This article discusses the theory and practice of health and education, beginning with the notion of the hegemony (in health education practice) of strategies linked to the notion that to grasp established knowledge always leads to the acquisition of new behaviors and practices. Five different axioms have oriented education and health practices, either juxtaposed or at different moments: (1) the notion of overcoming the determination of knowledge over practices; (2) the determination of representations over practices; (3) the analysis of representations within the traditional framework of right and wrong; (4) reciprocity between representations and practices; and (5) the importance of considering practices amenable to re-elaboration through representations, thus situating experience in understanding subjects' illness processes, as well as the way subjects culturally construct illness. The article highlights the need for a link between social representations and illness-as-experience in health education practices.
Summaryobjective To investigate the relationship between hookworm and Ascaris lumbricoides infection and performance on three subsets of the Wechsler Intelligence Scale for Children -third edition (WISC-III) (Digit Span, Arithmetic and Coding) and Raven Colored Progressive Matrices.methods Cross-sectional study of 210 children between the ages of 6 and 11 years in Americaninhas, Minas Gerais, Brazil. Separate proportional odds models were used to measure the association between the intensity of helminth infections and poor performance on each of the four cognitive tests.results After adjusting for sex, age, socioeconomic status and other helminth infections, moderate-tohigh-intensity hookworm infection was associated with poor performance on the WISC-III Coding subtest [OR = 3.20; 95% confidence interval (CI) = 1.43-7.17], low intensity of hookworm infection was associated with poor performance on the WISC-III Coding subtest [odds ratio (OR) = 3.71; 95% CI = 1.80-7.66] and moderate-to-high-intensity A. lumbricoides infection was associated with poor performance on the Raven test (OR = 2.03; 95% CI = 1.04-3.99), all in comparison with uninfected children. Children co-infected with A. lumbricoides infection and hookworm infection had greater odds of poor performance on some WISC-III subtests than children with only A. lumbricoides infection.conclusions These findings suggest that hookworm infection may be associated with poorer concentration and information processing skills, as measured on the WISC-III Coding subtest, and that A. lumbricoides infection may be associated with poorer general intelligence, as measured through the Raven Colored Progressive Matrices. This study also presents evidence that polyparasitized children experience worse cognitive outcomes than children with only one helminth infection.
Most educational initiatives were not actively oriented toward health promotion, understood as the strengthening of autonomy and self-management of health processes, social engagement, and employment of dialogic teaching approaches. However, some progress has been made moving away from hegemonic models of education in primary health care.
Objective: to construct reflections on the health education device, considering the educational health practices developed in the Primary Health Care and in the nursing training.Method: this is a reflexive essay based on the concept of a device proposed by Deleuze.Results: we unraveled the lines of visibility and enunciation, the lines of force and the lines of subjectivity of the health education device, highlighting the real wills implied in the modes of subjectivation produced in this device. The lines of visibility and enunciation of the health education device are located in visible, discursive, hybrid and contradictory fields, which at times are built from a specific notion of health and education and at different times by another notion. In this device, subject-educator and subject-learner are objects of the lines of force; they recompose and are recomposed by modulations configured in the spheres of power and knowledge. The projects of each subject can predispose lines of fracture and lead to productions of subjectivities that leave the powers and knowledge of a device to reinvent themselves in another device. In order to predispose lines of fracture in the health education device, it is necessary to design training processes that allow nurses to take creative positions in their health education practices.Conclusion: this essay allowed us to expand the conceptual territories involved in educational practices in health and nursing education, opening the way to understand the subjectivation processes in health education. DESCRIPTORS:Education in health. Primary health care. Nursing. Public health. Education in nursing. DISPOSITIVO EDUCAÇÃO EM SAÚDE: REFLEXÕES SOBRE PRÁTICAS EDUCATIVAS NA ATENÇÃO PRIMÁRIA E FORMAÇÃO EM ENFERMAGEM RESUMOObjetivo: construir reflexões sobre o dispositivo educação em saúde, considerando as práticas educativas em saúde desenvolvidas na Atenção Primária à Saúde e a formação em enfermagem.Método: trata-se de um ensaio reflexivo que se ancora no conceito de dispositivo proposto por Deleuze.Resultados: desenredamos as linhas de visibilidade e de enunciação, as linhas de força e as linhas de subjetividade do dispositivo educação em saúde, destacando as vontades de verdade implicadas nos modos de subjetivação produzidos nesse dispositivo. As linhas de visibilidade e de enunciação do dispositivo educação em saúde instalam-se em campos visíveis, discursivos, híbridos e contraditórios, que em dados momentos se constroem a partir de uma noção específica de saúde e de educação e em momentos diferentes por outra. Nesse dispositivo, sujeito-educador e sujeito-educando são objetos das linhas de força; recompõem e são recompostos por modulações configuradas nas esferas do poder e do saber. Os projetos de cada sujeito podem predispor linhas de fratura e conduzir a produções de subjetividades que saem dos poderes e dos saberes de um dispositivo para se reinventar noutro. Para predispormos linhas de fratura no dispositivo educação em saúde, é necessário concebermos processos formativos qu...
Necator americanus Glutathione-S-Transferase-1 (Na-GST-1) plays a role in the digestion of host hemoglobin by adult N. americanus hookworms. Vaccination of laboratory animals with recombinant Na-GST-1 is associated with significant protection from challenge infection. Recombinant Na-GST-1 was expressed in Pichia pastoris and adsorbed to aluminum hydroxide adjuvant (Alhydrogel) according to current Good Manufacturing Practice. Two Phase 1 trials were conducted in 142 healthy adult volunteers in the United States and Brazil, first in hookworm-naïve individuals and then in residents of a N. americanus endemic area in Brazil. Volunteers received one of three doses of recombinant Na-GST-1 (10, 30, or 100 μg) adjuvanted with Alhydrogel, adjuvanted with Alhydrogel and co-administered with an aqueous formulation of Glucopyranosyl Lipid A (GLA-AF), or the hepatitis B vaccine. Vaccinations were administered via intramuscular injection on days 0, 56, and 112. Na-GST-1/Alhydrogel was well tolerated in both hookworm-naïve and hookworm-exposed adults, with the most common adverse events being mild to moderate injection site pain and tenderness, and mild headache and nausea; no vaccine-related severe or serious adverse events were observed. Antigen-specific IgG antibodies were induced in a dose-dependent fashion, with increasing levels observed after each vaccination in both trials. The addition of GLA-AF to Na-GST-1/Alhydrogel did not result in significant increases in specific IgG responses. In both the US and Brazil studies, the predominant IgG subclass induced against Na-GST-1 was IgG1, with lesser amounts of IgG3. Vaccination of both hookworm-naïve and hookworm-exposed adults with recombinant Na-GST-1 was safe, well tolerated, and resulted in significant antigen-specific IgG responses. Based on these results, this vaccine will be advanced into clinical trials in children and eventual efficacy studies.Trial registrationClinicalTrials.gov (NCT01261130 for the Brazil trial and NCT01385189 for the US trial)
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