Impacto da estratégia saúde da família com equipe de saúde bucal sobre indicadores de saúde bucal: análise em municípios do nordeste com mais de 100 mil habitantes

This study examined in municipalities of Northeast of Brazil with more than one hundred thousand people who incorporation of Oral Health Teams (OHT) into the Family Health Strategy (FHE) the possible impact on oral health indicators. Sought to answer whether implementation OHT brought the best indicators of health problems and coverage, compared to areas without coverage by the FHE through a community trial in parallel, quasi-randomized. In each of the municipalities surveyed were 20 census tracts, 10 were located in areas covered by oral health teams in the ESF and 10 industries in areas not covered. The final sample consisted of 59.221 individuals. We compared oral health indicators related to health problems, access to services and coverage of oral health actions. The analysis strategy was based on the calculation of prevalence ratios and confidence intervals, adjusted for confounding factors through Poisson regression with robust variance. It also has measured the association between an indicator of social inequality for comparison between areas. The best results are associated with indicators of access and coverage of oral health actions at the expense of the indicators of health problems, suggesting a possible maintenance of a traditional model of practice yet. The results also suggest a possible effect of a specific policy in the area of primary care on inequality in access. From the discussions presented throughout this work, we can see that the impact analysis of public policy, obtained by comparing areas with and without the intervention, not only captures the effect on the target population, but other dimensions of organization service and therefore should be understood as one of the analytical possibilities related to the management

Avaliação do impacto do plano de expansão da rede federal na qualidade dos institutos federais de educação segundo indicadores de desempenho

The Expansion Plan of the Federal Network of Vocational Education foresees the construction of 860 new units of instruction until 2020, representing a strong growth against the 140 existing units prior to its disclosure by Federal Government of Brazil, in 2005. The Federal Institutes of Education, Science and Technology have been performing the expansion while experiencing the shortcomings and challenges of units still in development, created in previous phases of the Plan. The quality of the services of these institutions has been evaluated by the control bodies, which require the submission of performance indicators in annual management reports of institutions under their jurisdiction. In this context of expansion process, particularly, is desirable to identify possible changes in quality standards. Thus, this research was motivated by the following problem: there was difference in the performance of the Federal Institutes of Education, Science and Technology after the inauguration of the first units of phase II of the Expansion Plan of the Federal Network of Vocational Education? This is an exploratory-descriptive, ex-post-facto, quantitative approach research, which aims to contribute to the knowledge of the impact of the expansion of the Federal Network. The data were collected from 12 indicators presented in management reports of 38 Federal Institutes through years 2007 to 2011 to evaluate the performances using descriptive statistical techniques. The indicators were analyzed in both consolidated and open manners by the following perspectives: country region, growth of instruction units and institutions origin. Was also performed a multivariate analysis of clusters in order to identify excellence groups of Institutes. The results showed differences in the expansion plan s development among Brazilian regions, both in terms of infrastructure and academic indicators, with better results in the Midwest and South, and that there are differentiated profiles of institutes as its origin, where the best quality indicators occur in those originated by integration of different educational institutions. Still, were identified two excellence groups, with emphasis on academic management, human resources and expansion

Impacto do Programa de Saúde da Família sobre indicadores de saúde bucal na população de Natal -RN

The aim of this study was to assess the impact of the Family Health Program (FHP) on a number of oral health indicators in the population of Natal, Brazil. The study is characterized as a quasi-random community intervention trial. The intervention is represented by the implementation of an Oral Health Team (OHT) in the FHP prior to the study. A total of 15 sectors covered by the FHP with OHT were randomly drawn and paired with another 15 sectors, based on socioeconomic criteria, not covered by the teams. A few sectors were lost over the course of the study, resulting in a final number of 22 sectors, 11 covered and 11 not covered. We divided the non-covered areas into two conditions, one in which we considered areas that had some type of assistance program such as the Community Agents Program (CAP), FHP without OHT, BHU (Basic Health Unit) or no assistance, and the other, in which we considered areas that had only BHU or no assistance. Community Health Agents (CHAs) and Dental Office Assistants (DOAs) applied a questionnaire-interview to the most qualified individual of the household and the data obtained per household were transformed into the individual data of 7186 persons. The results show no statistical difference between the oral health outcomes analyzed in the areas covered by OHT in the FHP and in non-covered areas that have some type of assistance program, with a number of indicators showing better conditions in the non-covered areas. When we considered the association between covered and non-covered areas under the second condition, we found a statistical difference in the coverage indicators. Better conditions were found in covered areas for indicators such as I have not been to the dentist in the last year with p < 0.001 and OR of 1.64 and I had no access to dental care with p < 0.001 and OR of 2.22. However, the results show no impact of FHP with OHT on preventive action indicators under both non-covered conditions. This can be clearly seen when we analyze the toothache variable, which showed no significant difference between covered and non-covered areas. This variable is one of the most sensitive when assessing oral health programs, with p of 0.430 under condition 1 and p of 0.038 under condition 2, with CI = 0.70-0.90. In the analysis of health indicators in children where the proportion of deaths in children under age 1, the rate of hospitalization for ARI (Acute Respiratory Infections) in those under age 5 and the proportion of individuals born underweight were considered, a better condition was found in all the outcomes for areas with FHP. Therefore, we can conclude that oral health in the FHP has little effect on oral health indicators, even though the strategy improves the general health conditions of the population, as, for example child health

Impacto do Programa Saúde da Família sobre indicadores de saúde da criança em municípios de grande porte da região Nordeste do Brasil

The present study carried out in the context of the Baseline Studies of the PROESF was aimed at evaluating the impact of the Family Health Program (PSF) on indicators for child health in cities with more than 100,000 inhabitants in the Brazilian Northeast. Four cities were investigated. In each one, twenty censual sectors were selected randomly from areas covered by the PSF and compared with twenty sectors selected from areas not covered by the PSF on the basis of socioeconomic criteria. In most cases, no significant differences were found between the areas covered and not covered by the PSF. The only difference found was a significantly lower rate of hospital admissions due to diarrhea but this was on account of the Program of Community Health Agents. The PSF exerted no additional effect on the reduction of this indicator. It was also observed that the way by which the program is implemented in each city interferes directly in the results. Thus, there is no basis for considering the PSF per se ineffective or not differing from other programs with regard to its health care patterns. An evaluation of the PSF would necessarily have to include an analysis of the way the program is implemented and conducted in each case, besides considering its general socioeconomical and political characteristics.

Aplicação de indicadores webométricos nos programas de Pós-Graduação das engenharias recomendados pela CAPES

This study aims to identify, through the application of webometric indicators, which Post-Graduate Courses in Engineering recommended by the Coordination of Improvement of Higher Personnel Education (CAPES) in Brazil stand out in the web space, in relation to the communication process and dissemination of scientific information in the academic environment. For this, we analyzed the structures content of the sites, the use, through the conduct of investigations and searches, the quality of information available, as well as the structure of existent hypertexts in the sites of this universe of search. The tools and methodologies adopted for this study are: search engines (Google, Yahoo), Mapper software (Xenu Link Sleuth) and analysis software and visualization of networks (and Ucinet6 NetDraw). Webometric indicators are also used, such as size of the web sites, visibility, web impact factor, brightness and density of the network. These instruments provide a brief analysis and evaluation for this webometric study. Therefore, from the incursion of the literature used, it appears that there are many advantages of using this type of metric study in the so called Information Society. The obtained results could identify which postgraduate courses in engineering has a better availability of their information on the Web, as well to define which of these courses stands out in relation to the use of their information, which has been outstanding in respect to its impact factor and which offers a greater number of links that serve as a source of information for its users, contributing, in its turn, with the navigability of the same network. In summary, it is asserted that the webometric study presents promising results, which are able to achieve the proposed objectives, as well as identify the factors that contribute significantly to the good visualization of these sites in the network, thus helping the spread of information and scientific communication through the use of the Web.

Assistência odontológica diferenciada para crianças de 0 a 3 anos: avaliação de impacto no Serviço Público Municipal em Natal-RN

In Brazil, 0-5 years old children just have an oral health care system since 1990 s. Innumerable experiences of implantation of the attendance to the babies in the cities had appeared throughout the years, but it hasn´t been evaluated the comparative effect between children displayed and not displayed to the program. In this regard, the main of this research was describe the Early Childhood Oral Health Care in public health service in Natal, Rio Grande do Norte, Brazil and evaluate the impact of this specific oral health care for babies by comparison of indicators between exposed and non-exposed children. It was created an experimental group, formed by children covered by program which was paired, based on sex, age and socioeconomic status, with a control group, formed by uncovered children. After filling ethical application, the parents of children were questioned about some risk factors to dental caries and, in sequence, it was accomplish an oral examination in the child. It was verified the Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), dmf-s and verification of caries activity. The sample was 40 children in each group. The results showed, for VPI, a difference of 7 percentile points for the experimental group, however this difference had no statistical significance, obtained by Student s t test (p=0.314). In relation to GBI, the control group showed a low mean (0.8%) comparing with experimental group (2.77%) and this difference was statistically significant (p=0.003). The results for dmf-s and evaluation of caries activity showed no statistical difference between groups. Among the probable reasons for absence of impact of intervention, could be included: (a) the practice model was the same in two groups, or the difference was very weak and (b) the oral health care has intrinsic limitations for to impact on oral health in low income populations

Avaliação longitudinal do impacto da saúde bucal na estratégia saúde da família em Natal

As a result of the financial incentive provided by the GM / MS 1.444, since 2000, Brazil has experienced a substantial increase in the number of oral health services at the Family Health Strategy. There is, however, evidence that these teams have produced qualitatively different experiences which do not translate necessarily into improved quality of life and health. Thus, evaluative research of great importance. This study aims to assess the impact of the Family Health Strategy in oral health in a longitudinal perspective natalense the years 2006 and 2009. This is an intervention study whose design is a community trial in parallel, nearly randomized. The sample consisted of census tracts covered by oral health teams in the Family Health and the Traditional Model (Basic Health Units and non-FHS Program of Community Health Agents and areas not covered.) The sample was determined by drawing ten census tracts to form the experimental group and ten other sectors for the control group by pairing intentional based on socio-economic and geographic. To check the net effect of the intervention was performed multivariate analysis by Poisson regression. As a result of cross-sectional analysis of year 2009, it was found that the effects of the ESF in Natal were satisfactory only for the variables of injuries and for other purposes without and with negative impact on stock coverage reclaimers. However, the longitudinal analysis revealed that the ESB / ESF improved their performance in dealing with grievances, access and coverage of the type of actions and this fact is independent of age, sex and social and economic conditions. In other employees' words are related to the presence of the Family Health Strategy in the region. However it does not say that both models under study (the Family Health Strategy Model and Traditional) are different in terms of performance and it is pertinent to reflect on the need for further development of evaluation studies that use other approaches able to clarify the dynamics of the process whose results can come to the knowledge of the actors responsible for leading the ESF and encourage them to incorporate the assessment in their routine

Percepções ambientais de comunidades rurais e indicadores de sustentabilidade como subsídios à conservação de áreas de caatinga no Rio Grande do Norte

Environmental degradation is a global problem that particularly affects areas subject to seasonal climatic variations, such as the brazilian semiarid region, namely the Caatinga Domain. Combined with other negative factors, such as natural resource misuse and disorderly land occupation, the consequences of Environmental Degradation have challenged science in the quest for addressing the resulting social and environmental problems. Accordingly, Environmental Perception methodology, by analyzing the concepts, attitudes and values, (especially those pertaining to environmental conservation) represent an important tool in studies that address the relationship between the environment and human actions. Sustainability Indicators are also relevant tools to assess the possible causes and consequences of environmental problems. Among several Sustainability Indicators available, the PressuresState-Impact-Response (PSIR) method is an analytical tool that permits the grouping of factors affecting sustainability as well as their consequences for nature and human health, and thus indicate mitigating actions for society and the public authorities. From this perspective, three areas of Caatinga were studied in Rio Grande do Norte state: Seridó Ecological Station (ESEC), Municipality of Serra Negra do Norte; Private Natural Reserve Stoessel de Brito (PNRSB), Municipality of Jucurutu; and part of the Serra de Santana, Municipality of Tenente Laurentino Cruz. The areas are both legally protected and unprotected and subject to diferent management protocols, though their share the common characteristic of human misuse of natural resources. In this scenario, this thesis´ main goal was to introduce the rural communities into the conservation process, using the results of Environmental Perception of such communities, combined with the analysis of the sustainability of municipalities through PSIR. Information on Environmental Perception was obtained from primary and secondary data from previous studies carried out in the ESEC Seridó and PRNP Stoessel de Brito. Additional data was obtained through direct observation and interview forms applied to rural communities in the Municipality of Tenente Laurentino Cruz. The results showed that respondents possessed a broad knowledge regarding environmental degradation, its causes and consequences for the caatinga biome. PEIR analysis showed that environmental degradation was smaller in countries with protected areas, as compared to those without. The population´s knowledge about environmental degradation and their acceptance of conservation units, as showed by Environmental Perception Analysis, coupled with the results of PEIR, suggest that those attitudes may foster actions aimed at reduction of environmental degradation in the Caatinga domain