Violência dimensionada: análise da notificação / Dimensioning of violence: analysis of notification

Objetivo: realizar um levantamento epidemiológico das notificações de violência registradas no Departamento Regional de Saúde de São Paulo, Brasil, instituição responsável por 40 municípios do noroeste paulista. Metodologia: trata-se de um estudo transversal, com pesquisa no banco de dados do Departamento Regional de Saúde de São Paulo, analisando fichas de notificação de acidentes e violências, no período de 2013 a 2015. O estudo foi aprovado pelo Comitê de Ética em Pesquisa (Processo n 2007-01343). Resultados: dos 133.537 atendimentos identificados, somente 153 foram registrados como violência; sendo 53,3% das vítimas mulheres; 45,1% de 20 a 34 anos; 48,7% brancos; 39,87% solteiros; 52,94% dos casos ocorreram em ambiente residencial; 47,71% deles entre 18:01 e 24:00 horas; 91,5% das ocorrências foram encaminhadas para as delegacias por meio de profissionais da área da enfermagem. Uma gama significativa das formas de violência, por despreparo ou desconhecimento do profissional, não é devidamente registrada, impedindo a formulação de novas políticas para o seu combate. Conclusão: a maioria das notificações de violência eram de vítimas mulheres, jovens, brancas e solteiras; com ocorrência em ambiente residencial no período noturno; e os encaminhamentos para delegacias foram realizados principalmente por técnicos de enfermagem.

Objective: to perform an epidemiological survey of notifications of violence registered at the Regional Health Department of São Paulo, Brazil, an institution responsible for 40 municipalities in the northwest of São Paulo. Methodology: this is a cross-sectional study, with research in the Regional Health Department of São Paulo database, analyzing accident and violence notification forms, from 2013 to 2015. The study was approved by the Research Ethics Committee (Process nº 2007-01343). Results: of the 133,537 services identified, only 153 were recorded as violence; 53.3% of the victims were women; 45.1% from 20 to 34 years old; 48.7% white; 39.87% single; 52.94% of cases occurred in a residential environment; 47.71% of them between 18:01 and 24:00 hours; 91.5% of the occurrences were referred to police stations by professionals in the nursing field. A significant range of forms of violence, due to the professional's lack of preparation or lack of knowledge, is not properly registered, preventing the formulation of new policies to combat it. Conclusion: most reports of violence were from women, young, white and single victims; occurring in a residential environment at night; and referrals to police stations were made mainly by nursing technicians.

Insuficiência renal crônica: análise qualitativa sobre saúde bucal / Chronic kidney insufficiency: qualitative analysis on mouth health

Objetivou-se avaliar a autopercepção de doentes renais crônicos sobre saúde bucal e analisar os fatores envolvidos no tratamento da insuficiência renal. Trata-se de uma pesquisa qualitativa, com o emprego da técnica de grupo focal. Foram realizados dois grupos focais com uma amostra de 12 doentes renais crônicos, com a participação de pesquisador/moderador, observador e seis participantes em cada grupo e um roteiro com questões norteadoras. Os discursos foram gravados e transcritos, os conteúdos textuais foram processados no software IRAMUTEQ e analisados pela técnica de classificação hierárquica descendente (CHD) e análise de conteúdo. Seis categorias emergiram da análise multivariada pela CHD: (1) Sofrimento; (2) Expectativa; (3) Acesso ao Tratamento; (4) Serviços de Saúde; (5) Valorização; (6) Funções da Boca. A análise qualitativa demonstrou que apesar do grande sofrimento relatado pelos doentes renais crônicos, há uma autopercepção positiva e que pode ser verificada nas categorias elencadas. A análise interpretativa do corpus textual sugere ausência de assistência odontológica e alguns fatores envolvidos neste processo de iniquidade

Self-perception by chronic kidney patients on mouth health is evaluated and the factors involved in the treatment of kidney insufficiency are analyzed. Qualitative research with focal group technique was applied to two groups with a sample of 12 chronic kidney patients, with the participation of researcher/moderator, observer and six participants of each group and a list of questions. Discourses were recorded and transcribed, textual contents were processed by IRAMUTEQ and analyzed by descendent hierarchized classification technique (CHD) and content analysis. Six categories emerged from the multivariate CHD analysis: (1) suffering; (2) expectations; (3) access to treatment; (4) health services; (5) valorization; (6) mouth functions. Qualitative analysis revealed that, in spite of great suffering by chronic kidney patients, a positive self-perception is perceived and may be verified in the listed categories. The interpretative analysis of the textual corpus suggests an absence of dentistry assistance and other factors involved in the iniquity process

Vaccination coverage and immunity against hepatitis B in public health dentists

Abstract INTRODUCTION: Occupational exposure is a major risk factor for hepatitis B (HB) transmission. METHODS: Vaccination coverage and immunity verification from 64 dentists of the Brazilian Unified Health System were investigated. An immunochromatographic method was used to verify immunity against the disease. RESULTS: Overall, 77.77% of participating dentists completed the vaccination schedule; 37.50% had negative anti-HBs test results. Furthermore, 60.93% of participants never underwent anti-HBs tests and 40% did not know how to correctly interpret results. CONCLUSIONS: Numerous dentists were not immune to the disease. Few participants previously performed the test, with many not knowing how to interpret the results.

Quality of life of people with HIV/AIDS - the influence of social determinants and disease-related factors

Abstract INTRODUCTION: This study assessed the quality of life (QoL) of people with HIV/AIDS. METHODS: This cross-sectional epidemiological study was conducted at a specialized HIV/AIDS health facility of the Brazilian Public Health Service. Data were collected using the HIV/AIDS-Targeted Quality of Life (HAT-QoL) instrument. RESULTS: The study included 109 participants. Among the many significant statistical associations found in the study, the variables that had a greater effect on the domains assessed by the instrument were educational level, occupation, financial situation, ethnicity, and symptomatology. CONCLUSIONS: Sociodemographic factors and HIV/AIDS-related aspects were influential in the QoL of people living with HIV/AIDS.

Reemerging diseases in Brazil: sociodemographic and epidemiological characteristics of syphilis and its under-reporting

Abstract INTRODUCTION: This paper analyzed sociodemographic and epidemiological data of individuals with syphilis as well as the compulsory reporting of the disease, for being a reemerging disease in Brazil. METHODS: General information and sociodemographic, epidemiological, clinical, and laboratory data were verified in compulsory reporting. RESULTS: From 2010 to 2016, 157 reporting forms were explored. Acquired and gestational syphilis occurred predominantly in those 20 to 29 years of age and those who did not complete secondary education. Compulsory reporting forms were not complete. CONCLUSIONS: The number of syphilis cases has varied over the years in the city. Incomplete compulsory reporting was noted.

Oral Health Condition and its Impact on the Quality of Life of Dependents / Condição de Saúde Bucal e seu Impacto na Qualidade de Vida em dependentes Químicos

Chemical dependency is a chronic disease, which in addition to generating catastrophic consequences throughout the social structure, favors the ppearance of oral alterations, which are influential factors in the quality of life of these individuals. The objective of this study was to investigate the impact of oral health status, self-perception, oral hygiene habits and access to dental services in the quality of life of drug addicts. This is a quantitative cross-sectional exploratory study with chemical dependents living in poverty in a rehabilitation center. The data collection was divided in two phases, the first with the application of two research instruments, a survey built exclusively for this study and the Oral Health Impact Profile (OHIP-14). The second phase was performed the DMFT index (decayed, missing and restored teeth). In the analysis of the data, the OHIP-14 was processed by the additive method, and dichotomized by low median and high impact. The bivariate analyzes were performed with the independent variables using the chi-square test and Fisher's exact test with a significance level of 5%. 38 individuals in a state of recovery and social reinsertion were part of the study. There were statistically significant associations between quality of life and tooth pain in the last 6 months, need for dental treatment, xerostomia, DMFT, and daily toothbrushing number. It was concluded that there was the impact of oral health condition, self-perception and habits of hygiene on the quality of life of chemical dependents. However, no statistically significant associations were found regarding access to dental services. (AU).

A dependência química é uma doença crônica, que além de gerar consequências catastróficas em toda a estrutura social, favorece o urgimento de alterações bucais, que são fatores influentes na qualidade de vida destes indivíduos. Objetivou-se investigar o impacto da condição de saúde bucal, autopercepção, hábitos de higiene oral e acesso aos serviços odontológicos na qualidade de vida de dependentes químicos. Trata-se de um estudo exploratório transversal quantitativo com dependentes químicos em situação de pobreza de um centro de reabilitação. A coleta dos dados foi divida em duas fases, sendo a primeira com aplicação de dois instrumentos de pesquisa, um inquérito construído exclusivamente para este estudo e o Oral Health Impact Profile (OHIP-14). A segunda fase foi realizada o índice CPO-D (dentes cariados peridos e restaurados). Para análise dos dados, o OHIP-14 foi processado pelo método aditivo, e dicotomizado pela mediana em baixo e alto impacto. A partir disto, foram feitas as análises bivariadas com as variáveis independentes utilizando o teste Qui-quadrado e Exato de Fisher com nível de significancia em 5%. Fizeram parte do estudo 38 indivíduos em estado de recuperação e reinserção social. Verificouse associações estatisticamente significantes entre a qualidade de vida e a dor de dente nos últimos 6 meses, necessidade de tratamento odontológico, xerostomia, CPO-D e número de escovação dentária diária. Conclui-se que houve o impacto da condição de saúde bucal, autopercepção e hábitos de higiene horal na qualidade de vida dos dependentes químicos. Entretanto, não foram encontradas associações significantes em relação ao acesso aos serviços odontológicos. (AU).

Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil

Abstract INTRODUCTION: In the 1990s, Brazil adopted a public policy that allowed for universal, free access to antiretroviral therapy (ART). Since then, treatment adherence has become a new challenge for administrators of sexually transmitted disease/acquired immunodeficiency syndrome (STD/AIDS) policies. This study quantified adherence to ART and verified whether there is an association between sociodemographic variables and clinical/laboratory data in human immunodeficiency virus (HIV)-infected patients. METHODS: This was a cross-sectional, exploratory study with a quantitative approach that was conducted over 8 months. The target population contained patients who were assisted at the ambulatory care facility specialized in STD/AIDS of a medium-size city located in Northwest São Paulo. In order to verify the level of adherence to ART, a validated CEAT-VIH (Assessment of Adherence to Antiretroviral Therapy Questionnaire) questionnaire was used. Sociodemographic aspects and clinical/laboratory data were obtained from the medical records. The results were analyzed using the Student's t-test and Pearson's coefficient. RESULTS Herein, 109 patients were interviewed, 56% of whom were male. The age of the population ranged 18-74 years (mean 45.67 years). Adherence to ART was classified as insufficient in 80.7% of cases. There was an association between ART adherence and presence of symptoms and/or opportunistic infection (p=0.008) and economic status (p<0.001). CONCLUSIONS: Adherence to ART among HIV carriers cared for by the public health system is low. Patients who reported a favorable economic status and those without symptoms and/or opportunistic infection demonstrated greater treatment adherence than those who needed to take more than 3 pills a day.

Sociodemographic and epidemiological profile of leprosy patients in an endemic region in Brazil

Abstract: INTRODUCTION: The incidence of Hansen's disease is high in overlooked populations. METHODS: Data of Hansen's disease cases reported in the information system of the Department of Informatics, Brazilian Unified Health System, from 2013 to 2014 were analyzed. RESULTS: Among 434 studied cases of Hansen's disease, the female sex (52.5%), adult age (73.7%), low educational level (61.8%), and multibacillary form were associated with higher prevalence rates. CONCLUSIONS: Hansen's disease is more frequent among female adults with a low educational level, and the prevalence of multibacillary leprosy reflects disease detection at late stages.

Influence of oral health on quality of life in pregnant women

This study evaluated the relationships between oral conditions and oral healthrelated quality of life (OHRQoL), as well as related factors. A crosssectional study was performed on 119 postnatal women who had sought prenatal care during pregnancy in the public health system of São Paulo State, Brazil. The women received oral clinical exams and were interviewed using the questions on the OHIP14. A second survey with information about their socioeconomic status, pregnancy and health habits was administered. The highest OHIP14 scores were found in the area of physical pain, with an average score of 10.6. Average DMFT rate for the population was 12.2 (±6.1), with the majority having DMFT ≥4.5 (89.9%). Most of the women needed some type of dental prosthesis (59.7%), had some type of periodontal disease (90.8%), tooth decay (73.9%), missing teeth (64.7%) and were in need of oral treatment (68.1%). The OHIP14 scores were significantly associated with age (p=0.02), first pregnancy (p<0.001), need for dental prosthesis (p<0.001), presence of dental caries (p<0.001) and missing teeth (p=0.01). In the multivariate analysis, the worst OHRQoL was significantly associated with the presence of caries (p=0.03). The results suggest an association between the worst oral condition and poorer quality of life during pregnancy. This risk group should be prioritized in the health services in order to treat and recover the oral health of pregnant women, promoting better oral health conditions and better quality of life for their children.

O presente estudo avaliou as relações entre condições bucais e o impacto da saúde bucal na qualidade de vida de gestantes, bem como fatores relacionados. Um estudo transversal foi realizado em 119 mulheres que, durante a gravidez, tinham procurado atendimento prénatal no sistema público de saúde do Estado de São Paulo, Brasil. Foram realizados exames clínicos bucais e as gestantes foram entrevistadas utilizando o questionário OHIP14, forma abreviada, e um segundo inquérito, com informações sobre os seus hábitos de status sócioeconômico, gravidez e saúde foi administrado. As maiores pontuações OHIP14 foram encontrados na área de dor física, com uma pontuação média de 10,6. A taxa média de CPOD para a população foi de 12,2 (± 6,1), com a maioria tendo um CPOD de ≥4.5 (89,9%). A maioria das mulheres precisava de algum tipo de prótese dentária (59,7%), tiveram algum tipo de doença periodontal (90,8%), apresentaram cárie dentária (73,9%), falta de dentes (64,7%) e estavam na necessidade de tratamento odontlógico (68,1% ). Os escores do OHIP14 estiveram significativamente associados com a idade (p = 0,02), primeira gravidez (p <0,001), necessidade de prótese dentária (p <0,001), presença de cárie dentária (p <0,001)) e falta de dentes (p = 0,01). Na análise multivariada, o pior impacto da saúde bucal sobre a qualidade de vida de gestantes esteve significativamente associada com a presença de cárie (p = 0,03). Os resultados sugeriram que a pior condição bucal esteve relacionada com pior qualidade de vida durante a gravidez. Este grupo de risco deve ser priorizado nos serviços de saúde, a fim de tratar e recuperar a saúde bucal destas grávidas, promovendo melhores condições de saúde bucal e da qualidade de vida de seus filhos.

Assessment of health-related quality of life and related factors in patients with chronic liver disease

ABSTRACT BACKGROUND AND OBJECTIVES: Assessing health-related quality of life is an important aspect of clinical practice. Thus, the present study attempts to assess the health-related quality of life of patients with chronic liver disease. METHODS: A cross-sectional survey was conducted on 133 chronic liver disease patients, using three instruments: a demographic questionnaire, the Chronic Liver Disease Questionnaire, and Model for End-Stage Liver Disease index. Variables were expressed as frequencies, percentages, means, and standard deviations. The statistical analysis included Pearson's correlation, Student's t-test, and analysis of variance (p < 0.05 was considered significant). RESULTS: The mean age of included subjects was 50.5 ± 13.3 years. The majority were male (66.2%), Caucasian (70.7%), and had a family income of US$329-US$658.2. Over half of the patients (56.4%) were infected by hepatitis C virus and 93.2% had low Model for End-Stage Liver Disease scores. Model for End-Stage Liver Disease score was related to age (r = 0.185;p = 0.033). Higher mean Chronic Liver Disease Questionnaire scores were obtained for emotional function (39.70/SD ± 12.98) and while lower scores were obtained for abdominal symptoms (16.00/SD ± 6.25). Fifty-two patients (39.1%) presented overall low (<5) Chronic Liver Disease Questionnaire scores. Furthermore, Chronic Liver Disease Questionnaire score was related to family income (r = 0.187, p = 0.031). CONCLUSION: Most individuals presented high mean Chronic Liver Disease Questionnaire scores, indicating low health-related quality of life, especially individuals with low family income.

The stigma and prejudice of leprosy: influence on the human condition

INTRODUCTION: To analyze the knowledge, feelings and perceptions involving patients affected by leprosy, as a better understanding of these factors may be useful to decrease the stigma and prejudice associated with the condition. METHODS: The study cohort consisted of 94 patients who underwent treatment for leprosy at the Health Units in the City of Cuiabá, Mato Grosso (MT), Brazil. The study questionnaire included items to collect information on socio-demographic data, knowledge about the disease, stigma, prejudice, self-esteem and quality of life of leprosy patients. Bivariate analyses were used to assess the data based on the chi-square test with a 5% significance threshold. RESULTS: The results revealed that the study population consisted predominantly of males (55.3%) with an income between 1 and 3 times the minimum wage (67%). The survey respondents reported that the most significant difficulties related to the treatment were the side effects (44.7%) and the duration of the treatment (28.7%). A total of 72.3% of the subjects were knowledgeable about the disease, of whom 26.6% had the leprosy reaction. Stigma and prejudice were cited by 93.6% of the participants. Based on the responses, 40.4% of patients reported being depressed and sad, and 69.1% of the subjects encountered problems at work after being diagnosed. A total of 45.7% of the patients rated their quality of life between bad and very bad. CONCLUSIONS: Our results suggest that leprosy causes suffering in patients beyond pain and discomfort and greatly influences social participation. .

Quality of life of people living with HIV/AIDS treated by the specialized service in Vitória-ES, Brazil / Qualidade de vida de pessoas que vivem com HIV/AIDS assistidas no serviço especializado em Vitória (ES), Brasil

The aim of this study is to establish the factors that influence the quality of life of people living with HIV/AIDS being treated at a specialized public service. The participants answered the questionnaire on sociodemographic conditions, issues related to HIV and daily habits. The quality of life was analyzed using the HIV/AIDS-targeted quality of life (HAT-QoL) instrument with 42 items divided into 9 fields: General Activity, Sexual Activity, Confidentiality Concerns, Health Concerns, Financial Concerns, HIV Awareness, Satisfaction with Life, Issues related to Medication and Trust in the Physician. Bivariate and multiple linear regressions were performed. Of the participants, 53.1% were women and had a mean age of 42 years. In analyzing the quality of life, the HAT-QoL domain with the lowest average was Financial Concerns (39.4), followed by Confidentiality Concerns (43.2), Sexual Activity (55.2) and Health Concerns (62. 88). There was an association between the variables: not being gainfully employed (p < 0.001), being mulatto or black (p = 0.045) and alcohol consumption (p = 0.041) with the worst quality of life scores. Inadequate socioeconomic and health conditions had a negative impact on the quality of life of people with HIV/AIDS.

O objetivo do presente estudo é verificar os fatores que influenciam na qualidade de vida das pessoas que vivem com HIV/AIDS assistidas no serviço especializado. Os entrevistados responderam os questionários sobre condições sociodemográficas, aspectos relacionados ao HIV e hábitos. A qualidade de vida foi analisada por meio do instrumento HAT-QoL, com 42 itens divididos em nove domínios: Atividade Geral, Atividade Sexual, Preocupações com Sigilo, Preocupação com a Saúde, Preocupação Financeira, Conscientização sobre o HIV, Satisfação com a Vida, Questões relativas à medicação e Confiança no médico. Análises bivariadas e regressão linear múltipla foram realizadas. Dos entrevistados, 53,1% eram mulheres e tinham média de idade de 42 anos. Na análise da qualidade de vida, o domínio do HAT-QoL com menor média foi Preocupação financeira (39,4), seguido de Preocupação com sigilo (43,2), Atividades sexuais (55,2) e Preocupação com a saúde (62,88). Houve associação entre as variáveis não ter vínculo trabalhista (p < 0,001), ser pardo ou negro (p = 0,045) e consumir bebida alcoólica (p = 0,041), com piores escores da qualidade de vida. Condições socioeconômicas e de saúde inadequadas apresentaram impacto negativo na qualidade de vida das pessoas com HIV/AIDS.

Relationship betweenPerception of Oral Health, Clinical Conditions and Socio-Behavioral Factors of Mother-Child

To verify a mother's perception about her and her child`s oral health as well as to analyze its association with socio-behavioral factors.Material and Methods:The study was conducted with 73 pairs of mother and child, through interviews, using a semi-structured questionnaire and clinical exam. The clinical variables studied were: caries prevalence and gingival diseases and nonclinical variables: socio-behavioral factors, perception and habits.Bivariate analyzes, logistic regression and odds ratio (p ≤ 0.05 and 95% CI) were employed.Results:Most mothers considered their oral health as poor (57.5%) and their children as good (68.5%). In the multivariate analysis, measures of self-perception of oral health were significantly associated with the presence of caries in the mother (p <0.01), and oral health perception of the child was related to the presence of caries (p <0.01) and marital status (0.05).Conclusion:The clinical and behavioral factors were associated with themeasures of perceived oral health...

Social aspects of dental caries in the context of mother-child pairs

The relationship between mother and child in the context of oral health has traditionally been exposed by the scientific literature in microbiology, which lacks a broad and necessary discussion of health and illness seen as processes, both biological and social. Objective: Investigate the family social determinants associated with the caries history of children and the need for dental treatment (NDT) among their mothers was the objective of this study. Material and methods: This research employed a cross-sectional study of mother-child pairs living in southern Brazil. Data collection occurred in public institutions of early childhood education. The instruments included a structured questionnaire administered to mothers and clinical oral examinations of the mothers and children. The social variables considered were marital status, maternal education, number of children, income, employment status, and frequency of visits to a dental professional. The measured outcomes were the maternal NDT and child caries history. Data were analyzed by the chi-square test (χ2) and by discriminant analysis. Results: The final sample consisted of 272 mother-child pairs and it was found that the greatest need for treatment was among mothers with low educational level and low family income who rarely or never visited a dentist. Tooth decay was less frequent in only child, and most frequent in children of mothers with low educational attainment, and in children in lower income households who rarely or never visited the dentist. The social determinants of caries in children and of the maternal NDT were similar. It follows that the maternal NDT and caries history among children were strongly associated with maternal education (p<0.0001), household income (p<0.0001), and frequency of visits to a dental professional (0.0018). Caries history among children was also associated with number of children in the household (p<0.0001). Conclusions: ...

A participação do auxiliar em saúde bucal na equipe de saúde e o ambiente odontológico / The dental assistant participation in the public health team and the dental environment

Introdução: A composição da equipe de saúde bucal e as condições sanitárias e ergonômicas no ambiente de trabalho influenciam na qualidade do atendimento odontológico prestado ao paciente. Objetivo: Neste estudo observacional e transversal, objetivou-se verificar a participação do auxiliar na equipe odontológica do serviço público, bem como os itens relacionados com a legislação sanitária e a existência e a distribuição dos equipamentos no consultório. Material e Método: A coleta de dados foi realizada por meio de aplicação de questionários e observações nos locais de atendimento. Foram entrevistados 75 cirurgiões-dentistas de nove municípios do DRS XV - São José do Rio Preto-SP e avaliados 34 consultórios. Resultado: Do total de 75 cirurgiões-dentistas, 21 (28%) trabalhavam sozinhos, sendo seis (29%) em escolas e 15 (71%) em UBS. Dos 34 consultórios, dois (6%) não apresentavam qualquer equipamento de esterilização e, dos que possuíam, a autoclave era o meio mais utilizado, em número de 15 (44%). Dos consultórios analisados, 13 (38%) não possuíam lixeiras do lixo comum e, em 18 (53%), as existentes eram inadequadas. Quanto ao lixo contaminado, em 21 (62%), as lixeiras eram inadequadas e, em dois (6%), ausentes. Ou seja: em apenas 11 (32%), as lixeiras para este tipo de lixo eram adequadas. Notou‑se ainda que 13 (38%) não tinham lavatórios para mãos; em 23 (68%), havia toalheiro de papel; em 20 (59%), saboneteiras adequadas, e o compressor estava instalado dentro dos consultórios em cinco (15%) dos locais de atendimento. Quanto à adequação dos consultórios para o trabalho auxiliado, todos (n = 19) estavam insatisfatórios. Conclusão: A existência do ASB apresentou-se principalmente nos CEOs e nas Unidades de Saúde da Família por exigência legal e foram encontradas condições sanitárias e ergonômicas inadequadas, sugerindo a necessidade de reorganização no processo de trabalho e de gestão.

Introduction: The formation of Oral Health Team, healthy and ergonomic work conditions influence on quality of dental attendance to patient. Objective: In this observational and cross-sectional study, it was observed the participation of the dental assistants (ASB) on dental team on public health, to verify the items related to health legislation, the existence and distribution of equipment in dental offices. Material and Method: The data collection was performed using questionnaires and observations on locals for consultation. It were interviewed 75 dentists from 9 cities of Health Regional Department (DRS) - XV - São José do Rio Preto City and it was evaluated 34 dental offices. Result: Of total 75 dentists, 21 (28%) worked alone and among them, 6 (29%) worked at school and 15(71%) at Health Basic Unit (UBS). From 34 dental offices, 2 (6%) did not show any equipment for sterilization and among those that had it, the autoclave was the most used method (44%). Among the analyzed dental offices, 31 (91%) had dustbin for common waste and 23 (68%) of contaminated waste was inadequate. It was noted that 13 (38%) did not have local to wash de hands; in 23 (68%) there was paper towel; in 20 (59%) there was ideal soap dishes, and the compressor was installed into dental offices in 5 (15%) of local for attendance. In relation to dental offices adequacy for the help work, all of them (n = 19) were dissatisfied. Conclusion: The existence of ASB was present in the Centers of Dental Specialties (CEO) and Units of Family Health due legal exigencies and it were found inadequate healthy and ergonomic conditions, suggesting the necessity of reorganization of work and management processes.

A importância da saúde bucal na ótica de pacientes hospitalizados / The importance of oral health in the view of inpatients

A percepção da condição bucal é um importante indicador de saúde, pois sintetiza a condição real de saúde, as respostas subjetivas, os valores e as expectativas culturais. O estudo avaliou a importância da saúde bucal segundo a percepção de pacientes internados em um hospital da cidade de Araçatuba (SP). Foi aplicado um questionário semi-estruturado para a coleta de dados e utilizado para análise estatística o programa Epi Info 2000. Os resultados mostraram que metade dos pacientes haviam realizado a última visita ao cirurgião-dentista em um período compreendido entre seis a doze meses devido a problemas periodontais (35 por cento) e cárie dentária (20 por cento). Observou-se que, embora todos os pacientes considerassem ter uma "boa" higiene bucal, o tratamento periodontal foi identificado como o de maior necessidade entre os pacientes (67,93 por cento). A presença do cirurgião-dentista no corpo clínico hospitalar foi considerada por todos os entrevistados como fundamental para contribuir no cuidado integral à saúde dos pacientes hospitalizados. Quanto ao papel do dentista em um hospital, a grande maioria dos pacientes (90,63 por cento) afirmou ser o "cuidar dos dentes". Assim, conclui-se que todos os pacientes têm conhecimento do quão é importante a manutenção das condições adequadas de saúde bucal, principalmente em pacientes hospitalizados.

The perception of oral condition is an important health indicator as it synthesizes the condition of objective health, subjective answers, cultural values and expectative. The study evaluated the importance of oral health according to the perception of inpatients of a hospital unit at Araçatuba city, São Paulo State. A partially structured questionnaire was used to collect data. The program Epi Info 2000 was used to statistics analysis. The results show that half of patients affirmed that visited a dental surgeon on a period between 6 and 12 months due to periodontal problems (35 percent) and dental caries (20 percent). It was observed that although all patients consider to have a good oral hygiene, the periodontal treatment was identified like the more necessary among them (67.93 percent). The presence of a dental surgeon at the hospital clinical group was considered by all the patients essential to collaborate with the integral care of health of inpatients. About the role of dental surgeon in a hospital, the majority of patients (90.63 percent) affirmed to be the act of "caring on the teeth". So, it is possible to conclude that all the patients know the importance of the maintenance of oral health appropriated conditions specially of inpatients.

Conductas de estudiantes del área de la salud frente a la exposición ocupacional a material biológico / Health students behavior when espoused to biological material

El objetivo de este estudio fue verificar la percepción de estudiantes de odontología relacionada a las actitudes frente a la incidencia de accidente ocupacional con material biológico. La población estudiada estaba formada por alumnos del último año del curso de Odontología. Se aplicó un cuestionario semi-estructurado, con la intención de verificar exposición ocupacional a material biológico. Participaron de la investigación 117 alumnos, siendo que 47 (40,2 por ciento) informaron haber sufrido algún tipo de accidente con material biológico y 100 (85,5 por ciento) afirmaron no haber tenido o tuvieron poca orientación sobre la forma de proceder. 59 (50,4 por ciento) dijeron no saber después de cuánto tiempo debería ser iniciada la quimioprofilaxis al VIH, 82 (70,1 por ciento) cuál es la duración y 86 (73,5 por ciento) sobre su eficacia. Se concluye que existe deficiencia de conocimiento sobre el tema y actitudes a ser tomadas en el caso de infortunio profesional.

The aim of this study was to verify the perception of ending students of Dentistry Course in relation to attitudes front occurrence of occupation accident with biological material. Studied population was constituted by students of last year of Dentistry Course. It was applied a semi-structured questioner with the aim to verify the occupational exposition at biological material. Just 117 students participated of this research being 47 (40,2 percent) cited suffer themselves some kind of accident with biological material and 100 (85,5 percent) affirmed didn't had suffered or had little orientation about how to conduct. Just 59 (50,4 percent) said they didn't know after how much time it was adequate to start the chemical prophylaxy at HIV, 82 (70,1 percent)what was it duration and 86 (73,5 percent) what was the efficacy. It was possible to conclude that there is absence of know about this theme and attitudes to realize on professional misfortune cases.

Perfil epidemiológico da violência física intrafamiliar: agressões denunciadas em um município do Estado de São Paulo, Brasil, entre 2001 e 2005 / Epidemiological profile of domestic violence: complaints of aggression filed in a city in São Paulo State, Brazil, from 2001 to 2005

Este estudo examinou agressões físicas intrafamiliares registradas em Araçatuba, São Paulo, Brasil, durante 2001-2005. São descritas características sócio-demográficas de agressores e vítimas; parentesco; local, horário, dia da semana e motivos das agressões; tipos de lesão e uso de álcool/drogas pelos agressores. Das 7.750 ocorrências, 1.844 estavam relacionadas à agressão física intrafamiliar: 81,1 por cento envolvendo parceiros íntimos (grupo A), 11,6 por cento pais/responsáveis e filhos (grupo B) e 7,3 por cento outros familiares (grupo C). Nos três grupos, as agressões ocorreram principalmente em casa, sendo os agressores predominantemente do sexo masculino. No grupo A as agressões ocorreram principalmente nos finais de semana (38,9 por cento), sendo o ciúme, motivo freqüentemente relatado (21,5 por cento). No grupo B, crianças/adolescentes constituíram 68,1 por cento das vítimas, predominando as meninas entre os adolescentes; 3,8 por cento dos agressores eram adolescentes, e 5,2 por cento das vítimas tinham idade > 60 anos. Nos três grupos, predominaram lesões leves, principalmente equimoses e escoriações, acometendo cabeça e membros superiores. Os agressores estavam freqüentemente alcoolizados: 26,8 por cento (grupo A), 21,6 por cento (grupo B), e 17,1 por cento (grupo C). O uso de drogas foi provavelmente subestimado nos três grupos (2,2 por cento, 1,8 por cento e 4,5 por cento respectivamente).

The aim of this study was to analyze complaints of household physical aggression filed in Araçatuba, São Paulo, Brazil, from 2001 to 2005. The study described the social characteristics of aggressors and victims, their family relationship, locale, time of day, day of week, causes of aggression, kind of injuries, and use of alcohol/drugs by aggressor. Of 7,750 complaints of aggression, 1,844 involved domestic violence: 81.1 percent involved the spouse or partner (group A), 11.6 percent parents/guardians and children (group B); and 7.3 percent other family members (group C). In the three groups, the aggressions occurred mainly at home, and the aggressors were mostly males. In group A, aggressions occurred mainly on weekends (38.9 percent), with jealousy as the most frequently reported cause (21.5 percent). In group B, children/adolescents constituted 68.1 percent of the victims, mostly girls, while 5.2 percent of victims were ? 60 years old. All three groups involved mostly minor injuries like bruises and excoriations to the head and upper limbs. Aggressors were frequently under the influence of alcohol: 26.8 percent (group A), 21.6 percent (group B), 17.1 percent (group C). Drug use was probably underestimated in the three groups (2.2 percent, 1.8 percent, and 4.5 percent, respectively).

Perfil dos administradores de hospitais públicos do Estado do Paraná / Public hospital manager profile in the State of Paraná

Nesta pesquisa qualitativa, realizada com oitenta e nove administradores de hospitais públicos do Estado do Paraná, objetivou-se revelar o perfil socioeconômico e gerencial desses gestores, uma vez que se relacionam diretamente à prática administrativa no campo da saúde pública. Como instrumento para a coleta de informações utilizou-se um questionário semi-estruturado, previamente testado e validado. Com base nos dados sociais e econômicos, verificou-se que a idade média dos administradores foi 47 anos e que a grande maioria pertencia ao gênero masculino (92 por cento). Com relação ao grau de escolaridade houve ascendência do nível superior completo (66 por cento), e quanto à renda média mensal, o predomínio concentrou-se entre 5 a 10 salários-mínimos. As ações mais mencionadas pelos administradores, desenvolvidas durante a sua prática de trabalho, foram o gerenciamento de recursos humanos, o planejamento das ações, a mediação entre serviço de saúde, profissionais e população e as relações políticas. Vale ressaltar que 68 administradores (76,4 por cento) admitiram trabalhar sob a ótica da gestão clássica, com centralização do poder e limitada autonomia dos outros níveis gerenciais e operacionais, e somente 5 profissionais (5,6 por cento) afirmaram desempenhar suas funções de forma descentralizada, com a atuação conjunta de outros profissionais e a participação da população. Evidencia-se que as pessoas que assumem o cargo de administrador de hospital público no Estado do Paraná possuem nível educacional e de renda relativamente elevado; entretanto, em sua maioria, não apresentam formação técnica apropriada para assumir essa função, constituindo-se em gestores parcialmente desprovidos de competências e de habilidades extremamente necessárias para o exercício da gestão em saúde pública.

Responsabilidade do profissional de saúde sobre a notificação de casos de violência doméstica / Responsibility of health providers in domestic violence reporting

A notificação da violência doméstica pelos profissionais de saúde contribui para o dimensionamento epidemiológico do problema, permitindo o desenvolvimento de programas e ações específicas. O objetivo do trabalho foi verificar a responsabilidade desses profissionais em notificar a violência, especialmente a doméstica e as possíveis implicações legais e éticas a que estão sujeitos. Assim, foi realizada pesquisa na legislação brasileira e códigos de ética da medicina, odontologia, enfermagem e psicologia. Quanto à legislação, as sanções estão dispostas na Lei das Contravenções Penais, Estatuto da Criança e Adolescente, Estatuto do Idoso e na lei que trata da notificação compulsória de violência contra a mulher. Também existem penalidades em todos os códigos de ética analisados. Conclui-se que o profissional de saúde tem o dever de notificar os casos de violência que tiver conhecimento, podendo inclusive responder pela omissão.

Domestic violence reporting by health providers contributes to the epidemiological assessment of the magnitude of the problem, which allows the development of specific programs and actions. The aim of the study was to assess the level of responsibility of these providers towards reporting violence, especially domestic violence, and potential related legal and ethical implications. The Brazilian legislation and ethics code of Medicine, Dentistry, Nursing and Psychology were studied. Legal sanctions are found in the Criminal Law of Misdemeanor Offenses, the Child and Adolescent Statute, the Elderly Statute and in the law establishing mandatory reporting of violence against women. There are also penalties in all ethics codes reviewed. It is concluded that health providers have the legal duty of reporting known domestic violence cases and they can even be charged with omission.