Rio de Janeiro, Brazil
Rio de Janeiro, Brazil

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The study sought to understand the meanings and significances that physicians attribute to the Death Certificate (DO) and the implications of subjectivity in the production of information on mortality. Guided by qualitative research, semi-structured interviews and content analysis, techniques were chosen for understanding representations and experiences involved in the filling out of the DO. The results revealed that different meanings and significances are attributed to the DO depending on how death occurred, in accordance with the different attributes the document acquires from a practical standpoint, in terms of 'epidemiological' and 'legal' functions. The results suggest that the DO used as a technical and objective instrument for data collection and production of health statistics does not lack subjectivity, which turns it into an instrument that in the medical practice and social reality reflects cultural issues, the social position of the subjects who fill it out and their representations of death.


Domingues R.M.S.M.,Institute Pesquisa Clinica Evandro Chagas Fiocruz | de Mello Lauria L.,Secretaria Municipal de Saude | Saraceni V.,Secretaria Municipal de Saude | do Carmo Leal M.,Escola Nacional de Saude Publica Sergio Arouca
Ciencia e Saude Coletiva | Year: 2013

This article seeks to evaluate knowledge, practices and attitudes of health care workers (HCW) involved in antenatal care in the Unified Health System (SUS) in Rio de Janeiro City (RJC) and to identify major barriers to the implementation of treatment for syphilis in pregnancy care protocols. A cross-sectional study was conducted with 102 HCW in antenatal care at SUS, corresponding to 70% of the eligible pool. Univariate and bivariate analysis were performed using SPSS version 16.0. A number of barriers were identified with respect to knowledge of and familiarity with the current protocols, difficulties related to DST management, relationship with patients and clinics organizational context, which were distinct according to the type of health unit. HCW who had greater access to training and technical manuals had a better performance, although the overall effect was discrete. Identifying barriers to adherence to health care protocols is essential to formulate intervention strategies. Access to protocols through training and technical manuals showed a discrete effect in the improvement of the care delivered to patients, pointing to the need of innovative ongoing education of HCW.


de Araujo V.E.M.,Federal University of Minas Gerais | Pinheiro L.C.,Federal University of Minas Gerais | de Almeida M.C.M.,Secretaria Municipal de Saude | de Menezes F.C.,Secretaria Municipal de Saude | And 4 more authors.
PLoS Neglected Tropical Diseases | Year: 2013

Background:Visceral leishmaniasis (VL) is a vector-borne disease whose factors involved in transmission are poorly understood, especially in more urban and densely populated counties. In Brazil, the VL urbanization is a challenge for the control program. The goals were to identify the greater risk areas for human VL and the risk factors involved in transmission.Methodology:This is an ecological study on the relative risk of human VL. Spatial units of analysis were the coverage areas of the Basic Health Units (146 small-areas) of Belo Horizonte, Minas Gerais State, Brazil. Human VL cases, from 2007 to 2009 (n = 412), were obtained in the Brazilian Reportable Disease Information System. Bayesian approach was used to model the relative risk of VL including potential risk factors involved in transmission (canine infection, socioeconomic and environmental features) and to identify the small-areas of greater risk to human VL.Principal Findings:The relative risk of VL was shown to be correlated with income, education, and the number of infected dogs per inhabitants. The estimates of relative risk of VL were higher than 1.0 in 54% of the areas (79/146). The spatial modeling highlighted 14 areas with the highest relative risk of VL and 12 of them are concentrated in the northern region of the city.Conclusions:The spatial analysis used in this study is useful for the identification of small-areas according to risk of human VL and presents operational applicability in control and surveillance program in an urban environment with an unequal spatial distribution of the disease. Thus the frequent monitoring of relative risk of human VL in small-areas is important to direct and prioritize the actions of the control program in urban environment, especially in big cities. © 2013 Araújo et al.


Richter V.B.,Prefeitura de Guaira | de Almeida T.C.A.,Secretaria Municipal de Saude | Prudencio S.H.,State University Londrina | de Toledo Benassi M.,State University Londrina
Food Quality and Preference | Year: 2010

The objective of this work was to propose an alternative use to ranking method, as descriptive test, here named Ranking Descriptive Analysis (RDA). RDA was compared with Free-Choice Profiling (FCP) and Quantitative Descriptive Analysis (QDA). Four chocolate puddings were used as samples. A group of assessors performed FCP. Another group of selected assessors developed a list of attributes and their corresponding definitions. These assessors were divided into two groups: a panel was trained to perform the QDA and other panel was familiarised with the RDA procedures. Sample discrimination was similar using the three techniques. The RDA panel showed better consensus than the other two ones. The QDA showed the best correlation with the instrumental analysis of color and texture. Despite the larger number of assessors, RDA has the advantage of minor costs associated with the requirement of fewer sessions and a smaller amount of product than required by other techniques. © 2010 Elsevier Ltd.


Baduy R.S.,State University Londrina | Feuerwerker L.C.M.,University of Sao Paulo | Zucoli M.,Secretaria Municipal de Saude | Borian J.T.,Secretaria Municipal de Saude
Cadernos de Saude Publica | Year: 2011

Healthcare production that assures comprehensiveness and equity has posed a challenge for Brazil's Unified National Health System. The aim of this study was to contribute to the debate on the issue, analyzing an experience with municipal healthcare management using regulation to improve quality of care. We conducted a case study in which data were obtained through direct observation, inter views, written narratives, and document analysis. The research subjects were health services managers and health workers. The results feature the concept of a living network, produced actively by building relations between the health workers in the different services. The study highlights the measures to support the care produced by the teams, based on healthcare regulation and work processes management. The results were expressive in upgrading the care, reducing the waiting lines for the specialties, and increasing the health workers' satisfaction. The key feature in the process was the evident need to enrich (through acts) the technical knowledge with light technologies and active movements by management in the production of care.


Ferreira J.O.,Secretaria Municipal de Saude
Revista de saúde pública | Year: 2013

Evaluate a program promoting exercise and healthy eating among adolescents. This was a cross-sectional study of 911 adolescents aged 13 to 18 years old in public schools in Goiania, Midwestern Brazil, 2010. The participants were divided into two groups: intervention (schools taking part in the Healthy Living, project) and control. The following were deemed to be exercise: displacement, physical education classes in school, physical activity outside school, and leisure-time physical activity. Pupils who totaled 300 or more minutes per week were defined as active. Consuming protective foods five or more days a week was classified as adequate intake. Statistical analyses made using the Chi-square test. Most adolescents were identified as inactive or insufficiently active, 65.7% in the Intervention Group and 65.2% Control Group, showing no significant differences between groups, and with higher prevalence among girls. Slightly more than half of adolescents consumed health protective foods 5 or more days a week, 56.6% in the Intervention Group and 50.4% in the Control Group (p = 0.373). There were no differences between schools in the Intervention Group and Control Group with regard to food choices and physical activity. This indicates that the Healthy Living project needs to be reevaluated to improve the effectiveness in achieving its objectives.


Fernandes M.T.O.,Secretaria Municipal de Saude | Silva L.B.,Federal University of Minas Gerais | Soares S.M.,Federal University of Minas Gerais
Ciencia e Saude Coletiva | Year: 2011

This study aimed to reveal the technologies of working with groups of diabetic and hypertensive peoples in the perspective of Family Health professionals. It is a qualitative research, carried through in the primary care units of a sanitary district of Belo Horizonte, Minas Gerais State, Brazil. The data had been analyzed according to the technique of content analysis proposed by Bardin. The study showed that the groups coordinators need a theoretical foundation and that exist the incorporation of technologies that embrace the context of a practice sometimes exists little criticized and differentiated and others wrapped up by diversified elements of the care. In this direction, sensitization for the necessity of the technologies that allows humanized attitudes, not only in the perspective of the coordinators, but also in the users ́, as the look at the diabetic and hypertensive peoples goes beyond the monitoring related to the use of medicines.


This study evaluated a concept-program developed in the area of a Family Health Unity, which monitored, for two years, the returns of infant children to regular attendance by the dentist, through their vaccines cards. A cross-sectional study was conducted, involving a convenience sample of 123 children aged 12 to 36 months, residents in the area. Data were collected during a campaign of immunization, in 2007, through a questionnaire answered by parents, vaccines cards checking, and clinical examination of children. The results showed that 81% of the examined children were registered in the FHU for dental care; from them, 95% had entered before reaching one year of life, having vaccines cards registration. It was also found that 50% of the children had visited the dentist more than once per year of life and 58% of them returned for dental appointments in the year before the survey. The prevalence of dental caries was lower in this group of children (17%), than in the group without frequent returns, or the one not registered in the FHU (26%). It was concluded that the accines card can be a useful tool for tracking the frequency of babies to dentist.


Sarquis O.,Instituto Oswaldo Cruz | Carvalho-Costa F.A.,Instituto Oswaldo Cruz | Toma H.K.,Federal University of Rio de Janeiro | Toma H.K.,IOC Instituto Oswaldo Cruz | And 3 more authors.
Parasitology Research | Year: 2012

An entomological survey was carried out in four rural localities situated in the state of Ceará, assessing Chagas disease seroprevalence in man, focusing on the presence of vectors in natural foci contiguous to the domestic and peridomestic environments. Fifty-three Triatoma brasiliensis, nine T. pseudomaculata and 71 Rhodnius nasutus were collected in their natural habitats as far as 10 m from the houses, and 663, 59 and 8 respectively were captured in peridomestic artificial structures, adjacent to the houses, including henhouses, pigpens, corrals, perches and piles of bricks, tiles and wood. Within the households, 37T. brasiliensis, one specimen of T. pseudomaculata and one of R. nasutus were captured. Overall, Trypanosoma cruzi infection rates were 2.3% for T. brasiliensis and 11.3% for R. nasutus. Despite that the seroprevalence survey in man did not reveal positive results using two serological techniques, natural triatomine habitats are juxtaposed to man-made artificial ecotopes, resulting in overlapping habitats. The contiguity between natural ecotopes and human dwellings increases the interaction between vectors and humans, challenging continuous surveillance and vector control efforts. © Springer-Verlag 2012.


Veloso M.M.X.,Federal University of Pará | Magalhaes C.M.C.,Federal University of Pará | Dell'Aglio D.D.,Federal University of Rio Grande do Sul | Cabral I.R.,Federal University of Pará | Gomes M.M.,Secretaria Municipal de Saude
Ciencia e Saude Coletiva | Year: 2013

Violence is a serious public health problem and notification of incidents is fundamental for epidemic surveillance and for the definition of priorities and public politics of health prevention and promotion. The study sought to characterize the occurrence of domestic violence, sexual and other forms of violence, based on the information of the database of the Information System of Notification of Offences (Sinan), on the records of violence of the city of Belém in the state of Pará, in the period from January 2009 to December 2011. In this period 3,267 notifications were recorded, which represented an increase of 240% in the number of notifications of the year 2009 compared to 2011. In relation to the sex of the victims it was observed that, on average, 83.2% of cases against women and this proportion was similar in all three years analyzed. Sexual violence was the most prevalent with 41.8% of reported cases; followed by psychological violence at 26.3% and physical violence at 24%. The results show that notification is fundamental for understanding the profile of violence and for intervention and elaboration of integrated public politics that promote health and the quality of life in this area of Brazil.

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