Desenvolvimento de um Questionário Quantitativo de Freqüência Alimentar (QQFA) para gestantes usuárias de Unidades Básicas de Saúde de Ribeirão Preto, São Paulo, Brasil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Fatores associados ao tabagismo em idosos: Inquérito de Saúde no Estado de São Paulo (ISA-SP)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Atenção odontológica no Programa de Saúde da Família de Campos dos Goytacazes

Durante décadas, a política de saúde bucal no Brasil foi centrada na prestação de assistência à doença, e ainda hoje grande parcela da população brasileira não tem acesso a cuidados odontológicos. Pela Portaria nº 1.444, de 28 de dezembro de 2000, o Ministério da Saúde estabelece incentivo financeiro para a reorganização da atenção à saúde bucal aos municípios. Insere-se, assim, a Odontologia no programa e, conseqüentemente, a possibilidade de ampliar e reorientar a atenção odontológica no Brasil. Dentro desse contexto, este estudo teve por objetivo avaliar a situação da equipe de saúde bucal inserida no Programa de Saúde da Família (PSF) do município de Campos dos Goytacazes - RJ, em 2002. Os resultados demonstraram algumas limitações na inclusão e funcionamento da Odontologia no PSF da cidade. A atenção odontológica deve ser inserida no PSF, atendendo aos princípios básicos do Plano de Reorganização das Ações de Saúde Bucal na Atenção Básica, proposto pelo Ministério da Saúde, e à consolidação do Sistema Único de Saúde.

Análise quantitativa e qualitativa do nível de conhecimento dos alunos do curso de fisioterapia sobre a atuação do fisioterapeuta em saúde pública

Fisioterapia é a ciência da saúde que estuda, previne e trata os distúrbios cinéticos funcionais em órgãos e sistemas do corpo humano. O objetivo deste estudo é verificar a expectativa dos alunos do primeiro ao quinto semestre de fisioterapia sobre a atuação do fisioterapeuta em saúde pública e a expectativa desses alunos quanto à inserção do profissional de fisioterapia no Programa de Saúde da Família (PSF). Trata-se de estudo realizado na Faculdade Marechal Rondon, com 107 alunos, tendo como critério de exclusão os alunos do sétimo semestre. Foi usado um questionário, contendo onze questões, sendo oito de múltipla escolha e três dissertativas. Os dados passaram por tratamento estatístico, em que foram utilizadas a análise descritiva através do programa Microsoft Excel 2003 e análise do discurso do sujeito coletivo. A respeito da atuação do fisioterapeuta no Sistema Único de Saúde (SUS), 44% dos alunos consideram muito importante, 36% consideraram que o papel do fisioterapeuta no PSF é muito importante, enquanto 24% dos alunos consideram não saber informar quanto à eficácia de seu atendimento. Os alunos consideram importante a atuação do fisioterapeuta no SUS e PSF, mas pouco tem conhecimento sobre a atuação do fisioterapeuta em saúde pública.

A reforma psiquiátrica brasileira: aspectos históricos e técnico-assistenciais das experiências de São Paulo, Santos e Campinas

Este artigo tem como objetivo abordar as experiências desenvolvidas, a partir da década de 1980, nos municípios de São Paulo (capital), Santos e Campinas, no sentido de compreender as suas determinações materiais, sociais e políticas, o avanço do processo de rompimento com o modelo manicomial e a emergência de forças criativas e produtivas, necessárias para a construção da atenção psicossocial em saúde mental, bem como conhecer a contribuição do Sistema Único de Saúde no avanço da reforma psiquiátrica nos municípios. A investigação que fundamenta este trabalho é parte de uma tese sobre a atenção em saúde mental, na qual os projetos inovadores desses municípios serviram de moldura e parâmetro para a análise da política de saúde mental em municípios de pequeno e médio portes do estado de São Paulo.

Panorama atual da ética em pesquisa em seres humanos

In the last decades, medical care has been increasingly permeated by the concept of evidence-based-medicine, in which clinical research plays a crucial role in establishing diagnostic and treatment. Following the improvements in clinical research, we have a growing concern and understanding that some ethical issues must be respected when the subjects are human beings. Research with human subjects relies on the principles of autonomy, beneficence, no maleficence and justice. Ordinance 196/96 from the National Health Board adds to the Brazilian legislation such renowned bioethical principles.Aim: Discuss the main ethical aspects involved in research with human subjects.Materials and Methods: Critical analysis of Ordinance 196/96 and related literature.Conclusion: Ordinance 196/96 rules research with human subjects; nevertheless, it requires more in-depth discussions regarding the informed consent, use of placebo, research with vulnerable populations and research in developing countries.

Infecção hospitalar--aspectos éticos.

The author focuses the question of hospital infection, analysing the background on which the control committees were created. The hospital infection is discussed under bioethical principles and the Medical Ethics Code, examining the aspects related to the government, the Hospital Directorship, the Committee and the Control Service of Hospital Infection, and the assisting physician. A closer integration between the activities of the Program of Control of Hospital Infections and those of the Medical Ethics Committee is proposed, aiming at the patient and at the community, targets of total medical attention.

Dissipation of DDT in a heavily contaminated soil in Mato Grosso, Brazil

After the prohibition of organochlorine-pesticide use in Brazil for controlling insect vector diseases, Mato Grosso State gathered the exceeding DDT and stored it irregularly in an open air area that belongs to the National Health Foundation, causing soil contamination. This study aimed to evaluate the contamination level and dissipation of p,p′-DDT and p,p′-DDE in this area. For that, surface soil samples were collected on 19 September 2000, 15 December 2000, 4 April 2001 and soil samples 30-40 cm; 60-70 cm and 90-100 cm deep were taken from five points in the studied area on 17 July 2001. The contaminants were determined by a small scale method which consists on extraction and clean-up steps combined into one step by transferring soil samples mixed with neutral alumina to a chromatographic column prepacked with neutral alumina and elution with hexane:dichloromethane (7:3 v:v). The eluate was concentrated and the analytes were quantified by gas chromatography with an electron-capture detector. p,p′-DDT at surface soil ranged from 3800 to 7300 mg kg -1. 30-40 cm deep soil sample concentrations varied from 0.036 to 440 mg kg -1 while 90-100 cm deep samples varied from 0.069 to 180 mg kg -1. Volatilization is probably the main dissipation process. The p,p′-DDT is moving slowly downward in the soil profile, however, the levels of this contaminant are high enough to present risk to underground waters. © 2005 Elsevier Ltd. All rights reserved.

A identidade do agente comunitário de saúde: Uma abordagem fenomenológica

The structure of Brazil's National Health System (SUS) is being firmed up through programs adding a new element to its multi-professional healthcare teams: Community Healthcare Agents. This study examines psycho-social factors that are significant for the construction of this identity, from the standpoint of these Community Healthcare Agents, using the hermeneutic phenomenology of Paul Ricoeur as its reference methodology. The subjects of this survey were seven Community Healthcare Agents who were asked during interviews (with informed consent and after approval by the Research Ethics Committee) to: 'Tell me about your experience as Community Healthcare Agent'. The analysis of their replies indicated the following topics: previous experience; capacity-building for the job; bonding; building up expertise; gratifying experience; feelings of power(lessness); communications; daily work routines, personal growth; criticisms of the institution; user-agent experiences; and insertion into the social reality. The overall analysis disclosed the phenomenon through the convergence and divergence of the grouping of these topics, viewed from the standpoint of these Community Healthcare Agents and the psycho-social aspects constructing their identity.

Committees for ethics in research involving human subjects

In Brazil since October 1996 there have been guidelines for research involving human subjects. Now human subjects know when their treatment is part of research. Deceit is no longer tolerated. But is not enough to say we offer an explanation to the potential subject and we offer a choice before he or she is confronted with an informed consent form. As in all professional activity, scientific investigation needs social controls. In Brazil, the ultimate responsibility of an investigation lies on the investigator, but in every institution where research is carried out there is a Committee for Ethics in Research. All Committees are subordinated to the National Commission of Ethics in Research, which is submitted to the Brazilian Institute of Health. During 2005 around 17,000 protocols involving 700,000 human subjects were revised by 475 Committees distributed all over the country. Approximately 7,000 people are now working in these Committees.

Análise da prescrição de medicamentos de pacientes hipertensos atendidos pelo SUS da rede municipal de saúde de Rincão - SP

The purpose of this study was to identify the drugs most often prescribed for hypertension at the Municipal Health Care Center of the town of Rincäo, State of São Paulo, Brazil, and the principal interactions arising from their association with other drugs, both anti-hypertensives and those in other classes. The study included 725 hypertensive patients registered at this health care center who were regularly seen by a physician every three months. Data were collected on age, sex, occurrence of diabetes, smoking, sedentary lifestyle and overweight, to obtain a profile of the hypertensive population of the area. Control records of all patients were available at the pharmacy in the health care center, where patients obtained their drugs once a month. Of the 725 patients, 38% were male and 62% female. Most (57%) were between 50 and 70 years of age, 21% used tobacco and 43% led a sedentary lifestyle. Single-drug therapy accounted for 33% of the prescriptions, multidrug therapy for 66%. In addition to anti-hypertensives, 50% of the patients took drugs of other therapeutic classes. Of those receiving multidrug therapy, 34% used three or more anti-hypertensives and 66% used only two of these drugs. Drug interactions were detected in as many as 47% of the prescriptions. Captopril was the drug that showed most interactions with others (54%), followed by hydrochlorothiazide (27%), furosemide (14%), propanolol (4%), and nifedipine (1%). The analysis revealed that drug consumption by the patients investigated is high, with a concomitantly high number of episodes of drug interaction.

Análise dos aspectos legais das prescrições de medicamentos

This article describes a survey of prescriptions dispensed in drugstores and pharmacies in the city of Araraquara in the state of São Paulo, Brazil, in May 2006. Their contents were assessed for compliance with the laws in force on drug prescription and dispensing. A total of 1,335 prescriptions were examined: 40 (3%) were unsigned, 212 (15.9%) did not contain the prescribing physician's stamp, 170 (12.7%) were undated. There were prescriptions containing corrections (4.6%), and written in code (4.4%). Only 58.8% were legible and easy to understand; nevertheless all of them were dispensed. Some did not specify the name of the patient (7.2%). On how to use the medication prescribed, not a single prescription contained all the information required by law. Specifically, 7.6% lacked information on dosage, 54.3% on presentation, 33.6% on how to take the drug, and 51.2% on duration of treatment. The data show a general failure to comply with the laws on drug prescription and dispensing. Incomplete information on the drugs and their correct use could lead to irrational use and errors in medication. The lack of prescribers' signature and stamp, date of emission and name of patient can lead to fraudulent and counterfeit prescriptions. Thus, the data found point to the need for capacitation of prescribing and dispensing professionals and the importance of the role of professional associations in guiding their members.

Gestantes vivendo com HIV/AIDS: Características antropométricas e peso ao nascer dos seus recém-nascidos

PURPOSE: To describe the anthropometric and pregnancy characteristics of women with HIV/AIDS, assisted by the Brazilian National Health System and the birth weight of their newborns. METHODS: The participants were women assisted at public STD/AIDS clinics of the Municipal Health system of São Paulo. The anthropometric characteristics were evaluated by trained nutritionists and other information was obtained from the medical records. For comparison of the survey data to those of the general population, secondary maternal and pregnancy data were obtained from live birth certificates through the Live Birth Information System. Continuous variables were summarized as mean and standard deviation or as the 25th, 50th and 75th percentiles and minimum and maximum values. The other variables are presented as percentages. Means were compared by the Student's t-test or Kruskal-Wallis test depending on the fulfillment of assumptions, with the decision based on the p value. RESULTS: We found the presence of inadequate maternal nutrition according to triceps skinfold (60.9%). The BMI/gestational age showed the presence of underweight (18.5%) and overweight or obesity (40%). There was no association between disease status (HIV or AIDS) and weight, height, and lean or fat mass. Mean newborn birth weight was lower than the value for the general population without infection or disease. The results of this study indicate the need to develop adapted curves to allow a more accurate nutritional assessment of this population group.

Detecção de faltas em sistemas de distribuição de energia elétrica usando dispositivos programáveis

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Automação do despacho dinâmico de viaturas para o atendimento das ordens de serviços nas redes de distribuição de energia elétrica

Pós-graduação em Engenharia Elétrica - FEIS