Preliminary risk analysis applied to the handling of health-care waste

Between 75% and 90% of the waste produced by health-care providers no risk or is "general" health-care waste, comparable to domestic waste. The remaining 10-25% of health-care waste is regarded as hazardous due to one or more of the following characteristics: it may contain infectious agents, sharps, toxic or hazardous chemicals or it may be radioactive. Infectious health-care waste, particularly sharps, has been responsible for most of the accidents reported in the literature. In this work the preliminary risks analysis (PRA) technique was used to evaluate practices in the handling of infectious health-care waste. Currently the PRA technique is being used to identify and to evaluate the potential for hazard of the activities, products, and services from facilities and industries. The system studied was a health-care establishment which has handling practices for infectious waste. Thirty-six procedures related to segregation, containment, internal collection, and storage operation were analyzed. The severity of the consequences of the failure (risk) that can occur from careless management of infectious health-care waste was classified into four categories: negligible, marginal, critical, and catastrophic. The results obtained in this study showed that events with critics consequences, about 80%, may occur during the implementation of the containment operation, suggesting the need to prioritize this operation. As a result of the methodology applied in this work, a flowchart the risk series was also obtained. In the flowchart the events that can occur as a consequence of a improper handling of infectious health-care waste, which can cause critical risks such as injuries from sharps and contamination (infection) from pathogenic microorganisms, are shown.

Synergistic effect of green coffee oil and synthetic sunscreen for health care application

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Characteristics of physical activity programs in the Brazilian primary health care system

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

Humanization of health care: a reflexive theoretical essay based on the philosophy of Emmanuel Lévinas

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

Knowledge and practice of women regarding cervical cancer in a primary health care unit

Objectives: evaluating the level of information about the examination of uterine cervical cancer and its association with sociodemographic variables in women of a health care unit in the city of Bauru, São Paulo, Brazil. Methods: we conducted a cross-sectional descriptive study with 370 women aged 25 to 59, through structured interviews in their own homes; we used descriptive statistics and the χ2 test. Results: 40.5% of the women had not undergone the Papanicolaou test at the recommended frequency; 58.2% incorrectly defined the test, and 69.5% did not know about the risk factors for the development of cervical cancer; the knowledge about the test showed statistically significant association with schooling and family income of the studied population. Conclusions: women present deficiencies on the proper practice of the Papanicolaou test, on knowledge about the test, risk factors and prevention methods. Therefore, it is necessary to develop primary health actions for the most vulnerable population.

The Effect of a Community-Based, Primary Health Care Exercise Program on Inflammatory Biomarkers and Hormone Levels

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Physical inactivity of adults and 1-year health care expenditures in Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The impact of physical activity on mitigation of health care costs related to diabetes mellitus: findings from developed and developing settings Diabetes mellitus and physical exercise

Over the last decades, the prevalence of diabetes mellitus (DM) has been increasing globally such that nowadays the disease constitutes an important outcome related to early mortality among adults. In parallel with the high prevalence, healthcare costs related to DM treatment have increased significantly, exacerbating its burden on modern society. The scientific literature points out that obesity and physical inactivity have a central role in the development of most DM cases. In fact, either physical exercise practice or an increase in the level of physical activity, constitute relevant tools in the guidelines for treatment of the disease. On the other hand, the effect of physical activity on the economic consequences of DM is not completely clear. The identification of the actual burden of lifestyle changes on the reduction of healthcare costs related to DM is relevant, primarily for developing nations, where it could represent a cheaper strategy for treating the disease and its complications than paying for drug treatment, which is commonly related to collateral effects. That being said, the prevention of DM and other diseases and consequently the mitigation of the costs related to these outcomes seem to depend essentially on the promotion of healthy habits. The aim of the present review was therefore to discuss recent evidence on the effects of physical activity/exercise on mitigation of health care cost related to DM.

A METHODOLOGY TO EVALUATE OBSOLETE INVENTORY IN HEALTH CARE

Many organizations are currently facing inventory management problems such as distributing inventory on-time and maintain the correct inventory levels to satisfy the customer or end users. Organizations understand the need for maintaining the accurate inventory levels but sometimes fall short leading a wide performance gap in maintaining inventory accurately. The inventory inaccuracy can consume much of the investment on purchasing inventory and many times leads to excessive inventory. The research objective of thesis is to provide a decision making criteria to the management for closing or maintaining the warehouse based on basic purchasing and holding cost information. The specific objectives provide information regarding the impact of inventory carrying cost, obsolete inventory, inventory turns. The methodology section explains about the carrying cost ratio that would help inventory managers to adopt best practices to avoid obsolete inventory and also reduce excessive inventory levels. The research model was helpful in providing a decision making criteria based on the performance metric developed. This research model and performance metric had been validated by analysis of warehouse data and results indicated a shift from two-echelon inventory supply chain to a one-echelon or Just In Time (JIT) based inventory supply chain. The recommendations from the case study were used by a health care organization to reorganize the supply chain resulting in the reduction of excessive inventory.

Decentralization and corruption: evidence from primary health-care programmes

The aim of this article is to evaluate whether there is an association between decentralization and corruption. In order to do so we analyse Brazilian health-care programmes that are run locally. To construct objective measures of corruption, we use the information from the reports of the auditing programme of the local governments of Brazil. Results point that there is no relationship between decentralization and corruption, whatever the measure of decentralization used.

Prevalence of beta-hemolytic Streptococcus in children with special health care needs

Pharyngotonsillitis by beta-hemolytic Streptococcus mostly affects children and imunocompromissed, being Streptococcus pyogenes (Group A) the most common agent in bacterial pharyngotonsillitis. Aim: This work targeted the research of beta-hemolytic Streptococcus Group-A (SBHGA) and No-A (SBHGNA) in the oropharynx of individuals with special health needs from the APAE (Maceio-AL). Method: A prospective study with oropharynx samples from patients with Down syndrome and other mental disorders (test) and students from a private school (control) aged 5-15 years. Cultures in blood agar (5%) were identified through Gram/catalase tests and bacitracin/trirnethoprim-sulfamethoxazole disk diffusion method, applying the chi-squared statistical analysis. Results: A total of 222 bacterial colonies were isolated in 74 individuals from APAE and 65 in the control group. In the test group, previous episodes of pharyngotonsillitis were reported by 36.49% (27/74) and 9.46% (7/74) were diagnosed with symptoms and/or signs suggestive of oropharynx infection. No positive sample of S. pyogenes was confirmed at APAE, being all samples classified as SBHGNA, with 5 SBHGA in the control group. Conclusion: The early identification of beta-hemolytic Streptococcus is important for the fast treatment of pharyngotonsillitis and the absence of S. pyogenes avoid future suppurative or not-suppurative sequels in the group from APAE.

Production of nursing care in primary health care services

This descriptive and quantitative study aimed to characterize the production of nursing care in primary health care services in a region of the city of Ribeirao Preto, state of Sao Paulo, Brazil. The study sample comprised care actions delivered by nurses and registered in the HygiaWeb Information System, from 2006 to 2009. Statistical analysis was performed. Results showed that nursing care delivered by nurses accounted for 9.5 to 14.6% of total professional care provided by professionals. Eventual care actions were the most frequent. The concentration of programmatic care was higher for children, women, pregnant and postpartum women. In conclusion, the predominance of eventual care demonstrated that the health system has been focused on acute conditions. Little of nursing work has been directed at the achievement of comprehensiveness, considering the inexpressive share of longitudinal follow up in total care delivery. The expansion of nursing staff represents potential for care delivery to the population, but further qualification of nursing actions is needed.

Fighting Misconceptions to Improve Compliance with Influenza Vaccination among Health Care Workers: An Educational Project

The compliance with influenza vaccination is poor among health care workers (HCWs) due to misconceptions about safety and effectiveness of influenza vaccine. We proposed an educational prospective study to demonstrate to HCWs that influenza vaccine is safe and that other respiratory viruses (RV) are the cause of respiratory symptoms in the months following influenza vaccination. 398 HCWs were surveyed for adverse events (AE) occurring within 48 h of vaccination. AE were reported by 30% of the HCWs. No severe AE was observed. A subset of 337 HCWs was followed up during four months, twice a week, for the detection of respiratory symptoms. RV was diagnosed by direct immunofluorescent assay (DFA) and real time PCR in symptomatic HCWs. Influenza A was detected in five episodes of respiratory symptoms (5.3%) and other RV in 26 (27.9%) episodes. The incidence density of influenza and other RV was 4.3 and 10.8 episodes per 100 HCW-month, respectively. The educational nature of the present study may persuade HCWs to develop a more positive attitude to influenza vaccination.

Providing health care to women with tuberculosis: the family focus perspective

To analyze the relationship between the practice of family health team workers and women with tuberculosis, according to the family focus dimension. The participants were eight family health team workers from a city in the Joao Pessoa metropolitan area (Paraiba -PB). Data were collected through semi-structured interviews, and then subjected to thematic content analysis. The workers recognize the critical social condition that women with tuberculosis live in, as well as the prejudice they face. They suggest that these women require care based on the concept of comprehensiveness in health. They also highlight the importance of Directly Observed Therapy -Short Course, the existence of incentives, and the women's poor adherence to educational activities and groups. Few workers recognize the inclusion of relatives in the care of women with tuberculosis, which implies the need for discussion regarding this fact with the purpose of improving tuberculosis treatment effectiveness.

The participation of the nutritionist in Primary Health Care in a large urban center

Nutritionists are important professionals for ensuring the implementation of health promotion, treatment and rehabilitation. However, their participation in primary healthcare from a quantitative standpoint is limited. The city of Sao Paulo has experienced an uneven urbanization process triggering new problems of insecurity in terms of food and nutrition. This article analyzes the performance of the primary healthcare nutritionist in a large urban center. It is a quantitative study that used data from the Municipal Health Department, population data of Sao Paulo and a semi-structured questionnaire applied in individual interviews. All regions of the city are found to have fewer nutritionists than the recommendation of the Federal Council of Nutritionists. There are 123 nutritionists in the basic healthcare network and 51 in the Family Health Support Nuclei (FHSN) (57.3%). Each nutritionist from the FHSN accompanies 7.1 family health strategy teams on average. The age groups corresponding to children are less frequently seen by nutritionists. Comparing the activities, the transition from a model of primary health care focused on individual care to a model that prioritizes group care was observed.