bluuebunny/crossref_metadata_2025 huggingface dataset:
Branding e influencers en la comunicación de moda. Gucci como caso de estudio
Authors: Sanz-Marcos Paloma , Pérez-Curiel Concha
Published: July 2019

La figura del influencer ha conseguido sustituir a los medios de masas tradicionales revolucionando las comunicaciones de tipo comercial. En este contexto, el público millennial advierte un escenario en las redes sociales que de manera muy acusada incide en la gestión de las marcas de moda. A partir de una metodología comparativa de análisis de contenido cuantitativo y cualitativo de triple enfoque (marca-estrategia-consumidor) y sobre una muestra de 4672 publicaciones en Instagram, se mide la capacidad de influencia y de respuesta de los sujetos, la temática y las estrategias de branding de la firma Gucci, reconocida en el año 2017 como la mejor marca durante el año 2016. Los resultados indican que, a diferencia de otras marcas competidoras, la firma ha dirigido sus esfuerzos de comunicación hacia una difusión de sus productos hacia la consideración de la propia marca como prescriptora e influencer para llegar al público.
Preferencias de celebración matrimonial: el auge del evento nupcial
Authors: Mamani Condori Noemi Angela , Andrés Arko Boris , Fuentes Cuiñas Ana Alejandra
Published: July 2019

Desde los últimos años, se ha podido observar una disminución en las uniones matrimoniales (en tasas de nupcialidad y cifras absolutas). El 2017 registro 10.525 matrimonios inscriptos, a diferencia del año anterior con 11.630, según Dirección de Estadísticas y Censos. El objetivo de esta investigación fue identificar y caracterizar a los individuos que tienen la intención de formar un matrimonio, así como realizar procesos, servicios o eventos de celebración nupcial. Se realizó muestreo no aleatorio de 733 casos. La población objeto de estudio se compuso de habitantes de CABA y Gran Buenos Aires, ambos géneros, edades entre 18 y 65 años. Se utilizaron técnicas de análisis multivariado: Análisis Chi cuadrado y de correlaciones bivariadas. Los resultados indican individuos femeninos, jóvenes (18-30) y nivel educativo universitario en curso o superior como el grupo de mayor tendencia a la realización de eventos nupciales. Además, se observa mayor inclinación a viajar como método de celebración.
Compromiso activo y valor de marca en el sector del lujo
Authors: De la Oliva Ramos Eugenio , Gallart Camahort Valentín , Fernández Durán Laura
Published: July 2019

El presente artículo pretende analizar la relación entre diversas dimensiones (notoriedad, lealtad, imagen y compromiso) y cómo éstas afectan al valor de marca en el sector del lujo. Para ello se realizaron un total de 310 encuestas válidas a personas que hubieran adquirido o consumido marcas de lujo. En este estudio se presentan cinco hipótesis distintas con las que se busca establecer la existencia de las relaciones entre dimensiones planteadas, sus intensidades, y cómo afectan al valor de marca en el sector del lujo. El artículo contribuye, principalmente, a clarificar los efectos del compromiso activo, una dimensión novedosa en el estudio del valor de marca. Posteriormente, se presentarán las conclusiones obtenidas y sugerencias para futuras investigaciones empíricas.
La subjetivación de género en la escolarización diferenciada por sexo = Gender subjectivation in single-sex schools
Authors: Primón Mateo
Published: July 2019

ResumenEn el presente trabajo de investigación nos preguntaremos qué construcción de sujeto se hace en cinco escuelas de sexo único de Zona Norte de la Provincia de Buenos Aires a partir del análisis de los idearios, la sección “Misión, Visión y Valores”, las actividades extracurriculares, las noticias y los reglamentos de estas escuelas. Usaremos como eje principal las categorías de distinción, socialización y misión futura. Concluiremos que las escuelas analizadas tienden a transmitir fuertes estereotipos de género y de clase social mediante mecanismos de distinción social, de socialización diferenciada y mediante la transmisión de expectativas futuras sobre sus alumnos y alumnas. Además, resaltaremos la importancia que cobran las prácticas institucionales en las escuelas más allá de los contenidos escolares.AbstractIn this research paper we will question what kind of subject are created in five single-sex schools from San Isidro, Argentina. Our research will be based on the analysis of this schools’ ideario, “Mission, Vision and Values” section, the extracurricular activities, news and rules, using as theoretical framework the concepts of distinction, socialization and social expectations. Our conclusions show that single-sex schools tend to reproduce strong gender stereotypes and class consciousness through mechanisms of social distinction, differenced socialization and through the transmission of future expectations over its students. We will also highlight the importance of institutional practices in schools beyond school contents.
Measuring the perception of violence against women at UABC Law School, Campus Valle Dorado = Medición de la percepción de la Violencia contra las Mujeres en la escuela de Derecho de la UABC, Campus Valle Dorado
Authors: Soberano Serrano Alma Alejandra , Delhumeau Rivera Sheila
Published: July 2019

AbstractDespite of the efforts made by civil society and the legal modifications made in the Mexican legislation, the existing violence towards women does not decrease and it shows its normalization in professions like Law that require alternatives based on gender sensitization. This work consists of the results of a survey on perception of violence against women with students of the Law School of the Autonomous University of Baja California in the summer of 2018, which through six dimensions (physical violence, psychological violence, sexual violence, deprivation, normalization of violence and social capital) tries to understand the factors considered as violent, while presenting a proposal for protocol of attention to this problem in the university campus.ResumenA pesar de los esfuerzos realizados por la sociedad civil y las modificaciones legales hechas en la legislación mexicana, la violencia existente contra las mujeres no disminuye y muestra su normalización en profesiones como la ley que requieren alternativas basadas en la sensibilización de género. Este trabajo consiste en los resultados de una encuesta sobre la percepción de la violencia contra las mujeres con estudiantes de la Facultad de Derecho de la Universidad Autónoma de Baja California en el verano de 2018, que a través de seis dimensiones (violencia física, violencia psicológica, violencia sexual, privación, normalización de la violencia y capital social) trata de entender los factores considerados violentos, al tiempo que presenta una propuesta de protocolo de atención a este problema en el campus universitario.
Acoso sexual como violencia de género: Voces y experiencias de universitarias chilenas = Sexual harassment as gender violence: Voices and experiences of chilean university students
Authors: Ramirez Raunigg Karin , Trujillo Cristoffanini Macarena
Published: July 2019

ResumenEn Chile, la legislación solo tipifica el acoso sexual —tipo particular de violencia sexual— en el ámbito laboral. Por lo mismo, las agresiones suscitadas en espacios académicos aún son vagamente visibilizadas. En este contexto, aquí se presenta un estudio cualitativo realizado en la Región de Valparaíso, tras las movilizaciones feministas lideradas por estudiantes universitarias en mayo de 2018. En él, se examinan los discursos orales de víctimas de actos de acoso sexual perpetrados en las principales universidades de la zona. A partir de entrevistas, se analiza el impacto que estos hechos tienen en las víctimas, las dificultades legales que enfrentan las potenciales denunciantes y el papel que desempeñan las redes de apoyo como mecanismos de resistencia ante este tipo de agresiones.AbstractIn Chile, current legislation doesn’t refer to sexual harassment in higher education contexts. Consequently, sexual assaults occurred in the academic sphere become a vaguely visible phenomenon. In this scenario, the researchers present a qualitative case studio developed in the Valparaíso Region, before the feminist mobilizations from 2018 —a series of student demonstrations led by young women college students. Specifically, in this studio, the researchers analyze oral discourses by women who had been victims of sexual harassment episodes perpetrated by students and scholars at the main universities of the region. Through several interviews, the researchers examine the impact of sexual harassment in the lives of the victims, the main obstacles that these victims find in their search of justice, and the role that social networks play as safety zones for women resistance.
Sexualidade e loucura femininos no Correio da Manhã. Um estudo a partir de Michel Foucault = Female sexuality and madness in the Correio da Manhã. A study from Michel Foucault
Authors: Alves Flores Isadora Luiza Francisca , Barros João
Published: July 2019

ResumoO objetivo deste texto é discorrer sobre o papel do discurso jornalístico na construção do feminino no início do séc. XX no Rio de Janeiro. Através da série de reportagens intituladas Sedutor e Algoz veiculadas pelo jornal Correio da Manhã, será possível visualizar como a relação entre o discurso jornalístico e a produção intelectual que visava o controle sobre a conduta feminina se dava nesse período. Para tanto, recorreremos aos argumentos de Michel Foucault. Através de sua proposta sobre a relação saber-poder e também sobre a influência do gênero folhetinesco sobre o discurso jornalístico, poderemos perceber como esse discurso em específico poderia influenciar apreensões sobre a sexualidade e a loucura femininas no período acima mencionado.AbstractThe purpose of this text is to discuss the role of journalistic discourse in the construction of the feminine at the beginning of the 20th century in Rio de Janeiro. Through the series of stories titled Seducer and tormentor published by the newspaper “Correio da Manhã”, it will be possible to visualize how the relationship between the journalistic discourse and the intellectual production, that aimed the control over the female conduct, occurred during this period. To do so, we will turn to the arguments of Michel Foucault. Through his proposal on the relation between knowledge and power and on the influence of the novel genre on the journalistic discourse, we can see how this discourse could influence apprehensions about female sexuality and madness in the mentioned period.Keywords: Sexuality; madness; journalistic discourse; Michel Foucault; Correio da Manhã
La violencia obstétrica en el embarazo y el parto desde la perspectiva de la vulneración de derechos: autonomía y consentimiento informado = Obstetric violence as a violation of autonomy and informed consent rights in pregnancy and childbirth
Authors: Busquets Gallego Marta
Published: July 2019

ResumenEste artículo explora la violencia obstétrica desde una perspectiva legal centrada en la vulneración de los derechos fundamentales de autonomía y consentimiento informado en el embarazo y el parto. Partiendo de una aproximación a la legalidad vigente aplicable, se explora qué relevancia tienen embarazo y parto a la hora de ejercer estos derechos, así como las creencias y condicionantes que afectan a su interpretación y ejercicio. También se hace un acercamiento a las dimensiones de las vulneraciones en este ámbito. Por último, se presentan distintas propuestas para promover el respeto a los derechos fundamentales en la atención obstétrica.AbstractThis article explores obstetric violence from a legal perspective, focusing on the violation of the fundamental rights of autonomy and informed consent in pregnancy and childbirth. Starting from an approximation to the current applicable law , it explores how pregnancy and birth affect these rights, as well as the beliefs and conditions that affect their interpretation and exercise. There is also an approach to the dimensions of the violations in this area. Finally, different proposals are presented to promote  respect for fundamental rights in obstetric care.
La violencia contra la mujer en el teatro de Federico García Lorca = Violence Against Women in the Theatre of Federico García Lorca
Authors: Gámez García María del Mar
Published: July 2019

ResumenEste trabajo se propone examinar los diferentes tipos de violencia contra la mujer que es posible encontrar en el teatro de Federico García Lorca con el propósito de ofrecer una nueva visión sobre el conjunto de su obra teatral basada en esta temática y en la relación entre sus personajes femeninos y masculinos desde una perspectiva contemporánea. Otro de los objetivos de este trabajo será abordar las causas que podrían haber llevado al dramaturgo granadino a abordar este asunto. El estudio del tema de la violencia contra la mujer en la obra de García Lorca nos permitirá reflexionar sobre las causas, manifestaciones y dimensiones de la violencia machista tanto en la sociedad patriarcal de su época como en las sociedades actuales.AbstractThis paper examines the different types of violence against women in the theatre of Federico García Lorca with the aim to offer a new vision of this topic and of the relationship between his female and male characters in his theatrical works from a contemporary point of view. Another of the purposes of this article will be to analyze the possible causes that could have led the Spanish playwright to deal with this topic in most of his plays. The study of the topic of violence against women in the theatre of García Lorca will allow us to reflect on the causes, manifestations, and dimensions of misogynist violence in the patriarchal society of his time, as well as on our current societies.
El cine como agente socializador del amor romántico en las adolescentes: el caso de “A tres metros sobre el cielo” = Cinema as a socializing agent of romantic love in adolescents: The case of “Three meters above the sky"
Authors: Cardona Segura Ana Sofía , Ferrer Victoria , Cifre Gallego Eva
Published: July 2019

ResumenEl objetivo de este estudio es conocer el efecto que produce el cine como agente socializador en el enamoramiento tradicional y analizar la aceptación de ciertos mitos de amor romántico en 16 chicas adolescentes a través del visionado de la película A tres metros sobre el cielo, considerándola como un ejemplo de producto cultural que incorpora violencia simbólica mediante una exaltación de dichos mitos. Teniendo en cuenta su orientación sexual, y a través de grupos de discusión obtenemos que las chicas heterosexuales muestran mayor aceptación de las películas de género romántico y que aceptan en mayor medida los mitos de amor romántico que las chicas bisexuales.AbstractThe aim of this study is to know the effect that the cinema produces as a socializing agent in the traditional infatuation and to analyze the acceptance of certain myths of romantic love in 16 adolescent girls through the viewing of the movie Three meters above the sky considering it as an example of cultural product that incorporates symbolic violence through an exaltation of these myths. Taking into account their sexual orientation, and through the discussion group we obtain that the heterosexual girls show greater acceptance of the romantic films and that they accept in a greater measure the myths of romantic love than the bisexual girls.
Transversalidad de género como modelo de adjudicación de derechos a la mujer indígena en Colombia = Gender mainstreaming as a model of awarding women indigenous rights in Colombia
Authors: Bermúdez Puentes Karen Vanessa , Carreño Segura Karen Liseth
Published: July 2019

ResumenEl presente estudio busca construir un modelo de adjudicación que tenga como base la transversalidad de género, manifestado posteriormente en una Política Publica que rompa con paradigmas jurídicos y horizontes semánticos ya consolidados. Los modelos de adjudicación de derechos empiezan a jugar un papel predominante, por cuanto son ellos los que permiten que el sistema jurídico desemboque en una adecuada aplicación. Así, se replantean o generan cuestionamientos acerca de los paradigmas que deben responder a realidades sociales, más aún, cuando se trata de la mujer indígena, quien es cobijada por el enfoque diferencial étnico.AbstractThe present study is looking for building an awarding model based on gender mainstreaming, stated subsequently in a public politic that break through paradigms and landscapes already set. The mainstreaming models start to play a key role, due to its power to allow the legal. System to end in a proper implementation Thus, it's reformulated or questioned about social realities paradigms, even so when it is about indigenous woman, whom is covered by ethnic differential approach.
Infectadas. Una lectura sobre los cuerpos de las mujeres que viven con el Virus del Papiloma Humano en Quito = Female Patients. A close look of the female patients infected with the Human Papillomavirus in the city of Quito
Authors: Rivera Carrillo Solange Poleth
Published: July 2019

ResumenEl Virus del Papiloma Humano (HPV) tipificado como una Infección de Transmisión Sexual, es considerado como un problema de salud pública en Ecuador. El virus ha incidido en las mujeres tanto en su salud, como en sus comportamientos y en las percepciones de su cuerpo. Este artículo analiza cómo se construyen sus cuerpos, sexualidad y relaciones sentimentales después de contraer el HPV. Se realizaron entrevistas semi estructuradas y observación participante a 20 mujeres que acuden a un hospital de Quito. Los resultados muestran que sus cuerpos son construidos a través del estigma y la regulación de los comportamientos y su sexualidad.AbstractHuman Papilloma Virus (HPV) is codified as a sexual transmitted disease (STD) in Ecuador: therefore, it has been considered and handled as a public health issue within the country. The virus has affected the heath of patients as in their behaviors and in the perceptions of their body. The aim of this article is to analyze how a group of patients deals with their bodies, sexuality and personal relations after being infected. For this analysis, twenty Hospital patients in Quito were observed. They actively participated in the process that included clinical diagnoses and structured interviews. The results showed that their bodies and sexuality have been approached with stigma and regulation.
Violencias y resistencias a la terapéutica asilar patriarcal de enajenadas en Chile, siglo XX = Violence and resistance to the patriarchal asylum treatment of alienated in Chile, 20th century
Authors: Contreras Tapia Javiera Patricia
Published: July 2019

ResumenEste artículo se construye como un análisis crítico del discurso con perspectiva de género respecto a la violencia ejercida a través del disciplinamiento y terapéutica asilar sobre los cuerpos de mujeres encerradas por diagnóstico de locura en la Casa de Orates de Santiago de Chile, del siglo XX. En él se cuestiona la ejecución de la disciplina psiquiátrica como mecanismo de poder-sujeción del sistema patriarcal sobre las enajenadas. Utilizando como objeto de estudio las cartas escritas por las internas y las memorias psiquiátricas de los médicos tratantes del asilo. Un análisis que evidencia el poder psiquiátrico y la dominación masculina en los fragmentos testimoniales de estas enajenadas, como manifestación identitaria de su resistencia al poder.Abstract            This article is constructed as a critical analysis of discourse with a gender perspective regarding the violence exerted through disciplinary and therapeutic asylum on the bodies of women locked up by a diagnosis of madness in the Casa de Orates of Santiago de Chile, of the 20th century. In him the execution of the psychiatric discipline is questioned like mechanism of power-subjection of the patriarchal system on the alienated ones. Using as an object of study the letters written by the inmates and the psychiatric memories of the treating physicians of the asylum. An analysis that demonstrates the psychiatric power and masculine domination in the testimonial fragments of these alienated, as an identity manifestation of their resistance to power.
Colonialismo y memoria de la violencia militar en las mujeres viequenses = Colonialism and memory of military violence in Vieques women
Authors: Irizarry Cruz Dora María
Published: July 2019

ResumenEl presente artículo trata sobre la materialización de la violencia colonial militar (1941-2003) en la vida de las mujeres viequenses y cómo estas se han enfrentado a dicha violencia construyendo prácticas decoloniales de resistencia comunitaria. La investigación fue enmarcada a través de dos categorías: colonialidad del género y prácticas decoloniales. Para obtener los resultados se llevó a cabo una etnografía audiovisual en la isla de Vieques, Puerto Rico, durante los años 2012-2013, con incursiones al campo entre los años 2014 y 2015. Se realizaron 34 entrevistas semi-estructuradas a mujeres negras, mulatas y blancas, de clase trabajadora, entre las edades de 20 y 70 años.AbstractThis paper is about the materialization of colonial military violence (1941-2003) in the lives of women in the island of Vieques (Puerto Rico) and how they have dealt with it by building decolonial practices of community resistance. Research was framed by two categories: coloniality of gender and decolonial practices. Results were gathered by means of audiovisual ethnography (2012-2013) and field work in 2014 and 2015. Thirty-four semi-structured interviews were carried out to black, mulatto and white working class women ages 20-70.
La primera reforma tributaria en la historia de la humanidad
Authors: Cano Morales Abel María , Restrepo Pineda Carlos Mario , Villa Monsalve Omar Osvaldo
Published: July 2019

El presente acápite trata acerca del relato milenario de la primera reforma social, descrito por Noah Kramer, en el libro La historia empieza en Sumer, y que ha sido traducido por el autor directamente de las tablillas sumerias. El artículo presenta un apólogo, sobre el contexto en el cual se dio esa primera reforma social, que sin lugar a dudas fue una verdadera reforma tributaria en favor del pueblo. El texto comienza describiendo las características de la civilización sumeria, el entorno geográfico en el cual se desarrolló, sus invenciones como la escritura, la rueda, la cerveza, la organización del comercio, los sistemas políticos y los sistemas tributarios y aduaneros. Es en medio de ese auge que los sumerios terminan siendo dominados por los Acadios. Cabe anotar que en el contexto descrito en el párrafo anterior se hace alusión a que una ciudad prospera como Lagash en tiempos de los sumerios, termina empobreciendo a sus habitantes con una exagerada y desordenada carga tributaria y un sistema tributario caótico en manos de los Acadios.  Es en este testimonio que se realizó una de las primeras reformas sociales, que por sus características es considerada como la primera reforma tributaria de la cual tiene conocimiento la humanidad.
What’s in a word? Language and self-assessed health in the National Health and Nutrition Examination Survey
Authors: Natta Meredith Van , Zimmer Zachary
Published: July 2019

This study examines the extent to which the Spanish language influences the way in which respondents report health using the ubiquitous self-assessed health (SAH) outcome. We account for citizenship status, ethnicity, and a series of other covariates. The study uses the 2003-2016 national health and nutrition examination survey (NHANES) (n=39,107). Analyses treat SAH as non-ordered categorical and employ multinomial regressions. Results indicate that those answering in Spanish are considerably and significantly more likely to rate health as “fair/regular” ceteris paribus. Non-U.S. citizens and naturalized citizens are significantly more likely to rate their health favorably in comparison to U.S.-born; those identifying as Hispanic, Black, and other/multiracial are likely to rate health less favorably than others regardless of citizenship or interview language. A model that examines only foreign-born and accounts for years lived in the U.S. shows Spanish language still strongly predicted SAH outcomes, but years spent in the U.S. did not, a finding that does not support notions of acculturation. The study concludes that there is a language bias in the standard SAH measure typically used national-level health surveys and national-level surveys such as NHANES should adjust the question translation to better understand the health of immigrants.
Wypełnianie szczeliny? O perspektywie feministycznej w refleksji literaturoznawczej nad polskim oświeceniem
Authors: Kowalewska Danuta
Published: July 2019

The article raises the problem of the use of the feminist criticism apparatus in research on the Polish Enlightenment literature. The method has not been popular among Polish experts of the epoch. The article discusses the advantages of feminism in literature studies as well as the potential risks associated with the application of the category gender to research on early literature. The greatest threat seems to be the failure to take into account the historical and socio-cultural context. The paper refers to other epochs or foreign literature, which may constitute a starting point for research into the literature of Polish Enlightenment. One such work is a monograph by Marek Jastrzębiec-Mosakowski entitled Strategie wymazywania. Kobiece bohaterki w męskich tekstach francuskiego Oświecenia [Strategies of erasure. Female heroines in the male texts of French Enlightenment]. The article lists researchers of Polish Enlightenment who notice the potential of gender studies (Barbara Judkowiak, Weronika Pawlik-Kwaśniewska) and  points to the areas of research and possibilities offered by the use of feminist criticism tools. The article aims at restoring the names of the previously anonymous female authors, discovering or re-reading their work, as well as opening new spaces for their description and interpretation.
The style of ‘regular irregularities’ – rococo gardens and their reception in Polish garden art of the 18th century
Authors: Malawski Seweryn
Published: July 2019

The stylish difference of the Rococo in the garden art is still the topic of the researchers’ discussion. The Rococo, which was in opposition to the formal and rhetorical art of the Baroque, brought a new value to the eighteenth-century gardens. This value was expressed primarily in the elements of the composition, asymmetry, irregularity, wavy line, fragmentation of form and ornamentation, as well as in relation to nature and specific mood.France is considered to be the fatherland of the Rococo style, from where this new, light style has spread to other European countries. The dissemination of new ideas was favored by print theoretical dissertations and collections of projects. The works by authors such as L. Liger, J-F. Blondel, J-B-A. le Blond, F. de Cuvilliés, M-A. Laugier, G-L. Le Rouge, W. Chambers, S. Switzer and B. Langley enjoyed particular popularity.Many impressive gardens with Rococo features were created especially in Germany and Poland. Their special flourishing in Poland fell on the times of the Polish-Saxon Union, and especially during the reign of Augusts III in the years 1733-1763.Special attention should be paid to the projects related to the patronage of the first minister H. Brühl. Rococo features can be found in several of his gardens, such as garden at Nowy Świat in Warsaw, garden in Wola, the unfinished garden project for the former Sanguszko palace or a garden in Brody (Pförten). Rococo compositions were also created in the gardens of Prince Adam Poniński at Żyzna street in Warsaw and in Górce. In 1966, the concept of a magnificent royal garden at the Ujazdów Castle was created. Noteworthy is also the arrangement of gardens in Puławy from the times of Zofia and August Czartoryski as well as Flemming in Terespol. The designers of many Polish gardens of that period were Saxon architects, such as: J.D. von Jauch, J.F. Knöbel, C.F. Pöppelmann, E. Schröger or J.Ch. Knöffel. From the 1770s, Rococo creations in Poland began to give way to landscape concepts.
O que o direito constitucional à saúde tem a dizer sobre a cobertura universal?
Authors: Delduque Maria Celia , Barros Fernando Cupertino de , Oliveira Alethele S , Alves Sandra Mara , Filho Moacyr Rey
Published: July 2019

O presente ensaio crítico tem com o advento o questionamento da

compatibilidade das diretrizes da Organização Mundial da Saúde no que se refere à Cobertura Universal à luz da Constituição Federal de 1988 do Brasil, em especial o capítulo da Ordem Social em que é consignado a saúde como direito de todos e proclama a criação do Sistema Único de Saúde, concluindo-se que o conceito desenvolvido pela OMS não guarda simetria com o estipulado na Carta Política.
Cuidados continuados: uma falha na malha da rede de serviços de saúde
Authors: Polisaitis Ariane , Malik Ana Maria
Published: July 2019

O rápido crescimento da população idosa portadora de doenças crônicas e degenerativas e a pressão por redução de custos nos hospitais por parte das fontes pagadoras públicas e privada têm demandado serviços de longo prazo por serem mais adequados para a população e menos onerosos. Com o envelhecimento populacional as necessidades de saúde tendem a se tornar mais crônicas e complexas. O objetivo deste artigo, após revisão bibliográfica sobre realidades de sistemas de saúde de países desenvolvidos e levantamento de dados nacionais, é propor uma reflexão sobre as mudanças no padrão saúde e doenças, necessidades de cuidados diferenciados e eficiência do sistema de saúde por meio da reorganização em redes de serviços que incluam cuidados continuados. A transformação do sistema de saúde deve estar nas agendas de instâncias superiores do governo, pois faltam políticas públicas de saúde que norteiem como iremos acompanhar os longevos, as doenças crônicas e a estruturação e implementação de redes para continuidade de cuidados. O Brasil tem um grande potencial para evoluir em um sistema de saúde que integre os cuidados continuados, incluindo aquele voltado para problemas agudos e pós agudos configurando, assim, uma rede de cuidados.
Percepções e crenças de higiene de mão de enfermeiras trabalhando em dois hospitais de Kinshasa
Authors: Muyulu Nicole , Richard Lucie , Silva Roxane Borgès da , Prud’Homme Alexandre
Published: July 2019

O objetivo deste estudo foi documentar percepções e crenças sobre a higiene das mãos entre enfermeiras em Kinshasa, República Democrática do Congo (RDC). O modelo PRECEDE-PROCEED orientou o trabalho, focando na análise nos fatores de predisposiçãoe facilitadores. A abordagem utilizada foi do tipo descritivo correlacional. A amostra de conveniência incluiu enfermeiros de dois hospitais que participaram de um programa de treinamento de higiene das mãos. Os dados foram coletados por meio de um questionário autoaplicável. O enfoque das questões foi sobre o conhecimento, a percepção da higienização das mãos e as normas sociais a esse respeito, bem como sobre o acesso à infraestrutura que facilita a adoção desse comportamento. Análises bivariadas e ultivariadas foram realizadas. Os resultados mostram menores escores para as escalas medindo o conhecimento e o acesso à infraestrutura, em comparação aos demais construtos estudados. Associações multivariadas significativas foram observadas no modelo de regressão relativo às percepções das normas sociais na higienização das mãos. Destacaram-se como preditores significativos: pertencer à faixa etária mais elevada (50 anos ou mais) e o local da prática (hospital e unidade). Esses resultados levantam questões sobre o impacto de longo prazo do programa de treinamento oferecido antes do presente estudo. Os resultados também apontam para a potencial influência do meio da prática na percepção de normas sociais. Mais pesquisas são necessárias para entender melhor a relação entre as características da enfermeira e os comportamentos de higiene das mãos.
O papel do farmacêutico em sistemas públicos e universais de saúde: um panorama comparado do Brasil, Canadá e Portugal
Authors: Conill Eleonor Minho , Damasceno Mônica Alves
Published: July 2019

Apesar do reconhecimento da importância da assistência farmacêutica, há dificuldades na integração deste profissional ao sistema de saúde e na atenção primária (APS). O estudo faz uma síntese das normas referentes à assistência farmacêutica no Brasil, com ênfase na inserção do farmacêutico na APS. Estes elementos são comparados com os modelos adotados no Canadá e Portugal, países que possuem sistemas públicos universais orientados por essa política. Foi realizada revisão bibliográfica com as seguintes palavras-chave: “Assistência Farmacêutica”, “Atenção Farmacêutica”, “Política Nacional de Assistência Farmacêutica” e “Atenção Primária à Saúde” através do Pubmed, Google Acadêmico, sites governamentais, Conselhos profissionais e organismos que constituem fontes para comparações internacionais. O Brasil é o país com o sistema mais generoso do ponto de vista de oferta de medicamentos, além de apresentar grande número de normas que regulam a assistência farmacêutica. Outra singularidade se refere à presença do farmacêutico nas Unidades prestadoras de atenção básica. Com relação ao Canadá observa-se a existência de uma lista limitada de medicamentos autorizados por cada Província e uma proposta de seguro para medicamentos – o Pharmacare. Em Portugal, o governo adota uma lista também limitada para reembolso de medicamentos, que devem ser prescritos pelo nome genérico. Além disso, há um movimento dos farmacêuticos para integração das farmácias ao sistema. Conclui-se mostrando a centralidade dessa discussão para o dilema de ampliar o acesso a medicamentos sem favorecer um consumo desfavorável à saúde e a sustentabilidade dos sistemas.
Objeção de consciência na interrupção voluntária da gravidez. Entre a marginalização de profissionais e o retorno do aborto ilegal
Authors: Spina Elena
Published: July 2019

A lei n.194 / 1978, ao legalizar a interrupção voluntária da gravidez (VIP) na Itália, introduziu a cláusula da objeção de consciência e, desde então, muitos ginecologistas têm invocado esse direito (os chamados pró-vida que se opõem ao pró-direito-escolha). A hipótese deste artigo é dupla e diz respeito às conseqüências da objeção de consciência: por um lado, os ginecologistas pró-escolha experimentam uma forma de marginalidade, em termos de carga de trabalho, status social e poder, resultando em seu isolamento e estigmatização; por outro, a dificuldade de acessar serviços VIP pode levar ao retorno do aborto ilegal. O objetivo é imaginar quais as conseqüências que isso pode trazer para os usuários e profissionais e entender como será possível garantir um equilíbrio entre o direito à interrupção voluntária da gravidez e a objeção de consciência. Em termos de metodologia, realizou-se uma revisão de literatura, seguida de uma pesquisa por material documental (jornais e sites italianos e estrangeiros discutindo VIP e objeção de consciência); Além disso, uma longa entrevista foi realizada com um ginecologista pró-escolha, que representa um caso simbólico no contexto italiano. Algumas considerações sobre os cenários futuros fecham o artigo.
O projeto de cuidados antecipados, a percepção dos membros e parceiros da Rede Regional de Saude de Lausanne (Suíça)
Authors: Devaux Lila , Chinet Mathilde , Nicolas France , Anhorn Philippe
Published: July 2019

Nos últimos anos, na Suíça, vários instrumentos (Directivas Antecipadas, Representante Terapêutico, etc.) foram disponibilizados aos doentes para lhes permitir indicar quais os cuidados que desejam receber ou não em caso de incapacidade de discernimento. No entanto, os objetivos destas ferramentas não são alcançados devido, entre outras coisas, à falta de apoio do paciente.Graças a um inventário, a Rede Regional de Saúde de Lausanne (RSRL) identificou as bases de um conceito teórico, o seu valor agregado para os profissionais e os eixos de trabalho que permitem a sua operacionalização. Este inventário explora as práticas atuais dos profissionais e sua visão de futuro através de entrevistas, questionários e observações de campo.Os resultados do inventário indicam que os profissionais sentem a necessidade de conhecer os valores do paciente, principalmente para facilitar a “tradução” das escolhas do paciente na sua prática profissional. A interdisciplinaridade é necessária no processo de apoio. O estabelecimento de um processo e padrões de referência comuns entre os profissionais atraiu o interesse dos inquiridos para assegurar uma melhor coordenação. A RSRL visa, através do Projeto de Cuidados Antecipados (ACP), apoiar a autodeterminação de pacientes com doenças crônicas e/ou degenerativas. Durante os cuidados e o acompanhado por um profissional especializado, os pacientes podem expressar seus valores, desejos e definir um objetivo de cuidados. Este objectivo destina-se a orientar a sua gestão actual e a que podera ocorrer em caso de incapacidade de discernimento. O projeto SAP também tem como objetivo fornecer aos profissionais uma referência comum para melhorar a continuidade dos cuidados.A implementação deste projeto exigirá uma mudança de cultura por parte dos profissionais e dos doentes. A remoção de certos obstáculos torna-se perimordial, tal como a falta de um registo electrónico dos doentes partilhado por todas as partes interessadas no sistema de saúde.
Questions of true incidence and prevalence of obesity in children and adolescents
Authors: Martynova I. N. , Vinyarskaya Irina V. , Terletskaya R. N. , Postnikova E. V. , Frolova G. S.
Published: July 2019

There are presented data of the study of the prevalence rate of obesity in children and adolescents residing in the city of Ivanteevka of the Moscow region. Indices of the prevalence rate of obesity were calculated per 1000 in child population of the appropriate age. The obesity in children and adolescents in the structure of endocrine diseases was found to be ranked as second. During the period from 2000 to 2013 there was revealed a consistent upward trend in the frequency of obesity in children. There was shown a possibility for the existence of regional features of the prevalence of obesity in children. The low incidence rate of the detection of obesity in children of the Moscow region may be caused by underdiagnosis of this form ofpathology. On the basis of own data the authors showed that the true prevalence rate of the obesity in children is much higher than the official data according to medical help seeking by patients. However, only 26.6% of children and adolescents with obesity are observed and receive treatment at the pediatric endocrinologist. This demonstrates the needfor increment in the medical activity and responsibility of children and parents, enhancement of their motivation in keeping healthy lifestyle, as well as improvement of the efficiency of the prevention of obesity by medical staff of children's polyclinics.
Comprehensive ultrasound diagnosis in the evaluation of liver parenchyma and stages of fibrosis in children with autoimmune hepatitis
Authors: Dvoryakovskaya Galina. M. , Ivleva S. A. , Dvoryakovskiy I. V. , Surkov A. N. , Potapov A. S. , Gundobina O. S. , Smirnov I. E.
Published: July 2019

There are presented data of the comprehensive ultrasound examination of 88 children, aged from 3 to 16 years, with autoimmune hepatitis (AIH), types 1 and 2. There was performed a comparative evaluation of morphological and ultrasound (US) changes in the structure of the liver parenchyma in 67 children with AIH with the use of non-invasive ultrasound techniques Acoustic Structure Quantification (Live ASQ) for transient elastography of the liver (TEL) and quantitative estimation of the structure of the liver parenchyma. It was established that in 5 patients the mean value of the density index (DI) was equal to 1.69, and the elasticity of 5.40 kPa, that corresponded on data of the morphological study to minimal and moderate fibrosis according to the METAVIR scoring system (F1-2). In advancedfibrosis in 19 children with AIH DI in average was equaled to 2.47 and values of elasticity were 10.90 kPa (F3). In 49 patients at the stage of liver cirrhosis (LC) (F4) the elasticity value was 26.10 kPa and DI - 3.63. These consistencies indicate to the diagnostic significance of ultrasound non-invasive techniques ASQ and TEL and the appropriateness of their use in pediatrics.
From the history of vaccine prevention: vaccination against smallpox
Authors: Mikirtichan Galina L.
Published: July 2019

In the article there is considered the history of vaccination against smallpox, first variolation, and then vaccination after its discovery in 1796 by E. Jenner. Until the XVIII century the inoculation method for the protection from smallpox has long been practiced in traditional medicine in several countries, as well as in certain regions of Russia, it differed in the local character, andfailed to arouse widespread. Gradually, in the XVIII century. variolation as a method of protection against smallpox becomes a common heritage and extends from Western Europe to Russia. One of the brakes ofthe introduction and development of not only the inoculation, but in later, and vaccinations there was the existence ofprejudices against the smallpox vaccination, in Russian society, as in other countries. There are presented data on the first inoculation experiments that prepared the important event - the inoculation of smallpox of the Empress Catherine the Great (1768). Her example promoted the spread of smallpox vaccination in 1770-80-ies, and by the number of vaccinated cases Russia not only caught up with the European countries, but also had been ahead of them. Smallpox variolation was performed in special ‘smallpox’ houses, orphanages, and educational institution (training school at the Academy of Arts, Cadet Corps, the Smolny Institute). There were inoculated mostly babies, from the first year of life. At the same time, in many countries where variolation has got spread, there were cases of the development of severe forms of smallpox, and even occurrence of epidemics, which contributed to the beginning of the experiments on the verification of the observation, existed from immemorial time, that people who had been recovered from cowpox, do not sufferedfrom the natural form. There is considered the activity of the English doctor E. Jenner, who focused its efforts on research and development of a more secure method ofprotection against smallpox - vaccination. There was shown the role of existing childcare facilities, including educational buildings, which there was worked out a technique of smallpox vaccination in children, because they were the group most exposed to the disease. Thanks to this discovery in the XX century smallpox was the first disease which humanity has managed to defeat by vaccination.
Congenital cleft of the lip and palate in children: pathogenetical significance of matrix metalloproteinases
Authors: Mardanov Ayaz E. , Smirnov I. E. , Mamedov A. A.
Published: July 2019

There are presented data about the prevalence offormation of congenital cleft lip and palate (CCLP) - one of the most common birth defects of the maxillofacial region in children. According to WHO the occurrence of children born with CCLP in the world is 0,6-1,6 cases per 1,000 live births, and varies greatly from the region to region and ethnic group residing there. At the same time, in 63,1% of patients there were established chromosomal abnormalities, and in 36,9% - non-chromosomal syndromes. In Russia, every year there are occurred from 3,5 to 5 thousand children with such defects that requires the development of new methods ofprevention of these malformations. There are reported modern views on the pathogenetical and potent diagnostic significance of the evaluation of the content of tissue matrix metalloproteinases (MMPs) and their inhibitors in mechanisms of the formation of CCLP, shown the probable associations of changes in the expression or activity of MMP and TIMP with various forms of malformations of the palate and upper jaw.
Hygiene and health of children, adolescents and young people at the Imperial Moscow University - the First MGMU named after I.M. Sechenov (On the 90-th anniversary of the Department of hygiene of children and adolescents of the Pediatric Faculty of the First MGMU named after I.M. Sechenov)
Authors: Kuchma Vladislav R.
Published: July 2019

Domestic fundamentals of hygiene and healthcare of children, adolescents and young people have been laid at the Imperial Moscow University (IMU) by clinicians andhygienists (N.A. Tolsky, S.G. Zybelin, F.I. BarsukMoiseev, M. Ya. Mudrov, G.A. Zakharin, G.N. Speransky, F.F. Erisman, V.E. Ignatiev). In 1881 in IMU there was introduced associated professor course of hygiene. From 1886 V.E. Ignatiev gave privat-associate professor course of lectures on school hygiene. Hygienic Institute was scientific and educational base for training doctors-hygienists. In 1884 in IMU the was organized the Department of Hygiene (Head of the Department-F.F. Erisman). The department of school hygiene, hygiene of children and adolescents of the 1st Moscow State University-First MGMU named after I.M. Sechenov was headedfrom 1926 to 1947 by prof. A.V. Molkov, throughout 1947-1953 - Associate Professor P.M. Ivanovsky, from 1953 to 1962 - Prof. M.D. Bolshakova, from 1962 to 1974 - Associate professor A.Z. Belousov, from 1974 till 1991 - Profesor V.N. Kardashenko and from 1992 - corresponding member of the Russian Academy of Sciences V.R. Kuchma. Training is carried out on the hygiene, basics of the formation of children’s health, hygiene of children and adolescents, and 7 programs ofpostgraduate education. There are performed studies of the physical development of children. There are substantiated criteria of social and hygienic monitoring of the child population at the local, regional and federal levels. Currently, studies are carried out in hygienic safety of the use of information and communication learning tools and ways to ensure their work (PC of new generations, readers, iPad, interactive whiteboards, electronic textbooks, Internet, mobile communication, Wi-Fi).
The dynamics of the blood content of N-terminal fragment of brain natriuretic peptide (NT-proBNP) in hypertrophic cardiomyopathy in children
Authors: Ermolenko Vasilisa S. , Silnova I. V. , Basargina E. N.
Published: July 2019

N-terminal pro-brain natriuretic peptide (NT-proBNP) is the unbiased marker of congestive heart failure. Levels of this marker have not been studied in children with hypertrophic cardiomyopathy (HCM). There are presented data of the comparison of blood concentrations of NT-proBNP in hereditary HCM and other diseases associated with myocardial hypertrophy in children. There was examined 41 patient (age: from 3 to 90 months) with myocardial hypertrophy The patients were divided into 3 groups. There was evaluated the interrelationship between NT-proBNP concentrations and the severity of heart failure and echocardiographic parameters. Results. It was established that in the first group of patients with hereditary HCM (41,4%) there was revealed the significant positive relationship between NT-proBNP concentrations and values of the bloodflow velocity and pressure gradient in the LV outflow track, interventricular septum thickness and LVposterior wall thickness (LVPWT), in cases from the second group (34.1%) with syndromes of malformations and metabolic diseases - with RV anterior wall thickness and LVposterior wall thickness, bloodflow velocity and pressure gradient in the RV outflow track, in the third group with myocardial remodeling against background of arterial hypertension the positive correlation was revealed with LVPWT, whereas negative one - with the fraction of left ventricular output. Maximal blood level of NT-proBNP in blood was detected in pronounced hemodynamic disturbances in patients from the second and third group Conclusion. NT-proBNP level assessment is necessary for differentiated diagnostics of HCM and associated diseases.