Advances in Mexico in the middle of the Decade of Action for Road Safety 2011-2020.

OBJECTIVE: To analyze the progress towards the accomplishment of the expected goal in the middle of the Decade of Action for Road Safety 2011-2020 in Mexico and its states. METHODS: This is a secondary analysis of road traffic deaths in Mexico between 1999 and 2015. We projected the trend for the period 2011-2020 using a time series analysis (autoregressive integrated moving average models). We used the value of the Aikaike Information Criterion to determine the best model for the national level and its 32 states. RESULTS: Mexico is progressing, approaching the proposed goal, which translates into 10,856 potentially prevented deaths in the five-year period from 2011 to 2015. This was due to a decrease in the number of deaths of motor vehicle occupants, as the deaths of pedestrians and motorcyclists were higher than expected. At least one third of the states had values below their goal; although the mortality rate remains unacceptably high in five of them. We identified four states with more deaths than those originally projected and other states with an increasing trend; thus, both cases need to strengthen their prevention actions. CONCLUSIONS: The analysis can allow us to see the progress of the country in the middle of the Decade of Action, as well as identify the challenges in the prevention of traffic injuries in vulnerable users. It contributes with elements that provide a basis for a need to rethink both the national goal and the goal of the different states.

Causas de queimaduras em crianças atendidas em um hospital público de Alagoas / Causes of burns in children at a public hospital of Alagoas / Causas de quemaduras en niños atendidos en un hospital público de Alagoas

Objetivo: Conhecer as causas de queimaduras em crianças de 0 a 5 anos atendidas em um hospital público de Maceió, Alagoas. Método: Trata-se de um estudo de abordagem quantitativa, observacional, de recorte retrospectivo, do tipo descritivo, com dados dos prontuários de crianças atendidas em Centro de Tratamento de Queimaduras do Estado, no período de janeiro 2012 a dezembro de 2015. Analisam-se as variáveis como agente causador, sexo, idade, região do corpo afetada, Superfície Corporal Queimada e grau de queimadura, por frequência simples e porcentagem, apresentados em tabelas, utilizando o programa Microsoft Office Excel® 2010. Resultados: Este estudo analisou 92 casos de queimaduras, destacando-se o sexo masculino como o mais acometido pelo agravo (78,95%). A região do corpo mais afetada foi o tórax, com média de 89%. A faixa etária de 0 a 1 ano foi a mais vitimada, com 57,89%, seguindo o segmento de 2 a 3 anos. Escaldadura por café, com índice 50%, foi o principal agente causador, seguido de água quente, com 47,62%, n=10, em 2012. O maior fator de risco foi o descuido dos adultos, prevalecendo queimaduras de segundo grau. Não houve mortalidade. Conclusão: As causas de queimaduras em crianças estão relacionadas a escaldaduras com café e água quente, no momento das refeições e manuseio de alimentos na cozinha, causando queimaduras de segundo grau, com predomínio do sexo masculino, acometendo principalmente o tórax e membros superiores.

Objective: To know the causes of burns in children from 0 to 5 years attended at a public hospital in Maceió, state of Alagoas. Methods: This is a quantitative, observational, retrospective, descriptive, cross-sectional study with data from the medical records of children attended at the State Burn Treatment Center from January 2012 to December 2015. The variables such as causative agent, sex, age, region of the affected body, Burned Body Surface and degree of burn were measured by simple frequency and percentage, presented in tables, using the program Microsoft Office Excel® 2010, are analyzed. Results: This study analyzed 92 cases of burns, with males being the most affected (78.95%). The region of the body most affected was the thorax, with an average of 89%. The age group from 0 to 1 year was the most victimized, with 57.89%, following the segment of 2 to 3 years. Coffee scald, with a 50% index, was the main causative agent, followed by hot water, with 47.62%, n=10, in 2012. The greatest risk factor was the neglect of adults, with second-degree burns prevalent. There was no mortality. Conclusion: The causes of burns in children are related to scalds with coffee and hot water, at the time of meals and food handling in the kitchen causing second degree burns, predominantly male, affecting mainly the thorax and upper limbs

Objetivo: Conocer las causas de quemaduras en niños de 0 a 5 años en un hospital público de Maceió, en el Estado de Alagoas. Método: Se trata de un estudio de abordaje cuantitativo, observacional de recorte retrospectivo, del tipo descriptivo, con datos de los prontuarios de niños atendidos en Centro de Tratamiento de Quemaduras del Estado, en el período de enero de 2012 a diciembre de 2015. Se analizan las variables como agente causante, sexo, edad, región del cuerpo afectada y grado de quemadura, por frecuencia simples y porcentaje, presentados en tablas, utilizando el programa Microsoft Office Excel® 2010. Resultados: Este estudio analizó 92 casos de quemaduras, destacándose el sexo masculino como el más acometido por el agravio (78,95%), la región del cuerpo más afectada fue el tórax, con un promedio del 89%. El grupo de edad de 0 a 1 año fue la más victimizada, con 57,89%, siguiendo el segmento de 2 a 3 años. La escaldadura por café, con índice de 50%, fue el principal agente causante, seguido de agua caliente, con 47,62%, em 2012. El mayor factor de riesgo fue el descuido de los adultos, prevaleciendo quemaduras de segundo grado. No hubo mortalidad. Conclusión: Las causas de quemaduras en niños están relacionadas con escaldaduras con café y agua caliente, en el momento de las comidas y manejo de alimentos en la cocina causando quemaduras de segundo grado, predominio del sexo masculino, afectando principalmente al tórax y miembros superiores.

Advances in Mexico in the middle of the decade of action for road safety 2011-2020 / Avances en México a la mitad del decenio de acción para la seguridad vial 2011-2020

ABSTRACT OBJECTIVE To analyze the progress towards the accomplishment of the expected goal in the middle of the Decade of Action for Road Safety 2011-2020 in Mexico and its states. METHODS This is a secondary analysis of road traffic deaths in Mexico between 1999 and 2015. We projected the trend for the period 2011-2020 using a time series analysis (autoregressive integrated moving average models). We used the value of the Aikaike Information Criterion to determine the best model for the national level and its 32 states. RESULTS Mexico is progressing, approaching the proposed goal, which translates into 10,856 potentially prevented deaths in the five-year period from 2011 to 2015. This was due to a decrease in the number of deaths of motor vehicle occupants, as the deaths of pedestrians and motorcyclists were higher than expected. At least one third of the states had values below their goal; although the mortality rate remains unacceptably high in five of them. We identified four states with more deaths than those originally projected and other states with an increasing trend; thus, both cases need to strengthen their prevention actions. CONCLUSIONS The analysis can allow us to see the progress of the country in the middle of the Decade of Action, as well as identify the challenges in the prevention of traffic injuries in vulnerable users. It contributes with elements that provide a basis for a need to rethink both the national goal and the goal of the different states.

RESUMEN OBJETIVO Analizar el avance de la meta esperada a mitad del Decenio de Acción para la Seguridad Vial 2011-2020 en México y sus entidades federativas. MÉTODOS Análisis secundario de las muertes por accidentes de tránsito en México para el 1999-2015. Se proyectó la tendencia para el periodo 2011-2020 utilizando análisis de series de tiempo (modelos autorregresivos integrados de medias móviles). Se utilizó el valor del Criterio de Información de Aikaike para determinar el mejor modelo para el nivel nacional y sus 32 entidades federativas. RESULTADOS México va avanzando cercano a la meta propuesta, lo que se ha traducido en 10,856 defunciones potencialmente prevenidas en el quinquenio 2011 a 2015. Esto ha sido a expensas de una disminución en el número de muertes de ocupantes de vehículos de motor; ya que las muertes en peatones y motociclistas han ido por arriba de lo que se esperaba. Al menos una tercera parte de las entidades federativas tuvo el número de defunciones por debajo de su meta; aunque en cinco de ellas la tasa de mortalidad continúa inaceptablemente alta. Se identificaron cuatro entidades con más muertes que las proyectadas originalmente y otras con tendencia al incremento donde se requiere, para ambos casos, fortalecer las acciones de prevención. CONCLUSIONES El análisis realizado permite observar los avances del país a mitad del Decenio de Acción, así como identificar los retos en materia de prevención de lesiones causadas por el tránsito en usuarios vulnerables. Aporta elementos para soportar la necesidad de replantear tanto la meta nacional como la de las distintas entidades federativas.

Unintentional pediatric injuries in São Paulo. How often is it severe?

Purpose: To evaluate severity and built a pilot of a national databank about pediatric trauma and to determine its severity. Methods: Prospective study of unintentional pediatric trauma in five hospitals in the city of São Paulo, Brazil. Results: 916 patients in 4 months. 61.5% of traumatized children were male, average 6.5 years. 48. 4% were falls. Most families had an average monthly income less than three minimum wages. 42% of accidents occurred at home. 18.9% of children were alone. 59,8% of parents thought it could be prevented. 26.5% of children had previous accidents. GCS was severe: 5 patients, moderate: 8 patients. 21 patients were intubated (2.4%), RTS 7 in 10.2%, PTS 8 in 3.6%. 8.5% patients were considered severe, which was related to falls (p=0.001); sports (p=0.045); pedestrian (p=0.006); child education (p=0.015) and cared by male (p=0.007). Conclusions: Severity occurred in 8.5% and was associated to falls, sports, traffic, child education, and cared by male. Simple preventive measures could have prevented most of the accidents. The tested tool for details was successful and can be used throughout the country.(AU)

Evaluación de impacto de las intervenciones de prevención en clientes / Assessment of the impact of prevention interventions in customers

Las prestaciones preventivas son fundamentales para prevenir accidentes laborales. Sin embargo, hasta ahora la Mutual (ACHS) en que se realiza el estudio no contaba con una metodología sistemática para su evaluación. Este trabajo presenta una metodología desarrollada por la organización (mutual) para evaluar las intervenciones preventivas, la cual está basada en Brodersen, K. H., Gallusser, F., Koehler, J., Remy, N., & Scott, S. L.1 Para cada empresa-sucursal se estiman los accidentes que habrían ocurrido de no haberse realizado intervenciones preventivas. Esta serie se compara con la serie real, y se calcula si son diferentes al 95 por ciento de confianza. De ser efectiva, se utiliza en un modelo de regresión lineal que estima el efecto marginal por tipo de intervención. Los supuestos de Brodersen et al.¹ se cumplen en la Mutual, justificando su utilización. Los resultados señalan que la "Capacitación sin propuesta Push", "Plan de acción del modelo preventivo" y "Primeros auxilios psicológicos" tienen efectos significativos en la reducción de accidentes. La "Capacitación con propuesta Push" y "Fuerza de tarea" no muestran efectos significativos. Estos resultados varían según el sector económico. Nuestra recomendación es adoptar esta metodología. También sugerimos implementar metodologías complementarias, para validar su idoneidad.

Preventive services are essential to prevent accidents. However, until now the Mutual did not have a systematic methodology for evaluation. This paper presents a methodology developed by the Mutual to evaluate preventive interventions. It is based on Brodersen, KH, Gallusser, F., Koehler, J., Remy, N., & Scott, SL (2013). For each company-branch, it was estimated accidents that may have occurred if preventive interventions would not have been performed. This series is compared to the actual series, and it is estimated if it is different to 95 percent of confidence. To be effective, it is used in a linear regression model that estimates the marginal effect by type of intervention. Brodersen et al.¹ Assumptions are met in the Mutual, justifying its use. The results indicate that "no proposal Training Push", "preventive action plan model" and "Psychological first aid" have significant effects in reducing accidents. "Training with proposal Push" and "task force" does not show significant effects. These results vary depending on the economic sector. Our recommendation is to adopt this methodology. We also suggest implementing complementary methodologies to validate their suitability.

Perfil sociodemográfico e etiológico de pacientes internados em um centro de referência para tratamento de queimados em Mato Grosso do Sul / Demographic and etiologic profiles of patients hospitalized in a reference center for burn treatment in Mato Grosso do Sul

INTRODUÇÃO: O presente estudo abordou a questão da hospitalização de 13 pacientes, crianças e adolescentes, enfocando especificamente o paciente queimado internado em um Centro de Tratamento de Queimaduras. O objetivo foi o de observar e analisar a percepção dos envolvidos no processo de tratamento, para compreender a relação desse paciente com a dor, com o processo de tratamento, com a qualidade de vida no ambiente hospitalar e com sua autoimagem. Levantar informações que revelem a importância de um trabalho profilático do trauma térmico. MÉTODO: Para atender os objetivos da pesquisa, foi utilizado o método de investigação de Estudo de Caso com abordagem qualitativa. RESULTADOS: Os resultados apontaram uma maioria dos pacientes do sexo masculino. O agente etiológico predominante foi o etanol. Os acidentes causaram queimaduras de gravidades diversas, sendo 1 de 1º e 2º graus, 7 de 2º e 3º graus e 5 de 3º grau. O tempo de internação variou de 15 a 75 dias. As idades dos pacientes variaram entre 1 ano e oito meses a 18 anos. Quanto à escolarização, com exceção do paciente mais novo, todos frequentavam a rede de ensino. Quanto ao nível socioeconômico, a maioria tem uma renda familiar de até dois salários mínimos, que não são suficientes. De modo geral, encontra-se apenas uma pessoa trabalhando, por família. CONCLUSÕES: Os resultados pesquisados demonstram a necessidade de orientação aos pais, com programas educativos e campanhas de prevenção.

INTRODUCTION: The present study addressed the issue of hospitalization in 13 patients, children and adolescents, specifically focusing on burn patients admitted to a center for burn treatment. The objective of this study was to observe and analyze the perception of those involved in the treatment process in order to understand the relationship of the patient with pain and the treatment process with the quality of life in the hospital environment and with their self-image, and to collect information on the importance of prophylactic treatment on thermal trauma. METHODS: To meet the objectives of the research, we used the case study method with a qualitative approach. RESULTS: The results showed that most of the patients were male. The predominant etiologic agent was ethanol. The accidents caused burns of various severities, first- and second-degree burns in 1 patient, second- and third-degree burns in 7 patients, and third-degree burns in 5 patients. The length of hospitalization ranged from 15 to 75 days. The ages of the patients ranged from 1 year 8 months to 18 years. As to education, with the exception of the youngest patient, all attended the school network. Regarding socioeconomic level, most had a family income of up to 2 minimum wages, which was not sufficient. In general, only one person worked per family. CONCLUSIONS: The results demonstrate the need to provide guidance to parents, with educational programs and campaigns.

Morbilidad por accidentes en menores de cinco años / Morbidity caused by accidents in children under five years

Fundamento: los accidentes o lesiones no intencionales representan un problema de salud mundial y constituyen una de las primeras causas de morbilidad en la edad pediátrica.Objetivo: describir la morbilidad por accidentes en niños menores de cinco años del área de salud V de Cienfuegos.Métodos: estudio descriptivo realizado en Policlínico Área V, Cienfuegos, encaminado al análisis de la morbilidad por accidentes (ocurridos en el periodo junio-noviembre de 2008) en niños de cero a cinco años, pertenecientes a los consultorios 3, 4, 23 y 25 de dicha área de salud. Se trabajó con las variables demográficas, tipo de accidente, causas, lugar de ocurrencia, presencia de adultos en el momento de ocurrido, solicitud asistencia médica, y factores de riesgo. Resultados: sufrieron accidentes el 40,2 por ciento de la población estudiada y la frecuencia de accidentes alcanzó un 48,2 porciento. Se mostraron más afectados los niños de dos, tres y menores de un año, así como el sexo masculino. Las caídas, las quemaduras y la aspiración de cuerpos extraños, resultaron los accidentes más frecuentes, y en su mayoría ocurrieron en el hogar. Conclusiones: el estudio mostró una alta prevalencia de accidentes en la población estudiada, lo que evidencia que lamentablemente los adultos no están haciendo todo lo posible por disminuir la ocurrencia de accidentes. Se requiere ser más activos en la vigilancia del niño y en la eliminación de posibles factores detonantes del accidente(AU)

Background: Accidents or unintentional injuries are a global health problem. In addition, they are considered as one of the leading causes of morbidity in children. Objective: To describe the morbidity caused by accidents in children under the age of five years in the V Health Area in Cienfuegos.Methods: A descriptive study was conducted in Area V Polyclinic, Cienfuegos, aimed at analyzing the morbidity caused by accidents (from June to November 2008) in children from zero to five years who belonged to consultations 3, 4, 23 and 25 of that health area. The demographic variables, type of accident, cause, place of occurrence, adult presence at the time of the accident, request for medical assistance, as well as risk factors were analyzed. Results: 40.2 percent of the population studied had accidents and the accident frequency rate reached 48.2 percent. Children aged two, three and less than one year were the most affected as well as males. Falls, burns and foreign body aspiration were the most frequent accidents, occurring mostly at home. Conclusions: Unfortunately adults are nice the occurrence of accidents. They need to be more active in the child vigilance and the elimination of potential triggering factors of the accident(AU)

Epidemiological and clinical characteristics of injuries among adolescents attended at an emergency service in the city of Ribeirão Preto, São Paulo.

CONTEXT AND OBJECTIVE: Injuries are an important cause of morbidity during adolescence, but can be avoided through learning about some of their characteristics. This study aimed to identify the most frequent injuries among adolescents attended at an emergency service. DESIGN AND SETTING: Retrospective descriptive study on adolescents attended at the emergency service of the Teaching Health Center, Faculdade de Medicina de Ribeirão Preto (FMRP), between January 1, 2009, and September 30, 2009. METHODS: Age, sex, type of injury, site, day and time of occurrence, part of body involved, care received, whether the adolescent was accompanied at the time of injury and whether any type of counseling regarding injury prevention had been given were analyzed. RESULTS: Among 180 adolescents attended, 106 (58.8%) were boys and 74 (41.1%) were girls. Their ages were: 10 to 12 (66/36.6%), 12 to 14 (60/33.3%) and 14 to 16 years (54/30%). The injuries had occurred in public places (47.7%) and at home (21.1%). The main types were bruises (45.1%) and falls (39.2%), involving upper limbs (46.1%), lower limbs (31%) and head/neck (13.1%). The injuries occurred in the afternoon (44.4%) and morning (30%), on Mondays (17.7%) and Thursdays (16.6%). Radiological examinations were performed on 53.8%. At the time of injury, 76.1% of the adolescents were accompanied. Some type of counseling about injury prevention had been received by 39.4%. CONCLUSIONS: Although the injuries were of low severity, preventive attitudes need to be incorporated in order to reduce the risks and provide greater safety for adolescents.

Epidemiological and clinical characteristics of injuries among adolescents attended at an emergency service in the city of Ribeirão Preto, São Paulo / Características clínicas e epidemiológicas de lesões entre adolescentes atendidos em um pronto-socorro na cidade de Ribeirão Preto, São Paulo

CONTEXT AND OBJECTIVE: Injuries are an important cause of morbidity during adolescence, but can be avoided through learning about some of their characteristics. This study aimed to identify the most frequent injuries among adolescents attended at an emergency service. DESIGN AND SETTING: Retrospective descriptive study on adolescents attended at the emergency service of the Teaching Health Center, Faculdade de Medicina de Ribeirão Preto (FMRP), between January 1, 2009, and September 30, 2009. METHODS: Age, sex, type of injury, site, day and time of occurrence, part of body involved, care received, whether the adolescent was accompanied at the time of injury and whether any type of counseling regarding injury prevention had been given were analyzed. RESULTS: Among 180 adolescents attended, 106 (58.8 percent) were boys and 74 (41.1 percent) were girls. Their ages were: 10 to 12 (66/36.6 percent), 12 to 14 (60/33.3 percent) and 14 to 16 years (54/30 percent). The injuries had occurred in public places (47.7 percent) and at home (21.1 percent). The main types were bruises (45.1 percent) and falls (39.2 percent), involving upper limbs (46.1 percent), lower limbs (31 percent) and head/neck (13.1 percent). The injuries occurred in the afternoon (44.4 percent) and morning (30 percent), on Mondays (17.7 percent) and Thursdays (16.6 percent). Radiological examinations were performed on 53.8 percent. At the time of injury, 76.1 percent of the adolescents were accompanied. Some type of counseling about injury prevention had been received by 39.4 percent. CONCLUSIONS: Although the injuries were of low severity, preventive attitudes need to be incorporated in order to reduce the risks and provide greater safety for adolescents.

CONTEXTO E OBJETIVO: Lesões são importante causa de morbidade na adolescência, mas podem ser evitadas mediante o conhecimento de algumas de suas características. Este estudo visa identificar as lesões mais frequentes entre adolescentes atendidos em um serviço de pronto-atendimento. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo e descritivo sobre adolescentes atendidos no Pronto-Atendimento do Centro de Saúde Escola da Faculdade de Medicina de Ribeirão Preto (FMRP), entre 01/01/2009 e 30/9/2009. MÉTODOS: Analisou-se idade, sexo, tipo de lesão, local, dia e período do ocorrido, parte do corpo acometida, cuidados recebidos, se o adolescente estava acompanhado no momento da lesão e se havia recebido alguma orientação quanto à prevenção de acidentes. RESULTADOS: Dos 180 adolescentes 106 (58,8 por cento) eram rapazes e 74 (41,1 por cento) moças, com idades entre 10 a 12 anos (66/36,6 por cento), 12 a 14 anos (60/33,3 por cento) e 14 a 16 anos (54/30 por cento). 47,7 por cento das lesões aconteceram em locais públicos e 21,1 por cento, em casa. Os principais foram contusões (45,1 por cento) e quedas (39,2 por cento), acometendo membros superiores (46,1 por cento), membros inferiores (31 por cento) e cabeça/pescoço (13,1 por cento). As lesões ocorreram nos períodos da tarde (44,4 por cento) e manhã (30 por cento) e às segundas-feiras (17,7 por cento) e quintas-feiras (16,6 por cento). Foram realizados exames radiológicos em 53,8 por cento dos pacientes. No momento da lesão 76,1 por cento dos adolescentes estavam acompanhados. 39,4 por cento haviam recebido algum tipo de orientação sobre prevenção de lesões. CONCLUSÕES: Embora as lesões tenham sido de baixa gravidade, é necessário incorporar atitudes preventivas de modo a diminuir os riscos e proporcionar maior segurança aos adolescentes.

Investigação de acidentes biológicos entre profissionais de saúde / Investigation of biological accidents among health care workers / Investigación de accidentes biológicos entre los trabajadores de la salud

Os objetivos deste trabalho foram identificar a principal categoria profissional exposta a risco biológico e os principais tipos de acidentes ocorridos entre trabalhadores da área de saúde, em Campos dos Goytacazes, RJ. A partir da análise das fichas denotificação de acidentes biológicos dos 183 profissionais acidentados entre janeiro de 2005 e setembro de 2005, observamos que a categoria profissional mais exposta foi a dos auxiliares/técnicos de enfermagem (54,1%), seguida pela dos acadêmicos de medicina e odontologia (10,4%). A ocorrência de acidentes com materiais perfurocortantes foi relacionada à manipulação frequente desses objetos e ao comportamento dos profissionais que utilizam práticas que oferecem riscos de acidentes com agulhas, tais como o descarte inadequado de objetos perfurocortantes.

Repercussões no contexto familiar de injúrias não-intencionais em crianças / The repercussion from unintentional injuries in children on the family context

O objetivo desta pesquisa é estudar as características da criança como vítima de injúrias não-intencionais e seu familiar-acompanhante, descrever as repercussões dessas injúrias na família e identificar a concepção de familiares-acompanhantes sobre fatores de risco no domicílio e o conhecimento de práticas preventivas. Estudo descritivo, realizado com 29 familiares e/ou acompanhantes de crianças internadas em um hospital de emergência, em Fortaleza, Ceará, em 2005. A maioria das crianças tinha entre 5 a 10 anos, do sexo masculino, e prevaleceu a injúria no trânsito. Em relação aos acompanhantes, predominou renda de até um salário mínimo e eles afirmaram que conhecem os tipos mais comuns de injúrias com crianças e os modos de evitá-los. As repercussões atingem as dimensões emocionais, econômicas e sociais, somando-se verbalizações de medo, culpa e arrependimento, protesto e resignação. Conclui-se que o tema precisa ser amplamente discutido, mobilizando pessoas em instâncias formadoras de opiniões para reorientação da práxis na Saúde e Educação.

The objective of this work is to study the characteristics of the child when victim of unintentional injury, as well as those of his family caregiver. This was accomplished by describing the repercussion of those injuries in the family and identifying the family caregivers' conception of risk factors in the home, as well as their knowledge of preventive practices. A descriptive study was conducted with 29 relatives or caregivers of injured children at an emergency hospital in Fortaleza, Ceará, Brazil, in 2005. Most of the children were between 5 and 10 years old and were male; the most prevalent instances of injury were traffic-related. Regarding the caregivers, the most prevalent income range for this group was up to minimum wage. They reported knowing the most frequent types of injuries to children, as well as the ways to avoid them. The repercussions within the family context reach emotional, economical, social and cultural dimensions, with expressions of fear, guilt, regret, protest and resignation. It is concluded that this subject needs to be widely discussed, mobilizing opinion-makers to the reorientation of the praxis in health and education.

Report on the collision between a spinner dolphin and a boat in the Fernando de Noronha Archipelago, Western Equatorial Atlantic, Brazil / Relato de colisão entre um golfinho-rotador e uma embarcação no Arquipélago de Fernando de Noronha, Atlântico central equatorial, Brasil

This paper reports a case of collision between an individual spinner dolphin and a boat in the Fernando de Noronha Archipelago, as an example of disturbance potentially caused by tourism industry activities. Photos illustrating the inflicted injuries on the animal are presented, and preventive measures to avoid this kind of accidents are proposed. This is the first report on a collision between spinner dolphins and boats.

Neste artigo, um caso de colisão entre um golfinho-rotador e uma embarcação é registrado no arquipélago de Fernando de Noronha, como um exemplo de perturbação causada potencialmente por atividades turísticas. São apresentadas fotografias ilustrando os ferimentos causados no animal e o uso de medidas de prevenção para evitar este tipo de acidentes é proposto. Este é o primeiro registro de colisão entre golfinhos-rotadores e embarcações.