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1.
Port of Spain; Caribbean Epidemiology Centre; 3 ed; June 2011. vi,25 p.
Monografia em Inglês | MedCarib | ID: med-17905

RESUMO

All CAREC member countries must have functioning surveillance systems for communicable and noncommunicable diseases and deaths. Each country must also have guidelines approved and endorsed by relevant authorities in the Ministry of Health to support these systems. This regional policy guidelines document is: i) a guide for the development or strengthening of national surveillance guidelines for communicable and non-communicable diseases and deaths; ii) intended to be used as an advocacy tool for the development of national and regional surveillance systems for communicable and non-communicable diseases and deaths; iii) a description of the regional surveillance systems for communicable and non-communicable diseases and deaths.


Assuntos
Vigilância Sanitária , Monitoramento Epidemiológico , Vigilância da População , Caribbean Public Health Agency , Doenças Transmissíveis
2.
Rev. panam. salud p£blica ; 21(6): 365-372, June 2007. maps, tab
Artigo em Inglês | MedCarib | ID: med-17350

RESUMO

OBJECTIVE: To critically assess the prevalence among schoolchildren 6 to 9 years of age throughout the Dominican Republic of a bacille Calmette-Guerin (BCG) vaccination scar, and to examine the relationship between nutritional and sociodemographic factors and the likelihood of having a BCG scar. METHODS: This correlational study used the database of the Second National Census on Height and Weight of Elementary School First Grade Students, which was conducted in the Dominican Republic August 2001-May 2002, to provide a critical assessment of BCG coverage nationwide. The Census information for the children included the presence of BCG scar, their nutritional status, and basic demographic data. We developed a new sociodemographic indicator, the "Rosa Index", to examine the potential influence of poverty and other environmental characteristics on scar presence. We used logistic regression models to predict the presence of a BCG scar. RESULTS: An overall BCG scar prevalence of 55.3 percent (85 644/154 887)was found. Malnourished children were less likely to have a BCG scar than were children with adequate nutritional status (odds ratio = 0.91; 95 percent confidence interval: 0.87, 0.95, P<0.05). Children who were 7-9 years old were less likely to have a BCG scar than were children 6 years old. Children in the areas of the country more than two hours' driving distance from the capital city of Santo Domingo more often exhibited lower BCG scar prevalence levels than did children in Santo Domingo. A higher Rosa Index (better level of socioeconomic characteristics) was correlated with higher BCG scar prevalence values (r=0.54, P<0.05). CONCLUSIONS: Our study findings indicate that BCG coverage appears to be inadequate for schoolchildren in the Dominican Republic. Nevertheless, the presence of a scar in a higher proportion of younger children suggests that coverage has improved in recent years. More programmatic and economic emphasis needs to be placed on extending early BCG vaccination coverage to the areas of the country where vaccination coverage is lower, and on examining the potential role that poverty may have on vaccination effectiveness (AU)


Assuntos
Humanos , Criança , Vacina BCG , Vigilância da População , Tuberculose , Cicatriz , Vacinação , Fatores Socioeconômicos , República Dominicana , Região do Caribe
3.
Rev. panam. salud p£blica ; 19(2): 112-117, Feb. 2006. maps
Artigo em Inglês | MedCarib | ID: med-17093

RESUMO

OBJECTIVES: West Nile Virus (Flavivirus: Flaviviridae; WNV) has spread rapidly throughout the Caribbean Basin since its initial detection there in 2001. This report summarizes our current knowledge of WNV transmission in tropical America. METHODS: We reviewed the published literature and consulted with key public health officials to obtain unpublished data. RESULTS: West Nile virus infections first appeared in human residents of the Cayman Islands and the Florida Keys in 2001, and in appparently healthy Jamaican birds sampled early in 2002. Serologic evidence of WNV infection in 2002 was detected in horses, chickens and resident free-ranging birds in Guadeloupe, the Dominican Republic, and eastern Mexico. In 2003, WNV spread in Mexico and northern Central America, and serologic evidence was detected in the Bahamas, Puerto Rico and Cuba. In 2004, the first serologic evidence of WNV activity in South American ecosystems surfaced in September-October in Colombia and Trinidad, where domestic animals circulated WNV-neutralizing antibodies. CONCLUSIONS: The sparse reports of equine, human and avain disease in Latin America and the Caribbean is puzzling. Isolates are needed to evaluate viral attenuation or other possible explanations for reduced disease burden in tropical ecosystems (AU)


Assuntos
Humanos , Animais , Vírus do Nilo Ocidental , América Latina , Vigilância da População , Flavivirus , Região do Caribe , Arbovirus
5.
Am J Trop Med Hyg ; 65(4): 318-24, Oct. 2001. maps, tab
Artigo em Inglês | MedCarib | ID: med-50

RESUMO

Hepaptits is common in the Stann Creek District of Southern Belize to determine the etiologies, incidence and potential risk factors for acute jaundice, we conducted active surveillance for cases. Cases of jaundice diagnosed by a physician within the previous 6 weeks were enrolled. Evaluation included a questionnaire and laboratory tests for Hepatitis A, B. C, D, and E, a blood film for malaria, and a serologic test for syphilis. Etiologies of jaundice among 62 evaluable patients included acute hepatitis A, 6 (9.7 percent), acute hepatitis B, 49 (79.0 percent) hepatitis non-A-E, 2 (3.2 percent), and malaria, 5 (8.1 percent). There were no cases of acute hepatitis E. One patient each with antibody to hepatitis C and D were detected. The annualized incidence of hepatitis A was 0.26 per 1000. All cases of hepatitis A were in children 4-16 years of age. The annualized incidence of hepatitis B, 2.17 per 1000, was highest in adults aged 15-44 years (4.4 per 1000) and was higher in men (36 cases; 3.09 per 1000) than women (13 cases; 1.19 per 1000). Four (31 percent) of the women with hepatitis B were pregnant. The annualized incidence was significantly higher in Mestizo (6.18 per 10000 and Maya (6.79 per 1000) than Garifuna (0.38 per 1000) or Creole (0.36 per 1000). Persons with Hepatitis B were significantly more likely to be born outside of Belize (82 percent), had been in Belize < 5 years (73 percent), and lived and worked in rural areas (96 percent) than was the general population. Of those o 14 years of age with Hepatitis B, only 36 percent were married. Few persons admitted to transfusions, tattoos, IV drug use, multiple sexual partners, visiting prostitutes, or sexually transmitted diseases. Only 1 of 49 had a reactive test for syphilis. Six patients were hospitalized (including 3 with acute hepatitis B and one with Hepatitis A), and none to our knowledge died. Acute hepatitis B is the most common cause of viral hepatitis in the Stann Creek District, but the modes of transmission remain obscure. Infants, women attending prenatal clinics, and new workers are potential targets for immunization with Hepatitis B vaccine. (AU)


Assuntos
Adulto , Criança , Pré-Escolar , Pessoa de Meia-Idade , Feminino , Humanos , Masculino , Gravidez , Adolescente , Hepatite/epidemiologia , Icterícia/diagnóstico , Belize/epidemiologia , Hepatite/etiologia , Hepatite/imunologia , Hepatite B/epidemiologia , Hepatite B/imunologia , Hepatite B/prevenção & controle , Vacinas contra Hepatite B , Icterícia/etiologia , Malária/complicações , Malária/epidemiologia , Doença Aguda , Vigilância da População , Testes Sorológicos , Inquéritos e Questionários , Transmissão de Doença Infecciosa/prevenção & controle
6.
Am J Epidemiol ; 153(2): 184-7, Jan. 2001. tab, gra
Artigo em Inglês | MedCarib | ID: med-111

RESUMO

Incidence data on open-angle glaucoma (OAG) are limited and difficult to obtain. To date, few studies have reported incidence directly measured from population-based cohorts. Other reported estimates have been derived indirectly from age-specific prevalence by using several assumptions, and their validity is unknown. To the authors' knowledge, this report presents the first comparison of observed versus indirect estimates of OAG incidence based on data from the population-based Barbados Incidence Study of Eye Diseases (1992-1997) (n= 3,427; 85 percent participation). The observed 4-year incidence of OAG was 1.2 percent (95 percent confidence interval (CI):ages 60-69 years, and 4.2 percent (95 percent CI: 2.6, 6.3 percent) in persons at ages 70 or more years. When incidence was calculated from the prevalence data, power function fitting achieved a closer approximation to observed incidence than did logistic curve fitting. Calculated incidence rate for each group were similar when assuming mortality that was equal (incidence rate= 0.7, 1.3, 2.3, and 4.8 percent) or differential (incidence rate= 0.7, 1.2, 2.4, and 4.8 percent). Other nonlogistic approaches also increased the resemblance of observed and calculated estimates. The absence of longitudinal data, reasonably valid incidence estimates of OAG were obtained from available prevalence data. These estimation techniques can be useful when OAG incidence estimates are required for research or public health purposes. (AU)


Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Estudo Comparativo , Glaucoma de Ângulo Aberto/epidemiologia , Interpretação Estatística de Dados , Observação/métodos , Vigilância da População/métodos , Barbados/epidemiologia , Modelos Logísticos , Incidência , Distribuição por Idade , Estudos de Coortes
9.
J Pedriatr ; 136(1): 80-5, Jan. 2000.
Artigo em Inglês | MedCarib | ID: med-749

RESUMO

The prevalence, incidence, risk factors, clinical associations, and morbidity of gallstones were studied in 311 patients with homozygous sickle cell disease and 167 patients with sickle cell-hemoglobin C disease in a cohort study from birth. Gallstones developed in 96 patients with homozygous sickle cell disease and 18 patients with sickle cell-hemoglobin C disease; specific symptoms necessitating cholecystectomy occurred in only 7 patients with homozygous sickle cell disease.(AU)


Assuntos
Adulto , Criança , Humanos , Masculino , Feminino , Adolescente , Anemia Falciforme/epidemiologia , Colelitíase/epidemiologia , Doença da Hemoglobina SC/epidemiologia , Anemia Falciforme/genética , Anemia Falciforme/mortalidade , Colecistectomia , Colelitíase/complicações , Colelitíase/cirurgia , Estudos de Coortes , Seguimentos , Doença da Hemoglobina SC/mortalidade , Homozigoto , Incidência , Jamaica/epidemiologia , Vigilância da População , Prevalência , Fatores de Risco , Taxa de Sobrevida
11.
Bull World Health Organ ; 78(No. 7): 868-76, 2000. tab
Artigo em Inglês | MedCarib | ID: med-119

RESUMO

The Global Youth Tobacco Survey (GYTS) project was developed by the World Health Organization and the US Centers for Disease Control and Prevention to track tobacco use among youth in countries across the world, using a common methodology and core questionnaire. The GYTS is school based and employs a two stage sample design to produce representative data on smoking among students aged 13-15 years. The first stage consists of a probabilistic selection of schools. All students in the selected classes are eligible for the survey. In 1999, the GYTS was conducted in 13 countries and is currently in progress in over 30 countries. This report describes data from 12 countries: Barbados, China, Costa Rica, Fiji, Jordan, Poland and the Russian Federation (Moscow), South Africa, Sri Lanka, Ukraine (Kiev), Venezuela and Zimbabwe. The findings show that tobacco use in the surveyed age group ranged from a high of 33 percent to a low of 10 percent. While the majority of current smokers wanted to stop smoking, very few were able to attend a cessation programme. In most countries the majority of young people reported seeing advertisements for cigarettes in media outlets, but anti-tobacco advertising was rare. The majority of young people being taught in school about the dangers of smoking. Environmental tobacco smoke exposure was very high in all countries. These results show that the GYTS surveillance system is enhancing the capacity of countries to design, implement, and evaluate tobacco prevention and control programmes. (AU)


Assuntos
Feminino , Humanos , Masculino , Adolescente , Tabagismo/epidemiologia , Abandono do Hábito de Fumar/métodos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Tabagismo/epidemiologia , Publicidade , Distribuição por Idade , Incidência , Vigilância da População , Prevalência , Fatores de Risco , Distribuição por Sexo , Tabagismo/prevenção & controle , Organização Mundial da Saúde , Barbados
12.
American Journal of Public Health ; 89(8): 1254-5, 1999. gra
Artigo em Inglês | MedCarib | ID: med-582

RESUMO

OBJECTIVES: This article describes the effort to eliminate measles from Jamaica and its impact on measles incidence. METHODS: In addition to routine measles vaccination, the Jamaican Ministry of Health implemented a strategy of a 1-time only catch-up vaccination campaign, conducted in 1991, and periodic follow-up campaigns, the first of which occurred in 1995. RESULTS: Since 1991, despite careful surveillance, no serologically confirmed indigenous cases of measles have occurred in Jamaica. CONCLUSIONS: Measles virus circulation has been interrupted in Jamaica. The Jamaican experience provides further evidence that global measles eradicaion is achievable.(AU)


Assuntos
Criança , Pré-Escolar , Lactente , Humanos , Adolescente , Programas de Imunização/organização & administração , Sarampo/prevenção & controle , Incidência , Jamaica/epidemiologia , Sarampo/epidemiologia , Vigilância da População
13.
Am J Public Health ; 89(8): 1254-5, Aug. 1999.
Artigo em Inglês | MedCarib | ID: med-1387

RESUMO

OBJECTIVES: This article describes the effort to eliminate measles from Jamaica and its impact on measles incidence. METHODS: In addition to routine measles vaccination, the Jamaican Ministry of Health implemented a strategy of a 1-time-only catch-up vaccination campaign, conducted in 1991, and periodic follow-up campaigns, the first of which occurred in 1995. RESULTS: Since 1991, despite careful surveillance, no serologically confirmed indigenous cases of measles have occurred in Jamaica. The Jamaican experience provides further evidence that global measles eradication is achievable (Au)


Assuntos
Criança , Pré-Escolar , Humanos , Lactente , Adolescente , Sarampo/prevenção & controle , Programas de Imunização/organização & administração , Incidência , Vigilância da População , Jamaica/epidemiologia , Sarampo/epidemiologia
14.
Hum Biol ; 71(3): 417-30, Jun. 1999.
Artigo em Inglês | MedCarib | ID: med-1391

RESUMO

Fluctuating asymmetry, small deviations from perfect bilateral symmetry, is negatively correlated with health and positively correlated with sexual selection in human adults, but the accumulation, persistence, and fitness implications of asymmetries during childhood are largely unknown. Here, we introduce the Jamaican Symmetry Project, a long-term study of fluctuating asymmetry and its physical and behavioral correlates in rural Jamaican children. The project is based on an initial sample of 285 children (156 boys and 129 girls), aged 5 to 11 years. We describe the design of the project and the methodology of measuring 10 paired morphometric traits. All traits except hand width showed fluctuating asymmetry. Fluctuating asymmetries of the legs tended to be related and were less than half as great as fluctuating asymmetries of the arms and ears. Therefore the legs may show high developmental stability resulting from selection for mechanical efficiency. A fluctuating asymmetry composite score revealed that boys have significantly lower fluctuating asymmetry than girls and that this effect resides mainly in the elbows. There were significant positive relationships between composite fluctuating asymmetry and age, height, and weight, but multiple regression analyses showed that age was negatively related to fluctuating asymmetry, whereas body size was positively correlated. These findings are compared with results from recent English studies (Au)


Assuntos
Criança , Pré-Escolar , Feminino , Humanos , Masculino , Antropometria , Estatura/genética , Variação Genética , Análise de Variância , Vigilância da População , População Rural , Amostragem , Jamaica
15.
West Indian med. j ; 48(1): 9-15, Mar. 1999.
Artigo em Inglês | MedCarib | ID: med-1242

RESUMO

A population based probability sample of 958 persons (454 males and 504 females) aged 15 to 49 years was surveyed in Jamaica in late 1993 for lifestyle and behaviour risk factors. Demographic characteristics of the sample were comparable to the general population. 60 percent of persons visited a private doctor the last time that they were ill. Based on self-reporting, 18 percent of the women and 8 percent of the men had never their blood pressure taken. 40 percent of the women had never had a Papanicolaou smear, 29 percent had never had a breast examination and 33 percent said that they were overweight compared with 18 percent of men. Smoking cigarettes and marijuana was more common among men (36 percent) than women (11 percent) as were drinking alcohol (79 percent of men, 41 percent of women) and heavy alcohol use (30 percent of men, 9 percent of women). Injuries requiring medical attention in the previous five years were reported by 40 percent of the men and 15 percent of the women. 34 percent of the men and 12 percent of the women regularly carried a weapon and 18 percent of the sample had participated in or witnessed at least one violent act in the previous month. Most of the people interviewed used a contraceptive method; 10 percent were not sexually active. Significantly more men than women had two or more sexual partners in the previous year (54 percent vs 17 percent, p<0.001) or reported ever having a sexually transmitted disease (29 percent vs 9 percent, p<0.001). Younger persons were more sexually active and more likely to use condoms during the most recent sexual intercourse. Higher socio-economic status and educational level generally had a more positive effect on health behaviour. This survey provides vital information relevant to planning health promotion campaigns and assessing their success.(AU)


Assuntos
Adolescente , Adulto , Estudo Comparativo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atitude Frente a Saúde , Comportamentos Relacionados com a Saúde , Consumo de Bebidas Alcoólicas/epidemiologia , Neoplasias da Mama/epidemiologia , Comportamento Contraceptivo , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Jamaica/epidemiologia , Estilo de Vida , Fumar Maconha/epidemiologia , Obesidade/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vigilância da População , Fatores de Risco , Fatores Sexuais , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/epidemiologia , Tabagismo/epidemiologia , Esfregaço Vaginal/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia
17.
Rev panam salud publica ; 5(3): 152-6, Mar. 1999.
Artigo em Inglês | MedCarib | ID: med-1365

RESUMO

The purpose of this descriptive study was to identify and describe barriers to early detection of breast cancer, as well as current breast cancer screening behaviors and attitudes regarding the disease, among women aged 20 and older on the Caribbean island of Tobago. Tobago is smaller of the two islands that make up the nation of Trinidad and Tobago. Between February and June 1996, 265 women fitting the age criteria completed a structured survey questionnaire. Women of African descent made up 89 percent of the respondents. In terms of age, 48 percent of those surveyed were between 20 and 39, 40 percent were between 40 and 59, and 12 percent were 60 or older. Barriers to early detection identified were a low level of breast self-examination, infrequent clinical breast examinations as part of regular care, unavailability of mammography services on Tobago, cost of screening, and difficulty of travelling to Trinidad for mammography. Furthermore, only a minority of the study participants had ever attended early detection or public awareness programs. The results were nearly the same for individuals with a family history of breast cancer, who would have a higher risk of occurrence of the disease. In addition, the majority of the respondents reported what can be considered a cultural barrier to early detection practices, a belief that no matter what they did, if they were to get breast cancer, they would get it. The authors recommend that mammography services be made available on Tobago. The authors also intend to use findings to help develop an appropriate, culturally sensitive breast cancer awareness and early detection program for women on this island.(Au)


Assuntos
Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias da Mama/epidemiologia , Interpretação Estatística de Dados , Programas de Rastreamento , Vigilância da População , Fatores de Tempo , Índias Ocidentais/epidemiologia , Fatores Etários , Trinidad e Tobago/epidemiologia
18.
Int J Cancer ; 80(5): 662-6, Mar. 1, 1999.
Artigo em Inglês | MedCarib | ID: med-1408

RESUMO

Adult T-cell leukemia/lymphoma (ATL), a rare outcome of infection with human T-lymphotropic virus (HTLV-I), is endemic in central Brooklyn, which has a large Caribbean migrant population. Previous studies have suggested that HTLV-I prevalence in central Brooklyn may be similar to that recorded in the Caribbean islands. We established a pilot 1-year surveillance program to identify cases of ATL in 7 of 10 hospitals serving the residents of 18 zip codes of central Brooklyn with a combined population of 1,184,670. Of the 6,198 in-patient beds in the catchment area, approximately 83 percent were covered. Twelve incident cases of ATL were ascertained, all among persons of Afro-Caribbean descent, indicating an annual incidence in African-Americans in this community of approximately 3.2/100,000 person-years. Unexplained hypercalcemia was the most useful screening method, identifying 3 of 5 patients not referred for possible ATL by a local hematologist. The female:male ratio was 3:1. The age pattern was different from that reported in the Caribbean Basin and closer to the pattern seen in Japan. Our study supports evidence that HTLV-I infection and ATL are endemic in central Brooklyn and suggests that a more intensive surveillance program for this disease coupled with intervention efforts to reduce HTLV-I transmission are warranted.(Au)


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Leucemia-Linfoma de Células T do Adulto/epidemiologia , Demografia , Anticorpos Anti-HTLV-I/sangue , Incidência , Jamaica/etnologia , Cidade de Nova Iorque/epidemiologia , Projetos Piloto , Vigilância da População , Fatores de Risco , Trinidad e Tobago/etnologia , Leucemia-Linfoma de Células T do Adulto/sangue , Leucemia-Linfoma de Células T do Adulto/imunologia
19.
West Indian med. j ; 47(Suppl. 4): 16-9, Dec. 1998.
Artigo em Inglês | MedCarib | ID: med-1294

RESUMO

Maternal and Child Health (MCH) policy over the past two decades has been strongly influenced by research. The paper presents examples of some of the research undertaken and its significant influence in shaping health service delivery. Research in child health has focussed on oral rehydration therapy, immunization and perinatal morbidity and mortality. On the maternal side, morbidity and mortality have been examined with particular focus on problems which contribute to maternal and perinatal morbidity and mortality. Policies arising out of the outcome of these studies have influenced organization of service delivery, information system development, manpower development and deployment, maternal education, surveillance/auditing, quality of care, design of physical facilites and selection of equipment. The results of these studies have also led to the identification of areas requiring further study and testing of intervention to correct the deficiencies identified. These studies demonstrate that research can and does influence health policy, and has impacted positively on the quality and cost of care provided through our health services.(AU)


Assuntos
Criança , Pré-Escolar , Feminino , Humanos , Lactente , Bem-Estar da Criança , Política de Saúde , Bem-Estar Materno , Pesquisa , Imunização , Qualidade da Assistência à Saúde , Assistência à Saúde , Hidratação , Custos de Cuidados de Saúde , Educação em Saúde , Mortalidade Infantil , Jamaica , Mortalidade Materna , Avaliação de Resultados em Cuidados de Saúde , Vigilância da População , Recém-Nascido
20.
West Indian med. j ; 47(Suppl. 4): 20-1, Dec. 1998.
Artigo em Inglês | MedCarib | ID: med-1304

RESUMO

The volcano on Montserrat, after being dormant for over 400 years, has been active for the past two years, last erupting on 27 June, 1997. With the capital, Plymouth, in the unsafe zone, major dislocation of people, facilities and services has occurred. The Health Department is splintered over five sites across an eight mile span and the temporary 30 bed hospital, sited at a primary school, is separated from its Casualty and Out-patient Department and Operating Theatre by 0.25 mile. In order to maintain continuity of care for communities, efforts have been made to keep evacuated clients and their community health workers as close together as possible. The mass emigration has depleted the health services, creating severe stress for those remaining. Elderly relatives have frequently been left behind, necessitating the establishment of special geriatric care facilities to cater to their needs. Increased and continuous health surveillance and mass media education have been integral to the prevention of major disease outbreak - particularly with added challenges to food safety, and management of liquid and solid waste disposal. Cooperation from neighbouring states, particularly Antigua, Barbados and Guadeloupe, as well as from the United Kingdom, has been critical in the management of the continuing crisis.(Au)


Assuntos
Idoso , Humanos , Assistência à Saúde , Erupções Vulcânicas , Serviços de Saúde Comunitária/organização & administração , Continuidade da Assistência ao Paciente , Surtos de Doenças/prevenção & controle , Serviço Hospitalar de Emergência/organização & administração , Contaminação de Alimentos , Educação em Saúde , Serviços de Saúde para Idosos/organização & administração , Vigilância da População , Administração em Saúde Pública , Saneamento/classificação , Índias Ocidentais , Salas Cirúrgicas/organização & administração , Ambulatório Hospitalar/organização & administração
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