Reiki for Cancer Patients Undergoing Chemotherapy in a Brazilian Hospital: A Pilot Study.

The purpose of this pilot study was to explore whether individualized Reiki given to cancer patients at a Brazilian hospital improved symptoms and well-being. Data from 36 patients who received 5 Reiki sessions were collected using the MYMOP and were compared before and after their treatment and also with 14 patients who did not receive Reiki and who acted as a comparison group. Twenty-one patients reported feeling better, 12 felt worse, and 3 reported no change. Of the comparison group, 6 patients reported feeling better and 8 felt worse. The Reiki practice delivered as part of the integrative care in oncology did produce clinically significant effects, although not statistically significant results, for more than half of the patients undergoing cancer treatment.

Retinoblastoma diagnosis: a proposal based on the experience of Centro Infantil Boldrini, Brazil.

Advanced disease is a risk factor for eye loss in patients with retinoblastoma (RB). We still record critical rates of enucleation, especially for unilateral RB due to advanced stages of disease at diagnosis. This retrospective study of 223 RB patient records referred to treatment at Centro Infantil Boldrini, Brazil, between 1978 and 2008, showed that 176 patients (79%) presented intraocular tumors while 47 (21%) already had extraocular involvement. At the time of diagnosis, the age of patients was 26.2 months in the group that had enucleated eyes and 13.7 months in the group that preserved both eyes. Under a multiple logistic regression model, familial history (OR = 0.195; p = .01) and age at diagnosis in months (OR = 1.047; p = .04) were significantly correlated with enucleation. Strategies to early detect RB must be changed in order to offer better chances of ocular preservation with visual function. Authors propose a systematic referral of all children to the ophthalmologist for an indirect ophthalmoscopy once a year in the first two years of life, as a measure to be adopted by all pediatricians in daily routine to early detect the tumor.

Spatial distribution of the risk of dengue fever in southeast Brazil, 2006-2007.

BACKGROUND: Many factors have been associated with circulation of the dengue fever virus and vector, although the dynamics of transmission are not yet fully understood. The aim of this work is to estimate the spatial distribution of the risk of dengue fever in an area of continuous dengue occurrence. METHODS: This is a spatial population-based case-control study that analyzed 538 cases and 727 controls in one district of the municipality of Campinas, São Paulo, Brazil, from 2006-2007, considering socio-demographic, ecological, case severity, and household infestation variables. Information was collected by in-home interviews and inspection of living conditions in and around the homes studied. Cases were classified as mild or severe according to clinical data, and they were compared with controls through a multinomial logistic model. A generalized additive model was used in order to include space in a non-parametric fashion with cubic smoothing splines. RESULTS: Variables associated with increased incidence of all dengue cases in the multiple binomial regression model were: higher larval density (odds ratio (OR) = 2.3 (95%CI: 2.0-2.7)), reports of mosquito bites during the day (OR = 1.8 (95%CI: 1.4-2.4)), the practice of water storage at home (OR = 2.5 (95%CI: 1.4, 4.3)), low frequency of garbage collection (OR = 2.6 (95%CI: 1.6-4.5)) and lack of basic sanitation (OR = 2.9 (95%CI: 1.8-4.9)). Staying at home during the day was protective against the disease (OR = 0.5 (95%CI: 0.3-0.6)). When cases were analyzed by categories (mild and severe) in the multinomial model, age and number of breeding sites more than 10 were significant only for the occurrence of severe cases (OR = 0.97, (95%CI: 0.96-0.99) and OR = 2.1 (95%CI: 1.2-3.5), respectively. Spatial distribution of risks of mild and severe dengue fever differed from each other in the 2006/2007 epidemic, in the study area. CONCLUSIONS: Age and presence of more than 10 breeding sites were significant only for severe cases. Other predictors of mild and severe cases were similar in the multiple models. The analyses of multinomial models and spatial distribution maps of dengue fever probabilities suggest an area-specific epidemic with varying clinical and demographic characteristics.

Stress and coping among workers at psychosocial care centers in the interior of the state of Sao Paulo.

BACKGROUND: Psychosocial Care Centers (CAPS) are community-based facilities designed as a substitutive model to break with asylum-based care and aligned to the principles underlying the Unified Health System (Sistema Único de Saúde-SUS); thus they promote patient-centered care. OBJECTIVE: To establish the prevalence of stress and its association with biosocial characteristics and coping strategies within the work process of healthcare providers at CAPS in a city in the interior of the state of Sao Paulo, Brazil. METHOD: Cross-sectional quantitative study involving administration of three questionnaires: biosocial, Work Stress Scale and a checklist of coping strategies. The sample comprised 193 healthcare providers from 11 different CAPS. RESULTS: Most participants were female, with average age 35 years old, single and without children. The levels of stress were rated high, with prevalence of 50.2%. The main associations found concern the participants' subjective appraisal of their job, particularly personal recognition and satisfaction. The coping strategies most frequently cited were problem-solving and social support. CONCLUSION: We found high levels of stress in the analyzed population and association of stress mainly with biosocial characteristics.

INTRODUÇÃO: Os Centros de Atenção Psicossocial (CAPS) são serviços comunitários que foram concebidos como modelo substitutivo que rompe com o modelo de atenção manicomial, alinhado aos princípios do Sistema Único de Saúde (SUS), promovendo uma clínica centrada no sujeito. OBJETIVO: Identificar a prevalência de estresse e suas associações com as características biossociais e as estratégias de enfrentamento relacionadas ao processo de trabalho dos profissionais da saúde que trabalham nos CAPS de uma cidade do interior de São Paulo. MÉTODO: Estudo transversal quantitativo utilizando três questionários de autopreenchimento: um biossocial, a Escala de Estresse no Trabalho (EET) e um com estratégias de enfrentamento do estresse (coping). A investigação foi desenvolvida com 193 profissionais de saúde de 11 CAPS. RESULTADOS: Houve predominância de sexo feminino, 35 anos, sem filhos e solteiros. O estresse foi considerado alto, com 50,2% de prevalência. As principais associações dizem respeito às questões subjetivas relacionadas à forma como o trabalhador avalia e sente seu trabalho. As estratégias de enfrentamento mais utilizadas foram resolução de problemas e suporte social. CONCLUSÃO: Observou-se elevado grau de estresse na população estudada e, principalmente, suas associações com características biossociais.

[Spatial distribution of risks for work-related injuries in a city of Southeastern Brazil]. / Topologia do risco de acidentes do trabalho em Piracicaba, SP.

OBJECTIVE: To assess spatial distribution of risks for work-related injuries controlled for nutritional variables and other covariables. METHODS: Hospital-based spatial case-control study with work-related injuries spatial distribution as the main variable of interest. A total of 794 workers were selected between May and October 2004. Inclusion criteria for cases (N=263) were: worker with work-related injury; living in Piracicaba (Southeastern Brazil); age between 15 and 60 years old; and cared at an orthopedics and trauma center. Controls (N=531) met the same criteria for age and residence, but had non-work-related injuries and workers accompanying cases were included as well. Spatial distribution was estimated by adjusting a generalized additive model with geographical coordinates of cases and controls as spatial non-linear component and the remaining covariables as linear components. RESULTS: The variation of estimated spatial risks for work-related injuries controlled for gender (OR=1.87, p<0.001), schooling (OR=0.85, p<0.0001), self-employed (OR=0.36, p<0.01), and waist circumference (OR=0.98, p=0.05) showed that the mideastern area and north-to-south "strip" have higher risk for injuries. CONCLUSIONS: The use of geoprocessing tools and nutritional variables can provide input for understanding the universe of risks for work-related injuries. Further investigation exploring these factors is needed.

Burnout and workorganization in Nursing.

BACKGROUND: Burnout syndrome (BS) consists of a set of symptoms that appear in response to chronic interpersonal stressors at work and involve the perceptions individuals have of themselves and their work environment. OBJECTIVES: To identify psychosocial risk and work organization factors able to predict mental suffering, and to estimate the prevalence of BS in a sample of nursing professionals from a public hospital in the state of São Paulo, Brazil. METHODS: Mixed methods research combining quantitative and qualitative approaches conducted at a public university hospital. Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to estimate the prevalence of BS. Thematic content analysis of narratives gathered in focus groups was performed to identify psychosocial risk factors at work (PRFW). RESULTS: The prevalence of BS at the investigated institution (5.7%) is consistent with the rates reported in the international literature. Analysis of the narratives gathered in focus groups revealed stressors in the organization of work. CONCLUSION: The present study also points to the need for a broader look into the causes of BS, in which consideration of singular psychosocial risk and work organization factors from the perspective of workers devoted to proving care to human beings has paramount importance.

INTRODUÇÃO: A síndrome deburnout (SB) éum conjunto de sintomas que surgem da resposta a estressores interpessoais crônicos no trabalho e envolvem a percepção que a pessoa tem de si própria e do ambiente em que realiza seu trabalho. OBJETIVO: Identificar os fatores de risco psicossociais e da organização do trabalho preditores de sofrimento mental, bem como estimar a prevalência da SB em uma população de profissionais de Enfermagem de um hospital público do interior do Estado de São Paulo. MÉTODOS: Pesquisa mista, combinando as abordagens quantitativa e qualitativa, desenvolvida em um hospital público universitário. Foram utilizados o Maslach Burnout Inventory-Human Services Survey (MBI-HSS), para estimar a prevalência de SB, e a análise de conteúdo em grupos focais (GFs), para identificar fatores psicossociais de risco no trabalho (FPRT). RESULTADOS: A prevalência de SB na instituição estudada (5,7%) foi compatível com a literatura internacional. A análise das falas emergentes dos GFs revelou a existência de FPRT atuando como estressores na organização do trabalho. CONCLUSÃO: Esta pesquisa apontou ainda a necessidade de um olhar mais amplo sobre as causas da SB, sendo de grande importância a inclusão, nos trabalhos, do estudo da singularidade dos fatores psicossociais e da organização do trabalho por meio da voz dos profissionais que têm como foco de trabalho o cuidado ao ser humano.

Low socioeconomic condition and the risk of dengue fever: A direct relationship.

This study aimed to characterize the first dengue fever epidemic in Várzea Paulista, São Paulo, Brazil, and its spatial and spatio-temporal distribution in order to assess the association of socioeconomic factors with dengue occurrence. We used autochthonous dengue cases confirmed in a 2007 epidemic, the first reported in the city, available in the Information System on Diseases of Compulsory Declaration database. These cases where geocoded by address. We identified spatial and spatio-temporal clusters of high- and low-risk dengue areas using scan statistics. To access the risk of dengue occurrence and to evaluate its relationship with socioeconomic level we used a population-based case-control design. Firstly, we fitted a generalized additive model (GAM) to dengue cases and controls without considering the non-spatial covariates to estimate the odds ratios of the occurrence of the disease. The controls were drawn considering the spatial distribution of the household of the study area and represented the source population of the dengue cases. After that, we assessed the relationship between socioeconomic variables and dengue using the GAM and obtained the effect of these covariates in the occurrence of dengue adjusted by the spatial localization of the cases and controls. Cluster analysis and GAM indicated that northeastern area of Várzea Paulista was the most affected area during the epidemic. The study showed a positive relationship between low socioeconomic condition and increased risk of dengue. We studied the first dengue epidemic in a highly susceptible population at the beginning of the outbreak and therefore it may have allowed to identify an association between low socioeconomic conditions and increased risk of dengue. These results may be useful to predict the occurrence and to identify priority areas to develop control measures for dengue, and also for Zika and Chikungunya; diseases that recently reached Latin America, especially Brazil.

Self-medication in children and adolescents.

OBJECTIVE: To determine the prevalence of self-medication in children and adolescents in the municipalities of Limeira and Piracicaba, state of São Paulo, and to correlate results with sociodemographic indicators and with the use of health care services (public or private). METHODS: Descriptive population-based study of a simple random sample from the two municipalities, comprised of 772 inhabitants from 85 urban census sectors selected through cluster sampling. INCLUSION CRITERIA: age < or = 18 years; interview with one parent/tutor; consumption of at least one drug in the previous 15 days. Subjects were divided into two study groups according to their pattern of drug use: self-medication (lay advice) and medical prescription. Linear association tests, descriptive analysis of variables and multiple logistic regression tests were carried out to analyze data. RESULTS: The prevalence of self-medication was 56.6%. Mothers (51%) and drugstore employees (20.1%) were most frequently responsible for self-medication. The main groups of self-prescribed drugs were: analgesic/antipyretic and non-hormonal anti-inflammatory drugs (52.9%); drugs acting on the respiratory tract (15.4%) and gastrointestinal drugs (9.6%); and systemic antibiotics (8.6%). The situation that most commonly motivated self-medication were respiratory diseases (17.2%), fever (15%), and headache (14%). Subjects in the age group of 7-18 years (odds ratio = 2.81) and public health care users (odds ratio = 1.52) showed increased risk for self-medication. CONCLUSIONS: The prevalence of self-medication in children and adolescents was high, which reinforces the need for public health interventions aiming at preventing this practice.

[AmostraBrasil: an R package for household sampling in Brazilian municipalities]. / AmostraBrasil: um pacote R para amostragem domiciliar em municípios brasileiros.

Given the relevance of epidemiological surveys and the difficulties in establishing an adequate sampling plan to conduct them, this article present the AmostraBrasil package, part of the open-access R software, which automatizes the taking of random samples - simple, systematic, and stratified - from households in any Brazilian municipalities (counties). The package also allows automatically obtaining the sampled households' geographic coordinates, was well as shapefiles of the municipality's perimeter and the sample's spatial distribution. The article describes the steps for installing and using the package in the Windows OS. Examples are provided of the package's applications: sampling and spatial distribution of 2,500 residential households in the city of Rio de Janeiro and generation of controls in estimating risk spatial distribution.

Yoga and health promotion, practitioners' perspectives at a Brazilian university: A pilot study.

UNLABELLED: The purpose of this paper is to present the results of the Program Yoga and Health Promotion offered to 18 participants, lecturers, workers and students of the State University of Campinas, Brazil. The program aimed at favoring well-being in relation to their physical, emotional and mental condition. Practitioners completed the Measure Yourself Medical Outcome Profile to identify the symptoms and the perception of self-reported well-being, and the T test was applied to the results of the participants' profiles before and after the program. Narratives were used based on trigger phrases. Seven categories (self-control; self-perception; well-being; body awareness; balance; mind-body; reflexivity), were identified through thematic analysis. The results were discussed according to the triangulation of methods. RESULTS: 14 participants scored better profiles, with a p-value <0.05. As regards the narratives, there were no negative perceptions about the yoga practice. IN CONCLUSION: yoga was a positive intervention for the group of participants.

Social scientists in public health: a fuzzy approach.

This study aims to describe and analyze the presence of social scientists, anthropologists, sociologists and political scientists in the field of public health. A survey by the Lattes Curriculum and sites of Medical Colleges, Institutes of Health Research Collective, seeking professionals who work in healthcare and have done some stage of their training in the areas of social sciences. In confluence with Norbert Elias' concepts of social networks and configuration of interdependence it was used fuzzy logic, and the tool free statistical software R version 2.12.0 which enabled a graphic representation of social scientists interdependence in the field of social sciences-health-social sciences. A total of 238 professionals were ready in 6 distinct clusters according to the distance or closer of each professional in relation to public health and social sciences. The work was shown with great analytical and graphical representation possibilities for social sciences of health, in using this innovative quantitative methodology.

[Knowledge of and compliance with universal precautions: students dealing with biohazards in Brazil and Colombia]. / Conhecimento e adesão às precauções padrão: Estudantes diante dos riscos biológicos no Brasil e na Colômbia.

Objective To assess scales of adherence to universal precautions and means of knowledge transmission among healthcare students in Brazil and Colombia. Methods We conducted a pilot study to validate the questionnaire that started a cohort study. Twenty-six students in Colombia and 25 in Brazil were intentionally selected. The participants were comparable in number and sociodemographic characteristics in both countries and studied the health professions (medicine, nursing and dentistry). The program SPSS version 18.0 was used to create the database and to carry out statistical analysis. Results We evaluated a total of 51 students. They had a a mean (SD) age of 21.78 (2.33), 84.3 % were women, 66.7 % had white skin, 47.1 % were medical students, and 70,6 % were in their 4th year. They answered about sexual habits reporting that 45.1 had only one partner% in the last year, 23.5 % did not use protection, and, of those who were protected, 45.1 % used a condom. The mean knowledge was 10.88 (±0.952) points to an expected 9 points; Cronbach's Alpha (α) was 0.823. The mean adherence to universal precautions (UPs) was 33.69 (±3.36) points to an expected 30.75; α was 0.741. We found a significant difference in knowledge levels (p<0.007) between the two countries and in the adherence to PUs by year of study (p<0.001). Conclusions Knowledge about means of transmission was good. Adherence to universal precautions was acceptable, but low in terms of the use of glasses, face masks, and discarding sharp objects. Dentistry students showed the best adherence.

Inflammatory bowel disease in an underdeveloped region of Northeastern Brazil.

AIM: To evaluate the demographic characteristics and clinical phenotypes of inflammatory bowel disease (IBD) in a geographic area in Northeastern Brazil. METHODS: This retrospective study was conducted at the Hospital of the Federal University of Piauí in Northeastern Brazil. Demographic characteristics and clinical phenotypes of IBD were analyzed in relation to the time of diagnostic confirmation, which was defined as the date of disease onset. Data were collected between January 2011 and December 2012 and included all census patients 18 years of age or older during that period for whom there was diagnostic confirmation of Crohn's disease (CD), ulcerative colitis (UC), or unclassified colitis according to the Montreal criteria. We also analyzed the period of time between the onset of clinical manifestations and the diagnosis of IBD (delay in the diagnosis). Statistical analyses included means and standard deviations for numeric variables and the Pearson χ2 adherence test for nominal variables. The annual index occurrence and overall prevalence of IBD at our institution were also calculated, with P values<0.05 indicating statistical significance. This study was approved by the Institutional Ethics and Research Committee. RESULTS: A total of 252 patients with IBD were included, including 152 (60.3%) UC patients and 100 (39.7%) CD patients. The clinical and demographic characteristics of all patients with IBD showed a female to male ratio of 1.3:1.0 and a mean age of 35.2 (SD=14.5) years. In addition, the majority of patients were miscegenated (171, 67.9%), had received higher education (157, 62.4%), lived in urban areas (217, 86.1%), and were under the age of 40 years (97, 62.5%). For patients with CD, according to the Montreal classification, the predominant features present from the onset of disease were an age between 17 and 40 years (A2); colonic disease location (L2); and nonstricturing, nonfistulizing disease behavior (B1). However, approximately one-quarter of all CD patients demonstrated perineal involvement. We also observed considerable delay in the diagnosis of IBD throughout the entire study period (mean=35.5 mo). In addition, the annual index occurrence rose from 0.08 to 1.53 cases/10(5) inhabitants/year during the study period, and the prevalence rate was 12.8 cases/10(5) inhabitants in 2012. Over the last two decades, there was a noted increase in the frequency of IBD in the study area. CONCLUSION: In this study, there was a predominance of patients with UC, young people under 40 years of age, individuals with racial miscegenation, and low annual incomes.

Spatial distribution of the risk of dengue and the entomological indicators in Sumaré, state of São Paulo, Brazil.

Dengue fever is a major public health problem worldwide, caused by any of four virus (DENV-1, DENV-2, DENV-3 and DENV-4; Flaviviridae: Flavivirus), transmitted by Aedes aegypti mosquito. Reducing the levels of infestation by A. aegypti is one of the few current strategies to control dengue fever. Entomological indicators are used by dengue national control program to measure the infestation of A. aegypti, but little is known about predictive power of these indicators to measure dengue risk. In this spatial case-control study, we analyzed the spatial distribution of the risk of dengue and the influence of entomological indicators of A. aegypti in its egg, larva-pupa and adult stages occurring in a mid-size city in the state of São Paulo. The dengue cases were those confirmed by the city's epidemiological surveillance system and the controls were obtained through random selection of points within the perimeter of the inhabited area. The values of the entomological indicators were extrapolated for the entire study area through the geostatistical ordinary kriging technique. For each case and control, the respective indicator values were obtained, according with its geographical coordinates and analyzed by using a generalized additive model. Dengue incidence demonstrated a seasonal behavior, as well as the entomological indicators of all mosquito's evolutionary stages. The infestation did not present a significant variation in intensity and was not a limiting or determining factor of the occurrence of cases in the municipality. The risk maps of the disease from crude and adjusted generalized additive models did not present differences, suggesting that areas with the highest values of entomological indicators were not associated with the incidence of dengue. The inclusion of other variables in the generalized additive models may reveal the modulatory effect for the risk of the disease, which is not found in this study.

Burnout e a organização do trabalho na Enfermagem / Burnout and work organization in Nursing

Introdução: A síndrome de burnout (SB) é um conjunto de sintomas que surgem da resposta a estressores interpessoais crônicos no trabalho e envolvem a percepção que a pessoa tem de si própria e do ambiente em que realiza seu trabalho. Objetivo: Identificar os fatores de risco psicossociais e da organização do trabalho preditores de sofrimento mental, bem como estimar a prevalência da SB em uma população de profissionais de Enfermagem de um hospital público do interior do Estado de São Paulo. Métodos: Pesquisa mista, combinando as abordagens quantitativa e qualitativa, desenvolvida em um hospital público universitário. Foram utilizados o Maslach Burnout Inventory-Human Services Survey (MBI-HSS), para estimar a prevalência de SB, e a análise de conteúdo em grupos focais (GFs), para identificar fatores psicossociais de risco no trabalho (FPRT). Resultados: A prevalência de SB na instituição estudada (5,7%) foi compatível com a literatura internacional. A análise das falas emergentes dos GFs revelou a existência de FPRT atuando como estressores na organização do trabalho. Conclusão: Esta pesquisa apontou ainda a necessidade de um olhar mais amplo sobre as causas da SB, sendo de grande importância a inclusão, nos trabalhos, do estudo da singularidade dos fatores psicossociais e da organização do trabalho por meio da voz dos profissionais que têm como foco de trabalho o cuidado ao ser humano.

Background: Burnout syndrome (BS) consists of a set of symptoms that appear in response to chronic interpersonal stressors at work and involve the perceptions individuals have of themselves and their work environment. Objectives: To identify psychosocial risk and work organization factors able to predict mental suffering, and to estimate the prevalence of BS in a sample of nursing professionals from a public hospital in the state of São Paulo, Brazil. Methods: Mixed methods research combining quantitative and qualitative approaches conducted at a public university hospital. Maslach Burnout Inventory-Human Services Survey (MBIHSS) was used to estimate the prevalence of BS. Thematic content analysis of narratives gathered in focus groups was performed to identify psychosocial risk factors at work (PRFW). Results: The prevalence of BS at the investigated institution (5.7%) is consistent with the rates reported in the international literature. Analysis of the narratives gathered in focus groups revealed stressors in the organization of work. Conclusion: The present study also points to the need for a broader look into the causes of BS, in which consideration of singular psychosocial risk and work organization factors from the perspective of workers devoted to proving care to human beings has paramount importance.

Geographic expression of AIDS epidemic in Campinas, Southeastern Brazil, between 1980 and 2005.

OBJECTIVE: To analyze the spatial distribution of reported AIDS cases in adults and its association with living conditions in the city of Campinas, Southeastern Brazil. METHODS: Data on AIDS cases in men (n=2,945) and women (n=1,230) aged more than 13 years and living in Campinas, recorded in the SINAN (Brazilian Information System for Notifiable Diseases), were used to map the spatial distribution of this disease and the male:female ratio. Maps were constructed for the following periods: from 1980 to 1995, from 1996 to 2000, and from 2001 to 2005. The variables included in the analysis were address, sex and age. A weighted composite index was used to study living and health conditions in the area. Patients' home addresses were geocoded on a cartographic base, after correction and standardization according to a reference database of streets. A generalized additive model was adjusted to analyze the spatial distribution of the ratio of male:female cases in space, in the three study periods. RESULTS: The ratio of male:female cases was higher in areas with better living conditions (central) and around the prison (northwestern), where families of prisoners and former prisoners live temporarily, while this ratio was lower in the city suburbs (southwestern). CONCLUSIONS: The trends towards the AIDS epidemic affecting more women and poorer individuals were confirmed by the decrease in the ratio of male:female cases in the period, particularly in vulnerable and impoverished populations. Geographic information systems and spatial data analysis can be useful for AIDS control and surveillance actions.

Social scientists in public health: a fuzzy approach / Cientistas sociais da Saúde Coletiva: uma abordagem pela óptica fuzzy

This study aims to describe and analyze the presence of social scientists, anthropologists, sociologists and political scientists in the field of public health. A survey by the Lattes Curriculum and sites of Medical Colleges, Institutes of Health Research Collective, seeking professionals who work in healthcare and have done some stage of their training in the areas of social sciences. In confluence with Norbert Elias' concepts of social networks and configuration of interdependence it was used fuzzy logic, and the tool free statistical software R version 2.12.0 which enabled a graphic representation of social scientists interdependence in the field of social sciences-health-social sciences. A total of 238 professionals were ready in 6 distinct clusters according to the distance or closer of each professional in relation to public health and social sciences. The work was shown with great analytical and graphical representation possibilities for social sciences of health, in using this innovative quantitative methodology.

O presente estudo objetiva descrever e analisar a presença dos cientistas sociais, antropólogos, sociólogos e cientistas políticos no campo da saúde coletiva. Foi realizado um levantamento junto à Plataforma Lattes e aos sites de Faculdades de Medicina, Institutos de Pesquisa em Saúde Coletiva, buscando os profissionais que atuam na área da saúde e que tenham realizado alguma etapa da sua formação nas áreas das ciências sociais. Em confluência aos conceitos de configuração social e de redes de interdependência de Norbert Elias, utilizamos a lógica fuzzy, tendo como ferramenta o software estatístico livre R, versão 2.12.0, que possibilitou uma representação gráfica da interdependência dos cientistas sociais no campo das ciências sociais-saúde-ciências sociais. O total de 238 profissionais foram dispostos em 6 clusters distintos, de acordo com a distância ou aproximação de cada profissional em relação à saúde coletiva e às ciências sociais. O trabalho se mostrou com grandes possibilidades analíticas e de representação gráfica da área estudada, além da utilização inovadora dessa metodologia quantitativa nas ciências sociais em saúde.

[Case-control studies with multinomial responses: a proposal for analysis]. / Estudo caso-controle com resposta multinomial: uma proposta de análise.

This study reviews articles on case-control studies in which the cases were classified in two or more types. Application of multinomial models and their adequacy for case-control studies are discussed. Among the available multinomial adjustments, we argue that the polytomous logistic model is the most suitable for obtaining epidemiological measures of risk and association in case-control studies. By way of illustration, we present an application of this model in a population-based case-control study, comparing the results with those obtained in a binomial logistic model. The multinomial approach allows investigating, in a single analysis, the occurrence of associations between covariates and more or more subclasses of cases, thus providing the epidemiologically relevant possibility of identifying individualized risk and protective factors for each subclass.

Conhecimento e adesão às precauções padrão: estudantes diante dos riscos biológicos no Brasil e na Colômbia / Knowledge of and compliance with universal precautions: students dealing with biological risk in Brazil and Colombia / Conocimiento y adhesión a las precauciones universales: estudiantes frente a los virus, en Brasil y en Colombia

Objetivo Avaliar as escalas de adesão às precauções padrão (PPs) e conhecimento sobre meios de transmissão entre estudantes da saúde no Brasil e na Colômbia. Métodos Trata-se de um estudo piloto para validar o questionário que iniciou estudo de coorte. Selecionamos intencionalmente 26 estudantes na Colômbia e 25 no Brasil, comparáveis em número e características sociodemográficas, que cursavam profissões da saúde (medicina, enfermagem e odontologia). Utilizamos o programa SPSS versão 18.0 para criar o banco de dados e a análise estatística. Resultados : Avaliamos 51 estudantes, com média ± Desvio Padrão de idade de 21,78 ± 2,33, dos quais 84,3 % eram mulheres, 66,7 % de cor de pele branca, , 47,1 % de medicina, e 70,6 % do 70 semestre. Responderam sobre hábitos sexuais afirmando que 45,1 % tiveram no último ano só um parceiro, 23,5 % não usaram proteção, e dos que se protegeram, 45,1 % utilizaram o preservativo. A média de con0hecimento foi 10,88 (±0,952) pontos, para valor esperado de 9 pontos; com Alpha de Cronbach's (α) de 0,823. A média de adesão às precauções padrão (PPs) foi 33,69 (±3,36) pontos, para 30,75 esperados. O α foi de 0,741. Encontramos diferença significativa no conhecimento (p<0,007) entre os dois países, e na adesão as PPs segundo o curso (p<0,001). Conclusões O conhecimento sobre meios de transmissão foi bom. A adesão às precauções padrão em geral foi aceitável, mas foi baixa para algumas precauções avaliadas como o uso de óculos, máscara e o descarte de perfurocortantes. Estudantes de odontologia tiveram melhor adesão.(AU)

Objective To assess scales of adherence to universal precautions and means of knowledge transmission among healthcare students in Brazil and Colombia. Methods We conducted a pilot study to validate the questionnaire that started a cohort study. Twenty-six students in Colombia and 25 in Brazil were intentionally selected. The participants were comparable in number and sociodemographic characteristics in both countries and studied the health professions (medicine, nursing and dentistry). The program SPSS version 18.0 was used to create the database and to carry out statistical analysis. Results We evaluated a total of 51 students. They had a a mean (SD) age of 21.78 (2.33), 84.3 % were women, 66.7 % had white skin, 47.1 % were medical students, and 70,6 % were in their 4th year. They answered about sexual habits reporting that 45.1 had only one partner% in the last year, 23.5 % did not use protection, and, of those who were protected, 45.1 % used a condom. The mean knowledge was 10.88 (±0.952) points to an expected 9 points; Cronbach's Alpha (α) was 0.823. The mean adherence to universal precautions (UPs) was 33.69 (±3.36) points to an expected 30.75; α was 0.741. We found a significant difference in knowledge levels (p<0.007) between the two countries and in the adherence to PUs by year of study (p<0.001). Conclusions Knowledge about means of transmission was good. Adherence to universal precautions was acceptable, but low in terms of the use of glasses, face masks, and discarding sharp objects. Dentistry students showed the best adherence.(AU)

Objetivo Evaluar escalas de adhesión a las precauciones universales y de conocimiento sobre medios de transmisión entre estudiantes de la salud, en Brasil y Colombia. Métodos Realizamos estudio piloto para validar cuestionario utilizado en el inicio del estudio de cohorte. Seleccionamos intencionalmente 26 estudiantes en Colombia y 25 en Brasil, comparables en número y características socio-demográficas, de profesiones de la salud (medicina, enfermería y odontología). Se utilizó el programa SPSS versión 18.0 para crear el banco de datos y realizar el análisis estadístico. Resultados Evaluamos 51 estudiantes, con media (SD) de edad de 21,78 años (2,33), 84,3 % eran mujeres, 66,7 % de tez blanca, 47,1 % de medicina, y 70,6 % del 70 período. Ellos contestaran sobre sus hábitos sexuales reportando que 45,1 % tuvieron en el último año sólo un compañero, 23,5 % no usaron protección, y de los que se protegieron, 45,1 % utilizaron el preservativo. La media de conocimiento fue 10,88 (±0,952) puntos, para una esperada de 9 puntos; con Alpha de Cronbach's (α) de 0,823. La media de adhesión a las Precauciones Universales (PUs) fue 33,69 (±3,36) puntos, con una expectativa de 30,75; α fue de 0,741. Se encontró diferencia significativa en el conocimiento (p<0,007) entre los dos países, y en la adhesión de las PUs según el curso (p<0,001). Conclusiones El conocimiento sobre medios de transmisión era bueno. La adhesión a las precauciones universales era aceptable, pero baja para el uso de gafas, tapabocas y el descarte de elementos cortantes y perforantes. Estudiantes de odontología tuvieron mejor adhesión.(AU)

Home medicine chests and their relationship with self-medication in children and adolescents.

OBJECTIVE: To investigate the contents of home medicine chests and their relationship with self-medication in children and adolescents in the towns of Limeira and Piracicaba, SP, Brazil. METHODS: This is a descriptive population study based on a home survey of a simple random sample from both towns, comprising 705 households from census sectors selected by means of cluster sampling. INCLUSION CRITERIA: age