Fatores de risco para o desenvolvimento de crianças atendidas em Unidades de Saúde da Família, ao final do primeiro ano de vida: aspectos sociodemográficos e de saúde mental materna

The scope of this article is to evaluate risk and protection factors for the development of 1-year-olds assisted at family health care units. It is a cross-sectional study involving 65 children of approximately 1 year of age and their mothers attended at two family health care units. The development was assessed using a developmental screening test (Denver II). The mothers filled out the SRQ-20 questionnaire to identify common mental disorder (CMD) indicators. After data collection, descriptive and inferential statistical analysis was performed. Global development was at risk in 43.1% of the children evaluated, and the most affected areas were language and fine motor development; 44.6% of mothers had results indicative of CMD when the child was 1 year of age. In bivariate analysis, reported depression, smoking, infections in pregnancy, CMD after birth and working outside the home were significantly associated with the children's development. After full statistical analysis, CMD was revealed as being a risk factor, and working away from home as being a protection factor. In order to increase the chances of success of programs targeted for children at health care units and avoiding the risk of impaired development, it is important to focus on two aspects: children's stimulation and maternal mental health.

Saúde mental do idoso: percepções relacionadas com o envelhecimento em interface com o atendimento de saúde na atenção básica

Worldwide, growth is seen in the elderly population, which has prompted the use oftechnologies of care that include all stages of life and for that use, it is necessary toprepare professionals to meet this growing demand population. This work aims to understand how old people feel by their condition and identify how old people perceive this treatment in the Family Health Unit. The research is characterized asqualitative and Minayo second analysis was used Bardin. After, thematicinterviews, it was possible to appreciate the topics: Good, dissatisfaction through the life and likes / dislikes of the service unit. This work can be seen that the elderlywho were well, allied to good living with this family, with spouses, autonomy, respect they encounter in society. And when compared with those who have a complaint, we find that lack of family and age restrictions and diseases are the main complaints

Individual and contextual factors related to dental caries in underprivileged Brazilian adolescents

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

Quality of life and socio-dental impact among underprivileged brazilian adolescents

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

De direito social a dispositivo de saúde: o trabalho na legislação de saúde vigente

Starting from the theoretical contributions of Michel Foucault and from a critical appraisal of the Declaration of Universal Human Rights and the 1988 Brazilian Constitution, this article maps the constitution of labor as a dimension that goes from social right to health device. In our analysis we find that labor as a social right and health device has a subjective protagonism and has social and economic aspects contemplated by documents. However in defining and orienting ways of being of individuals that work delivered speeches that fall in and control, hindering the openness of workers for movements of creation expansion of life and work in its positivity of experimentations. We conclude that is not enough to recognize labor as a social right, indicate its role as a health strategy or direct political efforts without problematizing not “what kind of work” can be supportive in a more creative construction of its own work and health.

O apoio institucional como uma das faces da função apoio no Núcleo de Apoio à Saúde da Família (NASF): para além das diretrizes

The aim of this study was to add to the debate about Family Health Support Centers (FHSCs), starting from reflections about the support function. Support is generally presented, in official documents from the Ministry of Health and in academic-scientific publications, accompanied by descriptors that characterize it. Differences in terminology are commonly encountered: “institutional support”, “managerial support”, “matrix support” and so on. With regard to FHSCs, published papers have highlighted the central role played by matrix support. However, we pose the question: what are the faces that the support function has been taking on in implementing such programs? To reflect on this and other issues, we developed a study of qualitative nature within a FHSC team in Paraná, outside of the state capital, using the methodological tools of participant observation, semi-structured interviews and discussion groups. We sought to demonstrate that the dynamics of the support function in FHSCs make it possible for both matrix support and institutional support to emerge.

Estudo qualitativo sobre as justificativas de adolescentes para a não adesão ao tratamento odontológico

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

Individual and contextual factors related to dental caries in underprivileged Brazilian adolescents

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

Variáveis de impacto na queda da mortalidade infantil no Estado de São Paulo, Brasil, no período de 1998 a 2008

This is an ecological, analytical and retrospective study comprising the 645 municipalities in the State of Sao Paulo, the scope of which was to determine the relationship between socioeconomic, demographic variables and the model of care in relation to infant mortality rates in the period from 1998 to 2008. The ratio of average annual change for each indicator per stratum coverage was calculated. Infant mortality was analyzed according to the model for repeated measures over time, adjusted for the following correction variables: the city's population, proportion of Family Health Programs (PSFs) deployed, proportion of Growth Acceleration Programs (PACs) deployed, per capita GDP and SPSRI (Sao Paulo social responsibility index). The analysis was performed by generalized linear models, considering the gamma distribution. Multiple comparisons were performed with the likelihood ratio with chi-square approximate distribution, considering a significance level of 5%. There was a decrease in infant mortality over the years (p < 0.05), with no significant difference from 2004 to 2008 (p > 0.05). The proportion of PSFs deployed (p < 0.0001) and per capita GDP (p < 0.0001) were significant in the model. The decline of infant mortality in this period was influenced by the growth of per capita GDP and PSFs.

Barriers related to non-adherence in a mammography breast-screening program during the implementation period in the interior of São Paulo State, Brazil

Mammography is the best exam for early diagnosis of breast cancer. Developing countries frequently have a low income of mammography and absence of organized screening. The knowledge of vulnerable population and strategies to increase adherence are important to improve the implementation of an organized breast-screening program. A mammography regional-screening program was implemented in a place around 54.238 women, aged 40-69 years old. It was proposed to perform biannual mammography free of cost for the women. We analyze the first 2 years of the implementation of the project. Mammography was realized in 17.964 women. 42.1% of the women hadn't done de mammography in their lives and these women were principally from low socio-economic status (OR=2.99), low education (OR=3.00). The best strategies to include these women were mobile unit (OR=1.43) and Family Health Program (OR=1.79). The incidence of early breast tumors before the project was 14.5%, a fact that changed to 43.2% in this phase. Multivariate analysis showed that the association of illiterate and the mobile unit achieve more women who had not performed mammography in their lives. The strategies to increase adherence to mammography must be multiple and a large organization is necessary to overpass the barriers related to system health and education.

Análise das internações por condições sensíveis à Atenção Primária em hospital de referência regional, SP/Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A experiência da saúde coletiva na formação profissional: retrato da extensão universitária

The guidelines of National Curriculum for Dental courses highlights the necessity in providing for the professional the ability to analyze and assess community’s problems and needs, and to create solutions for the society. The continuing education may be considered a useful tool for the teaching and learning because it favors the diversification of learning environments, which allows the insertion of undergraduate and graduate students into the real scenarios. This current study aimed to assess the Public Health projects and programs of the UNESP – Araçatuba Dental School, by describing the interaction experiences between faculty and health services in the professional career development. Historical, documentary and descriptive searches were performed based on the faculty archives such as official documents, reports, databases from the Pro-rector of continuing education and published papers in the period between 1964 and 2011. The following experiences were noted: the Extra-Muro Dental Service (SEMO), established in 1964, that focused in providing dental treatment to the rural population, highlighted the social inclusion of discriminated society groups since that time. In 1972, this service was expanded to several specific populations living in the urban areas. In the '60s, many educational campaigns were performed as homemade water filter and construction of wells and septic tanks which demonstrate the concern with the determinants of healthdisease process. At that time, the campaign of fluoridation of public water supplies in several counties started as Araçatuba, Birigui, Penápolis, Guararapes, Valparaíso and so on. The Campaign of “Good Teeth” from the '70s became wider over time and it was transformed in the "Oral Health Education Program" and it was continuously developed in all public schools of Araçatuba and some neighboring towns, benefiting children aged from 6 to 10 years-old. Several epidemiological studies of caries, periodontal diseases, malocclusion and fluorosis were conducted in cooperation with local governments, and counted with the participation of undergraduate and graduate students. Pereira Barreto – SP was the precursor city in Brazil to carry out fluorosis study. Currently, 12 projects of Public Health from the Institution of Higher Education in the Pro-rector of continuing education are being developed. The concern in qualifying the human resources in health is confirmed with the development of training courses and workshops for professionals, highlighting the training for people enrolled in the Family Health program; Community Health Agent training - Solidarity University, and Municipal Health Counselors training. The Graduate Program in Social and Preventive Dentistry, created in 1993, has an important role to train several professionals for the Unified Health System, and provides education to create researchers, professors and administrators, and enucleates research groups in several Brazilian states. In all activities showed herein, a dynamic participation of undergraduate and graduate students has been observed, and several books, guidelines, articles, brochures and booklets have been published as a result of the continuing education activities.. It was concluded that different projects and programs have been developed by the Public Health of UNESP –Araçatuba Dental School, which allow the exchange of experience between the university and health services, and benefit all participants enrolled in these activities.

A participação do auxiliar em saúde bucal na equipe de saúde e o ambiente odontológico

Introduction: The formation of Oral Health Team, healthy and ergonomic work conditions influence on quality of dental attendance to patient. Objective: In this observational and cross-sectional study, it was observed the participation of the dental assistants (ASB) on dental team on public health, to verify the items related to health legislation, the existence and distribution of equipment in dental offices. Material and method: The data collection was performed using questionnaires and observations on locals for consultation. It were interviewed 75 dentists from 9 cities of Health Regional Department (DRS) – XV – São José do Rio Preto City and it was evaluated 34 dental offices. Result: Of total 75 dentists, 21 (28%) worked alone and among them, 6 (29%) worked at school and 15(71%) at Health Basic Unit (UBS). From 34 dental offices, 2 (6%) did not show any equipment for sterilization and among those that had it, the autoclave was the most used method (44%). Among the analyzed dental offices, 31 (91%) had dustbin for common waste and 23 (68%) of contaminated waste was inadequate. It was noted that 13 (38%) did not have local to wash de hands; in 23 (68%) there was paper towel; in 20 (59%) there was ideal soap dishes, and the compressor was installed into dental offices in 5 (15%) of local for attendance. In relation to dental offices adequacy for the help work, all of them (n = 19) were dissatisfied. Conclusion: The existence of ASB was present in the Centers of Dental Specialties (CEO) and Units of Family Health due legal exigencies and it were found inadequate healthy and ergonomic conditions, suggesting the necessity of reorganization of w

Ética e atuação profissional: percepção de agentes comunitários de saúde

The perceptions of the Community Health Agent (CHA) referred to ethics in their work have been evaluated in this study. A questionnaire with social and ethical issues was applied in 61 ACS. 90% reported having received information about ethics, and “training courses” was the most cited source (68.9%). On a scale from 1 (least) to 5 (maximum), 67% claimed to have knowledge about ethics among 4 or 5 and 88.5% reported that this topic has an importance of 5 in their work. Ethical conflicts exposed had an average of 75% of respondents in agreement with the reference sources, and the two items involving “information privacy” showed the greatest disagreement. Ethics was considered important by the professional performance of subjects who had a good perception about the issue; however the topic about privacy of information generated controversy.

Acesso, segurança e uso de medicamentos por usuários

The present study aims to identify families who have stock and are making use of medications, as well as assess the conditions of storage, security and use of these drugs. The study was conducted in a city of São Paulo, the interviews were conducted in households enrolled in one of ten units of the Estratégia de Saúde da Família (ESF) that the city provides and the sample was defined by means of stratified random sampling (134households, IC 95%). Data collection was conducted through interviews with a semistructured questionnaire during the first half of 2011. We interviewed 118 (88.0%) households, of which 112 (95.0%) had medications that were stored n insecure or inadequate places in 75.4% of households, non-prescription self-medication was a common practice in 46 (47 4%) households, and lack of identification and security of medications stored was observed in 60 (53.6%) households. Most households had stock of medicines, which were done improperly or unsecure, or have specialties with lack of identification and security, which can lead to poisoning or e ineffective therapy. The Pharmaceutical Assistance under SUS lacks social initiatives, with actions directed for medications users, which can be supplied by the presence of the pharmacist in the ESF, essential for the promotion of racional use of medicines, that, through the Pharmaceutical Care, can identify, correct and prevent possible problems related to drugs.