Impact of worksite health-promotion programs in hospital admission costs and medical leaves in a sample of brazilian companies

Programas de saúde e bem-estar têm sido adotados por empresas como forma de melhorar a saúde de empregados, e muitos estudos descrevem retornos econômicos positivos sobre os investimentos envolvidos. Entretanto, estudos mais recentes com metodologia melhor têm demonstrado retornos menores. O objetivo deste estudo foi investigar se características de programas de saúde e bem-estar agem como preditores de custos de internação hospitalar (em Reais correntes) e da proporção de funcionários que têm licença médica, entre Abril de 2014 e Maio de 2015, em uma amostra não-aleatória de empresas no Brasil, através de parceria com uma empresa gestora de ‘big data’ para saúde. Um questionário sobre características de programas de saúde no ambiente de trabalho foi respondida por seis grandes empresas brasileiras. Dados retirados destes seis questionários (presença e idade de programa de saúde, suas características – inclusão de atividades de screening, educação sobre saúde, ligação com outros programas da empresa, integração do programa à estrutura da empresa, e ambientes de trabalho voltado para a saúde – e a adoção de incentivos financeiros para aderência de funcionários ao programa), bem como dados individuais de idade, gênero e categoria de plano de saúde de cada empregado , foram usados para construir um banco de dados com mais de 76.000 indivíduos. Através de um modelo de regressão múltipla e seleção ‘stepwise’ de variáveis, a idade do empregado foi positivamente associada e a idade do programa de saúde e a categoria ‘premium’ de plano de saúde do funcionário foram negativamente associadas aos custos de internação hospitalar (como esperado). Inesperadamente, a inclusão de programas de screening e iniciativas de educação de saúde nos programas de saúde e bem-estar nas empresas foram identificados como preditores positivos significativos para custos de admissão hospitalar. Para evitar a inclusão errônea de licenças-maternidade, apenas os dados de licença médica de pacientes do sexo masculino foram analisados (dados disponíveis apenas para duas entre as companhias incluídas, com um total de 18.957 pacientes do sexo masculino). Analisando estes dados através de um teste Z para comparação de proporções, a empresa com programa de saúde que inclui atividades voltadas a cessação de hábitos ruins (como tabagismo e etilismo), controle de diabetes e hipertensão, e que adota incentivos financeiros para a aderência de funcionários ao programa tem menor proporção de empregados com licençca médica no período analisado, quando comparada com a outra empresa que não tem estas características (também conforme esperado). Entretanto, a companhia com menor proporção de funcionários com licença médica também foi aquela que adota programa de screening entre as atividades de seu programa de saúde. Potenciais fontes de ameaça à validade interna e externa destes resultados são discutidas, bem como possíveis explicações para a associação entre programas de screening e educação médica a piores indicadores de saúde nesta amostra de companhias são discutidas. Novos estudos com melhor desenho, com amostras maiores e randômicas são necessários para validar estes resultados e possivelmente melhorar a validade interna e externa destes resultados.

Avaliação do cuidado na estratégia saúde da família em metrópoles do nordeste brasileiro

Objective: To evaluate the implementation of the Family Health Strategy (FHS) in Brazilian cities of the Northeast, expanding coverage, analyzing the progress, challenges and innovations. Methods: Multicentric Evaluation Research, Studies Baselines in urban centers, using as a case study method. Selected cases of Aracaju, being capital, advanced coverage with extended team, and Fortaleza, capital coverage incipient and minimal staff. In Fortaleza, purposive sample of 11 Units Primary (APS), 03 managers, 53 professionals and 109 users. In Aracaju, 09 units of APS, 02 managers, 36 professionals, and 90 users. Structured interviews for managers, and structured to professionals and users. Descriptive analysis focusing on the political and institutional dimensions, organization and comprehensive care. Results: There was consensus that the ESF is the preferred port users and acts as inducing changes in care. In the case of Fortaleza, the specificities were: care protocols and community activities aimed at chronic conditions (100%) , with greater participation of doctors and nurses (93%) ; conjunction with more complex services, but the teams reported difficulties with the examination center and experts, the long waits and poor access to local services were the main difficulties reported by users., As innovative practice, the therapeutic group of elderly caregivers mentioned by respondents; There was intersectoral initiatives and teams 87 % of users have participated in meetings about health problems. In the case of Aracaju, care protocols were directed to the lines of care and formulated locally, 85 % coverage of the population with FHS counterpart local financing; employees hired by public tender; 70 % of teams with expertise in public health center for continuing education acting; democratization in management; access technologies, welcoming and computerization in different integrated networks, and evaluation matrix. Conclusions: The ESF has promoted access to health care and inclusion of disadvantaged populations. Different perceptions and practices in the organization of care, with distinct trajectories of reorganization. In the case of Fortaleza, predominance of model programs valuing older, with evidence of advances in care practices and teamwork, but restricted to primary care practices and incipient in public policy perspective. In Aracaju, had network integration with technologies related to the family, in which the ESF is consolidated as public policy. It can be argued that the XII APS expanding coverage, exhibited efficacy, despite the challenges inherent to the different degrees of implementation

Uma análise histórico-epistemológica do conceito de grupo

This work aims to analyze the historical and epistemological development of the Group concept related to the theory on advanced mathematical thinking proposed by Dreyfus (1991). Thus it presents pedagogical resources that enable learning and teaching of algebraic structures as well as propose greater meaning of this concept in mathematical graduation programs. This study also proposes an answer to the following question: in what way a teaching approach that is centered in the Theory of Numbers and Theory of Equations is a model for the teaching of the concept of Group? To answer this question a historical reconstruction of the development of this concept is done on relating Lagrange to Cayley. This is done considering Foucault s (2007) knowledge archeology proposal theoretically reinforced by Dreyfus (1991). An exploratory research was performed in Mathematic graduation courses in Universidade Federal do Pará (UFPA) and Universidade Federal do Rio Grande do Norte (UFRN). The research aimed to evaluate the formation of concept images of the students in two algebra courses based on a traditional teaching model. Another experience was realized in algebra at UFPA and it involved historical components (MENDES, 2001a; 2001b; 2006b), the development of multiple representations (DREYFUS, 1991) as well as the formation of concept images (VINNER, 1991). The efficiency of this approach related to the extent of learning was evaluated, aiming to acknowledge the conceptual image established in student s minds. At the end, a classification based on Dreyfus (1991) was done relating the historical periods of the historical and epistemological development of group concepts in the process of representation, generalization, synthesis, and abstraction, proposed here for the teaching of algebra in Mathematics graduation course

A assistência estudantil e as cotas sociais nas universidades estaduais do nordeste: as faces do acesso ao direito

This paper discusses about the higher education in Brazilian society highlighting the struggle of the working class, as concerning the access to public universities, as well as highlights the contradictions implicit in social quotas adopted by Higher Education Institutions (HEIs) . The aim of this paper is on presenting the analysis of student assistance of the state universities in the Northeast that adopt quotas as social criteria of access for its students , presenting investigative locus as the following universities : UERN , UEPB , UPE and UNEAL . The paper presents the results of a qualitative study , based on a documentary analysis , based on dialectical and historical materialism in which she performed the reading of data from the following analytical categories: Higher Education, Social Quotas and Student Assistance. As main results, it is emphasized that the implementation of quotas as a means of access to higher education was not decisive for the form of planning and implementation of student assistance the university investigated; latent heterogeneity is that universities deal with actions to support student residence. And it is this heterogeneity and the variation in the conduct and understanding of student assistance , reflecting the lack of prioritization with the actions of the context of HEIs ; support programs are to stay focused on central campuses which are located the administrative offices of the universities, penalizing students enrolled in advanced units; also highlight that there is no link between the programs and projects related to student assistance with actions related to teaching, research and extension in universities investigated , which ultimately characterize the student assistance as an isolated action and punctual

Effect of oral hygiene education and motivation on removable partial denture wearers: longitudinal study

The purpose of this study was to determine the effect of two different preventive oral hygiene education and motivation programmes on the plaque and gingival index, as well as denture hygiene of patients provided with removable partial denture (RPD) during a 12-month follow-up.A total of 53 partially edentulous patients were recruited for this study. The presence or absence of plaque and gingival bleeding by gentle probing was scored on all tooth surfaces at the preliminary visit. The plaque and gingival indexes were measured using the Loe index. Following treatment, the patients were randomly divided into three groups. In Control Group I, subjects were instructed to continue their personal oral hygiene routine. In Group II, participants were given verbal instructions and a self-educational manual on oral hygiene without illustrations. In Group III, oral hygiene guidance was delivered using a combination of verbal instructions and a self-teaching manual. To evaluate the effect of the different modes of instruction, the presence or absence of plaque and gingival bleeding was scored on all tooth surfaces (day zero examination) and re-examined 7, 15 and 30 days, 3, 6 and 12 months following RPD placement. The state of denture hygiene was evaluated 7, 15 and 30 days and 3, 6 and 12 months following rehabilitation. Parametric statistics was applied to dental plaque and gingival indexes. For accumulation of plaque and calculus on the RPD, non-parametric statistic was applied.The frequency of plaque found during the preliminary visit was higher than that found in the other periods. With regard to gingival index, significant difference was found between the preliminary visit examination and other periods. There was a significant difference in the plaque accumulation on the denture surface between groups I and III.The different methods of oral hygiene instruction used in this study indicate that the type of education was not of significant importance.

Perda dentária em uma população rural e as metas estabelecidas pela Organização Mundial de Saúde

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

Programa de saúde vocal para educadores: ações e resultados

TEMA: a voz do professor tem sido foco de estudos nas últimas duas décadas devido à alta ocorrência de alterações vocais nesta classe profissional, assim, reforçou-se a necessidade dos professores participarem de ações para garantir saúde vocal. Poucos são os estudos na literatura que descrevem programas e seus resultados. PROCEDIMENTOS: Descrever um Programa de Saúde Vocal desenvolvido no período 2002 a 2005, para educadores de ensino público (infantil e fundamental) do interior do Estado de São Paulo, composto por grupos básicos de voz oferecendo conhecimento teórico prático de cuidados vocais, com triagem da qualidade da voz dos participantes; grupos avançados buscando reorganização dos processos de fonação e do uso vocal em sala de aula. RESULTADOS: em média 56% dos educadores inscritos frequentaram as ações; 62,9% das vozes apresentavam distúrbios na triagem vocal com maioria em grau discreto; no início dos grupos avançados 100% dos educadores participantes referiram mais de 3 sintomas associados ao uso vocal, e após, somente 45% deles ainda de 4 a 13 sintomas; os dados de autopercepção vocal revelaram baixos escores de impacto da voz nas atividades profissionais. CONCLUSÃO: a descrição revelou a necessidade de ajustes constantes do programa para alcançar seus objetivos. A baixa participação às ações pode estar relacionada à presença de impacto discreto da voz nas atividades profissionais, fato a ser mais bem investigado no futuro, e o benefício constatado objetivamente da participação dos educadores nos grupos avançados de voz foi a diminuição na quantidade de sintomas vocais.

Environmental education and the health risk question: how do we educate the educators working with this theme?

Our society is presently seeing a trend of continuous increase of risk with severe consequences, especially those linked to environmental aspects. It has obligated us to reflect on this production and its effects, either positive or negative, and, after a long reflection, to think about the adopted model of civilization and the possibilities of changing such a model. The educational institution is among the social departments responsible for this revision process, since it represents one possibility to promote a more critical vision from society, providing it with tools needed for a more responsible action. However, schools are dominated by a traditional work, which does not allow for enough and proper attention to these relevant and current questions, and which involve a critical analysis of the conceptions and values established by our civilization, resulting in the present patterns of science-technology-society relations and their influence on the environment and health. Several research works have indicated a diversity of barriers that obstruct this necessary change. Since formal education plays an important role in the education of society for this theme, in this paper the possibilities and difficulty dealing with this problem are discussed, focusing on the question of teacher education, based on investigations related to teacher education programs for environmental education. The data collected show the urgency for introducing this theme in teacher training programs, taking into account the fact that educators have their own conceptions, values and attitudes that should be considered in these programs.

Library professionals' education in the Mercosur countries

This paper deals with library professionals education in Mercosur - the Common Market of South America - established on 29 March, 1991 to expand the national markets of Argentina, Brazil, Paraguay and Uruguay, and promote free circulation of goods, services and production agents in that region. The paper presents, through a descriptive study, the undergraduate and graduate courses in Library Science, how many and what schools there are, and what programs are developed. It ends by identifying the directions in which they are moving and the challenges they are now facing.

Molecular phylogeny of advanced snakes (Serpentes, Caenophidia) with an emphasis on South American xenodontines: A revised classification and descriptions of new taxa

We present a molecular phylogenetic analysis of caenophidian (advanced) snakes using sequences from two mitochondrial genes (12S and 16S rRNA) and one nuclear (c-mos) gene (1681 total base pairs), and with 131 terminal taxa sampled from throughout all major caenophidian lineages but focussing on Neotropical xenodontines. Direct optimization parsimony analysis resulted in a well-resolved phylogenetic tree, which corroborates some clades identified in previous analyses and suggests new hypotheses for the composition and relationships of others. The major salient points of our analysis are: (1) placement of Acrochordus, Xenodermatids, and Pareatids as successive outgroups to all remaining caenophidians (including viperids, elapids, atractaspidids, and all other colubrid groups); (2) within the latter group, viperids and homalopsids are sucessive sister clades to all remaining snakes; (3) the following monophyletic clades within crown group caenophidians: Afro-Asian psammophiids (including Mimophis from Madagascar), Elapidae (including hydrophiines but excluding Homoroselaps), Pseudoxyrhophiinae, Colubrinae, Natricinae, Dipsadinae, and Xenodontinae. Homoroselaps is associated with atractaspidids. Our analysis suggests some taxonomic changes within xenodontines, including new taxonomy for Alsophis elegans, Liophis amarali, and further taxonomic changes within Xenodontini and the West Indian radiation of xenodontines. Based on our molecular analysis, we present a revised classification for caenophidians and provide morphological diagnoses for many of the included clades; we also highlight groups where much more work is needed. We name as new two higher taxonomic clades within Caenophidia, one new subfamily within Dipsadidae, and, within Xenodontinae five new tribes, six new genera and two resurrected genera. We synonymize Xenoxybelis and Pseudablabes with Philodryas; Erythrolamprus with Liophis; and Lystrophis and Waglerophis with Xenodon.

On-line collaborative learning for in-service teacher education

This article brings some of the results of a study that analyzes a hybrid course for in-service teachers in the Project Teletandem Brazil: foreign languages for all. In this project, Brazilian teachers of Spanish as a foreign language took part in a blended tandem learning course, communicating via videoconferencing with Uruguayan teachers of Portuguese as a foreign language. The aim of the study was to verify Brazilian teachers' concepts and beliefs concerning language and culture and how the teletandem interactions affected them. After the interactions, teachers' views of culture seemed to also incorporate aspects of culture as an interpersonal process, instead of the factual and static view which was previously predominant. Therefore teacher education programs must consider the possibility of conjugating theory and reflective practice through the use of videoconference tools in order to allow teachers to experience culture rather learn facts about it. © 2011 ACADEMY PUBLISHER.

Less advanced sectors in the Latin American fertility transition

Includes bibliography

Avaliação do tempo para acesso ao tratamento do câncer de mama no Distrito Federal

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Entre a teoria e a prática: o projeto político-pedagógico do curso de medicina da UFMA

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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

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