Avaliação do programa de atenção à saúde do trabalhador: uma abordagem da atenção primária

The accelerated industrialization, coming with the Industrial Revolution, caused profound changes in the working world. These changes led to the households risks from work environment. Trying to assist comprehensively the health of workers, Brazil has a program of Health Care Workers in the Primary Care, and the Family Health Strategy is the main entrance for this system. The study sought to determine if the actions of the health care worker have been developed in primary care through the Family Health Strategy. This is a quantitative study with a methodological evaluation, focusing on normative assessment. The sample was formed by professionals from Team Family Health Strategy, in the municipalities of Pau dos Ferros, Caicó and Natal in Rio Grande do Norte state. The sample consists of 202 professionals (Doctors, Nurses, Assistant / Technician Nursing and Community Health Workers) in 52 Health Family Units from the 3 municipalities cited. The instrument used consists of a checklist, from Manual of Primary Care 5 - Family Health - Occupational Health, Ministry of Health. The data were analyzed describing the variables by its frequency and doing a classification of cities from the scores obtained by each. It was observed that the Family Health professionals know the program of health care worker, however do not know the Manual of Primary Care 5, which is a guidance tool. As a result of non-appropriation of the FHT professionals with worker health, these activities are not performed, mainly surveillance in occupational health and health education labor

Caracterização física e sensorial do café produzido nas condições topoclimáticas de Jesuitas, Paraná

Climatic variations influence formation and maturation of coffee grains by altering their intrinsic characteristics, which call allow for several types of coffee qualities, including the potential for production of special coffee. This study was carried out to verify the effect of environmental conditions and crop cultivation on chemical composition and their consequences in cup quality of coffees from region of Jesuitas, Parana State. During the same crop season this study was accomplished (2002-2003), cup quality was evaluated among the producers in several coffee-growing municipalities in Parana State. It was observed that 86% of samples were classified simply as "soft" (smooth flavor) or "hard" (bolder flavor), and 14% were classified as rioysh/rio (strong unpleasant taste). The results concluded that the practices adopted by producers, who have collaborated with the study, reflected positively oil the final cup quality, when compared to the overall quality results in the State. The climatic conditions and practices of crop management and harvest ill the Jesuitas region made for bolder coffee with low acidity, comparable to high quality coffees produced in Brazil and abroad.

Fatores socioeconômicos contextuais associados à condição bucal de adolescentes no Brasil

Many surveys are conducted comparing oral health conditions with individual variables, such as socioeconomic and demographic factors. However, in the same way that individuals differ among themselves, the groups also have their own characteristics and the effects of this differentiation must be researched. Brazil, despite being one of the major economic powers of the world and shows an improvement in the average value of its health indicators, is also one of the most unequal and remains among the countries with the greatest health inequities. The purpose of this study was to investigate the importance of social determinants on the contextual level oral health among Brazilian adolescents, population not much researched by the literature. The research was made using an ecological approach in order to identify possible inequalities between cities and capitals. Using data from SBBrasil 2010 it was evaluated less common outcomes (loss of first molar, dental care index and T-Health) which provide information on the degree of morbidity of caries and health level of dental tissues, in addition to analyze the related services. The association of these oral health indicators with socioeconomic factors such as income, employment, education and inequality, collected from Census 2010, was analyzed by simple and multiple linear regressions. The study included the 27 state capitals and four clusters representing the municipalities of the country. It was possible to see better access to services in locations with better income distribution. However, the strong association of contextual factors related to poverty, low levels of education and poor housing and jobs with poorer levels of oral health in adolescents seems to overshadow the effects of income inequalities on dental caries in the country. In some locations, particularly within the North and Northeast, whichever one keeps dentistry mutilating, whose effects are already noticeable in its adolescent population. Access to restorative services in Brazil remains limited and unequal. The results of this study highlight the inequities in oral health in the country and show the need of the inclusion of new perspectives on the traditional approach of Preventive Dentistry and education models in Dentistry. Tackling health inequalities in oral health in the country requires the cooperation of various actors involved in the process and the inclusion of oral health in the context of overall health. The social determinants approach, as well as evaluating the distribution of oral diseases in the country and its inclusion in the context of overall health, should guide the implementation of programs and oral health practices in order to contribute to the reduction of inequalities

Perfil de mortalidade de idosos no Rio Grande do Norte: estudo comparativo entre duas faixas etárias e fatores relacionados

Measures of mortality represent one of the most important indicators of health conditions. For comprising the larger rate of deaths, the study of mortality in the elderly population is regarded as essential to understand the health situation. In this sense, the present study aims to analyze the mortality profile of the population from 60 to 69 (young elders) and older than 80 years old (oldest old) in the Rio Grande do Norte state (Brazil) in the period 2001 to 2011, and to identify the association with contextual factors and variables about the quality of the Mortality Information System (SIM). For this purpose, Mortality Proportional (MP) was calculated for the state and Specific Mortality Rate by Age (CMId) , according to chapters of ICD- 10, to the municipalities of Rio Grande do Norte , through data from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IGBE). In order to identify groups of municipalities with similar mortality profiles, Nonhierarchical Clustering K-means method was applied and the Factor Analysis by the Principal Components Analysis was resort to reduce contextual variables. The spatial distribution of these groups and the factors were visualized using the Spatial Analysis Areas technique. During the period investigated, 21,813 younger elders deaths were recorded , with a predominance of deaths from circulatory diseases (32.75%) and neoplasms (22.9 %) . Among the oldest old, 50,637 deaths were observed, which 35.26% occurred because of cardiovascular diseases and 17.27% of ill-defined causes. Clustering Analysis produced three clusters to the two age groups and Factor Analysis reduced the contextual variables into three factors, also the sum of the factor scores was considered. Among the younger elders, the groups are called misinformation profile, development profile and development paradox, which showed a statistically significant association with education and poverty and extreme poverty factors, factorial sum and the variable related to underreporting of deaths. Misinformation profile remained in the oldest old group, accompanied by the epidemiological transition profile and the epidemiological paradox, that were statistically associated with the development and health factor, as well as with the variables that indicate the SIM quality: proportion of blank fields about the schooling and underreporting. It proposed that the mortality profiles of the younger elders and oldest old differ on the importance of the basic causes and that are influenced by different contextual aspects , observing that 60 to 69 years group is more affected by such aspects. Health inequalities can be reduced by measures aimed to improve levels of education and poverty, especially in younger elders, and by optimizing the use of health services, which is more associated to the oldest old health situation. Furthermore, it is important to improve the quality of information for the two age groups

A produção das desigualdades: análise da relação entre trabalho infantil e indicadores sociais

The International Labor Organization (OIT) estimates that there are around 118 million children subjected to child labor around the world. In Brazil, there are 3.5 million workers aged between 5 and 17. This exploitation practice constitutes a serious social problem, including of Public Health, since these workers are exposed to a wide range of risks, such as those related to health, physical integrity and even to life, which may cause them to become sick adults and/or interrupt their lives prematurely. Therefore, this research aims to investigate the relationship between the frequency of child labor in the age group of 10 to 13 years and some socio-economic indicators. It is a quantitative research in an ecological study whose levels of analysis are the Brazilian municipalities grouped in 161 regions, defined from socioeconomic criteria. The dependent variable of this study was the prevalence of child labor in the age group of 10 to 13 years. The independent variables were selected after a correlation between the 2010 Census of child labor in the age group of 10 to 13 years and secondary data had been conducted, adopting two main independent variables: funds from the Family Allowance Program (PBF) per 1,000 inhabitants and Funds from the Child Labor Eradication Program (PETI) per a thousand inhabitants. Initially, it was conducted a descriptive analysis of the variables of the study, then, a bivariate analysis, and the correlation matrix was built. At last, the Multiple Linear Regression stratified analysis was performed. The results of this survey indicate that public policies , like the Bolsa Familia Program Features per 1000 inhabitants and Resources Program for the Eradication of Child Labour to be allocated to municipalities with HDI < 0.697 represent a decrease in the rate of child labor ; These programs have the resources to be invested in municipalities with HDI > = 0.697 have no effect on the rate of child labor. Other adjustment variables showed significance, among these the municipal Human Development Index (IDH), years of schooling at 18 years of age, illiteracy at 15 years of age or more, employees without employment contract at 18 years of age and the Gini Index. It is understood that the child labor issue is complex. The problem is associated, although not restricted to, poverty, the social exclusion and inequality that exist in Brazil, but other factors of cultural and economic nature, as well as of organization of production, also account for its aggravation. Fighting child labor involves a wide intersectoral articulation, shared and integrated with several public policies, among them health, sports, culture, agriculture, labor and human rights, with a view to guaranteeing the integrality of the rights of children and adolescents in situation of labor and of their respective families

Cooperação técnica internacional: aportes teóricos

Induzidos por uma mudança estrutural na dinâmica da sociedade internacional, muitos municípios, por meio do exercício da chamada paradiplomacia ou diplomacia federativa, vêm elaborando instrumentos de gestão municipal para captar recursos via experiências de Cooperação Técnica Internacional (CTI). Nesse contexto, o objetivo deste artigo é mapear conceitualmente o fenômeno de CTI, visando a facilitar sua compreensão e suas consequências práticas para a sociedade brasileira.

Interfaces cultural, política e organizacional do projeto caminhos do frio rota cultural no contexto da regionalização do turismo no brejo paraibano

This study is the analysis of cultural, political and organizational interfaces of "Caminhos do Frio Rota Cultural" Project in the context of tourism regionalization in Brejo Paraibano and it presents the characterization, routing and inventory of six municipalities of the Project, as well as the identification of cultural elements used for tourist in the routing of the pond, the investigation of political and organizational articulation and the verification of participation of each producing agent in the development of tourism resulting from the swamp of Paraiba. This is a qualitative descriptive and exploratory study, which makes use of the interpretive paradigm to perform an analysis of the environment where occurs the regionalization of tourism in Brejo of Paraíba and the social actors involved in this process in order to pursue development of the region through culture and tourism, with the collection spot in the six counties of the Project participants collected through interviews with managers, community, government agencies and tourist trade, and the use of the technique of direct observation. This time, with the data analysis it was possible to establish the production situation and its cultural and tourist development in the region of Brejo (PB), where culture has become a developmental tool within the tourism industry due to its innovation potential. It was possible to ratify the undisputed vocation of cultural tourism in the region in question, since other projects being developed with the use of cultural resources with a strong influence on the policies of regional tourism. Thus, the main result was that was seen is that the regional development has triggered a refunctionalisation / reappropriation of space just rebuilding a new territorial organization through the development of a regional autonomy of management, a capacity of collective ownership and the use of economic surplus, a spontaneous process of social inclusion as well as awareness and mobilization tourist (even if initial and shy), an appreciation of natural and cultural assets for all stakeholders and especially identification of the population with its region and its culture, as to achieve regional development is not enough to increase the economic, but above all the promotion of endogenous social factors such as changes in social and cultural values and the integration of social actors in this process. Finally, taking into account the definitions of sustainability, it is considered that cannot be said that the development model seen in the swamp of Paraiba is sustainable, but it is a model of regional development based on the unique characteristics that each municipality has and create a regional identity and have correponded expectations / desired results and therefore the viability of the region through the development of cultural tourism was proven

Lazer e urbanização: a dinâmica do setor de serviços no litoral de Parnamirim e Nísia Floresta - RN

The research here undertaken analyzes the process of urbanization on the coast of Panamirim - RN and Nísia Floresta - RN, arising from leisure, the main leisure expression was considered the second residence and coastal tourism. The leisure promoted the growth of businesses and public and private services to meet consumer demand in that area, which initially occurred with users of second home, and which also gradually begin to occupy the coastline of these municipalities in 1980 and more recently with the development of tourism in the 1990s until now. To undertake such an analysis, we did the georeferencing about the trade and also public and private services of that coast, characterizing them; evaluated the extent to which services deployed in this area meets the demands of tourists and users of second residence; it was also identified how the centrality of Natal interferes in the expansion of services in these locations. The spatial area of research includes the coastal municipalities of Parnamirim and Nísia Floresta, considering the limits of the census of the Instituto Brasileiro de Geografia e Estatística- IBGE, and about the time frame, it was considered the 1990s to the present day. The methodology consists of: 1. survey and reading of the literature related to the researched topic, serving as the theoretical analysis in the construction of the object studied; 2. collection and organization of secondary data by the IBGE and tourism sectors of the State of Rio Grande do Norte, Natal and main municipalities of the research; 3. Questionnaires and / or interviews with the traders, service providers, tourists, users of second homes, local residents, and government. The analysis of such data collected allowed the preparation of graphs, maps and tables that illustrate the results obtained in the research field, basing so the study. The relevance of the study is shown by the extensive survey data involving agents of the research, including tourists, users of second homes and, above all, the data for the service sector that did not exist in the analyzed area. The study results identified in the area analyzed the emergence of three new centers, arising from the urbanization process from leisure, one of them located in the municipality of Nísia Foresta Beach in Barra de Tabatinga, and two in Parnamirim, more specifically in locality Pium and Beach Pirangi do Norte. It was further observed that, being located in tourist areas, the main feature of these new centers is seasonality

Determinantes de competitividade de destinos turísticos aplicados aos roteiros regionais: uma avaliação do roteiro Seridó/RN

The tourism industry is gaining representation by move and stimulate the economy, especially by allowing the generation of employment and income, thus allowing growth opportunities for localities where tourism develops. Therefore, the present study entitled determinants of competitiveness of tourist destinations applied to regional routes: an evaluation of the Route of Seridó/RN, discusses the issue of competitiveness in tourism and tries to understand the scenery of this Route. The main objective of the study is to assess the conditions of competitiveness in the Route of Seridó/RN according to benchmarks and global determinants of competitiveness for tourist destinations. The study has also as specifics objectives: define dimensions of the reference model for use in evaluating the competitiveness of the Route of Seridó/RN; identify levels of governance and competitiveness in the municipalities that make up the sample set above the Route, and analyze to what extent the competitiveness of the Route correspond to the global reference of competitiveness of tourism destinations. Regarding the methodology, it is a search for an exploratory- descriptive and used a combination of quantitative and qualitative research method as expected and required in the implementation of the evaluation tool called Compet&enible Model. For data collection, it has been taken technical visits and also analysis of documents and materials. Data analysis was based on the records and documents and the use of simple descriptive statistics for the scores of the elements offered by Compet&enible Model. The results allowed us to know the real conditions of competitiveness of the Seridó/RN Route forward to the attributes of tourist destinations for global competitiveness: the dimension I, Governance, reached 17 points, classified as "in structuring" and dimension II, Competitiveness, reached 10 points, ranking "weak". These results highlight the need for greater involvement of the actors in the supply chain of tourism in Polo Seridó/RN for the actions, programs and projects are put into practice. It is expected that tourism is considered an important activity for the local and global development, serving as a reference for the future management of Seridó/RN Route, guiding new policy guidelines, planning and organization to better competitiveness

Complicações da terapia anticoagulante com warfarina em pacientes com doença vascular periférica: estudo coorte prospectivo

OBJETIVO: Estudar prospectivamente a freqüência de complicações em pacientes tratados com warfarina e acompanhados no Ambulatório de Anticoagulação da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista. MÉTODOS: Pacientes sorteados entre os agendados para consulta de junho de 2002 a fevereiro de 2004. Na primeira consulta, foi preenchida ficha com dados de identificação e clínicos. A cada retorno, ou quando o paciente procurou o hospital por intercorrência, foi preenchida ficha com a razão normatizada internacional, existência e tipo de intercorrência e condições de uso dos antagonistas da vitamina K. RESULTADOS: Foram acompanhados 136 pacientes (61 homens e 75 mulheres), 99 com tromboembolismo venoso e 37 com doença arterial; 59 pacientes eram de Botucatu, e 77, de outros municípios. Foram registradas 30 intercorrências: nove não relacionadas ao uso da warfarina e 21 complicações hemorrágicas (38,8 por 100 pacientes/ano). Uma hematêmese foi considerada grave (1,9 por 100 pacientes/ano). As demais foram consideradas moderadas ou leves. Não houve óbitos, hemorragia intracraniana ou necrose cutânea. A única associação significante foi da freqüência de hemorragia com nível médio de razão normatizada internacional. CONCLUSÃO: Nossos resultados mostram a viabilidade desse tratamento em pacientes vasculares em nosso meio, mesmo em população de baixo nível socioeconômico, quando tratados em ambulatório especializado.

Panorama dos resíduos sólidos urbanos nos municípios de pequeno porte do Brasil

The panorama of Urban Solid Waste (USW) in Brazil, in general lacks information, given the immensity of the country. However, it is from available data that the public executives should define the USW management. To contribute to the choice of a model for the management of USW in small municipalities, this study reviews the related literature, showing an overview of the final disposal of USW in small municipalities. Several data and researches are discussed, concluding that the available data, despite being provided by the public managers, who often attenuate the problem, should be considered for the proposition of policies to encourage the waste treatment

Doenças de Veiculação Hídrica em Trechos da Bacia do Rio Piranhas-Assu: ocorrência de bactérias oportunistas, caracterização epidemiológica e concepções de professores e agentes de saúde

Water is essential to life and all living organisms and their supply is necessary for economic development and quality of life of human populations, but their quality has been altered by human actions. In semi-arid northeast, the water is an issue of concern, especially its quality. This region is common to the construction of reservoirs that capture rain water, streams and temporary rivers in search of ease this situation, being intended for various purposes. Water scarcity is a limiting factor for the economic and social development of the region and contributes to the maintenance of waterborne diseases. About 80% of diseases that occur in developing countries are infected by waterborne pathogens. Therefore, this study aimed to determine in two environments that are part of semilênticos Armando Ribeiro Gonçalves reservoir, and a stretch of the river Assu, all located in the semiarid RN, the occurrence of opportunistic pathogenic bacteria; check the conceptions of teachers and health workers about the issues "waterborne diseases" and "bacteria" and a diagnosis of diarrheal diseases that affect the population in some municipalities of the semi-arid region of RN from a survey of epidemiological data. For identification of bacteria using commercial kits and the diagnosis of diarrheal disease was based on information from databases. The previous conceptions of teachers and health workers were obtained through questionnaires. The results confirmed the presence of opportunistic bacteria in the studied area, showing the importance of monitoring water quality. There was an under-reporting of cases of diarrhea pointing out flaws in the monitoring of Diarrheal Diseases and indicating the need to improve it. It was felt also the need to implement educational activities on topics dealt with both with teachers and health workers, since they were identified misconceptions on the subject

Desenvolvimento territorial no Rio Grande do Norte: uma identificação de clusters rurais

The general objective of this study is the identification of rural spaces in Rio Grande do Norte through a territorial approach. It looks if there is spatial correlations between municipalities that influence and are influenced by the rural environment, allowing the identification of clusters. To accomplish this objective it`s used, in the methodology, the factor analysis of principal components to achieve the indicators of rurality and territorial development, that deal with four dimensions of analysis: environmental, political-institutional, economical and spatial. Moreover, to identify the spatial correlations structure between municipalities it used the Moran index to both rurality and territorial development, leading to clustering identification. The results show that the rurality is present in most of Rio Grande do Norte municipalities, except in cases like Mossoró, Pau dos Ferros, Caicó and Natal, where can be regional dynamic poles. It is also verified that the more rural municipalities tend to be less developed, according to the territorial development index, and have less correlations with neighboring municipalities

Análise de uso e cobertura do solo no município de Parelhas/RN

The human interference in the semiarid region of Seridó Potiguar has promoted the increase of degraded areas. The economic dynamic that was established in the Seridó territory, especially after the fall of the trinomial cattle-cotton-mining in the 70s and 80s of the 20th century as pillars of the regional economy, resulted in an accelerated process of erosion of natural resources. The municipalities of the Seridó region have been spatially reordered by this new economic dynamic, marked by the growth of existing enterprises, and the development of new agricultural practices. One of the municipalities in the region that restructured its territorial space with the emergence of new agro-industrial activities was the town of Parelhas. With the demise of the trinomial cattle-cotton-mining in the 1980s, other productive activities were intensified from the 1990s, amongst them, pottery, responsible for the vegetal extraction for use as energy source. This recent economic and spatial restructuring in the region, reflected in the Parelhense municipal territory, required new productive ingredients responsible for the modification of past production relations that were based on cattle, cotton and mining. By that a process of exploring the environment was unleashed, especially the native vegetation, in an uncontrolled manner. In this context, the objective of this study was to survey and detect deforestation in the areas of Caatinga vegetation, used indiscriminately as energy supply for new agricultural practices, using remote sensing techniques based on the quantification of the Normalized Difference Vegetation Index / NDVI, Soil-Adjusted Vegetation Index / SAVI, surface temperature and rainfall data in the years 1990 and 2010. The results indicated that SAVI values above 0.2 in 1990 and 2010 represent the areas with the highest density of vegetation that occur exclusively along the major drainages in the town and areas of higher elevations. The areas between the ranges of values from 0.5 to 0.15 SAVI are areas with poor vegetation. On the other hand the highest values of temperature are distributed in the western and southeastern parts of the township, usually in places where the soil is exposed or there is sparse vegetation. The areas of bare soil decreased in extension in 2010 at 11, 6% when related to 1990, this was caused by a higher rainfall intensity in the first half of 2010, but no regeneration of vegetation occurred in some places in the western and southeastern areas of the municipality today, due to the extraction of firewood to fuel the furnaces of industries in town

Acquired immunodeficiency syndrome in Brazil

Aim. To describe the acquired immunodeficiency syndrome (AIDS) epidemic in Brazil and analyze the impact of federal government measures addressing the problem since its onset.Method. Retrospective review of AIDS epidemic data from its onset in 1980 up to the last published data in June 2001.Results. AIDS was first reported in Brazil in 1980. By 1988, all 27 Brazilian states had diagnosed cases, and until June 2000 more than half of Brazilian municipalities had recorded at least one case of the disease. The AIDS incidence reached its peak between 1996 and 1997 (14.7 per 100,000 population), and then declined between 1998 and 2000 to 9 per 100,000 population. In the last two decades, the proportion of deaths has been also significantly reduced. These were not random events, but reflected the efficiency of the program implemented by the Brazilian Health Ministry's Coordination on Sexually Transmitted Diseases and AIDS. The program includes an epidemiological surveillance modeling system, which records cases from several regular epidemiological bulletins; national network of diagnosis and monitoring of HIV-infected individuals (ill or not); highly active antiretroviral therapy available free to all patients; mother-infant protection program; educational programs on condom use; the introduction of the female condom; development of AIDS studies in different areas to provide practical solutions; constant preoccupation about drug costs accounting for the patent breaking; and national production of many drugs currently in use.Conclusion. Well-planned and implemented national program against AIDS can significantly reduce the burden of this disease to the population.