Delays In Receiving Obstetric Care And Poor Maternal Outcomes: Results From A National Multicentre Cross-sectional Study.

The vast majority of maternal deaths in low-and middle-income countries are preventable. Delay in obtaining access to appropriate health care is a fairly common problem which can be improved. The objective of this study was to explore the association between delay in providing obstetric health care and severe maternal morbidity/death. This was a multicentre cross-sectional study, involving 27 referral obstetric facilities in all Brazilian regions between 2009 and 2010. All women admitted to the hospital with a pregnancy-related cause were screened, searching for potentially life-threatening conditions (PLTC), maternal death (MD) and maternal near-miss (MNM) cases, according to the WHO criteria. Data on delays were collected by medical chart review and interview with the medical staff. The prevalence of the three different types of delays was estimated according to the level of care and outcome of the complication. For factors associated with any delay, the PR and 95%CI controlled for cluster design were estimated. A total of 82,144 live births were screened, with 9,555 PLTC, MNM or MD cases prospectively identified. Overall, any type of delay was observed in 53.8% of cases; delay related to user factors was observed in 10.2%, 34.6% of delays were related to health service accessibility and 25.7% were related to quality of medical care. The occurrence of any delay was associated with increasing severity of maternal outcome: 52% in PLTC, 68.4% in MNM and 84.1% in MD. Although this was not a population-based study and the results could not be generalized, there was a very clear and significant association between frequency of delay and severity of outcome, suggesting that timely and proper management are related to survival.

[access To Basic Health Services And Associated Factors: A Population-based Study].

This study sought to identify factors involved in access to the services of a basic health unit. It is a cross-sectional, population-based study involving 101 randomly-selected families residing in the area covered by the health unit. An adult resident of each household was interviewed. The response variable was whether or not the resident frequented the health unit if he/she or anyone in the family required assistance to resolve a health issue. The independent variables investigated were service provision aspects, demographic and socio-economic characteristics, individual habits, morbidities and use of the health unit. In addition to descriptive and univariate analysis, logistic regression was applied in the multivariate analysis. The results show that access to the basic health unit is associated with the treatment received previously (OR = 3,224) with accessibility (OR = 0,146) and micro-area of residence (OR = 10,918). These findings suggest that access is related to the impressions created by the care received at the health unit and is based on experiences with the service, but can also be strongly modulated by individual aspects and factors related to the territory.

Programas de educação de jovens e adultos e pesquisa acadêmica: a contribuição dos estudos do letramento

The purpose of this article is to introduce elements that allow building an interface between the academic research and the programs of basic education for youngsters and adults. It discusses contributions to these programs that can be found in the results of qualitative research studies. To this end, results of a five-year long project on teacher education are used, which aim was that of analyzing the interaction between teacher and student in youngster and adult literacy classes. The research project was conducted in natural contexts with the purpose of understanding a given social reality, and not of establishing general laws. Therefore, the credibility of its results was built through the observation of multiple contexts, and the gathering of data was made through various methods, from the perspective of several participants observed during a prolonged period of time. This empirical basis was used to evaluate recommendations contained in the report commissioned by Unesco to the International Literacy Institute for presentation at the World Forum on Education held in 2000 in Dakar. This report proposed that the continuous attendance of students to basic education programs is one of the great challenges of the new millennium. With respect to the problem of adult evasion from courses and programs, the article discusses the motivation and accessibility factors, pointed out in official documents as relevant factors to the success or failure of the programs.

Aspectos médicos e sociais no atendimento oftalmológico de urgência

Purpose: A survey was carried out on one hundred patients of the Emergency Service of the Ophthalmology Department of the Hospital das Clinicas of the University of Campinas (UNICAMP), in order to analyze the personal characteristics and the barriers against getting resolving ophthalmologic assistance. Variables, were the following: sex, age, home town, average distance between the place of initial symptoms and first visit to the hospital, time spent between the first examination (if performed in any other service) and the examination performed at the Hospital das Clinicas of University of Campinas, diagnosis, veracity of emergency, need to refer patients previously seen in other services to our Service and possibility of assistance and treatment at a secondary level. Methods: The sample showed the following characteristics: distances between 20 and 100 kilometers covered by 50.0% of the patients to be seen at University of Campinas. 75.0% of those patients needed someone to stay with them and 67.0% came from other municipalities. The long distances covered meant additional expenses for the treatment of diseases which should be treated locally. Results: Among the patients referred to University of Campinas by ophthalmologists of other services, 87.5% could have their diseases treated at a secondary level of assistance and 66.7% of real emergencies and 60% of false emergencies took longer than 7 days to reach the emergency room of University of Campinas. This shows the poor infrastructure of secondary services regarding excellence of emergency care and education of patients. Conclusions: We recommend education of general physicians and ophthalmologists for emergency eye care and also the supply of both secondary and tertiary public services or medicare, strategically setup in the whole state of Sao Paulo.

Os contrastes do ambiente urbano : espaço vazio e espaço de lazer

Universidade Estadual de Campinas. Faculdade de Educação Física

Educação pelo lazer : valores que envolvem a relação adulto-criança

Universidade Estadual de Campinas . Faculdade de Educação Física

Lazer nos acampamentos de ferias : uma analise da ação dos animadores socio-culturais

Universidade Estadual de Campinas. Faculdade de Educação Física

Estudo da distribuição da pressão plantar e do equilibrio corporal em corredores de longa distancia

Universidade Estadual de Campinas . Faculdade de Educação Física

Conteudos culturais do lazer : presença e aplicabilidade na hotelaria

Universidade Estadual de Campinas . Faculdade de Educação Física

Lazer nas atividades de aventura na natureza e qualidade de vida para pessoas com deficiência : um estudo a partir do caso da cidade de Socorro - SP

Universidade Estadual de Campinas . Faculdade de Educação Física

A configuração do lazer no espaço das Universidades da Terceira Idade

Universidade Estadual de Campinas . Faculdade de Educação Física

Desporto adaptado no Brasil : origem, institucionalização e atualidade

Universidade Estadual de Campinas. Faculdade de Educação Física

Projeto Sol Morumbi - Paulinia : as lembranças da infancia e adolescencia pelos caminhos da Educação Fisica

Universidade Estadual de Campinas . Faculdade de Educação Fisica

A integração do esporte adaptado com o esporte convencional a partir da inserção de provas adaptadas : um estudo de caso

Universidade Estadual de Campinas. Faculdade de Educação Física