Parâmetros assistenciais em saúde bucal: comparação entre duas programações do atendimento clínico no serviço público

Objective: To compare two forms of scheduling clinical dental care for the oral health teams (OHT) included in the strategy of family health, regarding productive aspects of assistance. Methods: Two OHT worked concurrently, using two methods of clinical care: the parameter recommended by the Ministry of Health Ordinance No. 1101, 2002, which establishes 03 dental visits per hour (c/h) per team, and a Testing model, with 02 c/h, being each method applied for a period of 615 hours. The quantitative data was collected in OHTs’ daily production spreadsheets, covering the following items: the number of dental visits (initial, for maintenance and for emergency procedures), procedures performed, consumption of material and sterilization cycles. Data was compared and statistically analyzed through the BioStat 5.0 by applying the paired t-test (p <0.05). Results: Under the Ministerial method and the Testing model, were performed, respectively, 288 and 365 first dental visits, 921 and 686 return dental visits, 167 and 172 emergency dental attendances, with 469 and 110 fouls, 212 and 327 treatments were finished and 2501 and 3046 dental procedures were realized. Among eleven analyzed consumables, five were consumed in smaller quantities in the Testing model: gloves (9%), anesthesia (38%), anesthetic needle (34%), suture material (24%) and aspirators (11%), while the six remaining items presented similar consumption rates between the two models. Conclusions: The testing model revealed to be more productive and economical.

Aplicação de princípios de ergonomia no atendimento odontológico

The dentist has been suggested as a professional vulnerable to labor risks mainly related to working posture. This study examined the application of ergonomics principles during the dental attendances made by university student of the last period of the Araçatuba Dental University. Twenty-four attendants were photographed and the images were digitally analyzed for the verification of 10 requirements that determine a healthy labor posture, defined by the project ISO Standard / TC 106/SC 6 N 411. It was observed that 50% of items from the check list obtained higher percentages of negative replies. The students had greater difficulties as to the correct position of the angle between the upper and lower leg when sitting, the ideal adjustment of the light focus reflector in the field of work and the patient positioning. It was concluded that the dental attendances were held without compliance with the ergonomic requirements. The greatest difficulties regarding the work posture were the sitting posture, the light beam and the patient positioning. Students need better guidance about ergonomic principles and requirements, which should occur at any time of life, but earliest they are installed, greater the benefits, assimilation and incorporation of adequate working postures will be. We need a reform that addresses all sectors of the dental system, so that learning and application of ergonomics in dentistry become effective, efficient and effective.

Reflexões sobre a importância da assistência odontológica preventiva e do adequado treinamento dos Cirurgiões Dentistas para o atendimento de pessoas com deficiência

People with disabilities require special dental care according to the type of disability, degree of involvement of intellectual and motor complications, such individuals may have dental problems that require specific training of the dentist. The objective of this study was a literature review emphasizing the need for early and preventive dental treatment for people with disabilities and training and technical knowledge necessary for quality service performed by the dentist. The literature review was conducted primarily using articles published nationally, to establish the development of dentistry for special patients in Brazil, thus emphasizing some policies and measures adopted in certain areas of the country. It was concluded that preventive care is essential and that the projects of health promotion are important facilitators of social inclusion and provide increased success in dental care. Technical training of professionals is extremely important, therefore, be important to trace an appropriate treatment plan and establish communication with the multidisciplinary team involved in patient care.

Reflexões sobre o conceito de atendimento humanizado em Odontologia

Humanization at dental care is highly important due to uneven relation between scientific / technical advances in dentistry and thequality of human contact. The dental treatment goes beyond the field of scientific knowledge. Therefore, the dental treatment requiresbalance among technical skill, scientific training, and humanist vision of health promotion. Contemporarily, humanization is understoodas tripod based on user's rights, dental practice and organization of a humanized model. Curriculum integration of ethical, humanistic,scientific and technical contents is an important and current challenge on teaching / learning process for professionals at Dentistry. Thispaper aims to, guided by the literature review, to present some considerations on human care in dentistry, with emphasis on theimportance of professional /patient relationship for promoting oral health. It is suggested that dentists reflect on the urgent need ontheoretical basis of humanization and patient-professional relationship for health care.Descriptors: Humanization of Assistance; Dental Staff

Carcinoma de lábio com prognóstico sombrio devido conduta médica inadequada

The Squamous Cell Carcinoma is what more happens among the oral cancers, being considered sweats incidence in more than 90%. As important prognostic factor competes the early diagnosis and the immediate institution of the treatment, that it can involve radiotherapy and chemotherapy besides the surgery. The initial lesions don’t offer great diagnostic difficulties and now complemental laboratory exams define the diagnosis quickly, In the present report, the initial medical conduct was inadequate, with incomplete interpretation of the laboratorial result and adoption of inadequate therapeutic conduct, what resulted in constant evolution of the lesion. The patient came to the consultation with that medical history, after six months of the first attendance accomplished in another center. To the physical exam, infiltrative ulcerated lesion was observed in the lower lip, with having accentuated tissue loss superficially. The patient accused spontaneous pain and she did use an ointment, recommended six months ago for occasion of the first attendance. As diagnostic conduct was indicated the accomplishment of cytology and biopsy, being defined the diagnosis of Squamous Cell Carcinoma. The patient was immediately guided to the medical service of its municipal district for manegement of the specialized oncologic treatment. The patient was submitted the surgery followed by radiotherapy, being verified involvement of another structures by contiguity. Now, the patient meets abed, without viable perspectives of cure. The present report emphasizes the importance of the clinical knowledge and professional responsibility in attendance of cases of that nature.

Perfil dos idosos participantes dos programas oferecidos em uma estratégia de saúde da família do município de Ponta Grossa/PR

O perfil, na área de saúde, tem por base quantificar a necessidade dos trabalhos a serem executados dentro da interdisciplinaridade. Assim, os trabalhos podem ser direcionados com maior exatidão, correspondendo diretamente aos anseios da população idosa frequentadora dos serviços de saúde. O objetivo desse trabalho é avaliar a realidade do atendimento ao idoso na Estratégia Saúde da Família. Foi utilizado um questionário autorizado pela SBGG/PR, (Sociedade Brasileira de Geriatria e gerontologia seção Paraná) para estudo transversal, que engloba perguntas sobre aspectos sociais, políticos e específicos sobre os atendimentos prestados em uma Unidade da Estratégia Saúde da Família. A população estudada corresponde a um grupo de 90 idosos de ambos os gêneros, freqüentadores da Unidade de Saúde da Família Dr. Nilton Luiz de Castro, no bairro Tarobá no Município de Ponta Grossa – PR. A maioria dos idosos que frequentam as Unidades de Saúde da Família são mulheres; 90% são independentes; 50% esperam entre trinta minutos e uma hora por uma vaga para consulta; 65% das doenças crônicas diagnosticadas são tratadas na unidade de saúde; 100% relataram que não havia nenhum médico especialista na área de geriatria atendendo na unidade de saúde; 90% dos idosos observaram que havia programas de apoio aos idosos na instituição. A falta de informação dos idosos auxiliada pelo descaso dado as suas condições como pacientes especiais, juntamente com a falta de programas para atendimento especializado são os principais problemas que atingem os idosos nas Unidades de Saúde da Família. A maioria dos problemas poderia ser resolvida com a disponibilidade de pessoas treinadas e preparadas para atender esta população.

Opportunistic microorganisms in patients with head and neck trauma

The use of antimicrobial agents has facilitated the dissemination of multi-resistant microorganisms, compromising dental and medical treatment. The aim of this study was to evaluate the distribution of different opportunistic microbial species in patients who suffered head and neck trauma, under temporary maintenance in nosocomial environment, particularly intensive care units, on the occurrence of such microorganisms in the oral cavity of the patients. It was selected 38 patients subjected to head and neck traumas. After emergency surgical procedures, clinical samples of saliva, sub and supragingival biofilms and mucosal surfaces were collected at two different moments: just after stabilization of the patient and soon after patients’ release from medical units. The presence of opportunistic and superinfecting microorganisms was evaluated by culture on selective and non-selective media, and the presence of the family Enterobacteriaceae, as well as genera Enterococcus, Pseudomonas, and Staphylococcus was assessed by PCR. It was found that the use of antimicrobials, even for short periods of time was sufficient to facilitate colonization by microorganisms of the families Enterobacteriaceae and Pseudomonadaceae, as well as yeasts and enterococci. These results support the concept that medical and dental teams should make a periodically change of antimicrobials used in treatment protocols in hospital for head and neck trauma patients, in order to minimize dissemination of opportunistic or superinfecting microorganisms.

Práticas parentais e repertório infantil: caracterização da demanda por atendimento e predição de abandono

The objective of this paper is: (a) to characterize behaviors of the 47 primary caregivers and their children who sought for psychological services, (b) to compare groups: abandonment x participants; boy x girl. The participants answered the interview inventory (RE-HSE-P), inventory (IHS-Del Prette) and scales (Rathus Assertiveness Scale and CBCL). For the results, 60% of the children presented behavior problems at clinical level. There is correlation between negative parenting practices and behavior problems and social skills among caregivers (HSE-P) and children. People who drop out psychological services, present lower frequence and quality of HSE-P and more behavior problems. There are not differences in comparisons between boys and girls. The results highlight the importance of evaluating clinical context, the contingent behaviors of parents and children employing different instruments in order to describe the relationship between behavior problem and potentialities of both interlocutors socially interacting.

Projeto: de médico e louco, todo mundo tem um pouco - algumas considerações sobre TOC´s e Design de Moda

Identify the needs of different target audiences and solve them with the application of principles and elements of design in fashion products, the objectives of the project were "from a doctor and crazy, everyone has a few" from the academics of Fashion Design UNIPAR / Cianorte. To Avoid clichés, educate the community and yourself about OCD´s, syndromes, phobias and quirks, maximized the positive balance of the project.

O atendimento educacional especializado e o ensino de física para pessoas surdas: uma abordagem qualitativa

The present work discusses the Physics education for deaf students, including the formation of the Physics education professional, the specialized educational service and the participation of translators and interpreters of the Sign Language in this process. We analyzed qualitatively the national policy for specialized education in the inclusive vision, legislation and national opinion related to the teaching profession in Physics. Using documentations, it was possible to identify the limitations and contradictions related to specialized educational service and the teaching and learning process in Physics.

Atendimento psicoterapêutico para crianças vítimas de violência sexual: projeto Sarauzinho

This experiment report refers to the project named “Sarauzinho”, which is linked to the extension “Workshops of Psychoanalysis and Artistics Gatherings” project. “Sarauzinho” was a partnership between UNESP and CREAS, created with the aim to assist children victims of sexual violence though a playful and artistic method and to implement a psychoanalytic listening of demands that appeared during the working group implementation. At the same time, the parents/responsible person who took the children to the meetings also received psychotherapeutic service at the waiting room, in an operative group format with psychoanalytic listening. The project has happened in 11 sessions (once a week, two hours each), with 4 kids and 4 caregivers participating. The service for the kids was organized in workshop models (open and free) and in little gatherings, with preprogrammed contents (playful and artistic). The initiative was inspired by the “Green houses”, a creation of the French psychoanalyst Françoise Dolto, and by the Museum “Imagens do Inconsciente do Centro Psiquiátrico Pedro II”, in Nise da Silveira, Rio de Janeiro city. This university extension activity has enabled the students to access some of the children’s traumas, as well as to obtain a better understanding of an infantile group psychotherapeutic service, with psychoanalytic listening. Besides, it has provided a playful and artistic environment to listen to the children and enable them to create new meanings of their traumas. For the adult participants, the meetings were moments to talk about their anxieties and to receive new guidance and instructions about their children’s education, especially about sexuality. The results, either related to the children’s meeting, as to the adult’s meeting, were favorable to the continuity of the project.

Do sagrado ao secular: a contribuição do saber médico para a construção dos cemitérios oitocentistas

Pós-graduação em História - FCHS

Escolas do campo e atendimento educacional especializado em sala de recursos multifuncional

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Características do processo de diagnóstico de hanseníase no atendimento primário e secundário

Contexto e objetivo: A hanseníase caracteriza-se por ter diagnóstico eminentemente clínico, principalmente através da constatação de hipo ou anestesia das lesões, ou seja, sem necessariamente o uso de exames adicionais, como baciloscopia e biópsia, utilizados para classificação clínica da doença. Buscou-se definir se há tendência à desvalorização da avaliação clínica em favor do excesso de exames complementares, investigar a adequação do registro nos atendimentos da atenção básica e compará-los com o obtido em serviço de média complexidade. Desenho e local: Estudo transversal, de base populacional, utilizando registros de prontuários, realizado em dois âmbitos de atendimentos de saúde da cidade de Campinas (SP): os Centros de Saúde e a assistência dermatológica especializada de hospital de ensino. Métodos: Os registros foram investigados por meio da aplicação de checklist, contendo itens indispensáveis ao atendimento a hansenianos. Associações foram testadas pela prova de Goodman e ao nível de 5% de significância. Resultados: Foram avaliados 33 prontuários oriundos dos centros de saúde e 36 do hospital, observou-se polarização entre registros adequados e ausentes, evidenciando a presença de efeito tudo ou nada nos atendimentos; de 26 variáveis, apenas em 5 (19,23%) obteve-se predomínio da avaliação do hospital sobre os centros de saúde; evidenciou-se dependência de exames complementares, solicitados em 67 dos 69 atendimentos (97,10%), para diagnóstico da doença. Conclusão: Confirmou-se, neste estudo, déficit da avaliação médica e indicação inadequada de exames adicionais. Por associar-se com excesso de solicitação de exames, a observação clínica mostrou-se incompleta, comprometendo a capacidade diagnóstica dos atendimentos a hansenianos.

Características sociodemográficas e clínicas que afetam a qualidade de vida em pacientes estomizados intestinais

Pós-graduação em Enfermagem (mestrado profissional) - FMB