[Nursing practices in the attention to a chronic condition (tuberculosis): analysis of secondary sources]. / Atuação da enfermagem na atenção a uma condição crônica (tuberculose): análise de fontes secundárias.

OBJECTIVE: To analyze nursing practiced in the treatment of tuberculosis, based on secondary data records. METHOD: Descriptive study of the retrospective survey kind, conducted in Ribeirão Preto, from August to December 2013. The data of 109 electronic and clinical medical records, and a TB reporting system in the state of São Paulo for residents in the municipality monitored in the reference clinics. Descriptive statistic techniques were used. RESULTS: The median of 46.0 (IQ: 17.0 to 96.0) calls throughout the treatment shows the patient's proximity to the health service and professionals, of which the primary persons responsible for follow-ups were nursing assistants (99.1%), which perform the House Visits (71.5%) for patients under a supervision regime (75.2%). CONCLUSION: The actions developed with the patients were mostly focused on the nursing staff, making the importance of this category to achieve the indicators related to the Millennium Development Goals for tuberculosis visible.

[Performance evaluation of primary care services for the treatment of tuberculosis]. / Avaliação de desempenho de serviços da atenção básica para o tratamento da tuberculose.

OBJECTIVE: Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. METHOD: An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). RESULTS: The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. CONCLUSION: The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.



[Delay in seeking initial care for tuberculosis diagnosis]. / Atraso na procura pelo primeiro atendimento para o diagnóstico da tuberculose.

Descriptive study, which aimed to analyze the time between the perception of TB symptoms onset and the first search for health services, according to TB patient characteristics in São José do Rio Preto - SP. 97 TB patients in treatment were interviewed with a structured instrument. The delay was identified by the median time between the perception of TB symptom's onset and the patients demand for care (> 15 days). To identify the variables related to delay the prevalence ratio were calculated. There was a delay seeking care among: male patients, aged 18 to 29 and 50 to 59 years, lower education and higher family income, pulmonary cases without HIV co-infection, presenting milder symptoms, users of alcoholic beverages and tobacco, those who did not perform preventive health control, and who sought health services closer to home. The recognition of users' profiles in the search for care is paramount for defining strategies that favor the use of services in a timely manner.

Educational intervention about airway obstructions for early childhood teachers: a quasi-experimental study.

OBJECTIVE: To verify the effect of an educational intervention about airway obstructions and an airway clearing technique in teachers from Municipal Child Education Centers in a municipality in western Paraná. METHOD: A quasi-experimental pre- and post-test study. Data was collectedusing a questionnaire with thirty questions to assess knowledge about the subject. For the analyses, the chi-square and McNemar tests were used, withanα = 5% of significance. RESULTS: After the training sessions, there was a 16.22% increase in the number of correct answers to the questions dealing with the recognition of the obstruction (<0.0001) and the airway clearance technique (<0.0001). CONCLUSION: The intervention improved the knowledge of early childhood teachers in the municipality regarding the identification of airway obstruction and techniquesairway clearing in school-age children.

[Delays in the diagnosis of tuberculosis in a town at the triple border of Brazil, Paraguay, and Argentina]. / Retardo no diagnóstico da tuberculose em município da tríplice fronteira Brasil, Paraguai e Argentina.

OBJECTIVE: To identify the factors linked to patients and health services in delays in the diagnosis of tuberculosis. METHODS: Epidemiological study in Foz do Iguaçu, Paraná, Brazil, 2009. The Primary Care Assessment Tool, adapted for appraising tuberculosis treatment, was the instrument used. Descriptive statistics techniques were used, such as frequency distributions, central tendency and dispersion measurements (median and interquartile intervals), and odds ratios. RESULTS: There were greater delays in seeking health services for those in the age group 60 years and older, for females, for patients with low levels of education, and for patients with poor knowledge of the disease. Clinical variables (being a new case and HIV infection) and behavioral variables (use of tobacco and alcohol consumption) were not linked with delays in diagnosis. The median time delays before diagnosis attributable to patients and to the health services were 30 days and 10 days, respectively. Emergency 24-hour medical services and primary health care services were not effective in identifying suspicious cases of tuberculosis and requesting tests to confirm the diagnosis, with a high percentage of referrals to the Tuberculosis Control Program clinic. CONCLUSIONS: Going to primary health care services for diagnosis increased the time before diagnosis of the disease was reached. The Tuberculosis Control Program clinic was more effective in diagnosis of tuberculosis, due to the training of the staff and to an organized process for receiving patients, including the availability of tests to support the diagnosis.

[Access to healthcare services for tuberculosis: analysis of patient satisfaction]. / Acesso aos serviços de atenção à tuberculose: análise da satisfação dos doentes.

Tuberculosis remains a pubic health challenge. Uncountable efforts are made to control the disease, and patient treatment and accessibility to healthcare can hinder reaching a cure. The objective of this article is to analyze the satisfaction of tuberculosis patients regarding tuberculosis control services. This is an epidemiological, prospective study, using both a quantitative and qualitative approach. Data were collected using a semi-structured questionnaire. Participants included 77 patients. The quantitative data were positively evaluated, and the qualitative data permitted an understanding of the patients' experience regarding their accessibility and treatment. Aspects such as the criteria for performing Directly Observed Treatment and the proximity of the healthcare facility to the patients' residence affected their satisfaction, which implies the need to reorganize healthcare services in order to provide more appropriate care to tuberculosis patients.

Sleep quality and its association with menopausal and climacteric symptoms.

OBJECTIVE: to assess sleep quality in menopausal women and its association with symptoms related to this period. METHOD: this is a cross-sectional, analytical and correlational study. Sleep was assessed using the Pittsburgh Sleep Quality Index; and climacteric symptoms, according to the Menopause Rating Scale. To compare the total score and each Menopause Rating Scale domain with the PSQI classification, the Mann-Whitney U non-parametric test was used. P<0.05 was considered significant. RESULTS: 261 women (67.8%) were classified as bad sleepers. There was a positive and significant correlation between the sleep scale scores and the total menopause score and its domains. Women categorized as poor sleepers had worse scores on the menopause symptom scale. CONCLUSION: women with worse sleep quality revealed greater severity of symptoms related to menopause.

Analysis of vaccine loss due to temperature change.

OBJECTIVES: to analyze vaccine losses in a Health Region in the Northwest of São Paulo. METHODS: retrospective cross-sectional study with secondary data obtained from Temperature Change Notification Forms used by the Epidemiological Surveillance Group XXIX of São José do Rio Preto between 2010 and 2017. Descriptive and inferential analysis were performed using multiple linear regression and significance level of 95%. RESULTS: in total, 341 notifications of temperature changes were analyzed, of which 70.1% were caused by structural reasons, 57.8% in industrial refrigerators and 91.2% in primary care services. Of the doses that suffered a change in temperature, 41.4% were lost and 58.6% were administered to the population. The highest percentage of lost doses compared to those applied occurred in smaller municipalities, although they reported less. CONCLUSIONS: nursing workers who work in vaccination rooms should make efforts to prevent temperature changes and avoid losses and higher public expenses.

The epidemiological dimension of TB/HIV co-infection.

This study aimed to analyze the epidemiological indicators of TB/HIV co-infection in São José do Rio Preto, São Paulo, Brazil from 1998 to 2006. Data of new TB cases that initiated treatment between January 1998 and December 2006 were obtained from the TB Notification System (EPI-TB) and 306 cases were reported. The incidence rate was 5.1/100,000 inhabitants in 2006. Most cases were men (72.5%) with ages ranging between 20 and 59 years (96.4 %). The majority (51%) had incomplete primary education. Pulmonary TB was the most common type (52.9%) and 46.1% of the patients received supervised treatment. In 2006, the cure rate was 33.3%, 14.3% death rate and no patient abandoned the treatment. Diagnosis occurred at the hospital in 60% of the cases. Results show the need of improved coordination between the city's Tuberculosis Control Program and the Sexually Transmitted Diseases and HIV Program.

Tuberculosis: knowledge among nursing undergraduate students.

OBJECTIVE: To analyze the knowledge about tuberculosis among nursing undergraduate students of a Federal Higher Education Institution. METHOD: Descriptive cross-sectional study, with quantitative approach. Data were collected through a questionnaire based on the WHO's guide to developing evaluation instruments on knowledge, attitudes and practices related to TB. Students were classified as "with knowledge" and "with little knowledge" based on the mean percentage of correct responses to the variables analyzed. Descriptive statistics techniques were used. RESULTS: 60 nursing students were interviewed. "with little knowledge" was observed among students who were studying at the university for less time and who had no previous contact with the subject, and "with knowledge" was observed among those whose knowledge about tuberculosis was acquired in the health services. CONCLUSION: Knowledge gaps among undergraduate nursing students were identified, suggesting the need to rethink teaching-learning strategies on the subject.

Cardiovascular risk stratification among hypertensive patients: the influence of risk factors.

OBJECTIVE: to assess the cardiovascular risk in hypertensive patients and the influence of risk factors on the stratification scores. METHODS: this is a cross-sectional study with hypertensive patients undergoing outpatient follow-up from November 2014 to February 2015. The Global Risk Score was used to assess cardiovascular risk. To assess the influence of the risk factors with the stratification of the cardiovascular risk score, the main components analysis was used. RESULTS: 57 patients participated in the study, and the majority (93.1%) was considered to be at high cardiovascular risk; the analysis of the main components identified five components that explain 85.2% of the total variation. CONCLUSION: the cardiovascular risk assessment demonstrated the importance of the identification of risk factors and, consequently, the need to implement actions aimed at controlling these factors, which constitutes a challenge in the adequate management of arterial hypertension.

Assistência à saúde mental nos serviços médicos de emergência: revisão integrativa / Asistencia a la salud mental en los servicios médicos de emergencia: revisión integrativa / Mental health care in emergency medical services: an integrative review

Objetivos: conhecer as características da assistência à saúde mental dispensada por profissionais de enfermagem nos serviços médicos de emergência. Método: revisão integrativa de literatura nas bases de dados Literatura Latino-Americano e do Caribe em Ciências da Saúde (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) e Cumulative Index to Nursing and Allied Health Literature (CINAHL), no período de março a junho de 2023, utilizando-se critérios de inclusão e exclusão previamente definidos. Resultados: obteve-se uma amostra final de 59 artigos os quais foram agrupados nas seguintes categorias temáticas: concepções em saúde mental, comunicação, intervenções, atendimento em rede, competência em cuidado em saúde mental e barreiras durante os atendimentos. Conclusão: o cuidado é feito de forma incipiente e permeado por elementos dificultadores. Os achados do presente estudo servem para rever e repensar práticas e políticas de cuidado em saúde mental e promover estratégias de aperfeiçoamento dos processos de trabalho.

Objetivos: conocer las características de la asistencia a la salud mental dispensada por profesionales de enfermería en los servicios médicos de emergencia. Método: revisión integrativa de literatura en las bases de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) y Cumulative Index to Nursing and Allied Health Literature (CINAHL), en el período de marzo a junio de 2023, utilizando criterios de inclusión y exclusión previamente definidos. Resultados: se obtuvo una muestra final de 59 artículos los cuales fueron agrupados en las siguientes categorías temáticas: concepciones en salud mental, comunicación, intervenciones, atención en red, competencia en atención en salud mental y barreras durante los atendimientos. Conclusión: el cuidado es hecho de forma incipiente y permeado por elementos difíciles. Los hallazgos del presente estudio sirven para revisar y repensar prácticas y políticas de cuidado en salud mental y promover estrategias de perfeccionamiento de los procesos de trabajo.

Objective: to know the characteristics of mental health care provided by nursing professionals in emergency medical services. Method: integrative literature review in the databases Latin American and Caribbean Health Sciences Literature (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) and Cumulative Index to Nursing and Allied Health Literature (CINAHL), from March to June 2023, using previously defined inclusion and exclusion criteria. Results: the final sample included 59 articles, which were grouped into the following thematic categories: conceptions in mental health, communication, interventions, network care, competence in mental health care and barriers during care. Conclusion: care is done incipient and permeated by difficult elements. The findings of this study serve to review and rethink mental health care practices and policies and promote strategies for improving work processes.

Educational intervention about airway obstructions for early childhood teachers: a quasi-experimental study / Intervención educativa sobre la obstrucción de las vías respiratorias para profesores de educación de la primera infancia: estudio casi experimental / Intervenção educativa sobre obstrução das vias respiratórias para professores de educação infantil: estudo quase-experimental

ABSTRACT Objective: To verify the effect of an educational intervention about airway obstructions and an airway clearing technique in teachers from Municipal Child Education Centers in a municipality in western Paraná. Method: A quasi-experimental pre- and post-test study. Data was collectedusing a questionnaire with thirty questions to assess knowledge about the subject. For the analyses, the chi-square and McNemar tests were used, withanα = 5% of significance. Results: After the training sessions, there was a 16.22% increase in the number of correct answers to the questions dealing with the recognition of the obstruction (<0.0001) and the airway clearance technique (<0.0001). Conclusion: The intervention improved the knowledge of early childhood teachers in the municipality regarding the identification of airway obstruction and techniquesairway clearing in school-age children.

RESUMEN Objetivo: Verificar el efecto de una intervención educativa sobre la obstrucción de las vías aéreas y una técnica de desobstrucción en docentes de Centros Municipales de Educación Infantil de un municipio del oeste de Paraná. Método: Estudio cuasiexperimental del tipo pre y postest. Se recolectó a los datos a través de un cuestionario con treinta preguntas para evaluar el conocimiento sobre el tema. Para los análisis se utilizaron las pruebas chi-cuadrado y McNemar, con α = 5% de significación. Resultados: Después del entrenamiento, hubo un aumento del 16,22% en el número de respuestas correctas a las preguntas relacionadas con el reconocimiento de la obstrucción (<0,0001) y la técnica de desobstrucción de la vía aérea (<0,0001). Conclusión: La intervención mejoró el conocimiento de los docentes de los centros municipales de educación infantil en cuanto a la identificación y técnica de desobstrucción de las vías respiratorias en niños en edad escolar.

RESUMO Objetivo: Verificar o efeito de uma intervenção educativa sobre a obstrução de vias aéreas e a técnica de desobstrução, em professores de Centros Municipais de Educação Infantil de um município do Oeste do Paraná. Método: Estudo quase-experimental do tipo pré e pós-teste. Os dados foram coletados por meio de um questionário com trinta questões para avaliar o conhecimento sobre a temática. Para as análises utilizou-se os testes de Qui-quadrado e McNemar, com α = 5% de significância. Resultados: Após o treinamento, houve o aumento de 16,22% no número de acertos das questões que tratavam do reconhecimento da obstrução (<0,0001) e da técnica de desobstrução das vias aéreas (<0,0001). Conclusão: A intervenção melhorou o conhecimento dos professores dos Centros Municipais de Educação Infantil, quanto a identificação e a técnica de desobstrução das vias aéreas em crianças de idade escolar.

Social representations of nurses of the Emergency Care Unit towards people with mental disorder / Representaciones sociales de las enfermeras y enfermeros de la Unidad de Cuidados de Urgencia hacia las personas con trastornos mentales / Representações sociais de enfermeiros da Unidade de Pronto Atendimento às pessoas com transtorno mental

ABSTRACT Objective: To understand the Social Representations of nurses from an Emergency Care Unit about the care provided to people with mental disorders. Method: Qualitative exploratory study, supported by the theoretical and methodological framework of the Theory of Social Representations. Interviews were conducted from July to August 2021. The data were processed using the IRaMuTeQ software. Results: 22 nurses were interviewed. From the processed data, three discursive categories were constructed: the tortuousness of the Psycho-Social Care Network (RAPs): in search of a path; the abyss between the health professional and the person with mental disorder; and unveiling the care of nurses in the Mental Health Emergency Care Unit. Conclusion: We identified a lack of knowledge about the Psychosocial Care Network, anchoring elements associated with previous negative experiences that influence the professional-patient relationship, and nursing care permeated by cognitive barriers. Such findings are unprecedented in the locality studied and relevant to promote the qualification of the work of nurses in mental health in the Emergency Care Unit.

RESUMEN Objetivo: Conocer las Representaciones Sociales de las enfermeras de una Unidad de Cuidados de Urgencia sobre los cuidados prestados a personas con trastornos mentales. Método: Estudio exploratorio cualitativo, apoyado en el marco teórico y metodológico de la Teoría de las Representaciones Sociales. Las entrevistas se realizaron entre julio y agosto de 2021. Los datos se procesaron con el software IraMuTeQ. Resultados: Fueron entrevistadas 22 enfermeras. A partir de los datos procesados, se construyeron tres categorías discursivas: lo tortuoso de la Red de Atención Psicosocial: en busca de un camino; el abismo entre el profesional de la salud y la persona con trastorno mental; y develar el cuidado de las enfermeras en la Unidad de Atención de Emergencias en Salud Mental. Conclusiones: Identificamos un desconocimiento de la Red de Atención Psicosocial, elementos de anclaje asociados a experiencias negativas previas que influyen en la relación profesional-paciente, y cuidados de enfermería permeados por barreras cognitivas. Tales hallazgos son inéditos en la localidad estudiada y relevantes para promover la cualificación del trabajo de enfermería en salud mental en la Unidad de Cuidados de Urgencia.

RESUMO Objetivo: Compreender as Representações Sociais de enfermeiros de uma Unidade de Pronto Atendimento sobre o cuidado dispensado às pessoas com transtornos mentais. Método: Estudo exploratório qualitativo, sustentado pelo referencial teórico-metodológico da Teoria das Representações Sociais. Foram realizadas entrevistas no período de julho a agosto de 2021. Os dados foram processados com o auxílio do software IraMuTeQ. Resultados: Foram entrevistados 22 enfermeiros. A partir dos dados processados foram cosntruídas três categorias discursivas: a tortuosidade da Rede de Atenção Psiscossocial: em busca de um caminho; O abismo entre o profissional de saúde e a pessoa com transtorno mental; e desvelando o cuidado dos enfermeiros da Unidade de Pronto Atendimento em saúde mental. Conclusão Identificou-se falta de conhecimento sobre a Rede de Atenção Psicossocial, elementos de ancoragem associados à experiências prévias negativas que influenciam a relação profissional-paciente e, um cuidado de enfermagem permeado por barreiras cognitivas. Tais achados são inéditos na localidade estudada e relevantes para promover a qualificação do trabalho do enfermeiro em saúde mental na Unidade de Pronto Atendimento.

Primary Health Care and tuberculosis: services evaluation. / Atenção Primária à Saúde e tuberculose: avaliação dos serviços.

INTRODUCTION:: In order to control tuberculosis, the Brazilian Ministry of Health recommends the decentralization of control actions directed to the Primary Health Care, and there are few studies on the performance of the Tuberculosis Control Program in decentralized contexts. OBJECTIVE:: To evaluate the performance of Primary Health Care services in tuberculosis treatment. METHODS:: This is an evaluative study with cross-sectional approach conducted in 2011. Two hundred and thirty-nine health professionals from Primary Health Care units were interviewed using a structured instrument based on the evaluation reference of the health services quality (structure - process - results). The performance of these services was analyzed applying techniques of descriptive statistics, validation, and construction of indicators and by determining the reduced variable "Z". RESULTS:: The indicators "participation of professionals in tuberculosis patients' care" (structure) and "reference and counterreference" (process) had the best evaluations, whereas "professional training" (structure) and "external actions for tuberculosis control" (process) had the worst results. CONCLUSION:: The decentralization of tuberculosis control actions has been taking place in a vertical manner in Primary Health Care. The challenge of controlling tuberculosis involves overcoming constraints related to the engagement, training, and turnover rates among health professionals, which is a coordination between services and monitoring of control actions in Primary Health Care.

Conhecimento e atitudes de pais de crianças/adolescentes sobre papillomavirus humano: estudo transversal / Conocimiento y actitudes de padres de niños/adolescentes sobre el virus del papiloma humano: estudio transversal / Knowledge and attitudes of parents of children/adolescents about human papillomavirus: cross-sectional study

Resumo Objetivo Analisar as características associadas aos pais de crianças e adolescentes que ouviram falar sobre o Papillomavirus humano, bem como o conhecimento sobre a infecção e a intenção de vacinar seus filhos. Métodos Estudo transversal com abordagem quantitativa, realizado por meio de entrevista utilizando instrumento estruturado. Entrevistaram-se 376 pais de crianças e adolescentes que aguardavam atendimento pediátrico em unidades de saúde de Três Lagoas/MS. Os dados coletados (características sociodemográficas; características reprodutivas e sexuais; conhecimento sobre o Papillomavirus humano e intenção de vacinar o/a filho/a) foram analisados por meio de técnica de estatística descritiva, teste de associação Qui-quadrado ou exato de Fisher e Teste T Student. Resultados Dentre os entrevistados, 327 (87,0%) afirmaram ter ouvido falar sobre o Papillomavirus humano. Identificou-se associação entre os pais que nunca ouviram falar sobre a infecção e sexo masculino, idade entre 18 e 25 anos e ensino fundamental incompleto. Dentre os pais que ouviram falar sobre o Papilomavírus Humano, 152 (46,5%) afirmaram que é uma infecção sexualmente transmissível, 245 (74,9%) garantiram que a transmissão ocorre através da relação sexual desprotegida, 275 (75,5%) desconhecem seus sinais e sintomas, 218 (66,7%) afirmaram erroneamente que tal infecção tem cura e 283 (86,5%) sabem da existência da vacina. Dentre todos os entrevistados, 98,1% levariam seu(ua) filho(a) para vacinar contra o vírus. Conclusão Observaram-se lacunas no conhecimento dos pais de crianças e adolescentes sobre o Papillomavirus humano, mostrando a necessidade de educação em saúde e divulgação de ações de enfrentamento à infecção em meios de comunicação e redes sociais.

Resumen Objetivo Analizar las características asociadas a padres de niños y adolescentes que escucharon hablar sobre el virus del papiloma humano, así como el conocimiento sobre la infección y la intención de vacunar a sus hijos. Métodos Estudio transversal, con enfoque cuantitativo, realizado por medio de encuesta con instrumento estructurado. Se encuestaron 376 padres de niños y adolescentes que esperaban atención pediátrica en unidades de salud de Três Lagoas, estado de Mato Grosso do Sul. Los datos recopilados (características sociodemográficas, características reproductivas y sexuales, conocimiento sobre el virus del papiloma humano e intención de vacunar al hijo/a) se analizaron por medio de técnica de estadística descriptiva, prueba de asociación ji cuadrado o prueba exacta de Fisher y test-T Student. Resultados Entre los encuestados, 327 (87,0 %) afirmaron haber escuchado hablar sobre el virus del papiloma humano. Se identificó relación entre los padres que nunca escucharon hablar sobre la infección y el sexo masculino, edad entre 18 y 25 años y educación primaria incompleta. De los padres que escucharon hablar sobre el virus del papiloma humano, 152 (46,5 %) afirmaron que es una infección de transmisión sexual, 245 (74,9 %) aseguraron que la transmisión ocurre a través de las relaciones sexuales sin protección, 275 (75,5 %) desconocen sus signos y síntomas, 218 (66,7 %) afirmaron erróneamente que tal infección tiene cura, y 283 (86,5 %) saben de la existencia de la vacuna. Entre los encuestados, el 98,1 % llevaría a su hijo/a vacunarse contra el virus. Conclusión Se observaron vacíos de conocimiento en los padres de niños y adolescentes sobre el virus del papiloma humano, lo que muestra la necesidad de educación para la salud y difusión de acciones para enfrentar la infección en medios de comunicación y redes sociales.

Abstract Objective Analyze the characteristics associated with the parents of children and adolescents who have heard about the human papillomavirus, as well as the knowledge about the infection and the intention to vaccinate their children. Methods Cross-sectional study with quantitative approach, conducted through a structured interview. We interviewed 376 parents of children and adolescents who were awaiting pediatric care at health services in Três Lagoas/MS. The collected data (sociodemographic characteristics; reproductive and sexual characteristics; knowledge about human papillomavirus and intention to vaccinate the child) were analyzed using descriptive statistics, Fisher's exact test or the chi-square association test and Student's t-test. Results Among the respondents, 327 (87.0%) said they had heard about the human papillomavirus. An association was identified between parents who had never heard of the infection and male sex, age between 18 and 25 years and unfinished primary education. Among the parents who had heard about the human papillomavirus, 152 (46.5%) stated that it is a sexually transmitted infection, 245 (74.9%) assured that the transmission occurs through unprotected sexual intercourse, 275 (75.5%) are unaware of its signs and symptoms, 218 (66.7%) mistakenly stated that this infection is curable and 283 (86.5%) know of the existence of the vaccine. Among all respondents, 98.1% would take their child to get vaccinated against the virus. Conclusion Gaps were observed in the knowledge of the parents of children and adolescents about the human papillomavirus, showing the need for health education and dissemination of actions to cope with the infection in the media and social networks.

Assessment of Primary Health Care in the Treatment of Tuberculosis in a Brazilian Locality of the International Triple Frontier.

OBJECTIVE: To evaluate the performance of Primary Health Care (PHC) in treatment of TB patients in a triple international border municipality. METHODS: The present study was an evaluative survey of cross-sectional and quantitative approach conducted with 225 PHC healthcare professionals. Data was collected through a structured and validated instrument, which provided five indicators of "structure" and four indicators of "process" classified as unsatisfactory, regular or satisfactory. RESULTS: The "structure" component was unsatisfactory for the indicator of professionals involved in TB care and training, and regular for the indicator of connection between the units and other levels of care. The "process" component was regular for the indicators of TB information, directly observed treatment and reference and counter reference on TB, and unsatisfactory for external actions on TB control. CONCLUSION: The "structure" and "process" components points out some weaknesses in terms of management and organization of human resources. Low frequency of training and the turnover influenced the involvement of professionals. Elements of "structure" and "process" show the need for investing in the PHC team and improving the clinical management of cases.

Latent Tuberculosis Infection Diagnostic and Treatment Cascade among Contacts in Primary Health Care in a City of Sao Paulo State, Brazil: Cross-Sectional Study.

BACKGROUND: Diagnosis and treatment of latent tuberculosis infection (LTBI) is a tool for global TB control, especially in close contacts. But data is scarce in high burden countries, under field conditions, including data on the benefits of LTBI management. OBJECTIVE: To analyze the LTBI diagnosis and treatment cascade among contacts in primary health care (PHC) services in São José do Rio Preto-SP, Brazil. METHODS: Cross-sectional design, conducted with contacts of pulmonary TB patients followed in all PHC services. Data was collected from May to September 2014 in the Reporting System for TB cases (TBWEB) and Reporting System for Chemoprophylaxis. Medical records and treatment follow-up forms were reviewed and all the nurses responsible for TB in PHC services were interviewed. RESULTS: Among 336 contacts included, 267 (79.4%) were screened for TB or LTBI, according to the presence or not of respiratory symptoms. Among those contacts screened, 140 (52.4%) were symptomatic, 9 (3.4%) had TB disease, 106/221 (48%) had positive TST result, meeting the criteria for LTBI treatment, and 64/106 (60.4%) actually started it. Overall, among 267 screened, only 64 (24%) started LTBI treatment. The completion rates of treatment among the contacts who started it, those with positive TST result and those screened were 56.3% (36/64), 16.3% (36/221) and 13.5% (36/267), respectively. Nurses claimed that asymptomatic TB contacts pay no attention to preventive health care and do not seek medical care as they do not have symptoms of the disease. In reviewing the medical records, high proportions of contacts without evaluation, incomplete assessment, incorrect records of contraindication for LTBI treatment, lack of notes regarding the identification and evaluation of contacts were identified. CONCLUSIONS: There is a need for better organization of the surveillance and investigation routine for contacts in PHC, considering the reorganization of the work process and the features of the local health system.

Analysis of vaccine loss due to temperature change / Análisis de pérdida de vacuna por cambio de temperatura / Análise da perda de vacinas por alteração de temperatura

ABSTRACT Objectives: to analyze vaccine losses in a Health Region in the Northwest of São Paulo. Methods: retrospective cross-sectional study with secondary data obtained from Temperature Change Notification Forms used by the Epidemiological Surveillance Group XXIX of São José do Rio Preto between 2010 and 2017. Descriptive and inferential analysis were performed using multiple linear regression and significance level of 95%. Results: in total, 341 notifications of temperature changes were analyzed, of which 70.1% were caused by structural reasons, 57.8% in industrial refrigerators and 91.2% in primary care services. Of the doses that suffered a change in temperature, 41.4% were lost and 58.6% were administered to the population. The highest percentage of lost doses compared to those applied occurred in smaller municipalities, although they reported less. Conclusions: nursing workers who work in vaccination rooms should make efforts to prevent temperature changes and avoid losses and higher public expenses.

RESUMEN Objetivos: analizar las pérdidas de vacunas en una Región de Salud del Noroeste de São Paulo. Métodos: estudio transversal retrospectivo, con datos secundarios obtenidos de los formularios de notificación de cambios de temperatura utilizados por el Grupo XXIX de Vigilancia Epidemiológica de São José do Rio Preto entre 2010 y 2017. Se realizó el análisis descriptivo e inferencial y se utilizó la regresión lineal múltiple y nivel de significancia del 95%. Resultados: se analizaron 341 notificaciones de cambios de temperatura, de las cuales el 70,1% fueron por motivos estructurales, el 57,8% en frigoríficos industriales y el 91,2% en los servicios de atención primaria. De las dosis que sufrieron un cambio de temperatura, el 41,4% se perdieron y el 58,6% se administraron a la población. El mayor porcentaje de dosis perdidas en comparación con las aplicadas se produjo en los municipios más pequeños, aunque informaron menos. Conclusiones: los trabajadores de enfermería que laboran en las salas de vacunación deben esforzarse por prevenir cambios de temperatura, evitando pérdidas y aumento de los gastos públicos.

RESUMO Objetivos: analisar as perdas de vacinas em uma Região de Saúde do Noroeste paulista. Métodos: estudo transversal retrospectivo, com dados secundários obtidos das fichas de notificação de alteração de temperatura utilizadas pelo Grupo de Vigilância Epidemiológica XXIX de São José do Rio Preto, entre 2010 e 2017. Foi realizada análise descritiva e inferencial, utilizando regressão linear múltipla e nível de significância de 95%. Resultados: foram analisadas 341 notificações de alteração de temperatura, sendo 70,1% causadas por motivos estruturais, 57,8% em refrigeradores industriais e 91,2% em serviços de atenção básica. Das doses que sofreram alteração de temperatura, 41,4% foram perdidas e 58,6% foram administradas na população. O maior percentual de doses perdidas em relação às aplicadas ocorreu em municípios menores, apesar de eles notificarem menos Conclusões: os trabalhadores de enfermagem que atuam em salas de vacinação devem se empenhar para prevenir alterações de temperatura, evitando perdas e aumento dos gastos públicos.

Sleep quality and its association with menopausal and climacteric symptoms / Calidad del sueño y su asociación con síntomas menopáusicos y climatéricos / Qualidade do sono e sua associação com os sintomas de menopausa e climatério

ABSTRACT Objective: to assess sleep quality in menopausal women and its association with symptoms related to this period. Method: this is a cross-sectional, analytical and correlational study. Sleep was assessed using the Pittsburgh Sleep Quality Index; and climacteric symptoms, according to the Menopause Rating Scale. To compare the total score and each Menopause Rating Scale domain with the PSQI classification, the Mann-Whitney U non-parametric test was used. P<0.05 was considered significant. Results: 261 women (67.8%) were classified as bad sleepers. There was a positive and significant correlation between the sleep scale scores and the total menopause score and its domains. Women categorized as poor sleepers had worse scores on the menopause symptom scale. Conclusion: women with worse sleep quality revealed greater severity of symptoms related to menopause.

RESUMEN Objetivo: evaluar la calidad del sueño en mujeres menopáusicas y su asociación con síntomas relacionados con este período. Método: estudio transversal, analítico y correlacional. El sueño se evaluó mediante el índice de calidad del sueño de Pittsburgh; y síntomas climatéricos, según la escala de calificación de la menopausia. Para comparar la puntuación total y cada dominio Menopause Rating Scale con la clasificación PSQI, se utilizó la prueba no paramétrica U de Mann-Whitnney. P <0,05 se consideró significativo. Resultados: 261 mujeres (67,8%) fueron clasificadas como mal durmientes. Hubo una correlación positiva y significativa entre las puntuaciones de la escala de sueño y la puntuación total de la menopausia y sus dominios. Las mujeres clasificadas como personas que duermen mal tuvieron peores puntuaciones en la escala de síntomas de la menopausia. Conclusión: las mujeres con peor calidad del sueño revelaron una mayor gravedad de los síntomas relacionados con la menopausia.

RESUMO Objetivo: Avaliar a qualidade do sono em mulheres menopausadas e sua associação com os sintomas relacionados a esse período. Método: Estudo transversal, analítico e correlacional. O sono foi avaliado por meio do Índice de Qualidade do Sono de Pittsburgh; e os sintomas do climatério, pelo Menopause Rating Scale. Para a comparação do escore total e de cada domínio do Menopause Rating Scale com a classificação do Índice de Qualidade do Sono de Pittsburgh (PSQI), foi utilizado o teste não paramétrico U de Mann-Whitney. Considerou-se valor p<0,05 como significante. Resultados: Foram classificadas 261 mulheres (67,8%) como más dormidoras. Houve correlação positiva e significativa dos escores da escala do sono com o escore total da menopausa e seus domínios. As mulheres categorizadas como más dormidoras apresentaram piores escores na escala de sintomas de menopausa. Conclusão: Mulheres com pior qualidade do sono revelaram maior severidade dos sintomas relacionados à menopausa.