The Articulation of Theoretical and Practical Knowledge in Analysis and Development of Activity of Care

This paper presents the methodological procedure adopted in the research Process of work in health: analysis and development of ways of doing and living in care relations, bringing the lived experience of researchers in the empirical field. The methodological procedures have its foundations on the concepts of Clinical Activity and Occupational health. it is proposed that the activities of work analysis are discussed, coordinated and carried out by an expanded research group, which involved researchers from academia, and professional service in focus, providing a combination of different knowledges. The object of research is the activity of nursing at the hospital Universitario Antonio Pedro, linked to the Federal Fluminense University. The results obtained from the characterization of the team and observation the activity in three sectors shall guide the future paths of research

Reflexões sobre a metodologia da clínica da atividade: diálogo e criação no meio de trabalho

Este artigo discute a metodologia da clínica da atividade. São analisados aspectos que apontam para a abertura dialógica possibilitada por esta abordagem, que viabiliza a criação de novos recursos para a atividade de trabalho, bem como a produção de conhecimento sobre esse processo de criação. Ressalta-se o modo pelo qual a metodologia dialógica e indireta pode desenvolver tais condições. O diálogo entre trabalhador(es) e o analista do trabalho pode mobilizar a experiência estabilizada como meio de viver novas experiências e assim propiciar o desenvolvimento de novos recursos para a ação. Articulam-se os métodos utilizados pela clínica da atividade com a psicologia vigotskiana, empreendendo a discussão acerca dos conceitos de criação e desenvolvimento.Este artículo discute la metodología de la clínica de la actividad. En el se analizan los aspectos que apuntan a la apertura dialógica posibilitada por dicho enfoque, el cual permite la creación de nuevos recursos para la actividad de trabajo, así como para la producción de conocimiento sobre ese proceso. Se hace énfasis en el modo por el cual la metodología dialógica e indirecta puede favorecer tales condiciones. El diálogo entre trabajador(es) y analista del trabajo puede movilizar la experiencia estabilizada como medio para vivir nuevas experiencias y así propiciar el desarrollo de nuevos recursos para la acción. Se articulan los métodos utilizados por la clínica de la actividad con la psicología vigotskiana, emprendiendo la discusión acerca de los conceptos de creación y desarrollo.Cet article discute la méthodologie de la clinique de l’activité. On y analyse des aspects qui révèlent l’ouverture dialogique rendue possible par cette approche, en permettant la création de nouvelles ressources pour l’activité de travail, mais aussi la production de connaissances à propos de ce processus de création. On souligne le moyen par lequel la méthodologie dialogique et indirecte permet de développer de telles conditions. Le dialogue entre les travailleurs et l’analyste du travail peut mobiliser l’expérience stabilisée comme moyen de vivre de nouvelles expériences et rendre possible le développement de nouvelles ressources pour l’action. On articule les méthodes dont se sert la clinique de l’activité avec la psychologie vygotskienne en reprenant la discussion concernant les concepts de création et de développement.This paper discusses the methodology of the activity clinic. The aspects under analysis point to the dialogue enabled by this approach, which makes it feasible to create new resources for the labour activity, as well as the production of knowledge about that creation process. It highlights the method this indirect dialogue methodology may follow to develop such conditions. The dialogue between the worker(s) and the labour analyst can mobilise the established experience as a way to live new experiences and thus favour the development of new resources for action. It combines the methods used by the activity clinic with the Vygotskian psychology, hence fostering a debate concerning the creation and development concepts

Clínica da atividade e análise institucional : intercessões possíveis

O artigo explora possíveis intercessões da clínica da atividade com princípios e conceitos da análise institucional, tendo como pressuposto que há, entre essas abordagens, uma base epistemológica comum, na qual se destacam a importância do princípio de transformar para conhecer e o foco da análise nas tensões que habitam o campo analisado. O principal objetivo deste texto é produzir entrelaçamentos teórico-metodológicos que possam levar a uma ampliação do campo da clínica do trabalho e, em especial, da clínica da atividade. Pensar a experiência do trabalho dando relevo ao universo normativo e às tramas institucionais que a atravessam possibilita, entre outros efeitos, alcançar, na análise, questões atuais como aquelas da interferência do racismo e das lutas antirracistas nos gêneros de atividade em foco.L'article explore les intercessions possibles avec les principes et les concepts de l'analyse institutionnelle, en supposant qu'il existe, parmi ces approches, une base épistémologique commune, dans laquelle se détachent l'importance du principe de transformer pour comprendre et le focus de l'analyse sur les tensions qui habitent le terrain analysé. L'objectif principal de ce texte est de produire des intercessions théorico-méthodologiques pouvant conduire à un élargissement du champ de la clinique du travail et, en particulier, de la clinique d'activité. Réfléchir à l'expérience de travail, mettre en valeur l'univers normatif et les rapports institutionnelles qui le traversent, permet, entre autres effets, d'atteindre, dans l'analyse, des problématiques d'actualité comme celles du racisme et des luttes antiracistes dans les genres d'activité visés

First use of antineoplastic agents in women with breast cancer in the state of Rio de Janeiro, Brazil

Context: Breast cancer is the most common cancer, except for non-melanoma skin cancer, among women in Brazil and worldwide. Breast cancer treatment involves surgery, radiotherapy and chemotherapy, which is used in 70% of patients. This study analyzes the utilization of antineoplastic agents among women undergoing their first round of chemotherapy in Brazil’s public health system (SUS) in the state of Rio de Janeiro.Methods: Data from the SUS Outpatient Information System’s authorizations for high-complexity outpatient procedures (APACs) billed between January 2013 and December 2019 were extracted, and three datasets were created: all type 1 and type 2 APACs (including all chemotherapy procedures performed); all type 1 APACs; and first type 1 APACs (containing data only for the first round of breast cancer chemotherapy). Names of antineoplastic agents were standardized to enable the subsequent classification of therapy regimens, mitigating limitations related to data quality. Absolute and relative frequencies were used to describe sociodemographic, clinical and treatment characteristics, therapy regimen and supportive drugs.Results: We analyzed 23,232 records of women undergoing their first round of chemotherapy. There was a progressive increase in the number of procedures over time. Women were predominantly white, lived in the capital and close to the treatment center. Most had stage 3 cancer at diagnosis (50.51%) and a significant proportion had regional lymph node invasion (37.9%). The most commonly used chemotherapy regimens were TAC (docetaxel, doxorubicine, cyclophosphamide) (21.05%) and and cyclophosphamide (17.71%), followed by tamoxifen (15.65%) and anastrozole (12.94%). Supportive drugs were prescribed to 386 women and zoledronic acid was predominant (59.58%).Conclusion: The findings point to important bottlenecks and possible inequities in access to treatment and medicine utilization for breast cancer patients in Brazil. Efforts to improve breast cancer treatment and prevention should not only focus on interventions at the individual level but address the disease as a public health problem. The study focused on women undergoing their first round of treatment, providing valuable insight into patient and treatment characteristics to inform policy decisions

Data sources for drug utilization research in Latin American countries—A cross-national study: DASDUR-LATAM study

Purpose: Drug utilization research (DUR) contributes to inform policymaking and to strengthen health systems. The availability of data sources is the first step for conducting DUR. However, documents that systematize these data sources in Latin American (LatAm) countries are not known. We compiled the potential data sources for DUR in the LatAm region. Methods: A network of DUR experts from nine LatAm countries was assembled and experts conducted: (i) a website search of the government, academic, and private health institutions; (ii) screening of eligible data sources, and (iii) liaising with national experts in pharmacoepidemiology (via an online survey). The data sources were characterized by accessibility, geographic granularity, setting, sector of the data, sources and type of the data. Descriptive analyses were performed. Results: We identified 125 data sources for DUR in nine LatAm countries. Thirty-eight (30%) of them were publicly and conveniently available; 89 (71%) were accessible with limitations, and 18 (14%) were not accessible or lacked clear rules for data access. From the 125 data sources, 76 (61%) were from the public sector only; 46 (37%) were from pharmacy records; 43 (34%) came from ambulatory settings and; 85 (68%) gave access to individual patient-level data. Conclusions: Although multiple sources for DUR are available in LatAm countries, the accessibility is a major challenge. The procedures for accessing DUR data should be transparent, feasible, affordable, and protocol-driven. This inventory could permit a comparison of drug utilization between countries identifying potential medication-related problems that need further exploration.Fil: Lopes, Luciane C.. University Of Sorocaba; BrasilFil: Salas, Daiana Maribel. University of Pennsylvania; Estados UnidosFil: Osorio de Castro, Claudia Garcia Serpa. Fundación Oswaldo Cruz; BrasilFil: Freitas Leal, Lisiane. McGill University; CanadáFil: Doubova, Svetlana V.. Mexican Institute of Social Security; MéxicoFil: Cañás, Martín. Universidad Nacional Arturo Jauretche; Argentina. Federación Médica de la Provincia de Buenos Aires; ArgentinaFil: Dreser, Anahi. Instituto Nacional de Salud Pública; MéxicoFil: Acosta, Angela. Universidad ICESI; ColombiaFil: Oliveira Baldoni, Andre. Federal University of São João Del-Rei; BrasilFil: de Cássia Bergamaschi, Cristiane. University of Sorocaba; BrasilFil: Marques Mota, Daniel. Brazilian Health Regulatory Agency; BrasilFil: Gómez Galicia, Diana L.. Universidad Autónoma del Estado de Morelos; MéxicoFil: Sepúlveda Viveros, Dino. Universidad de Chile; ChileFil: Narvaez Delgado, Edgard. No especifíca;Fil: da Costa Lima, Elisangela. Universidade Federal do Rio de Janeiro; BrasilFil: Chandia, Felipe Vera. Pontificia Universidad Católica de Chile; ChileFil: Ferre, Felipe. Universidade Federal de Minas Gerais; BrasilFil: Marin, Gustavo Horacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata; ArgentinaFil: Olmos, Ismael. State Health Services Administration; UruguayFil: Zimmermann, Ivan R.. Universidade do Brasília; BrasilFil: Fulone, Izabela. University of Sorocaba; BrasilFil: Roldán Saelzer, Juan. Instituto de Salud Pública; ChileFil: Sánchez Salgado, Juan Carlos. No especifíca;Fil: Castro Pastrana, Lucila I.. Universidad de Las Américas de Puebla; MéxicoFil: de Souza, Luiz Jupiter Carneiro. Fundación Oswaldo Cruz; BrasilFil: Machado Beltrán, Manuel. Universidad Nacional de Colombia; ColombiaFil: Tolentino Silva, Marcus. University of Sorocaba; BrasilFil: Mena, María Belén. Universidad Central del Ecuador; EcuadorFil: de França Fonteles, Marta Maria. Universidade Federal do Ceara; BrasilFil: Urtasun, Martín Alejandro. Universidad Nacional Arturo Jauretche; Argentina. Federación Médica de la Provincia de Buenos Aires; Argentin