Mortalidade por câncer de boca e condição sócio-econômica no Brasil

BORGES,D. M. L.et al. Mortalidade por câncer de boca e condição sócio-econômica no Brasil.Cad. Saúde Pública, Rio de Janeiro, v.25,n.2, p.321-327, fev, 2009

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.

Atividades educativas na rede pública de ensino: efeitos sobre a higiene oral e o nível de informação em Saúde Bucal

The contents introduction concerning the individual health cares reveals important since the school education. In this direction, the present study objectified to know an effect of Oral Health education intervention in the oral hygiene and in the schools children information level, of 4º e 5º basic education years. The study was composed by two groups, chosen of random form: control group (n = 115) and experimental group (n = 132), with 247 public net school children in total sample. The experimental group participated of some educative activities in Oral Health, with biweekly frequency, during the 4 months period, given for a surgeon-dentistry. Both the groups were submitted to a clinical examination for a previous verification of the Plaque Index (PI) and of Loe Silness Gingival Index (GI). A questionnaire with closed questions on Oral Health was applied before and after to verify the school children rightness index. After the intervention, the final data, represented for the PI, GI and Rightness Index verification, has been collected for statistical analyses through the chi-square test to a 95 % of reliable level, using the SPSS 10,0 software. The PI and GI were categorized in high and low on the initials index basis medium; already the Rightness Index was categorized in inadequate (< 50%) and adequate (≥ 50%). It was verified that the PI (p = 0,014; IC 0.24-0.86) and the GI (p = 0,013; IC 0,28-0,84) presented differences statistically significant, after the education activities, when compared to with the control, favoring the experimental group. It was verified too the experimental group got greater rightness index, presenting difference highly significant (p<0,0001; IC 3,73-26,81). It was still observed that there was no association between the oral hygiene indicators and the school children information level. Ahead the results, it can been concluded that education activities related in the school routine were capable to give positives effects in the oral hygiene control and in the information level about Oral Health, however, not necessarily, the individual with bigger information is that one who has practiced an oral hygiene more adjusted. One become necessary, however, that the education in Oral Health occurs of permanent and integrated form with others school actors, for the positive effect does not lose the student s life longterm

A produção das desigualdades: análise da relação entre trabalho infantil e indicadores sociais

The International Labor Organization (OIT) estimates that there are around 118 million children subjected to child labor around the world. In Brazil, there are 3.5 million workers aged between 5 and 17. This exploitation practice constitutes a serious social problem, including of Public Health, since these workers are exposed to a wide range of risks, such as those related to health, physical integrity and even to life, which may cause them to become sick adults and/or interrupt their lives prematurely. Therefore, this research aims to investigate the relationship between the frequency of child labor in the age group of 10 to 13 years and some socio-economic indicators. It is a quantitative research in an ecological study whose levels of analysis are the Brazilian municipalities grouped in 161 regions, defined from socioeconomic criteria. The dependent variable of this study was the prevalence of child labor in the age group of 10 to 13 years. The independent variables were selected after a correlation between the 2010 Census of child labor in the age group of 10 to 13 years and secondary data had been conducted, adopting two main independent variables: funds from the Family Allowance Program (PBF) per 1,000 inhabitants and Funds from the Child Labor Eradication Program (PETI) per a thousand inhabitants. Initially, it was conducted a descriptive analysis of the variables of the study, then, a bivariate analysis, and the correlation matrix was built. At last, the Multiple Linear Regression stratified analysis was performed. The results of this survey indicate that public policies , like the Bolsa Familia Program Features per 1000 inhabitants and Resources Program for the Eradication of Child Labour to be allocated to municipalities with HDI < 0.697 represent a decrease in the rate of child labor ; These programs have the resources to be invested in municipalities with HDI > = 0.697 have no effect on the rate of child labor. Other adjustment variables showed significance, among these the municipal Human Development Index (IDH), years of schooling at 18 years of age, illiteracy at 15 years of age or more, employees without employment contract at 18 years of age and the Gini Index. It is understood that the child labor issue is complex. The problem is associated, although not restricted to, poverty, the social exclusion and inequality that exist in Brazil, but other factors of cultural and economic nature, as well as of organization of production, also account for its aggravation. Fighting child labor involves a wide intersectoral articulation, shared and integrated with several public policies, among them health, sports, culture, agriculture, labor and human rights, with a view to guaranteeing the integrality of the rights of children and adolescents in situation of labor and of their respective families

A ocupação urbana do entorno de zonasde proteção ambiental de natal, suas condições de sustentabilidade e a relação com a ocorrência de insetos vetores

This study started from the hypothesis of the existence of a relation between the type of the urban occupation concerning to the sustainability conditions at the proximity of Environment Protected Zones and the occurrence of vectors insects in Natal, Rio Grande do Norte, Brazil. This research, which used data available by the City Administration Health and Urbanization Secretaries (respectively SMS and SEMURB), in the time period of 2006 to 2008, aimed to characterize the study site in terms of urban occupation, relating it to social environmental aspects of land occupation and the occurrence of vectors insects. This study is presented in two papers, the first one linking the occurrence of vectors insects and sustainable development indicators and the second relating the incidence of reported cases of Dengue and Dengue Hemorrhagic Fever (DHF) and the occurrence of larvae infection indexes of Aedes aegypti, in Natal, Rio Grande do Norte State. In the first paper, was made a correlation between Dengue Fever vectors and Visceral and Tegumentar Leishmaniasis vectors and sustainable development indicators, selected from IDS Brasil- 2008. Through factorial analysis a Sustainability Index (SI) was acquired for each region, the northern region of the municipality obtained lower numbers than southern region, which, in its turn, presented better sustainability conditions. Linking this index to vector infestation parameters shows a high significant correlation between the SI and the Breteau Index of Aedes aegypti (p=0,028) as well as with SI and sand flies infestation index (p=0,01). Higher rates in vectors infestation in regions with a lower Sustainable Development Index demonstrates that this index can be used to determine the increasing of probability of Aedes and sand flies occurrence in urban environment. The second paper analyzed the occurrence of the main vector of Dengue and DHF, the Aedes aegypti mosquito, and the relation between larvae infection indexes of this insect and reported cases of the diseases. This study revealed unexpected relation where areas with higher Breteau s Indexes showed lower infection rates of Dengue Fever, although showing high incidence of DHF

A incorporação de preceitos ambientais no sistema de gestão de resíduos sólidos do município de João Câmara - RN Brasil

The reality points to the global environmental sustainability as the only viable option for addressing the crisis at hand. The move towards sustainability calls for the generation / evaluation systems in their direction, through the incorporation of environmental requirements and in line with the National Policy on Solid Waste. Therefore, the proposed research supports the importance of social and environmental vision, complementing the technical view, the system for management of solid waste from East London, which is a municipality that has a system whose inadequacies are configured in environmental risk and health. Therefore, by observing, applying the model of sustainability indicators and content analysis of interviews, this research proposes to investigate the principles of sustainability and social participation are presented and what is the perception of risk about the inadequacies in the system. The results confirmed the hypotheses of the study and draw a picture of worrying data, such as very unfavorable indicators of sustainability, lack of channels of participation, uncommitted investments with the management system, devaluation of the collector of waste and differing perceptions about the risk by making actors act in isolation. This worrying situation is eased by the appearance of a series of elements are configured as opportunities for the integration of environmental principles in the system. And despite the inability of managers to participate in the research system, yet it behaves as an opportunity to implement public policies in the area of solid waste such as: the preparation of the municipal waste, the institutionalization of selective collection and organization of cooperative with the support of companies present in the city and educational institutions as the Federal Institute. The research is an opportunity for the implementation of policies in the area of solid waste and will collaborate with the building instruments for the quality of life of residents, for the socioeconomic conditions of collectors and the move towards a sustainable society

Avaliação da atenção humanizada ao abortamento em maternidade-escola, em Natal, Rio Grande do Norte

Unplanned pregnancy is experienced by millions of women worldwide. Such fact increases the risk of abortion-related morbimortality, which represents a serious public health problem. This study aims to evaluate the advances and challenges of the implementation of Humanized Abortion Care at the Maternity-School in Natal, state of Rio Grande do Norte. The research was evaluative, was preceded by an Evaluative Study, and resulted in a Case Study. The intentional sample totaled 102 subjects (60 users, 39 professionals and 3 managers). The collection techniques included documental analysis, semi-structured interview and observation with a field diary. The documental analysis was descriptive, while the Content Analysis by Bardin was used for semi-structured interviews and field diary. The Evaluative Study observed that Humanized Abortion Care is an evaluative program with preparation and pact of the logical model, of the matrix of indicators and evaluative questions. The Case Study showed that users were satisfied with the problem-solving capacity and access to the service; however, is also showed that they pointed out inadequacy in terms of environment, qualified hearing and reproductive planning. Professionals reported that the inefficiency of service consists of infrastructure and environment, which are considered inefficient and inadequate to humanized care, especially regarding patient accommodation, the lack of hospital beds, the reduced number of rooms in the surgical center and the lack of laboratory inside the maternity. Moreover, reproductive planning does not consist of an institutionalized practice in the service, and integrality with other services or partnership with the community is not in place. The Maternity Board emphasizes that the excessive demand of patients is one of the reasons that hinders the appropriate implementation of the technical standard. We then conclude that although satisfied regarding problem-solving capacity in terms of service and ease of access, there is room for improvement in qualified hearing systems, in the creation of a system to promote team work, implementation of ombudsman and satisfaction surveys. The right of shared choice did not prevail among users and health professionals with regard to the option of uterine evacuation procedure. Environment was the most mentioned category as that requiring more changes, seeing as a limited factor for the development of humanized and welcoming practices. Health professionals do not establish a periodic routine of planning practices, and such practices are not aligned with the Technical Standard. Incorporation of guidelines and availability of a plurality of methods and possibilities of choices for family planning are required. There is no institutionalization of reference and counter-reference, or partnerships with the community, which makes integrality of care not viable. The Standard needs to be included in the action plans of managers as one of the priorities in the construction of care strategies for women's health, in order to enable, allied to other initiatives, the real integration among safe conduct service, primary care network and social organizations. As a result, respect for human rights and adequate humanized care, as a way of attention and prevention of abortion, can be secured.

Mortalidade segundo sua causa de morte e seus determinantes: uma análise para as capitais brasileiras e municípios do nordeste do Brasil, 2000 e 2010

This dissertation considered the development of two papers, both related to mortality in Brazil. In the first article, "The context of mortality according to the three broad groups of causes of death in Brazilian capitals, 2000 and 2010", the objective was to analyze the mortality rate according to the three major groups of causes of death in Brazilian capitals. In the second article, "Typology and characteristics of mortality from external causes in the municipalities in the Northeast of Brazil, 2000 and 2010", it was built up a typology for the Northeastern municipalities taking into account information on mortality from external causes and a set of indicators related to socioeconomic, demographic, and infrastructure aspects of such municipalities, both articles for the years 2000 and 2010. Thus, we used data from the Mortality Information System of the Ministry of Health. Furthermore, it was used information from the Demographic Census for those years. The variables relating to socioeconomic and demographic conditions used in this study were those available on the home page of the United Nations Program for Development. The variables relating to socioeconomic and demographic conditions used in this study were those available on the home page of the United Nations Program for Development. Was used in Article 1 the pro-rata distribution method to accomplish the redistribution of ill-defined causes. Moreover, made use of the technique of cluster analysis with the aim of grouping the capital that had proportions of deaths from ill-defined causes similar to each other. Already in Section 2, we used the technique of Empirical Bayesian estimation; spatial statistics technique; and finally, the Grade of Membership method to find types of municipalities from information on mortality from external causes associated with socioeconomic, demographic and infrastructure variables. As the main results, it stands out in Article 1, in relation to data quality, we observed the formation of four groups of similar capital between themselves, as the proportion of illdefined causes. Regarding the behavior of mortality, according to the three major groups of causes of death, it was noted both for 2000 and for 2010 the prevalence of deaths from noncommunicable diseases for both sexes, although the reduction was identified rates in some of the capitals. Communicable diseases stood out as the second cause of death among women. Also, we found that deaths due to external causes are responsible for the second cause of death among men, as well as presenting an increase among women. As for the Article 2, stands out, in general, not just an extension of mortality from external causes in the municipalities, as well as an enlargement of the configurator stain existence of external cause deaths for the whole area of Northeast. Regarding the typology of municipalities, three vi extreme profiles were buit: the profile 1, which comprises municipalities with high rates of mortality from external causes and the best social indicators; the profile 2, that was composed of municipalities that are characterized by having low mortality rates from external causes and the lowest social indicators; and the profile 3, that brings together municipalities with intermediate mortality rates and median values considered in relation to social indicators. Although we have not seen changes in the characteristics of the profiles, we observed an increase in the proportion of municipalities that belong to the extreme profile 3, taking into account the mixed profiles.

Resiliência e apoio social em gestantes tardias

The gestation process, in general, is a very important event on a woman’s life and it brings phisical, phisiological and emotional changes, which by itself is an experience full of intense feelings. By late-aged pregnancy we mean those which occurs at the age of 35 or further. The occurance of this type of pregnancy is rising in Brasil and throughout the world, factors such as, better access to birth control resources and the search for financial stability explains the pregnancy delay. Important processes like resilience and social support can help late-aged pregnant women, in a benefical way, to adapt to the gestation process. Resilience is the capacity that a certain individual or group of individuals have to go through an adverse situation, be able to overcome it and become streghtened, transforming it in motivation for its biopsichosocial development. Social support is a complex and dinamic process that involves transactions between individuals and their social networks, meeting the social needs, promoting and complementing the personal resources that they have to face new demands. This research has the intention of raising information about the issues of late-aged pregnant women in the County of Natal- RN, the main objective was to evaluate the resilience indicators and the social support on late-aged pregnant women in the Natal-RN County. A transversal cut, correlational and descriptive research that was done with 150 lateaged pregnant women. The tools that were used were: A form with sociodemographic and gestation info, the scale of resilience and social support. An eletronic spreadsheet sofware (Excel e SPSS 21.0) was used to analize data which helped on the statistics according to its variables and the objective of this work. For the nominal variables, relative frequencies were used and for continuous the Pearson correlation and determination coefficient were used, regarding that; the sample had a normal distribution. The project fulfilled the ethnic aspects prescribed by Resolution 466/12 of the National Health Council, with a favorable decision (356.436/ 2013) of the UFRN Ethics on Research Committee. Most of the pregnant women had a low money income and education level, born in the state of Rio Grande do Norte they had an average age of 37,49 (±2,577), catholic, married, house wives, they had more than one child and were on their third trimester of pregnancy; they also had a low past abortion rate, not having planned their pregnancy, with an average of 4,22 (±2,506) pre-natal appointments, residing with an average of 3,673 (±1,397) people, having used any sort of birth control device and having high indicators of resilience and social support. The correlations kept between resilience, social support and some of the social demographics and gestation variables were considered low. Such data points out the fact that most of these women were in a stable relationship; they hadn’t had a past of abortion, they were involved with some kind of religion, they were not first pregnancy mothers, had an age on which they are not considered inexperienced mothers and even had scored high on the social support scale, these may all possibly be the most contributing factors on development and resilience building on these 35 years or more mothers. We expect that the data and information from this research may add up knowledge, actions and improvements regarding late-aged pregnant women and the pregnancy phenomena in general.

Construção e validação de instrumento de coleta de dados do casal grávido no âmbito da atenção básica

The research aimed to construct and validate a data collection instrument of pregnant couple as part of primary care. It was considered hypothesis that level of agreement from 70% among participants to validate the expert panel. The document has been based on the Theory of Human Needs by Horta and adjusted by Garcia and Cubas. It is a study of methodological type developed in four stages: identification of empirical indicators to pregnant women through an integrative literature review; evaluation of empirical indicators and their relation to human needs by focus group; structuring of the second version of instrument by categorization of indicators and appearance and content validation of the third version of instrument by judges, by use of Delphi technique. The collection of data was the first stage in months from August to October 2014 in the Journal of Midwifery and Women's Health and Scopus, PubMed, Lilacs, CINAHL, Cochrane databases. The remaining steps were carried out from November 2014 to February 2015. For the focus group was counted with participation of six experts through two meetings. As for the judges, it was obtained a population of 63 and final sample of 51 judges divided into 46 basic health units of Municipal City Health Natal/RN, Brazil. The study was approved by the Research Ethics Committee of Universidade Federal do Rio Grande do Norte, under Protocol number 876.200. For data analysis of the first stage it was used descriptive statistics and results are presented in tables and charts. At that stage were identified 162 empirical indicators and, when they were related to human needs, 64 by them were on psycobiological, 97 on psychosocial and one (1) on psychospiritual needs. Regarding the second and third stages, data were treated by process of categorizing and analyzing the Content Validity Index. The indicators obtained a 100% validation index. In appearance and content validation phase of instrument non-validated items were excluded and other items obtained index above 70%. Furthermore, it obtained 99% content validity index in the second version and 95.7% in the third version of the instrument as a whole and, therefore, validated tool. This instrument contains Health Institution, pregnant woman and her partner identification data, information on the human needs of the pregnant and items pertaining to systematize the collection of pregnant couple data during prenatal care. By the conclusion of the study, nurse shall have an instrument to collect the data of pregnant couple in primary care innovative by considering psychobiological, psychosocial and psychospiritual pregnant needs and insert health and sociodemographic data of pregnant partner in the context of pregnancy. Also, the document will serve as a tool for teaching and research in obstetrical nursing.

Avaliação da efetividade do Programa de Alimentação do Trabalhador

This study analyzed the Worker’s Healthy Eating Program in Rio Grande do Norte state (RN) to assess its possible impact on the nutritional status of the workers benefitted. To that end, we conducted a cross-sectional observational prospective study based on a multistage stratified random sample comparing 26 small and medium-sized companies from the Manufacturing Sector (textiles, food and beverages, and nonmetallic minerals) of RN, divided into two equal groups (WFP and Non WFP). Interviews were conducted at each company by trained interviewers from Tuesday to Saturday between September and December 2014. Data were collected on the company (characterization and information regarding the program’s desired results) and workers (personal and professional information, anthropometrics, health, lifestyle and food consumed the previous day). Population estimates were calculated for RN on the characteristics of workers and the study variables. The main variable was BMI. The secondary variables were waist circumference (WC), nutritional diagnosis, calorie intake, blood pressure, metabolic variables and lifestyle indicators. The statistical method used was hierarchical mixed effects linear regression for interval variables and hierarchical mixed effects logistic regression for binary variables. The variables measured in ordinal scales were analyzed by ordinal logistic regression adjusted for correlated variables, adopting robust standard errors. The results for interval variables are presented as point estimates and their 95% confidence intervals; and as odds-ratios and their 95% confidence intervals for binary variables. The Fisher’s exact and Student’s t-tests were used for simple comparisons between proportions and means, respectively. Differences were considered statistically significant at p<0.05. A total of 1069 workers were interviewed, of which 541 were from the WFP group and 528 from the Non WFP group. Subjects were predominantly males and average age was 34.5 years. Significant intergroup differences were observed for schooling level, income above 1 MW (minimum wage) and specific training for their position at the company. The results indicated a significant difference between the BMI of workers benefitted, which was on average 0.989 kg/m2 higher than the BMI of workers from the Non WFP group (p=0.002); and between the WC, with the waist circumference of WFP group workers an average of 1.528 cm larger (p<0.05). Higher prevalence of overweight and obesity (p<0.001) and cardiovascular risk (p=0.038) were recorded in the WFP group. Tests on the possible effect of the WFP on health (blood pressure and metabolic indicators) and lifestyle indicators (smoking, alcohol consumption and exercise) were not significant. With respect to worker’s diets, differences were significant for consumption of saturated fat (lunch and daily intake), salt (lunch, other meals and daily intake) and proteins (other meals and daily intake), with higher consumption of these nutrients in the WFP group. The study showed a possible positive impact of the WFP on nutritional status (BMI and WC) among the workers benefitted. No possible effects of the program were observed for the lifestyle indicators studied. Workers benefitted consumed less salt, saturated fat and protein. The relevance of the WFP is recognized for this portion of society and it is understood that, if the program can reach and impact those involved, the development of educational initiatives aimed at nutritional and food safety may also exert a positive influence.

Análise de conteúdo e validação clínica do diagnóstico de enfermagem autocontrole ineficaz da saúde

The study aims to analyze the content and measures of accuracy of the nursing diagnosis Ineffective Self Health in patients undergoing hemodialysis. Study of nursing diagnosis validation carried out in two stages, namely: content analysis by judges and accuracy of clinical indicators. In the first stage, 22 judges evaluated the setting and location of the diagnosis, clinical indicators and etiological factors and their conceptual and empirical definitions. We used the binomial test to determine the proportion of the judges of the relevance of the components of the nursing diagnosis. In the second stage, we used the Latent Class Analysis for the diagnostic accuracy by evaluating 200 patients in a hemodialysis clinic in northeastern Brazil. Research approved by the Ethics Committee, under the Opinion No 387 837 and CAAE 18486413.0.0000.5537. The results show that the judges evaluated as pertinent clinical indicators 12 and 22 etiological factors. Proposed amendment of the nomenclature of five indicators and six factors and the implementation of a clinical indicator for etiology and three etiological factors for clinical indicators. In conceptual and empirical definitions, judges judged as not relevant the conceptual and empirical definitions of a clinical indicator, the conceptual definitions of two etiological factors and empirical definitions four etiological factors. Still, changes were suggested in the conceptual and empirical definitions of two clinical indicators, the conceptual definitions of 12 etiological factors and empirical definitions of 11 etiological factors. Clinical indicators analyzed in the first stage were validated clinically in patients undergoing hemodialysis. The most frequent clinical indicators were Changes in laboratory tests (100%) and daily life choices ineffective to achieve health goals (81%); and three etiological factors had a higher frequency, they are: unfavorable demographic factors (94.5%), beliefs (79%) and comorbidities (77.5%). From Latent class analysis, diagnosis prevalence was estimated at 66.28%. Clinical indicators that showed the best sensitivity measures for the nursing diagnosis Ineffective Self Health were: daily life choices ineffective to achieve health goals and Expression of difficulty with prescribed regimens. In turn, the clinical indicators of inappropriate medication use, no expression of desire to control the disease, irregular attendance to the dialysis sessions and infection were more specific as to that diagnosis. Non-adherence to treatment was the only indicator that showed confidence intervals with values for sensitivity and specificity, statistically above 0.5, being the one who has better diagnostic accuracy as the inference of the nursing diagnosis Ineffective Self Health in hemodialysis clientele. Thus, it is believed that the improvement of the components of diagnosis in question will contribute to the development of more reliable nursing interventions to the health status of the individual in hemodialysis, providing a more scientifically qualified care.

Análise de conteúdo e validação clínica do diagnóstico de enfermagem autocontrole ineficaz da saúde

The study aims to analyze the content and measures of accuracy of the nursing diagnosis Ineffective Self Health in patients undergoing hemodialysis. Study of nursing diagnosis validation carried out in two stages, namely: content analysis by judges and accuracy of clinical indicators. In the first stage, 22 judges evaluated the setting and location of the diagnosis, clinical indicators and etiological factors and their conceptual and empirical definitions. We used the binomial test to determine the proportion of the judges of the relevance of the components of the nursing diagnosis. In the second stage, we used the Latent Class Analysis for the diagnostic accuracy by evaluating 200 patients in a hemodialysis clinic in northeastern Brazil. Research approved by the Ethics Committee, under the Opinion No 387 837 and CAAE 18486413.0.0000.5537. The results show that the judges evaluated as pertinent clinical indicators 12 and 22 etiological factors. Proposed amendment of the nomenclature of five indicators and six factors and the implementation of a clinical indicator for etiology and three etiological factors for clinical indicators. In conceptual and empirical definitions, judges judged as not relevant the conceptual and empirical definitions of a clinical indicator, the conceptual definitions of two etiological factors and empirical definitions four etiological factors. Still, changes were suggested in the conceptual and empirical definitions of two clinical indicators, the conceptual definitions of 12 etiological factors and empirical definitions of 11 etiological factors. Clinical indicators analyzed in the first stage were validated clinically in patients undergoing hemodialysis. The most frequent clinical indicators were Changes in laboratory tests (100%) and daily life choices ineffective to achieve health goals (81%); and three etiological factors had a higher frequency, they are: unfavorable demographic factors (94.5%), beliefs (79%) and comorbidities (77.5%). From Latent class analysis, diagnosis prevalence was estimated at 66.28%. Clinical indicators that showed the best sensitivity measures for the nursing diagnosis Ineffective Self Health were: daily life choices ineffective to achieve health goals and Expression of difficulty with prescribed regimens. In turn, the clinical indicators of inappropriate medication use, no expression of desire to control the disease, irregular attendance to the dialysis sessions and infection were more specific as to that diagnosis. Non-adherence to treatment was the only indicator that showed confidence intervals with values for sensitivity and specificity, statistically above 0.5, being the one who has better diagnostic accuracy as the inference of the nursing diagnosis Ineffective Self Health in hemodialysis clientele. Thus, it is believed that the improvement of the components of diagnosis in question will contribute to the development of more reliable nursing interventions to the health status of the individual in hemodialysis, providing a more scientifically qualified care.

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

Indicators and analyses that used the database from SB Brazil 2003 (the most recent nationwide oral health survey) have been criticized as unreliable due to sampling problems. The current study countered that this critique was based solely on statistical concepts, unsupported by empirical evidence. The critique's essentially epistemic approach leads to peremptory reductionism that denies other forms of knowledge and fails to recognize the multidisciplinary nature of epidemiology. The current study retrieves information on the implementation of the oral health survey and its impact on knowledge output in the field. The article draws an analogy between science and art, demonstrating the multifaceted images obtained by both. Thus, recognition of validity requires a full grasp of the field and appropriate use of value criteria. The current article concludes that use of the SB Brazil 2003 database is a reliable and relevant application of epidemiology to oral health.

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

Indicators and analyses that used the database from SB Brazil 2003 (the most recent nationwide oral health survey) have been criticized as unreliable due to sampling problems. The current study countered that this critique was based solely on statistical concepts, unsupported by empirical evidence. The critique's essentially epistemic approach leads to peremptory reductionism that denies other forms of knowledge and fails to recognize the multidisciplinary nature of epidemiology. The current study retrieves information on the implementation of the oral health survey and its impact on knowledge output in the field. The article draws an analogy between science and art, demonstrating the multifaceted images obtained by both. Thus, recognition of validity requires a full grasp of the field and appropriate use of value criteria. The current article concludes that use of the SB Brazil 2003 database is a reliable and relevant application of epidemiology to oral health.