Clima organizacional e satisfação laboral: um estudo sobre os núcleos hospitalares de epidemiologia de Natal/RN

The Hospital Epidemiology Nucleus (NHE) is a structure that has a specific organizational climate, which influence the level of job satisfaction among professionals working in it. This is a descriptive study with a quantitative approach, aimed to identify the relationship between organizational climate in the NHE regulated in the city of Natal / RN and the job satisfaction among its professionals from the perspective of theoretical issues about Organizational Development. The research was carried out in 13 hospitals with different kinds of sponsorship, 9 public, 3 philanthropic and 1 private. Data were collected using the instrument "organization in hospitals: issues relating to climate and job satisfaction , with 33 professionals appointed and active on NHE. This study obtained an appropriate consent of the Research Ethics Committee of the Hospital of Pediatrics Professor Heriberto Ferreira Bezerra, from the Riograndense Northern League Against Cancer and the Federal University of Rio Grande do Norte. Data collected were organized and treated with simple descriptive statistics. It was observed that from 33 of surveyed people, 93% was female, had an average of 40 years old age, with activity duration between 1 and 2 years (84.9%). Furthermore, 45.5% of industry professionals were nurses. It was identified that professionals working in NHE perceive and experience its work environment as an Organization Structure in construction. It was found that with the exception of the aspects "working life", "socio-cultural" and "organizational culture , the other internal and external factors to the NHE does not have strong expression in the forming of an organizational climate conducive to the development of the sector. It was found that 70% of interviewed perceive the organizational climate as favorable for the industry's progress. Regarding the job level of satisfaction, respondents feel fairly satisfied with the organizational structure. Therefore, the results of this study are suggestive that there is some factor that is greatly contributing to a healthy organizational climate that encourages the industry team members of the NHE present behaviors that identify them as actors committed and satisfied with the work, even face of all obstacles to implementation of epidemiological surveillance. Thus, it is suggested for futures studies to seek to determine how the organizational culture, while significant internal factor, influencing the organizational climate establishment of NHE and therefore the level of job satisfaction and well-being of each members of the team

Epidemiologia e caracterização molecular dos vírus Dengue circulantes no Rio Grande do Norte, 2013-2014

Dengue is an acute infectious disease, usually transmitted by Aedes aegypti mosquitoes. The etiologic agents belong to the family Flaviviridae, genus Flavivirus, and occur as four antigenically related but distinct serotypes designated DENV-1, 2, 3, and 4. In Brazil, the disease represents a national public health problem. The purpose of the present study was to describe epidemiological aspects of dengue in the State of Rio Grande do Norte, from 2013 to 2014. A total of 483 blood or serum samples, collected from January 2013 to December 2014, were studied by RT-PCR for viral detection and typing. The infection was confirmed in 36.44% (176/483) of the cases studied. This study detected the circulation of three serotypes of dengue virus in Rio Grande do Norte, DENV-1, 2, and 4. The predominant serotype in 2013-2014 was the DENV-4, representing 83.51% (81/97) and 68.35% (54/79) of the positive cases, respectively. Regarding the spatial distribution, most of the cases occurred in Natal and Caicó, with 9.28% (9/97) and 18.99% (15/79), respectively. The months with the biggest viral circulation in RN were March 2013 and May 2014. The female gender was the most affected, representing 69.07% (67/97) in 2013 and 54.43% (43/79) in 2014. The most affected age groups were 21-30 years (2013) and 11-20 years (2014) with 25.77% (25/97) and 20.25% (16/79) positive cases, respectively. Phylogenetic analysis indicated that genotype V (DENV-1) and genotype II (DENV-4) circulated in the State. Our results provide information about the dynamics of DENV in the Rio Grande do Norte, important for the development of disease control strategies.

Síndrome de Guillain-Barré: epidemiologia, prognóstico e fatores de risco

Introduction. Guillain-Barré syndrome (GBS) is an immune-mediated polyneuropathy and the principal cause of acute neuromuscular paralysis. The most prominent GBS subtypes are: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor-sensory axonal neuropathy (AMSAN) and Fisher syndrome (FS). Differences in geographical distribution of variants have been reported. In Brazil, there are few studies describing the characteristics of GBS, but none on the frequency of GBS variants and their clinical manifestations. Infection-induced aberrant immune response resulting from molecular mimicry and formation of cross-reacting antibodies, contribute to complement activation. Functional biallelic polymorphism in immunoglobulin receptors that influence the affinity of IgG subclasses and the type of immune response have been described, suggesting genetic susceptibility to developing disease. It remains unclear whether individuals carrying different FCGR alleles have differential risk for GBS and⁄or disease severity. The goals of this study were: (1) To characterize GBS and describe the clinical findings in a cohort of patients with GBS from the state of Rio Grande do Norte, Brazil; (2) to determine whether polymorphism in FCGR were associated with development of GBS, and (3) to tease out whether the global gene expression studies could be a tool to identify pathways and transcriptional networks which could be regulated and decrease the time of disease. Methods. Clinical and laboratory data for 149 cases of GBS diagnosed from 1994 to 2013 were analyzed. Genomic DNA and total RNA were extracted from whole blood. Antigangliosides antibodies were determined in the sera. In addition, we also assessed whether FCGR polymorphism are present in GBS (n=141) and blood donors (n=364), and global gene expressions were determined for 12 participants with GBS. Blood samples were collected at the diagnosis and post-recovery. Results. AIDP was the most frequent variant (81.8%) of GBS, followed by AMAN (14.7%) and AMSAN (3.3%). The incidence of GBS was 0.3 ⁄ 100,000 people for the state of Rio Grande do Norte and cases occurred at a younger age. GBS was preceded by infections, with the axonal variant associated with episodes of diarrhea (P = 0.025). Proximal weakness was more frequent in AIDP, and distal weakness predominant in the axonal variant. Compared to 42.4% of cases with AIDP (P<0.0001), 84.6% of cases with the axonal variant had nadir in <10 days. Individuals with the axonal variant took longer to recover deambulation (P<0.0001). The mortality of GBS was 5.3%. A worse outcome was related to an axonal variant (OR17.063; P=0.03) and time required to improve one point in the Hughes functional scale (OR 1.028; P=0.03). The FCGR genotypes and allele frequencies did not differ significantly between the patients with GBS and the controls (FCGR2A p=0.367 and FCGR3A p=0.2430). Global gene expression using RNAseq showed variation in transcript coding for protein isoforms during acute phase of disease. Conclusions. The annual incidence of GBS was 0.3 per 100,00 and there was no seasonal pattern. A predominance of the AIDP variant was seen, and the incidence of the disease decreased with age. The distribution of weakness is a function of the clinical variants, and individuals with the axonal variant had a poorer prognosis. Early diagnosis and variant identification leads to proper intervention decreasing in long-term morbidity. FCGR polymorphisms do not seem to influence susceptibility to GBS in this population. This study found deregulated genes and signs of transcriptional network alterations during the acute and recovery phases in GBS. Identification of pathways altered during disease might be target for immune regulation and with potential to ameliorate symptoms.

Epidemiologia e saúde bucal coletiva: um caminhar compartilhado.

The public health dentistry is a way to bring oral health to Brazilian National Health System (SUS) and vice-versa. Thus, the epidemiology, in this context, it is one of the most important allies. In this article we intend to discuss the "shared walkway" between epidemiology and public health dentistry, through two views: first, we analyzed the efforts to establish methodological models for oral health sectional studies and the possibilities to construct a national data base. Second, we discussed how this knowledge has been transformed in a qualified scientific production presented in meetings and papers, which reflects, at the same time, about the contribution of this process in the consolidation of public health dentistry field. We concluded that this "shared walkway" was (and still is), influenced by political aspects, which, in different moments, leads to an improvement of public health dentistry. The oral health epidemiology has been established as a knowledge area, with regard to the scientific production in Brazil. At the same time, provide a tool that contributes to make oral health care models more appropriate to National Health System principles and, in other hand, make better the discussions about the social determinants of oral diseases.

Epidemiologia e saúde bucal coletiva: um caminhar compartilhado.

The public health dentistry is a way to bring oral health to Brazilian National Health System (SUS) and vice-versa. Thus, the epidemiology, in this context, it is one of the most important allies. In this article we intend to discuss the "shared walkway" between epidemiology and public health dentistry, through two views: first, we analyzed the efforts to establish methodological models for oral health sectional studies and the possibilities to construct a national data base. Second, we discussed how this knowledge has been transformed in a qualified scientific production presented in meetings and papers, which reflects, at the same time, about the contribution of this process in the consolidation of public health dentistry field. We concluded that this "shared walkway" was (and still is), influenced by political aspects, which, in different moments, leads to an improvement of public health dentistry. The oral health epidemiology has been established as a knowledge area, with regard to the scientific production in Brazil. At the same time, provide a tool that contributes to make oral health care models more appropriate to National Health System principles and, in other hand, make better the discussions about the social determinants of oral diseases.

Validade científica de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003

NARVAI, Paulo Capel et al. Validade científi ca de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003. Caderno de saúde pública, Rio de Janeiro, v. 26, n. 4, p. 647-670, abr. 2010.

Prevalência de alterações fundoscópicas em estudantes na cidade de Natal/Brasil

Objetivo: Determinar a prevalência de alterações fundoscópicas em estudantes de escolas das redes pública e privada de Natal-RN. Métodos: Avaliação oftalmológica foi realizada em 990 alunos, de 5 a 21 anos, matriculados nas escolas das redes públicas e privada do município de Natal- RN, que estiveram cursando alguma série do ensino fundamental ou médio, no período de 03 a 06 de 2001. Resultados: Alterações fundoscópicas foram observadas em 5,3% dos estudantes. As anormalidades encontradas, por ordem de freqüência, foram: branco sem pressão, 1,0%; cicatriz de retinocoroidite sugestiva de toxoplasmose, 1,0%; atrofia do epitélio pigmentado da retina, 0,8%; nevos da coróide, 0,4%; escavação da cabeça do nervo óptico aumentada, 0,4%; degeneração em treliça, 0,3%; buraco operculado, 0,2%; fundus miópico, 0,2%; tortuosidade vascular aumentada, 0,2%; granuloma sugestivo de toxocaríase, 0,2%; hipoplasia da cabeça do nervo óptico, 0,1%; persistência da artéria hialoidea, 0,1%; persistência de fibras de mielina, 0,1%; retina sal e pimenta, 0,1%; retinosquise, 0,1%. Conclusão: Houve uma baixa prevalência de alterações fundoscópicas na população estudada

Prevalência de alterações fundoscópicas em estudantes na cidade de Natal-Brasil

Objetivo: Determinar a prevalência de alterações fundoscópicas em estudantes de escolas das redes pública e privada de Natal-RN. Métodos: Avaliação oftalmológica foi realizada em 990 alunos, de 5 a 21 anos, matriculados nas escolas das redes públicas e privada do município de Natal-RN, que estiveram cursando alguma série do ensino fundamental ou médio, no período de 03 a 06 de 2001. Resultados: Alterações fundoscópicas foram observadas em 5,3% dos estudantes. As anormalidades encontradas, por ordem de freqüência, foram: branco sem pressão, 1,0%; cicatriz de retinocoroidite sugestiva de toxoplasmose, 1,0%; atrofia do epitélio pigmentado da retina, 0,8%; nevos da coróide, 0,4%; escavação da cabeça do nervo óptico aumentada, 0,4%; degeneração em treliça, 0,3%; buraco operculado, 0,2%; fundus miópico, 0,2%; tortuosidade vascular aumentada, 0,2%; granuloma sugestivo de toxocaríase, 0,2%; hipoplasia da cabeça do nervo óptico, 0,1%; persistência da artéria hialoidea, 0,1%; persistência de fibras de mielina, 0,1%; retina sal e pimenta, 0,1%; retinosquise, 0,1%. Conclusão: Houve uma baixa prevalência de alterações fundoscópicas na população estudada

Efetividade da doxiciclina na profilaxia contra letptospirose

Leptospirosis is a worldwide zoonosis of considerable medical and economical importance that affects humans in both urban and rural contexts, as well as domestic animals and wild fauna. Leptospira interrogans is the causative agent and is transmitted to humans by indirect contact with contaminated soil or water. The clinical syndromes include sub clinical infection, self-limited anicteric febrile illness, and severe and potentially fatal illness, known as Weil´s syndrome. In developed countries, leptospirosis is related to occupational or recreational activities while in developing countries, outbreaks occur during floods. In those regions, traditional strategies to prevent the transmission are difficulties to be implemented because of costs and lack of community acceptance. In addition, no efficient vaccine is available for human use. Several studies have suggested that chemoprophylaxis with doxycycline pre and post-exposure may be effective to prevent leptospirosis. Leptospirosis has been reported in rural areas of the State of Rio Grande do Norte, Brazil since 1985 in rice farmers who present the anicteric illness. The disease cause great social and economics impact. The study was conducted in São Miguel where an epidemic of leptospirosis in rice farmers was reported. The main objective was to determine the efficacy of doxycycline in preventing Leptospira exposure. A taxa de soroprevalência de leptospirose na população estudada antes e após a colheita foi de 14,2% (n=22) e de 16.6% (n=27) respectivamente. Anti-Leptospira serology was determined for 61 subjects in two instances, pre and post-exposure to potential contaminated water. There was an increased risk of 29.0 per cent in acquiring infection for individuals that did not use doxycycline. In addition, an increased risk of 30.0 % observed in farmers who did not use protection when exposed to Leptospira. The adhesion to preventive chemoprophylaxis was 55.7%. Therefore doxycycline, under specific circunstances appears to be an effective alternative to protect against leptosprirosis infection. A large sample composed of individuals to adhere to preventive therapy is needed to define time, dosage and length of use of doxycycline in this area

Estudo da frequência e perfil epidêmico-sorológico da toxoplasmose ocular em pacientes atendidos no ambulatório de oftalmologia do hospital universitário onofre lopes no município de Natal, Rio Grande do Norte

Toxoplasmosis, provoked by the intracellular parasite Toxoplasma gondii, is one of the most prevalent parasitoses in the world. In humans, transmission occurs by three evolutionary forms of the parasite: oocysts, tissue cysts and tachyzoites. Wild and domestic felines are definitive hosts. The ocular form of toxoplasmosis can be of congenital origin with early or late clinical manifestations, or acquired after birth. T. gondii is considered the main culprit for most cases of infectious uveitis. This study aimed at assessing ocular toxoplasmosis, relating it to factors associated to the patient s lifestyle and describing the epidemic-serological and clinical profile of affected individuals. A cross-sectional study was conducted with a population of 159 patients. Univariate analysis (odds ratio) was used to evaluate the data, with a confidence interval of 95% and p-value < 0.05. A prevalence of 4% of ocular toxoplasmosis was observed in the population of patients treated at an ophthalmological clinic. Of patients directly examined by immunoenzymatic assay (MEIA-AxSYM®- Microparticle Enzyme Immune Assay), considering only uveitis, a frequency of anti-T. gondii of 73%, most of whom exhibited titulation between 40-99 UI IgG/mL. With respect to location of ocular lesions, bilaterality was observed in 57% of patients assessed by the ophthalmoscopy technique. When compared with the results of an active search of medical records, a similarity in ocular toxoplasmosis (74%) and bilateral lesion location (55%) was observed. Type I lesion was the most frequent type observed, with intraocular disposition in the macula. An epidemiological survey revealed that direct contact with cats; consuming raw or poorly cooked meat and direct contact with the soil were significantly associated with greater likelihood of acquiring ocular toxoplasmosis. Sample characterization in relation to age range was significant for patients between 31 and 40 years [χ², chi-square test (p = 0.04)], but population traits such as schooling, sanitary district, and monthly income were not significant. Results confirm that ocular toxoplasmosis is widely distributed in the metropolitan area of Natal, Brazil, with significant prevalence of ocular lesions provoked by T.gondii. It is suggested that sanitary authorities exert greater control in order to minimize the risk of toxoplasmic infection, mainly in pregnant women.

Frequência da infecção por Toxoplasma gondii em galinhas caipira e frangos de corte em regiões dos Estados do Rio Grande do Norte e Paraíba

Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, a protozoan that has a cosmopolitan geographic distribution and low host specificity. Usually a benign and selflimiting, infection can manifest itself in a severe systemic becoming overwhelming in fetuses and patients with immunosuppression. Domestic fowl are considered one of the most important hosts in the epidemiology of toxoplasmosis, since they are potential sources of infection for humans, in addition to playing the role of important indicators of environmental contamination by oocysts of T. gondii. We studied the prevalence of infection by the protozoan in chickens of different breeding systems mesoregions from the states of Rio Grande do Norte and Paraiba: broilers from commercial farms (200/PB) and free-range chickens of small farms (322/RN and PB). Were standardized IFAT and ELISA techniques for detecting specific antibodies in blood samples of birds, and commercial kit was used to determine the prevalence by IHAT. There was no seropositive reaction by T. gondii in the samples of broilers tested, indicating that the particularities of intensive management limit the chances of infection for these animals. Among the hens, the frequency of IgG anti-T. gondii diagnosed by the techniques of IHAT, IFAT and ELISA, respectively, were 3.73% (12/322), 37.88% (122/322) and 40.37% (130/322), for both young and adult animals. Amongst the seropositive samples by IFAT, 33 (27.05%) were positive at a dilution of 1:16, in 1:32, 31 (25.41%), in 1:64, 24 (19.67%), 15 (12.29%) in 1:128, and 19 presented titer greater than or equal to 1:256 (15.57%). The evaluation of the presence of anti-T. gondii should be careful, and reagents IHAT provided erratic results in this measure for the specie studied. This suggests the need for own standardization of the kit before the use in epidemiological studies in animal species. On the other hand, substantial agreement observed between IFAT and ELISA techniques (Kappa = 0.62) enables these methods as effective methodologies for the diagnosis of toxoplasmosis in chickens. The high prevalence of specific antibodies among poultry in the region studied attempts to the potential risk of transmission of toxoplasmosis to humans

Acesso aos serviços odontológicos e incidência de cárie em adolescentes e fatores de risco em município do Nordeste Brasileiro, 2006

The aims of this study were to analyze the access of dental services by child population, to determine the prevalence of dental caries, gingivitis and malocclusion in resident children from the municipal district of Sobral Ceará and to evaluate the incidence of the dental decay in adolescents associated with the factors related to socioeconomic condition, access to health services and self-perception. This study had as main factor the multidisciplinary represented by the participation of health professional (doctors, dentists, nurses) in the development of the survey's initial reference; student from Human Sciences area to apply the structured questionnaire in domiciliary visits; statistics professionals in the orientation of the analysis to be held and family health team (community health agents, dentists and dental clinic assistants) in the scheduling of domiciliary visits and the accomplishment of oral exam. The sample was determined from the domicile record that included children born between 1990 and 1994 to develop the research Children health conditions in the municipal district of Sobral Ceará . The first sample comprised 3425 parents of children from 5 to 9 years old, living in the urban area at the municipal district of Sobral Ceará, aiming at identifying the most important factors associated to the access to dental service. From this sample, 1021 children were selected in a systematic way, for the accomplishment to the epidemiological study of decay, gingivitis and malocclusion. In the study's third phase, in order to arrange the group to be followed, 688 adolescents were examined and interviewed, by means of the active search from the 1021 individuals that had been previously examined. It was observed that 50.9% of the children had access to dental service at least once in a lifetime. Of this total, 65.3% accomplished it during the last year, and 85.4% of these did in public services, what allows to identify the importance of this sector in the access to dental services. It was observed that the factors that most affected the access to dental 129 services were related to socioeconomic condition, such as the access to health plan, the possession of toothbrush, garbage collecting, mother s schooling, sewerage treatment and malnutrition. In relation to oral diseases, an increase in the DMF-T index according the age was observed, from 0.10 in five years old to 1.66 in the nine years old, while with the dmf-t index, the inverse happened, since the index decreased from 3.59 in five years old to 2.69 in nine years old. In relation to gingivitis, an average 32.7% of the children presented gum bleeding. In what concerns malocclusion, it was observed that 60.3% of the children didn't present any problem, 30.17% had light malocclusion and 9.5% severe malocclusion. The average incidence of dental caries was 1.86 teeth per youngster. Among the studied variables, tooth pain in the last six months, mother's income and school snack, adjusted by the perception about the need of treatment, the mother's schooling and the dentist's appointment at least once in a lifetime, were the variables that presented positive relationship with the high incidence of dental caries on this population by logistic regression. Variables of socioeconomic nature, related to the access to health services and behavior and biological variables presented a relationship with the high caries incidence. The study point out to the need of developing health actions in a humanized way, by an oral health team effectively bound to the population's interest, with the great objective to provide, with the public health services managers, adequate conditions to improve oral health

Hiperidrose compensatória após simpatectomia toracoscópica: características, incidência e influência na satisfação do paciente

Hyperhidrosis is an idiopathic condition characterized by excessive sweating. Symptoms generally begin in childhood or early adolescence, and rarely improve with age. The excessive localized sweating generally occurs either spontaneously, or in association with stressful or emotionally charged situations. This prospective study aimed to investigate predictive factors for compensatory hyperhidrosis after thoracoscopic sympathicotomy. From 2000 to 2002, 80 patients (53 female and 27 male) underwent hyperhidrosis surgery. The patients, ranging from 12 to 56 years old, were studied and followed-up for 42.51 ±5.98 months. A satisfaction grading using a visual analogue scale -VAS (0 = not at all satisfied, and 10 = fully satisfied) was used. The surgical procedure was performed bilaterally on the second ganglion (T2) for facial hyperhidrosis, on the third and fourth ganglia (T3 and T4) for axillary hyperhidrosis, and on the third ganglion (T3) for palmar hyperhidrosis. The results showed that, 68 patients (85%) presented with compensatory sweating (CS), which was classified as mild (33.8%), moderate (33.8%) and severe (32.4%). Considering the final surgical results, 70 patients (87.5%) were satisfied with the outcome of the operation, while 10 patients (12.5%) were dissatisfied. Degrees of satisfaction varied according to sex, age, BMI and extent of denervation. Moreover, the compensatory hyperhidrosis was more severe in abdomen and back than in legs. In conclusion, although CS is a frequent adverse effect of sympathicotomy, the degree of patient satisfaction was high. Some factors were related to the occurrence and severity of CS and the most adequate patients to be submitted to this operation are young adult women whose BMI is less than 24.9

Prevalência de oclusopatias e caracteríticas cefalométricas e dentais de escolares cearense da cidade de Fortaleza

The people of Ceará state are descended from miscegenation between the Portuguese colonizers and the native population, resulting in a different facial pattern from other populations. It is important that this pattern be thoroughly understood, along with its minimum and maximum values so that they can be assessed and respected, allowing professionals who deal with the craniofacial complex to work more efficiently and scientifically. Aim: To characterize the morphological pattern of individuals from Ceará state, whose father and grandfather are also native from Ceará, in the 10-12 year age group, not submitted to previous orthodontic treatment, in order to determine: 1) the prevalence of occlusal pattern; 2) the prevalence of dental anomalies (DA) and, 3) the skeletal and dental cephalometric characteristics of individuals that present with normal occlusion and harmonious facial pattern. Methodology: A list of 10-12 year-olds was obtained from 515 schools containing 162,713 students (Education Secretariat of Ceará State), from which 234 individuals were examined (107 boys and 157 girls). The assessment criteria adopted were: 1) Angle s Classification System to determine occlusal pattern. The occlusal characteristics were measured through overbite, overjet, crowding and interincisal diastema. 2) DA are anomalies of number, shape, size, eruption and structure and, 3) in the group that presented with normal occlusion, we used cephalometric analysis measures proposed by Downs, Steiner, Tweed, Holdaway, Jacobson and McNamara. Results: 1) 25.8% of the schoolchildren had normal occlusion, 47.5% class I malocclusion, 22.3% class II malocclusion and 4.2% class III malocclusion. No statistically significant difference was found between the age group studied and sex. Thirty percent of the individuals had normal overbite, while 36.7% and 19.7% had increased and reduced overbite, respectively. Normal overjet was found in 33.7% of the individuals, increased overjet in 50% and reduced in 16.3%. Dental crowding was observed in 62.5% of the individuals and the presence of interincisal diastema in 14.8%. 2) The prevalence of DA was 56.1%, 6.8% in the number, 10.8% in shape, 4.1% in size, 34.5% in eruption, 26.4% in structure and 17.4% had more than one DA. No association was found between DA and sex, but DA was significantly associated to malocclusion (p<0.05); 3) there was no association between sex or facial type between the measures of nasal-labial angle, position and effective maxillary length, effective mandibular length and the sagittal relationship between the molars, overjet and overbite, position of upper incisors, lower incisors and between the incisors themselves. There was a difference between sex, on the VERT index and in lower anterior facial height, upper incisor inclination and line-H, between facial types for the occlusal plane angles, mandibular plane, facial axis, lower incisor inclination, mandibular position, upper incisor position, lower anterior facial height, ANB and line-H. It was concluded that: 1) the most prevalent occlusal type was class I malocclusion, with no distinction for sex or age group, and the assessment of occlusal characteristics showed that excessive overbite and overjet were the most predominant findings, along with a high occurrence of tooth crowding; 2) a high prevalence of DA was found, particularly eruption anomalies, not influenced by sex but significantly associated to malocclusion and 3) individuals from Ceará are predominantly brachyfacial, exhibiting a number of similarities inherent to their facial pattern, such as a convex profile, retracted jaw, reduced lower third and protruded lower incisors. This study was multidisciplinary, involving researchers from the areas of epidemiology, radiology and dentistry, thereby meeting the multidisciplinarity requirements of the Postgraduate Program in Health Sciences

Mortalidade materna no estado da Paraíba, 2000 a 2004

Esta tese articulou as áreas do conhecimento da Epidemiologia, Saúde Pública, Demografia e Estatística. Para esta investigação, traçaram-se duas estratégias: por um lado, buscou-se relatar a trajetória dos direitos femininos em saúde no Brasil a partir do período pós-guerra até os dias atuais; por outro lado, objetivou-se analisar diferenciais da morte materna e suas associações com variáveis sociodemográficas das mulheres residentes no estado da Paraíba no período de 2000 a 2004. As explorações decorrentes destes objetivos resultaram na produção de três abordagens. Na primeira, procedeu-se a um olhar retrospectivo sobre as políticas de saúde da mulher no país e seus desdobramentos regionais, enfocando a saúde materna. A análise permitiu reconhecer que, apesar de todas as conquistas adquiridas pelas mulheres desde os anos 80, a população feminina brasileira, em particular a paraibana, ainda carece de melhorias nas condições de saúde, sendo esta situação retratada pelo elevado número de mortes maternas ocorridas nos últimos anos. Também se buscou retratar os esforços dos sistemas oficiais na luta pela melhoria da qualidade dos dados reconhecida, na agenda nacional, como sendo ainda uma grande preocupação atual. Na segunda, o objetivo foi identificar o poder associativo entre a raça das mulheres residentes no estado da Paraíba e algumas variáveis sociodemográficas. Os resultados mostraram que houve indícios significativos de que as mulheres não brancas da Paraíba tiveram maiores chances de morrer que as brancas com baixa escolaridade e por morte obstétrica direta. Na terceira, centrou-se no tipo de óbito materno, cujo objetivo consistiu em analisar associações entre o tipo de óbito materno das mulheres paraibanas e as variáveis: grupo etário, escolaridade e raça, no período de 2000 a 2004. Os testes estatísticos realizados apontaram que a mulher paraibana teve cinco vezes mais chances de morrer por morte obstétrica direta ou indireta na faixa etária abaixo dos 20 anos e acima dos 34 em relação a faixa etária entre 20-34 anos