Percepções ambientais de comunidades rurais e indicadores de sustentabilidade como subsídios à conservação de áreas de caatinga no Rio Grande do Norte

Environmental degradation is a global problem that particularly affects areas subject to seasonal climatic variations, such as the brazilian semiarid region, namely the Caatinga Domain. Combined with other negative factors, such as natural resource misuse and disorderly land occupation, the consequences of Environmental Degradation have challenged science in the quest for addressing the resulting social and environmental problems. Accordingly, Environmental Perception methodology, by analyzing the concepts, attitudes and values, (especially those pertaining to environmental conservation) represent an important tool in studies that address the relationship between the environment and human actions. Sustainability Indicators are also relevant tools to assess the possible causes and consequences of environmental problems. Among several Sustainability Indicators available, the PressuresState-Impact-Response (PSIR) method is an analytical tool that permits the grouping of factors affecting sustainability as well as their consequences for nature and human health, and thus indicate mitigating actions for society and the public authorities. From this perspective, three areas of Caatinga were studied in Rio Grande do Norte state: Seridó Ecological Station (ESEC), Municipality of Serra Negra do Norte; Private Natural Reserve Stoessel de Brito (PNRSB), Municipality of Jucurutu; and part of the Serra de Santana, Municipality of Tenente Laurentino Cruz. The areas are both legally protected and unprotected and subject to diferent management protocols, though their share the common characteristic of human misuse of natural resources. In this scenario, this thesis´ main goal was to introduce the rural communities into the conservation process, using the results of Environmental Perception of such communities, combined with the analysis of the sustainability of municipalities through PSIR. Information on Environmental Perception was obtained from primary and secondary data from previous studies carried out in the ESEC Seridó and PRNP Stoessel de Brito. Additional data was obtained through direct observation and interview forms applied to rural communities in the Municipality of Tenente Laurentino Cruz. The results showed that respondents possessed a broad knowledge regarding environmental degradation, its causes and consequences for the caatinga biome. PEIR analysis showed that environmental degradation was smaller in countries with protected areas, as compared to those without. The population´s knowledge about environmental degradation and their acceptance of conservation units, as showed by Environmental Perception Analysis, coupled with the results of PEIR, suggest that those attitudes may foster actions aimed at reduction of environmental degradation in the Caatinga domain

Validação do instrumento dos indicadores observáveis da qualidade do cuidado em instituições de longa permanência para idosos

The Nursing Homes are an important alternative care in the world, but Brazil still has no valid instrument to monitor the quality these institutions. In the United States, the Observable Indicators of Nursing Home Care Quality Instrument (OIQ) is used to assess the quality of Nursing Home care using 30 indicators of structure (2 dimensions) and process (5 dimensions) related to quality person-centered care. The present study aimed at cross-culturally adapting the OIQ in order to evaluate the quality of Nursing Home care in Brazil. Conceptual and item equivalence were determined to assess the relevance and viability of OIQ in the Brazilian context, using the Content Validity Index (CVI) and a group of specialists composed of 10 participants directly involved in the object of study. Next, operational, idiomatic and semantic equivalence were carried out concurrently. This consisted of 5 phases: (1) two translations and (2) their respective back translations; (3) formal appraisal of referential and general meaning; (4) review by a second group of specialists; (5) application of the pretest at three Nursing Homes by different social entities: health professionals, sanitary surveillance regulators and potential consumers. Measurement equivalence was evaluated by the Cronbach’s alpha test to verify the internal consistency of the instrument. To measure inter-evaluator agreement, the General Agreement Index (ICG) and Kappa coefficient were used. Timely compliance and 95% Confidence Interval of indicators, dimensions and total construct were estimated. The CVI obtained high results for both relevance (95.3%) and viability (94.3%) in the Brazilian context. With respect to referential meaning, similarity was observed, ranging between 90-100% for the first back translation and 70-100% for the second. In relation to general meaning, version 1 was better, classified as “unchanged” in 80% of the items, whereas in version 2 it was only 47%. In the pretest, the OIQ was easy to understand and apply. The following outcomes were obtained: a high Cronbach’s alpha (0.93), satisfactory ICG (75%) and substantial agreement between the pairs of evaluators (health professionals, regulators from the Superintendency of Sanitary Surveillance –SUVISA-, and potential consumers), according to the Kappa coefficient (0.65). It´s possible take the operational equivalence held since it preserved the original layout in the Brazilian version from the maintenance in application mode, response options, number of items, statements and scores. The performance of nursing homes obtained approximate average scores of 87, a variation 55-111 considering a range from 30 to 150 points. The worst outcomes were related to process indicators with a mean of 2.8 per item, while structure was 3.75 on a scale of 1 to 5. The lowest score was obtained for the care dimension (mean 2). The OIQ version was deemed to be a valid and reliable instrument in the Brazilian context. It is recommended that health professionals, regulators and potential consumers adopt it to access and monitor the quality of Nursing Home care and demonstrating opportunities for improvement.

Indicadores e fatores preditivos de uso abusivo de álcool em adultos jovens

The abusive use of alcohol is closely related to dependence and to social and work damages. The main focus of this thesis is to create an instrument about alcohol abuse, in order to differentiate the degree of commitment of the symptomatology, considering its psychosocial factors of prediction. As specific goals: I) characterize the state of the art about assessment related to the abuse and dependence to alcohol; II) investigate and systematize aspects related to the predictive psychosocial factors for alcohol dependence; III) build an instrument for the assessment of alcohol abuse and protection and risk factors for the development of an alcohol dependence; and IV) verify validity evidence of the instrument built for the Brazilian population. In Study I, it was possible to observe the prevalence of articles related to the use of alcohol in a problematic way, without a classification dependence, it is lower than the one of articles that investigate the disease when it is already manifested, not to mention a few systematic studies about the theme of alcohol abuse in the scientific environment. In Study II, focus groups (FGs) were conducted, the analysis about the discourses of the focus groups were made through the ALCESTE software and it was possible to observe a response pattern that existed among the participants in different groups, with the generation of five classes. In Study III, we developed an instrument that contemplated aspects of the Alcohol Dependence Syndrome of the Millon Clinical Multiaxial Inventory-III, in addition to the characteristics defined in Study I and in Study II. The final version of the instrument had 59 items assessed through the likert scale of five points. In Study IV, the administration of the instrument was performed in an online format with university students ranging from 18 to 24 years old, residents in Brazilian metropolitan cities. The results evidenced that the internal consistency of the instrument is considered satisfactory (α = 0,882) and in what it refers to classes, the most significant data was the one related to financial loss and criteria for the diagnosis of alcohol abuse. It is important to consider the evaluative potential of risk and protective factors for the development of alcohol dependence of the instrument as a whole. Once the indicators of abuse and the profile of the abusers has been modified, the patient may have his/her treatment/intervention focused on the trouble and/or specific syndrome, thus having a clear and fast improvement.

Impacto do Programa Saúde da Família sobre indicadores de saúde da criança em municípios de grande porte da região Nordeste do Brasil

The present study carried out in the context of the Baseline Studies of the PROESF was aimed at evaluating the impact of the Family Health Program (PSF) on indicators for child health in cities with more than 100,000 inhabitants in the Brazilian Northeast. Four cities were investigated. In each one, twenty censual sectors were selected randomly from areas covered by the PSF and compared with twenty sectors selected from areas not covered by the PSF on the basis of socioeconomic criteria. In most cases, no significant differences were found between the areas covered and not covered by the PSF. The only difference found was a significantly lower rate of hospital admissions due to diarrhea but this was on account of the Program of Community Health Agents. The PSF exerted no additional effect on the reduction of this indicator. It was also observed that the way by which the program is implemented in each city interferes directly in the results. Thus, there is no basis for considering the PSF per se ineffective or not differing from other programs with regard to its health care patterns. An evaluation of the PSF would necessarily have to include an analysis of the way the program is implemented and conducted in each case, besides considering its general socioeconomical and political characteristics.

Acurácia dos indicadores clínicos do diagnóstico de enfermagem falta de adesão em pessoas vivendo com AIDS

In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

Acurácia dos indicadores clínicos do diagnóstico de enfermagem falta de adesão em pessoas vivendo com AIDS

In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

Efeito de diferentes divisões territoriais na flutuação aleatória de indicadores socioeconômicos relacionados à determinação social da saúde

This research aimed to analyse the effect of different territorial divisions in the random fluctuation of socio-economic indicators related to social determinants of health. This is an ecological study resulting from a combination of statistical methods including individuated and aggregate data analysis, using five databases derived from the database of the Brazilian demographic census 2010: overall results of the sample by weighting area. These data were grouped into the following levels: households; weighting areas; cities; Immediate Urban Associated Regions and Intermediate Urban Associated Regions. A theoretical model related to social determinants of health was used, with the dependent variable Household with death and as independent variables: Black race; Income; Childcare and school no attendance; Illiteracy; and Low schooling. The data was analysed in a model related to social determinants of health, using Poisson regression in individual basis, multilevel Poisson regression and multiple linear regression in light of the theoretical framework of the area. It was identified a greater proportion of households with deaths among those with at least one black resident, lower-income, illiterate, who do not attend or attended school or day-care and less educated. The analysis of the adjusted model showed that most adjusted prevalence ratio was related to Income, where there is a risk value of 1.33 for households with at least one resident with lower average personal income to R$ 655,00 (Brazilian current). The multilevel analysis demonstrated that there was a context effect when the variables were subjected to the effects of areas, insofar as the random effects were significant for all models and with different prevalence rates being higher in the areas with smaller dimensions - Weighting areas with coefficient of 0.035 and Cities with coefficient of 0.024. The ecological analyses have shown that the variable Income and Low schooling presented explanatory potential for the outcome on all models, having income greater power to determine the household deaths, especially in models related to Immediate Urban Associated Regions with a standardized coefficient of -0.616 and regions intermediate urban associated regions with a standardized coefficient of -0.618. It was concluded that there was a context effect on the random fluctuation of the socioeconomic indicators related to social determinants of health. This effect was explained by the characteristics of territorial divisions and individuals who live or work there. Context effects were better identified in the areas with smaller dimensions, which are more favourable to explain phenomena related to social determinants of health, especially in studies of societies marked by social inequalities. The composition effects were better identified in the Regions of Urban Articulation, shaped through mechanisms similar to the phenomenon under study.

Los mecanismos de nivelación en el sistema de financiación de 2009: Una propuesta de indicadores para el análisis de su eficiencia

Este trabajo analiza el funcionamiento del sistema de financiación de las Comunidades Autónomas de régimen común en España aprobado en la Ley 22/2009, desde la perspectiva específica del análisis de sus mecanismos de nivelación. Con esa finalidad,se propone una batería de indicadores de reordenación, indicadores de intensidad de la nivelación e indicadores de distorsiones de la nivelación que se aplica para la evaluación del desempeño del sistema vigente, en comparación con el aprobado en 2001, y que puede asimismo utilizarse para la evaluación de sistemas comparados. Los resultados ponen de manifiesto que el sistema aprobado en 2009 mejora el funcionamiento del sistema anterior, en la medida en que aumenta la intensidad de la nivelación y se reduce la prevalencia y la intensidad de las principales distorsiones que se detectaban en sus resultados de nivelación (reordenaciones. sobrenivelaciones y desnivelaciones).

Indicadores de Resiliência em Adolescentes Institucionalizados: o papel da vinculação aos pares, aos professores e aos funcionários da instituição

Ser resiliente implica ser capaz de adaptar positivamente a contextos de grande adversidade. Esta capacidade depende de múltiplos fatores (individuais, relacionais e contextuais) cuja mobilização se encontra dificultada entre os adolescentes cujo desenvolvimento ficou comprometido pela experiência de maus-tratos. Quando protegidos pelo acolhimento institucional, é nos pares, nos professores e nos funcionários da instituição que estes adolescentes encontram o cuidado, o suporte e o encorajamento de que necessitam, e que tanto pesa sobre o seu bem-estar. Foi, assim, objetivo deste estudo examinar o papel que a qualidade da vinculação aos pares, professores e funcionários da instituição desempenha na promoção da resiliência em adolescentes institucionalizados. Os dados foram recolhidos junto de 45 adolescentes (18 rapazes e 27 raparigas), com idades compreendidas entre os 10 e os 20 anos, em regime de acolhimento institucional prolongado. Para o efeito foram utilizados um breve questionário sociodemográfico, o Child and Youth Resilience Measure – 28 – versão para Jovens (Liebenberg, Ungar & Van de Vijver, 2012; versão portuguesa Ferreira & Nobre-Lima, 2013), o Inventory of Parent and Peer Attachment Revised (Armsden & Greenberg, 1987; versão portuguesa Figueiredo & Machado, 2008) – versão para Pares e Professores – e o Questionário de Ligação aos Professores e Funcionários (Mota & Matos, 2005). Ainda que tenham sido encontradas correlações significativas entre a resiliência e cada uma das variáveis em estudo, a percepção de vinculação aos pares e aos funcionários da instituição sobressaem como as variáveis que melhor explicam a resiliência nestes adolescentes, em particular nos rapazes. Já nas raparigas, a única variável que parece explicar a resiliência é a percepção de vinculação aos funcionários da instituição. A discussão explora estes resultados em termos do seu significado e implicações práticas. / Being resilient implies the ability to positively adapt to contexts of great adversity. This ability depends on a variety of factors (individual, relational and contextual) that are mostly non operative among the adolescents whose development was compromised by maltreatment. When protected by residential care these adolescents rest on peers, teachers and residential caregivers to find the care, support and encouragement they need to improve their sense of wellbeing. Therefore, the aim of this study was to examine how attachment to peers, teachers and residential caregivers can contribute to foster resilience in institutionalized adolescents. Data was collected from a sample of 45 adolescents (18 boys and 27 girls), aged between 10 and 20 years old, under extended placement in an institution. The PI is composed by a brief social-demographic questionnaire, the Child and Youth Resilience Measure – 28 – Youth version (Liebenberg, Ungar & Van de Vijver, 2012, Portuguese version Ferreira & Nobre- Lima, 2013), the Inventory of Parent and Peer Attachment Revised (Armsden & Greenberg, 1987; Portuguese version Figueiredo & Machado, 2008) – Peers and Teacher’s version – and the Questionnaire of the Affective Relationship with Teachers and Employees (Mota & Matos, 2005). Although findings showed significant correlations between resilience and each one of the variables in study, the perception of attachment to peers and residential caregivers stood out as the most correlated variables to resilience among these adolescents, mainly among the boys. Conversely, the only variable that seems to explain resilience among girls is the perception of attachment to residential caregivers. The discussion explores the possible meaning and practical implications of these findings.

Entendiendo el uso y resultados del indicador años de vida ajustados por discapacidad

Este artículo pretende mostrar el alcance y las limitaciones del indicador “Años de vida ajustados por discapacidad” (AVAD) pero no desde la perspectiva técnica que sustenta la validez y generalidad del indicador, sino desde el punto de vista de la atención y entendimiento de quienes usan este indicador para tomar decisiones. Este artículo se compone de tres secciones: en la primera revisaremos los conceptos teóricos que utilizaremos. En la segunda parte señalamos tres puntos: qué tipo de indicador son los AVAD, cómo sus atraen a audiencias no expertas y qué tan entendibles son los resultados que arroja este indicador para las audiencias no expertas. En las conclusiones, nos enfocamos a recomendar el uso de este indicador a las audiencias no expertas cuando éstas entienden el trasfondo de lo que los AVAD están midiendo.

Capital intelectual y resultados organizativos: análisis en un conjunto de empresas del eje cafetero Colombiano

La presente investigación busca establecer el efecto del capital intelectual en los resultados de un conjunto de empresas del Eje Cafetero Colombiano, para lo cual se recurrió a diversos análisis bivariados, multivariados y de tipo exploratorio descriptivo, entre los cuales cabe mencionar el modelo clasificatorio o clúster, las correlaciones de Pearson y el análisis de componentes principales. Tras el procesamiento de los datos desde el punto de vista estadístico se puede afirmar que solo un reducido número de variables del capital intelectual tiene positivos y significativos efectos en los resultados organizativos. Adicionalmente, las comparaciones entre mejores empresas muestran que las que en su mayoría presentan altos indicadores de capital intelectual están entre la mayoría de las que alcanzan resultados sobresalientes, de lo cual se infiere una relación positiva que conviene indagarse en futuros estudios con más cantidad de sujetos, observaciones y homogeneidad entre ellos.

Variables asociadas al desempeño de la gestión orientada a resultados en la producción del servicio educativo

En los últimos veintitrés años, se ha logrado establecer una tendencia de crecimiento sostenido del presupuesto asignado en educación, lo cual se acentuado aún más en los últimos trece años. Adicionalmente al incremento presupuestal, a partir del año 2004, según datos del Minedu (2013), el número de alumnos matriculados en el sistema educativo ha disminuido en más de un millón. La disminución de matriculados, junto con el incremento presupuestal, han permitido mejorar los niveles de inversión por alumno matriculado de S/. 764 en el año 2000 a S/. 2432 en el año 2012. Sin embargo, en la evaluación censal de rendimiento escolar de 2013 –aplicada por el Ministerio de Educación–, solo el 33,0% de los estudiantes a nivel nacional alcanzó el nivel satisfactorio de aprendizaje en comprensión lectora, mientras que el 16,8% lo hizo en matemática. Estas cifras evidencian un avance tímido en relación con los resultados de la ECE 2012, que se reflejan en la mejora en 2,1 y 4,1 puntos porcentuales en comprensión lectora y en matemática respectivamente. Estos resultados –pese a que son positivos– están todavía lejos de alcanzar el logro esperado. De mantener esta tendencia, se requerirán varias decenas de años para llegar al 100% deseado. El incremento presupuestal descrito ha permitido que los tres niveles de gobierno cuenten con una magnitud de recursos sin precedentes, pero con limitaciones de gestión pública que impiden, en principio, gastar; y, luego, gastar adecuadamente. El presente trabajo de investigación propone, por un lado, las principales variables que se deben considerar para que el desempeño de la gestión de las instituciones responsables de la Educación Básica Regular en el nivel subnacional estén orientada a resultados; y, por otro, especificar las subvariables que estas requieren para poderse operativizar. El conocer y entender dichas las variables y subvariables permitirá, más adelante, precisar los indicadores necesarios para medir el desempeño de la gestión. De este modo, será posible que el sector Educación y las instancias relacionadas de los tres niveles de gobierno (bajo el proceso de descentralización y las funciones transferidas a los niveles sub-nacionales) dispongan de elementos específicos sobre los cuales puedan tomar decisiones y articular acciones operativas concretas para mejorar y acelerar los logros de aprendizaje en los niños y niñas.

Uso de indicadores bioquímicos na qualidade fisiológica de sementes florestais

The scientific research in seed technology is based on techniques that aim the reduction of costs and time, standardization, improvement and establishment of analytical methods while maintaining a high level of reliability of the results. This study sought to elucidate the reliability of electrical conductivity and pH of the exudate compared to the classic germination test, which was developed in two separate studies, however interrelated with each other, as to their final goals. The experimental material of this study consisted of seeds of the species Aspidosperma parvifolium (guatambu), Aspidosperma polyneuron (peroba-rosa), Cabralea canjerana (canjerana), Cariniana legalis (jequitibá), Gallesia integrifolia (pau-d'alho), Handroanthus chrysotrichus (ipê-amarelo), Lonchocarpus campestris (rabo-de-bugio) and Pterogyne nitens (amendoim-do-campo). The physiological quality of the studied seed species was evaluated through the electrical conductivity and pH test of the exudate by mass and individual methods being compared and correlated with the results obtained in the germination test. In addition to the tested methods, imbibition periods of the seeds were evaluated for conductivity and pH, which corresponded to 2, 4, 6, 8, 24 and 48 hours. The electrical conductivity test was efficient in both of the used methods to evaluate the physiological quality of the studied seed species when compared to the standard germination test. The pH test of the exudate applied by the individual method was more efficient and thorough to evaluate the physiological quality of the studied seed species, than the mass method. For the species Gallesia integrifolia, Cariniana legalis and Lonchocarpus campestris the pH tests of the exudate tests were not efficient due to poor or absent correlation between germination and pH.

Influência das etapas do processo de abate de suínos na prevalência de patógenos e níveis de microrganismos indicadores de qualidade e higiene

The pig slaughter process involve different steps that can influence the microbiological quality of carcasses. At this, the understanding of the slaughter process on the microbiological aspects is necessary for the implementation and evaluation of critical control points. The microbiological control of the slaughter process should involve the evaluation of pathogens prevalence and levels of quality and hygiene indicator microorganisms. This study aimed at investigating the influence of steps slaughter process on the microbiological levels of pig carcasses, and evaluate if there is correlation between pathogens (Salmonella spp. and Listeria monocytogenes) and indicators (aerobic mesophilic counts, total coliforms, Escherichia coli and Enterobacteriaceae) microorganisms. A high Salmonella soroprevalence in pigs were founded before the slaughter (57.49 %). While the Salmonella prevalence in carcasses at the initial stage of the slaughter was 26.67 % and in the final stage 1.11 %, L. monocytogenes was detected only in the final washing and cooling steps, with a prevalence of 21.11 and 8.89 %, respectively. The aerobic mesophilic counts, Enterobacteriaceae, total coliforms and E. coli levels in initial steps of slaughter process were 4.25 ± 0.37; 1.25 ± 0.38; 1.10 ± 0.35 and 0.86 ± 0.36, respectively. At the end of slaughter process the results were lower (ranging from 0.16 at 2.70 log CFU/cm2). The step that most reduced microbiological levels was the scalding. The dehairing was a critical step that led to a significant increase of microorganisms levels in the process (p < 0.05). The evisceration not proved to be a critical step on the increase of microbial levels, differently of the final washing, which showed significant increases (p < 0.05) over the levels of aerobic counts, total coliforms, E. coli and enterobacterias (0.30; 0.36; 0.27 and 0.42 log respectively) and Salmonella spp. and L. monocytogenes. The chilling contributes significantly to the reduction of microbiological levels of carcasses, bringing them to levels below the all process stages, with the exception of scalding. No correlation between the hygiene indicator microorganisms used and presence of Salmonella spp. and L. monocytogenes were obtained (p < 0.05). The results show that steps in the process are critical to the sanitary profile, which implies the need to implement actions in the process to reducing the microbiological levels.

Higiene da mãos: novas estratégias diferentes resultados?

A higiene das mãos é uma das medidas mais simples e efectiva na redução das infecções associadas aos cuidados de saúde. (Direcção Geral da Saúde, circular normativa nº 13/DQS/DSD – Orientação de Boa Prática para a Higiene das Mãos nas Unidades de Saúde). O Hospital Fernando Fonseca E.P.E. (HFF) aderiu à campanha de Nacional de Higiene das Mãos e passados cinco anos a avaliação do HFF, de acordo com a escala da Direcção Geral da Saúde é de muito satisfatório. Mas será que podemos melhorar de maneira a conseguirmos aumentar a taxa de adesão à higiene das mãos pelos profissionais de saúde? No Serviço de Cardiologia (Enfermaria e UCI) verifica-se que a taxa de adesão dos profissionais é menor antes do contacto com o doente. Apesar da existência de Solução Anti-séptica de Base Alcoólica no serviço, de cartazes alusivos e de formação periódica, que estratégias poderão mais ser implementadas para melhorar a adesão dos profissionais de saúde? No início de Março foi distribuído pelo serviço (unidades dos doentes e outros locais) pequenos cartazes (stoppers) a relembrar os profissionais de saúde para a higiene das mãos. A eficácia desta estratégia vai ser analisada através de alguns indicadores preconizados pela OMS. Daremos destaque ao consumo de SABA, comparando o seu consumo neste mês com os anteriores e, a taxa de adesão à higienização das mãos, através da observação- informação. A análise preliminar revela-nos um aumento do consumo de SABA o que nos poderá sugerir o sucesso da colocação de stoppers em locais estratégicos do serviço. Os resultados que daqui surgirem serão alvo de análise e discussão entre os profissionais de saúde de forma a envolver a equipa multidisciplinar na adopção de novas estratégias que visem uma melhor adesão à higiene das mãos. Reconhecemos que a eficácia desta medida é de curta duração pelo que de futuro visamos a implementação de outras medidas que melhorem igualmente a taxa de adesão dos profissionais à higiene das mãos. Bibliografia Direcção Geral da Saúde, circular normativa nº 13/DQS/DSD – Orientação de Boa Prática para a Higiene das Mãos nas Unidades de Saúde; Direcção Geral da Saúde – Departamento da Qualidade na Saúde - Orientação de Boa Prática para a Higiene das Mãos nas Unidades de Saúde, Lisboa, Junho de 2010;