Escolas Técnicas do SUS (ETSUS) no Brasil: regulação da integração ensino serviço e sustentabilidade administrativa

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Social disparity and oral health

There is a clear reported association between social disparity and oral health, for example, between dental caries and malnutrition in children. This fact is detected in several studies, and also found amongst the Brazilian population. However, several efforts have been made to improve the quality of life of the population and to achieve the 2015 Millennium Development Goals. Oral health is a branch to be improved among these goals. The Brazilian experience has been drawing the attention of authorities, insofar as there have been direct improvements in oral health through state oral health programs, and also indirect results by improving the quality of life of the population. Included within the Brazilian oral health programs are the Family Health Program and Smiling Brazil Program. The former is a global healthcare program which involves primary oral healthcare, while the latter is a specialized oral care program. Among the social programs that would indirectly improve oral health are Family Stipend and the Edmond and Lily Safra International Institute of Neuroscience of Natal (ELS-IINN). In conclusion, although oral health problems are related to socioeconomic factors, the implementation of primary oral health programs and programs to improve the population's quality of life may directly or indirectly improve the oral health scenario. This fact is being observed in Brazil, where the oral health policies have changed, and social programs have been implemented.

Políticas públicas e voz do professor: caracterização das leis brasileiras

OBJETIVO: Caracterizar as leis sobre saúde vocal publicadas em todo território nacional até o ano de 2006. MÉTODOS: Foram feitas buscas da documentação em sites oficiais, assim como um questionário elaborado pelas autoras foi divulgado no meio fonoaudiológico, por correio eletrônico, para captar o maior número de leis possível. Obtiveram-se 22 documentos que foram analisados quanto ao raio de abrangência, ações propostas, natureza dessas ações, público-alvo, secretarias envolvidas, iniciativa e promulgação das leis. Tais dados foram analisados de maneira absoluta (numérica) e relativa (percentualmente). RESULTADOS: Os documentos são, em sua maioria, leis de abrangência estadual, mais numerosas na região sudeste, propostas pelo poder legislativo, cuja viabilização compete a uma parceria entre secretarias de saúde e educação estaduais. As ações propostas, de modo geral, preconizam a implementação de assistência preventiva por meio de cursos teórico-práticos (90,91%), com periodicidade anual, ministrados por fonoaudiólogos, com a ressalva de que será oferecido, ao professor com distúrbio vocal, acesso ao tratamento fonoaudiológico e/ou médico (77,27%). em apenas três documentos (13,64%) avança-se para além de cursos, com propostas de ações de promoção à reabilitação, inclusive com menção ao ambiente de trabalho. Dois deles (9,09%) consideram os direitos do professor trabalhador. CONCLUSÃO: Levando-se em conta o grande número de casas legislativas no Brasil, poucas são as leis propostas a favor da saúde do professor, especialmente em relação à voz. Além disso, para que sejam aplicadas e transformadas em programas de saúde vocal, tais iniciativas devem partir de competência constitucional própria, a fim de garantir os recursos financeiros necessários para a sua viabilização.

Reforma psiquiátrica e transição paradigmática no interior do estado de São Paulo

Este trabalho investiga o aspecto qualitativo da Reforma Psiquiátrica no interior do estado de São Paulo, por meio da análise dos discursos presentes no campo da Saúde Mental. Balizamo-nos no referencial da Atenção Psicossocial enquanto corpo teórico-prático e ético para transformação paradigmática em Saúde Mental. Como método, utilizamos entrevistas semi-dirigidas com coordenadores de CAPS e coordenadores municipais de Saúde Mental, e observações participantes, analisadas por meio do método dialético de análise de discurso. Foram encontradas três matrizes teóricas principais dos discursos (Psiquiatria Tradicional, Psiquiatria Preventivo-Comunitária, Atenção Psicossocial) coexistindo no espaço institucional. A vertente Preventivo-Comunitária mostrou-se bem instalada e superando técnica e teoricamente a Psiquiatria Tradicional, porém dificultando o avanço da Atenção Psicossocial em termos éticos.

Environmental impact assessment in Brazil

Brazilian environmental impact assessment (EIA) had a relatively late birth and is still far from being operative by international standards. Currently, geological, economic, and social considerations are more highly valued. Nevertheless, EIA has become important in shaping governmental environmental policy. The state of São Paulo is responsible for 40% of all EIAs produced in Brazil, and the number of EIAs produced is proportional to state population density.

Care arrangements for people with dementia in developing countries

Background: Rapid demographic ageing will soon lead to large increases in the numbers of persons with dementia in developing countries. This study is the first comprehensive assessment of care arrangements for people with dementia in those regions. Methods: A descriptive and comparative study of dementia care; caregiver characteristics, the nature of care provided, and the practical, psychological (Zarit Burden Interview, General Health Questionnaire) and economic impact upon the caregiver in 24 centres in India, China and South East Asia, Latin America and the Caribbean and Africa. Results: We interviewed 706 persons with dementia, and their caregivers. Most caregivers were women, living with the person with dementia in extended family households. One-quarter to one-half of households included a child. Larger households were associated with lower caregiver strain, where the caregiver was co-resident. However, despite the traditional apparatus of family care, levels of caregiver strain were at least as high as in the developed world. Many had cutback on work to care and faced the additional expense of paid carers and health services. Families from the poorest countries were particularly likely to have used expensive private medical services, and to be spending more than 10% of the per capita GNP on health care. Conclusions: Older people in developing countries are indivisible from their younger family members. The high levels of family strain identified in this study feed into the cycle of disadvantage and should thus be a concern for policymakers in the developing world. Copyright © 2004 John Wiley & Sons, Ltd.

Subnotificação de acidentes do trabalho não fatais em Botucatu, SP, 2002

Objective: The implementation of work-related injury prevention policies has been hindered by underreporting of incidents among formal workers, and substantial underreporting among informal workforce. This study aimed at estimating the underreporting of work-related injury in a median-sized city. Methods: A random survey was carried out among residences in the urban area of Brazil. Residents were interviewed about the occurrence of work-related injury to people aged more than nine years in the last 90 days. All incidents reported were double checked in the National Social Security Institute (INSS) records. Results: There were 9,626 residences visited. It was estimated 79.5% (CI 95%: 78.8%-80.3%) of underreporting of work-related injury. Conclusions: Work-related injury reporting is poor in the study location and this may be occurring in other cities. Data suggest the need to build up information systems on Brazilian workers' health. It should incorporate methods, materials and human recourses necessary to recognize, store, analyze, and spread information support injury prevention policies and promote workers' health programs.

A comparison between diuretics and angiotensin-receptor blocker agents in patients with stage I hypertension (PREVER-treatment trial): Study protocol for a randomized double-blind controlled trial

Background: Cardiovascular disease is the leading cause of death in Brazil, and hypertension is its major risk factor. The benefit of its drug treatment to prevent major cardiovascular events was consistently demonstrated. Angiotensin-receptor blockers (ARB) have been the preferential drugs in the management of hypertension worldwide, despite the absence of any consistent evidence of advantage over older agents, and the concern that they may be associated with lower renal protection and risk for cancer. Diuretics are as efficacious as other agents, are well tolerated, have longer duration of action and low cost, but have been scarcely compared with ARBs. A study comparing diuretic and ARB is therefore warranted.Methods/design: This is a randomized, double-blind, clinical trial, comparing the association of chlorthalidone and amiloride with losartan as first drug option in patients aged 30 to 70 years, with stage I hypertension. The primary outcomes will be variation of blood pressure by time, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new subclinical atherosclerosis and sudden death. The study will last 18 months. The sample size will be of 1200 participants for group in order to confer enough power to test for all primary outcomes. The project was approved by the Ethics committee of each participating institution.Discussion: The putative pleiotropic effects of ARB agents, particularly renal protection, have been disputed, and they have been scarcely compared with diuretics in large clinical trials, despite that they have been at least as efficacious as newer agents in managing hypertension. Even if the null hypothesis is not rejected, the information will be useful for health care policy to treat hypertension in Brazil. Clinical trials registration number: ClinicalTrials.gov: NCT00971165. © 2011 Fuchs et al; licensee BioMed Central Ltd.

Leprosy treatment dropout: A sistematic review

Background: Leprosy is a chronic infectious disease endemic in some undeveloped areas, and still represents a public health problem in Brazil. Therefore, the control of this endemic disease depends necessarily on the institution of correct treatment and containment of treatment dropout. This study aims to conduct a systematic review of published studies on treatment dropout of leprosy. Methods. We conducted a systematic review of articles on treatment dropout of leprosy, published between january 2005 and april 2013, on MEDLINE and SciELO databases. The search was performed using the MeSH terms: leprosy; patients dropouts and the keywords: leprosy, treatment and noncompliance, leprosy in association, beside the equivalents in Portuguese. Results: There were originally 196 references. After analyzing the titles and abstracts of articles, 20 articles were obtained and included in the final sample. Discussion. Leprosy is a notifiable disease known as its disfiguring capability and the high rate of non-compliance to treatment. The low adhesion is responsible for the remaining potential sources of infection, irreversible complications, incomplete cure and, additionally, may lead to resistance to multiple drugs. Many factors are responsible for the interruption or dropout treatment: socioeconomic factors, education level, knowledge about the disease, lack of efficiency of health services, demographics, side effects of drugs, alcoholism, among others. Conclusion: The recent scientific literature about the subject diverge regarding the factors that most affect the dropout problem in treating leprosy patients. However, better integration between professionals and users, and greater commitment of the patient, are common points among the authors of the studies. © 2013 Girão et al.; licensee BioMed Central Ltd.

O ser e o estar índio: produção de identidades entre kaingang e krenak, em Vanuíre

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O projeto de criação e a implantação da ANCINE - Agência Nacional de Cinema: caminhos da política para o fomento e a proteção dos audiovisuais no Brasil (2000-2006)

Pós-graduação em História - FCLAS

O cenário ambiental paulista: no passado e no presente: considerações sobre as condições das unidades de conservação da Mata Atlântica de São Paulo

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

O programa de erradicação do trabalho infantil - PETI no município de Araçatuba-SP na perspectiva de crianças, adolescentes e autoridades envolvidas

Pós-graduação em Psicologia - FCLAS

Avaliação da qualidade da atenção básica nos municípios do Departamento Regional de Saúde de Sorocaba

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)