to two different education strategies: group education (54 subjects) and individual education (50 subjects). Group education comprised three monthly sessions, which involved play and interactive dynamics.

[Self-assessment in graduate public health programs: characteristics and constraints].

The purpose of this paper is to discuss the characteristics and constraints of internal appraisals or self-assessments in Graduate Public Health Programs, conducted through a study of the report on 25 programs participating in the three-year CAPES evaluation (2001-2003). Three main aspects were considered: (a) tools and/or procedures employed; (b) self-assessment procedures; (c) products for upgrading program quality. The findings indicate that different tools are employed and used improperly.

[Quality in the public health services emergency and some considerations about recent events at Rio de Janeiro city].

The main focus of the QUALISUS Program run by Brazil's Ministry of Health is the quest for quality in healthcare services, particularly in hospital emergency rooms. Taking as an example the crisis in health emergency services in Rio de Janeiro, this paper discusses some structural characteristics of this Program, emphasizing enhanced responsibility and a stronger team spirit for modified intake systems and building up of seamlessly integrated healthcare networks. Identifying possible solutions for this crisis based not only on funding, it suggests a quest for a new identity, redefining and integrating healthcare vocations, structuring flows and revising the work processes of healthcare services through a systemic approach focused on the user.

[The Integrar Project: an evaluation of comprehensive health care services in Vitória, Espírito Santo, Brazil].

This article describes an experience with the integration of various healthcare services, called the Integrar Project, in Vitória, capital of the State of Espírito Santo, Brazil, and analyzes the project's contribution to the development of comprehensive healthcare practices. The case study used a qualitative approach and covered the period from 2000 to 2003, identifying the project's potential in the areas of maternal and child health, continuing health education, and the family health strategy, but also identified difficulties in establishing integrated treatment projects involving both the Family Health Program teams and the various medical specialties. To a major extent the work proposal failed to materialize, highlighting the need to review the strategy to include new forms of communications and developing greater formal cooperation, beyond the existing informal coordination between individuals, teams, or services, based on a contractual logic in public healthcare services.

[Palliative care in cancer: elements for debating the guidelines].

The aim of this study was to present elements for debating guidelines on palliative care programs for cancer. A literature survey searched various databases (MEDLINE, LILACS, and Cochrane Library), homepages of palliative care organizations, publications by renowned authors in this area, reference textbooks on the subject, relevant articles cited by these books, and the thesis/dissertation database of CAPES (the Brazilian Coordinating Body for Training University Level Personnel). The data were grouped into four thematic categories: symptomatic palliation, organization of services, psychosocial characteristics, and spiritual characteristics.

[Validation of Diabetes Mellitus Knowledge (DKN-A) and Attitude (ATT-19) Questionnaires].

Objective: To present the cross-cultural adaptation of the Diabetes Knowledge Scale and Attitudes Questionnaires targeted to evaluate Brazilian Diabetes Mellitus patients.

Methods: These questionnaires underwent the following steps: presentation, translation, back translation, semantic and idiomatic assessments, cultural and conceptual similarities and a pilot test. They were administered in two opportunities a month apart in a sample of 61 Diabetes Mellitus type-2 patients from a university hospital.

[Managerial performance in public health services: a case study in Mato Grosso do Sul, Brazil].

This paper presents part of a doctoral dissertation that developed a theoretical model capable of identifying managerial performance in various administrative levels of a Municipal Health Secretariat. The methodology was a case study of the Municipal Health Secretariat in Campo Grande, capital of the State of Mato Grosso do Sul, Brazil. The theoretical model was based on recent debates emphasizing the need to modernize public administration, with an emphasis on efficacy and efficiency in the organizations as a whole.

[The Family Health Program: supervision or "shared vision"? A case study in a medium-sized Brazilian city].

This study discusses supervision of the Family Health Program (FHP) in Teresópolis Rio de Janeiro State, Brazil, based on a qualitative case study approach. Considering that supervision is an important tool in health programs management, five main objectives were achieved: analysis of supervisory activities, description of characteristics and working patterns, outlining of FHP supervisor profiles, and identification of subjective factors that could interfere in the supervision process. Finally, supervision was considered as an essential step in program organization and implementation.

[CAPES evaluation model: desirable and necessary, but incomplete].

Seeking to contribute to the improvement of evaluation criteria in the public health graduate studies program, this article presents the main characteristics identified by foreign observers during the 2001 program evaluation of the Brazilian government research support agency CAPES (Coordinating Body for Training University-Level Personnel) and presents some critical observations on the criteria used to evaluate the quality of teaching in graduate studies programs. These comments were based on recent trends in other countries.

[Experience with games in operative groups as part of health education for diabetics].

This paper presents and discusses an educational strategy implemented in a specialized hospital clinic. The goal was to stimulate individuals to reflect on their everyday lifestyles as related to their disease, specifically diabetes mellitus. The strategy can be characterized as an educational tool from the perspective of health promotion and disease prevention and control.

[Accreditation and its implementation in graduate studies in Public Health].

This article aims to contribute to a better understanding of the establishment and implementation of accreditation in graduate courses in public health and to encourage discussions to improve quality in this area. The term accreditation is defined, and two of its main thrusts are discussed: quality and competence. The basis for establishing and implementing an accreditation system is described, and some of the key characteristics of the Brazilian experience are presented.

[Avoidable perinatal deaths and the environment outside the health care system: a case study in a city in Greater Metropolitan Rio de Janeiro].

This paper focuses on the role of environmental factors external to the health care system in the occurrence of perinatal deaths in maternity hospitals belonging to the local health system in a city in Greater Metropolitan Rio de Janeiro in 1994. Elements from the political and administrative context that contribute to an understanding of the relationship between failures in health care and structural deficiencies in these maternity hospitals were divided into four groups of variables: distribution of resources, spatial and temporal factors, organizational and managerial features, and action by interest groups. Semi-structured interviews were conducted.