955 resultados para Saude publica - Administração
Resumo:
This study has as general object: to verify as the health professionals that work in different hospitals evaluate the hospital services; and specific objectives: identify how health professionals evaluate the work conditions in different hospitals and verify the central nucleus and the peripheral elements of the social representations elaborated by these professionals about these institution. This is a descriptive study realized in Natal, capital of Rio Grande do Norte. Were collected 213 questionnaires. Concerning the evaluation of the health services, high averages had been verified in the philanthropic hospital, for example, quality of the customer service. At the state hospital was observed lowest ones: respect to the privacy of the patients. Similar results were found about work conditions. It was observed as central nucleus the categories Overcrowded and Humanized care, in the state and philanthropic hospital respectively, and as peripheral elements Low wages and Overcrowded. Being thus the conflicts in this scene are inevitable because of the poor structure of some public hospitals, however, these problems can be foresee and solvable if the hospital has a free expression channel accessible to all agents. The evaluation has to become integrant part of the culture of the organization, a time that this will guide the steps in direction to the best quality in the hospital assistance
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Objectives: The purpose of the current study was to diagnose military police officers in Natal, Brazil as to the level and phase of stress in which they find themselves and the prevalent symptomatology (physical or mental). Methodology: Descriptive, crosscut study that investigated a sample of 264 individuals taken from a population of 3,193 military police officers of the Capital Police Command (CPC) in Natal, Brazil. The data were collected using the Lipp Stress Symptoms for Adults Inventory LSSI, and analyzed by tabulations, percentage calculations, t-test for proportions and Pearson s chi-squared test for associations between stress, symptomatology and military rank. Data collection was between June/2004 and January/2005. Results: It was found that 52.6% of the officers had symptoms of stress and 47.4% symptomatology of stress. This was distributed across all ranks, especially mid and upper-level officers as well as corporals and privates, with predominance in the resistance phase (36%) and a prevalence of psychological symptoms (76%). The only variable investigated that was related to stress was gender (P = 0.0337). Conclusions: It was concluded that there is stress among all ranks of military police officers in Natal, Brazil, especially mid and upper-level officers, corporals and privates, with a prevalence of psychological symptoms, low levels of physical symptoms and predominance in the resistance phase. It seems that stress levels do not differ significantly from those found in Brazilian men and women and do not indicate a situation of chronic fatigue
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Trypanosoma cruzi infection was evaluated in 390 resident individuals in different rural communities of Caicó municipality, State of Rio Grande do Norte (RN). Of 28 investigated communities the soroprevalence of T. cruzi infection was 2.8% in eight rural communities individuals. The epidemiological characteristics of seropositive shown that the age ranged from 22 to 64 years, being significantly raised from 31 years (90.9%). The female gender was predominant and low education degree. Those individuals reported that they never donated blood, but they had direct contact with triatomines bug. The isolation of the parasite was performed by blood culture and xenoculture methods to determine the genetic variability of the samples. Twenty seven T. cruzi isolates were analyzed by RAPD as genetic marker using three random primers (M13-40, gt11-F and L15996). The T. cruzi isolates showed 73.7% of shared bands considering the average obtained with the three primers, and were genetically well correlated. Using this marker it was possible to separate the populations of the parasite in three distinct groups. The first group composed by isolates obtained of triatomines and humans from four different districts (Caicó, Caraúbas, Serra Negra doNorte and Governador Dix-Sept Rosado); the second contained isolates obtained of triatomines of two different species (T. brasiliensis and P. lutzi) captured in Caraúbas and Serra Negra do Norte. The third grouped isolates obtained from humans of Angicos and Caicó municipalities. In different localities of distinct mesoregions, State of RN, a profile genetic well correlated was identified among all isolates and the presence of three distinct groups of the parasite circulating among vertebrate and invertebrate hosts
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The present study had the objective to identify to the Social Representations of the professionals of medicine and nursing superior level of the Program Health of the Family concerning the assistance for the gestation. The research was qualitative under the optics of the Theory of the Social Representations of Serge Moscovici, of the Central Nucleus of Jean-Claude Abric and of the Analysis of Content of Laurence Bardin. We worked with the following instruments for the collection of data: Questionnaires, with social-demographic data; Free association of Words, with the inductive terms Pregnancy, Assistance for Gestation and Care; Production of mental image and half-structuralized Interview, with the following question: What does the assistance for the gestation represent for you? . We interviewed all the professionals of nursing and medicine of the Program Health of the Family in the city of Santa Cruz /RN (ten for each profession) in the period of February and March of 2007. From the analysis of the social-demographics data, we respectively identified the following percentages for nursing and medicine: the feminine sex for nursing predominated (90%); the age between 24 and 33 (70 and 60%); the religion catholic (80 and 50%) and 50% of the two groups has up to two years of formation and work in the score of the research. The analysis of the others instruments resulted in two categories: Institutionalized vision and Vision of the Common-sense. In the free association of words, the category institutionalized vision is configured as Central Nucleus and of the common sense one as nucleus Peripheral, demonstrating that the Social Representations of the assistance for the gestation attendance are in the universes consensual. In the mental images, we identified to this same construction. In the content of the interviews, the institutionalized vision is permeated by the responsibility of making and the availability of having - assistance for the gestation is recommended by the Health department and necessary genders - while the vision of the common-sense can be represented by the category sort, whose role of professionals of the assistance for the gestation is to strengthen the responsibility for the woman of a maternity socially constructed. In short, the analyzed speeches reflect that, to the knowledge acquired in the academy, are incorporated in the knowledge of the daily professional, and conducted by popular myths. Medicine and nursing recognize the importance of the attendance in such a way for the chance to educate the women for the maternity as for the possibility to prevent complications, but in its speeches they had excluded from this process the masculine figure. We conclude that the meaning of the inductive term take care, part of the common-sense and is incorporated the institutionalized speech to humanize the assistance. However, the pregnancy ceases from being seen in its natural biological direction and starts to be analyzed as a moment of fragility and predisposition the illnesses. Finally, the social nursing and the central nucleus representations for the assistance in gestation for medicine is anchored in the speeches institutionalized and of the common-sense, reflecting the concern in establishing a humanized assistance with quality
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This study is an analysis of opportunities and challenges of health assistance migration from hospitals to home care from the approach of the Domiciliary Internment Program (PID) in Natal / RN. The research aims to identify the ways that the multidisciplinary team act and know the stories of these professionals about the situation experienced in the transition between the instituting and instituted on home care modalities. PID has as a prior focus the elderly person in stable medical conditions, not to replace the hospital care, but to offer a therapeutic support turned to the exercise of their autonomy and coexistence with the situation of diseases. The home in their internal coexistence rules preserves own customs. As the hospital care migrates to the home care, it happens in the confrontation and rationality negotiation and becomes something new, that is going to be directed by an instituting dimension. In the view of New History, that suggests an interdisciplinary approach and interprets the problems on its time and from the technique of thematic oral history, it can be seen that working in interdisciplinary team is able to incorporate new values in the way of healthcare assistance, it longs for maintaining the maximum functional capacity of patients, it presents results as the prevention of diseases, costs reduction in connection with the Hospital Service, empowers and expands the possibilities for the patient recovery by aligning with the daily life and the opportunity of the patient being assisted by a multiprofessional team, interacting on the concrete reality. Therefore, PID is in line with the contemporary demands and as an instrument to be considered in the review of a wider concept of the health-disease process
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Descriptive and quantitative study, with the objective of review the positive and negative aspects experienced by professionals working in the Family Health Strategy (ESF) of Ceará-Mirim town, at Rio Grande do Norte state. The population included 190 healthcare professionals that integrate the family healthcare staff and the data-collection occurred in a meeting at their workplace, with the implementation of a questionnaire. Results were organized in Microsoft Excel spreadsheet software, with descriptive statistical analysis in tables, graphs and tables through frequencies, averages values and standard deviations. There is a predominance of females (n = 137) and higher rates in almost all professions, and higher average age (38.9%, SD = 7.8) and income wage (average = 10) in the medical category. Regarding the more developed activities, for physicians and nurses are the healthcare actions in the Unit, the oral hygiene for dentists, the immunization for auxiliary nurses (Aux-N), educational meeting for the dental office assistants (ACD), and home visitations to community-based health workers (ACS). About the easiness of work, 93.2% said to be presence of professionals with a personal profile in public healthcare; about the difficulties, 86.8% of professionals cited the unavailability of material, followed by salary range reported by nurses (80.9% ), dentists (80.0%), physicians (73.3%), ACS (83.1%), and Aux-N (90.5%). In relation to working conditions, the unavailability of materials was the most mentioned, with the exception of dentists who reported improvement in wages. We still identify among these difficulties: the drugs availability regarded as first grade obstacle by ACS and physicians, the type of contracts in second grade cited by the ACD and dentists and, in third grade, the salary range cited by dentists and auxiliary nurses. It is concluded that the difficulties and easiness faced by ESF professionals are divergent among themselves. For physicians and nurses, whose healthcare actions become directed to specific groups, the individual and the family, their difficulties relate to the unavailability of materials. For dentists, whose actions more quoted were topical application of fluoride and supervised toothbrush, their greatest difficulty is the salary range. As to the Aux-N, ACD and ACS, for all of them the unavailability of materials has hindered the implementation of their activities in ESF
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Leprosy is a chronic infectious-contagious disease, caused by Mycobacterium leprae, manifested by dermatological and neurological signs and symptoms and has great disabling power. It was marked by a strong stigma throughout its history, since its bearers represented a threat, target of fear and social contempt. Currently, leprosy has treatment and cure, and the need to separate the diseased from family and social environment is no more necessary. However, patients still suffer prejudice and discrimination. This study aimed to understand the social representations of leprosy that interfere modifying mental health of the patient with leprosy in relation to stigma and prejudice. This is a descriptive and exploratory study, with qualitative approach, which involved 22 users of the Special Care Clinic in Infectious Diseases at the Hospital Giselda Trigueiro, located in Natal / RN. They were in use of multidrug therapy in the period of data collection, were of both sexes, aged between 16 and 80 years of age and classified as paucibacillary or multibacillary. The study was approved by the UFRN Ethics in Research Committee. Data collection was performed by filling the questionnaire identification and then for conducting the semi-structured interview, which was recorded. After the end of data collection, there was the construction of tables and graphs, using the Microsoft Excel Start 2010 for proper characterization of the research subjects; and for the treatment of the data obtained from the interviews, was used the Content Analysis and based on the Theory of Social Representations. The subjects studied were mostly male (64%), married or in a stable relationship (68%), concentrated in the age group 50-60 years (36%) and 28-38 years (23%), had at most elementary education (65%) and were low-income (59%). Of the total respondents, 64% were classified as multibacillary, with predominantly dimorfous form, and 50% had disability grade I or II, with different periods of diagnosis. The reports originate two categories: 1. The negative meanings of illness and leprosy; and 2. The positive meanings of illness in leprosy, which were subsequently subdivided into subcategories. Thus, it was found that in the group studied, the social representation of leprosy experiences a moment of transition, as regards the understanding of the disease and its way of experiencing the disease process. Such representation is anchored in the quality of information on the disease of its bearers and aimed at an attempt to face the illness of leprosy as a "normal process". It was found in this study that the transition is due to the work of combating stigma and consequences of leprosy, which is able to gradually transform reality, both regarding the team work of reference, and in relation to a broader character, of actions of health education, which favors overcoming of psychosocial disabilities
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O presente estudo tem por objetivo avaliar a satisfação dos usuários em relação à qualidade da Atenção Primária à Saúde no Rio Grande do Norte. Trata-se de Pesquisa Avaliativa observacional transversal, com abordagem quantitativa, a qual faz parte da Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ), da Universidade Federal do Rio Grande do Norte. Foram utilizados dados secundários de todas as entrevistas com usuários das equipes que participaram da Avaliação Externa do PMAQ no Estado do RN. A pesquisa foi realizada em 167 municípios do Estado do Rio Grande do Norte, na qual a população foi composta por 1.650 usuários. A amostra se deu por conveniência a partir dos seguintes critérios: usuários que estavam presentes na Unidade Básica de Saúde (UBS) para realizar qualquer tipo de procedimento e que consentisse em participar da avaliação. Foram excluídos os que tinham ido pela primeira vez na unidade e aqueles que não frequentaram há mais de 12 meses. A coleta dos dados foi realizada no período de setembro a novembro de 2013. Para tanto, foi elaborado um protocolo de pesquisa contendo as seguintes dimensões: organizacional, interpessoal e estrutural. Em relação à dimensão organizacional os resultados mostram que a marcação de consultas tem se configurado em empecilho ao acesso do usuário ao serviço de saúde, uma vez que se faz necessário para o atendimento, enfrentar filas, antes da abertura da unidade para pegar fichas. No tocante ao funcionamento da unidade, se destaca o fato dos usuários referirem que o horário de funcionamento da unidade atende à suas necessidades, apesar de funcionar 5 (cinco) dias por semana, a maioria das unidades permanece fechada no horário de almoço. Outro dado importante refere-se à coordenação do cuidado, cujos resultados apresentam diferenças maiores entre os usuários da região metropolitana e do interior do Estado em relação à Capital. Essa diferença se expressa principalmente em relação de marcação de consulta com outros profissionais especialistas. A dimensão interpessoal, no que diz respeito à categorias interação usuário-serviço-equipe e vínculo, demonstraram alguns avanços, contudo os melhores resultados foram observados em relação a satisfação com o cuidado, onde mais de 50% dos usuários se mostraram satisfeitos com o cuidado recebido nas unidades. Em contrapartida, o estudo mostrou que, na opinião de 56% dos usuários da capital, a falta de materiais e equipamentos influencia negativamente no cuidado. Por fim, o estudo contribuiu para reforçar a ideia de que a avaliação da satisfação dos usuários dos serviços de saúde pode ser uma ferramenta importante para subsidiar o processo de decisão compartilhada, de forma a se repensar as práticas profissionais, reorganizar o processo de trabalho desenvolvido, realocar recursos, readequar ações e redefinir objetivos que estejam coerentes com o projeto de saúde estabelecido
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This dissertation aimed to analyze the perception of students about (EPW Health) Education Program at Work for Health Training in the area of Health. It discusses the proposed theme from the perception of students graduating from the EPW- Health courses participants (dentistry, medicine, physiotherapy, nursing, nutrition, physical education) who have developed their school activities in family health units in the city of João Pessoa between 2009/2011.The program aims policies curricular changes as a potential route of contributions to training in healthcare. Attention is drawn to the new possibilities of working health training contextualized, ethically grounded, socially endorsed. It is pointed out in this process the need to adapt to the demands of professional profiles of SUS (Sistema Único de Saúde). This is an exploratory, descriptive study within a qualitative approach, conducted in the city of João Pessoa in the context of health care courses at the Federal University of Paraiba. The empirical material of this study was treated by the use of technical analysis "Categorical Content Theme" by Bardin. The results indicate prospects for promoting new practices and curricular changes, which highlights the EPW- Health, which has been presenting important experiences in teaching -community -service- with the inclusion of students in the municipal health network. We conclude that the path from collection to data analysis, corroborated with the literature to reaffirm the importance and urgency of change in educational processes with a view to greater proximity to the health needs and the SUS. The EPW- Health project is incipient and requires further investigation in terms of effective interdisciplinary and multidisciplinary character of its proposal
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Popular Health Education in its emancipatory dimension refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions. Under this view, health workers and health users are subjects of the educative process. Thus, this study aims to identify the key clinical and socio sanitary attributes and promote educational activities with patients with Diabetes Mellitus (DM) in a Family Health Care Unit of the Western Sanitary District, in the city of Natal / RN. It is an action research which uses the references of the Theory of Liberating Education, which is based on a problem-solving pedagogy and that values dialogue in the process of understanding oneself and the world. Thirty-six diabetics, who are residents of the area covered by the health care unit, and thirty health workers participated in the survey. Each group had an average of twelve participants, and the meetings took place at the Unit´s hall, using conversation wheels, group dynamics, life narratives, experiences telling, movie exhibition and discussions, music, knowledge telling, desires, limitations, beliefs and values socially constructed. Data collection took place during the second half of two thousand and thirteen through Free Word Association Technique (FWAT), recordings of conversation wheels, participative observation, group dynamics, testimonies, questionnaires, life narratives and photographs. The empirical material was organized and subjected to three analyzes: thematic content (Bardin), textual statistics analysis by software IRAMUTEQ (Ratinaud), and photographic analysis (Edmund Feldman). The data analyses originated words, expressions, categories, themes and creative situations showing that popular health education is in process of construction, but still very incipient in primary care. The National Policy on Popular Health Education shows us the necessary ways for the transformation of health practices and the build of a more shared and solidary society. The meetings could be place to reverse that normative logic that has been happening over the years in primary care, but that by itself is not enough. It is possible to conclude that the use of active practices, increasing of listening and training on Popular Health Education will enable changes in the scenario where users and health workers deal with diabetes mellitus. Thus we see the popular health education is being timidly incorporated to the educational process of the subjects involved in this study, and far away from the principles of participation, organization of political work, increase opportunities for dialogue, respect, solidarity and tolerance among different actors involved in addressing the health problems that are fundamental to the improvement in building healthy practices of primary care
Limites e possibilidades da educação em saúde na estratégia de saúde da família de Pau dos Ferros/RN
Resumo:
A Estratégia Saúde da Família (ESF) apresenta-se como um espaço privilegiado para a efetivação de práticas de educação em saúde orientadas pelo diálogo entre o saber científico e o saber popular, uma vez que é nesse espaço de saúde que profissionais e indivíduos/família se interrelacionam, criam vínculos, dialogam e constroem soluções para o enfrentamento dos problemas de saúde da população. O objetivo geral deste estudo foi analisar os limites e as possibilidades de efetivação da educação em saúde voltada para a coletividade na ESF de Pau dos Ferros/RN. Nesse sentido, buscou-se conhecer as concepções de educação em saúde dos profissionais de nível universitário da ESF; observar onde as práticas de educação eram desenvolvidas; conhecer os conteúdos e metodologias utilizadas para a efetivação das práticas de educação em saúde e caracterizar os espaços onde tais práticas eram desenvolvidas. Trata-se de uma pesquisa qualitativa, de caráter descritivo-exploratório realizada junto a nove equipes localizadas na zona urbana do município. Foram investigados 28 profissionais que atuam nessas equipes, dentre os quais elencamos: quatro médicos, oito enfermeiros e dezesseis cirurgiões dentistas. Fez-se uso da entrevista semiestruturada e da observação baseada em princípios etnográficos. Os dados foram analisados com base na técnica de análise de conteúdo de Bardin. O estudo obedeceu aos aspectos éticos contidos na Resolução 196/96 que regulamenta as Pesquisas Envolvendo Seres Humanos. Os resultados apontam que as concepções e práticas de educação em saúde dos profissionais da ESF são orientadas por uma educação bancária , pautadas pela transmissão e reprodução de conhecimentos. As temáticas são desenvolvidas de forma verticalizada, dissonantes da realidade de vida e saúde dos usuários. As práticas educativas são ofertadas majoritariamente por enfermeiros e estudantes de graduação em estágio na USF. Em sua maioria não são planejadas em equipe, e estão direcionadas à prevenção de doenças, distanciando-se da promoção da saúde. As principais dificuldades apontadas para a efetivação da educação em saúde dizem respeito à dificuldade de trabalhar em equipe, à falta de apoio da gestão, à estrutura física inadequada e a pouca adesão dos profissionais as práticas educativas. Portanto, a educação em saúde praticada na ESF não consegue instrumentalizar os sujeitos para que estes tenham autonomia e possam tornar-se sujeitos de suas vidas, de sua história. A prática educativa centrada na transmissão de conhecimentos ainda é uma realidade presente na ESF, constituindo-se em um desafio a ser superado
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This research assumes that for changes in health practices directed to an integral care, is crucial humanization, participation and autonomy of service users. In this sense, the research had investigated the issue of humanization involving users of the Family Health Strategy (FHS) in city of Mossoró, having as objectives: to analyze the perceptions of users on humanization in the production of health care in daily of Family Health Strategy, from these perceptions, identify elements featuring humanized and non-humanized in everyday practices related to production of health care; relate perceptions of users about humanization with the notions of extended clinic and social participation present in the National Humanization Policy (NHP); identify difficulties and potentialities in the production of health care from the perspective of humanization. It was a qualitative approach to data collection and it was used the methodology of Network Analysis of Everyday Life (NAEL), which allowed the questioning of health practices through an interactive discussion involving participants subjected. The analysis of data through the technique of content thematic analysis was performed and the results were interpreted related the Extended Clinic references and the users participation, related with the Gift Theory discussed by Marcel Mauss. The results indicated senses humanization linked to affection, reciprocity and honesty, highlighting as essential to humanized practices the trust, bonding, listening, dialogue and accountability. Were also mentioned other elements related to the organization of health services such as access and good functioning of the health services. The difficulties and potentialities show structural deficiencies of the health system and changes in the labor process. The participation of users deconstructing and reconstructing concepts remainder humanization in the production of health care is a key factor for the sedimentation of what is proposed in the HNP. Using the privileged space of the FHE to create more active people and understanding their needs and demands, is possible path to build a participative management
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A atenção primária à saúde é um importante cenário para o cuidado em saúde mental por suas características e pelo trabalho no território contribuir para a superação do modelo manicomial de atenção. Esta pesquisa partiu do questionamento sobre como acontece a atenção em saúde mental na atenção básica nas unidades em que se desenvolve a Residência de Medicina de Família e Comunidade em um município do sertão paraibano. Objetivou investigar as demandas de saúde mental e práticas de cuidado no contexto de ESF e da RMFC do município de Cajazeiras a partir do discurso dos profissionais ali inseridos e discutir estratégias de qualificação do cuidado em saúde mental nessa realidade. Utilizou-se abordagem qualitativa em que foram realizados grupos focais envolvendo profissionais de duas equipes da ESF e uma equipe de NASF. Os dados produzidos nos grupos foram analisados a partir do referencial da análise do discurso de inspiração foucaultiana. Como resultados evidenciou-se que os profissionais percebem a demanda em saúde mental na atenção básica principalmente na forma de sofrimento psíquico inespecífico e transtornos mentais graves. A atenção a essas pessoas não consegue superar a medicalização que é identificada por esses profissionais. A prática asilar persiste como alternativa para os casos de transtornos mentais graves, sendo limitada a incorporação do paradigma da desinstitucionalização como referencial para a prática profissional. Além disso, a relação com a rede de saúde encontra vários limites destacando-se a dificuldade de produção de continuidade e integralidade do cuidado. A partir disto, analisa-se a formação médica e sua capacidade de garantir o cuidado integral na atenção às demandas de saúde mental. No campo da pesquisa, dois modelos de formação se encontram. Os residentes participantes ou graduaram-se em Cuba ou em escola médica brasileira orientada pelas Diretrizes Curriculares Nacionais. Percebe-se então que a graduação, ao incorporar questões relativas à integralidade do cuidado, não é suficiente para gerar bons profissionais para o SUS. Considera-se necessário somar às mudanças na graduação a perspectiva da Educação Permanente em Saúde no mundo do trabalho, o envolvimento dos profissionais com a transformação das práticas de atenção à saúde e a construção da perspectiva da integralidade e da atenção psicossocial por dentro da Residência de Medicina de Família e Comunidade como importantes estratégias para a formação de médicos generalistas aptos para a atenção às demandas de saúde mental
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Sixty small farms of Botucatu County, S. Paulo, Brazil, given over to cattle breeding were studied. These farms account for 15% of the total of 402 farms that exist in the county. The sample was drawn by simple probabilistic technique. There were found to be one hundred and thirteen drinking places located on the farms. Samples of water were taken from these drinking places and examined for bacteria of the genus Salmonella, for the determination of Most Probable Number (MNP) of fecal coliform bacteria as well as determination of the water's pH. Water temperature was measured before collection. Samples from 15 drinking places (13.3%) were positive for Salmonella. The drinking places belonged to 12 of the sixty farms studied (20%). The following serotypes were identified: S. dublin, S. newport, S. madelia, S. IV 43:g,z57:-, S. saphra, S. glostrup, S. IV ochsenzool; S. I9,12:i:- and two new serotypes S. IV 41:z52:- and S. IV 50:d:-. Of the 113 samples studied 14 (12.4%) presented MPN/100ml of fecal coliforms above 4,000. There was no relationship between MPN/100ml of fecal coliforms above 4,000 and positivity for Salmonella. Highest positivity both for Salmonella and MPN/100mL of fecal coliforms over 4,000 occurred at temperatures above 18 degrees C. As regards pH, in both situations the highest positivity occurred between 6.0 and 7.0.