Showing papers in "Cadernos De Saude Publica in 2002"
TL;DR: In this article, the identity-building process for community-based health workers in the context of their role in the Health Family Program team and their interaction with the residents of communities where they work is analyzed.
Abstract: This article analyzes the identity-building process for community-based health workers in the context of their role in the Health Family Program team and their interaction with the residents of communities where they work. Based on this analysis we specifically emphasize conflicts of interpretation, power relationships between both sides of identity-building for community-based health workers from three perspectives: that included in the official training of these workers, that produced by workers concerning themselves, and that transmitted by the community. The fact that community-based health workers live the reality of health practices in the neighborhoods where they live and work and are trained with biomedical references makes them actors that convey both the contradictions and the possibility for a deep dialogue between these two forms of knowledge and practice.
280 citations
TL;DR: The study showed that the mortality rate justifies classifying this disease as a major health problem in Brazil, and found that the 30-59-year and over-60-year age groups were the most affected.
Abstract: This study analyzes 3,181 deaths from paracoccidioidomycosis in Brazil, based on 16 years of sequential data (from 1980 to 1995). During this period paracoccidioidomycosis showed considerable magnitude and low visibility, representing the eighth most common cause of death from predominantly chronic or recurrent types of infectious and parasitic diseases. It also had the highest mortality rate among the systemic mycoses. The mean annual mortality rate was 1.45 per million inhabitants, indicating a downward long-term trend (reduction of 31.28%), while spatial distribution among the different regions and States of Brazil was non-homogenous. The South (with the highest regional rate) and the Southeast showed a downward trend, while the Central West had the second highest rate in the country. At least one-fifth of Brazilian municipalities (or 22.71% of the country's total area) reported deaths from paracoccidioidomycosis. Overall nationwide mortality per area was 3.73/10,000km2. The disease was endemic in non-metropolitan areas. The majority of deaths occurred in males (84.75%), and there was a sex ratio of 562 men/100 women. The 30-59-year and over-60-year age groups were the most affected. The study showed that the mortality rate justifies classifying this disease as a major health problem in Brazil.
260 citations
TL;DR: While it is not possible to avoid dengue in areas infested with A. aegypti, it is possible to prevent major epidemics by improving epidemiological surveillance, and it is both possible and feasible to reduce the disease's case fatality from the current 5 to 6% to some 1% in the severe forms.
Abstract: Dengue is now the main reemerging disease in the world. In the absence of an efficacious preventive vaccine and effective etiologic treatment and chemoprophylaxis, the only vulnerable link for reducing dengue transmission is the mosquito Aedes aegypti, its principal vector. There are many difficulties in combating this mosquito in large and medium-sized cities. The complexity of contemporary urban life generates factors that facilitate the mosquito's proliferation and constraints on the reduction of its infestation rates. The objectives of dengue control should be based on available scientific and technical knowledge. Thus, while it is not possible to avoid dengue in areas infested with A. aegypti, it is possible to prevent major epidemics by improving epidemiological surveillance, and it is both possible and feasible to reduce the disease's case fatality from the current 5 to 6% to some 1% in the severe forms. The elaboration and execution of strategic plans for the organization of medical care for suspected dengue cases have proven to be a highly useful instrument to reduce case fatality both in other countries and in some cities of Brazil.
210 citations
TL;DR: It is necessary to clarify the legal notion of violence in Brazil, specifically the concept of suspicion, to create technical manuals to guide action in this area and improve the number and quality of services to assist the population.
Abstract: Reporting family violence against children has two main benefits: it protects the child from the violence and improves epidemiological control of violence. Health professionals play an important role in this area, since they are required to report any known or even suspected case of violence. Nevertheless, when and how to report has been questioned recently. This paper discusses the problems faced by health professionals and suggests specific solutions to the Brazilian case. The authors conclude that it is necessary: (a) to clarify the legal notion of violence in Brazil, specifically the concept of suspicion; (b) to create technical manuals to guide action in this area; (c) to improve the number and quality of services to assist the population; (d) to improve studies and discussion of the consequences of reporting, mainly concerning the notion of justice transmitted to Brazilian families through this practice.
175 citations
TL;DR: The literature review confirmed the poor oral health of the Brazilian elderly population and recommended improved data presentation and methodology in future research in this area.
Abstract: All indexed articles in BBO, LILACS, and MEDLINE databases from January 1998 to July 2001 were searched to analyze information on oral health among the elderly in Brazil. The year 1998 was used as a starting point, since this was the year the National Epidemiological Survey was published. Twenty-nine articles were found, of which 7 were analyzed in detail regarding key methodological aspects (age, sampling, data presentation) and the results were presented (DMFT index, proportion of missing teeth, edentulousness rate, and use and need of dental prostheses). DMFT ranged from 26.8 to 31.0, with approximately 84% of teeth missing. Prevalence of edentulousness was 68%. Few elderly did not need or use any kind of prosthesis. Denture use was more frequent in the upper than in the lower jaw. Lack of standardized data hampered an understanding of some key aspects of data analysis. Both data presentation and methodology must be improved in future research in this area. Despite all these caveats, the literature review confirmed the poor oral health of the Brazilian elderly population.
159 citations
TL;DR: Evaluation of cross-cultural equivalence between the Revised Conflict Tactics Scales originally developed in English and used to identify violence in couples and a Portuguese-language version for use in Brazil shows encouraging results.
Abstract: This article concerns the evaluation of cross-cultural equivalence between the Revised Conflict Tactics Scales (CTS2) originally developed in English and used to identify violence in couples and a Portuguese-language version for use in Brazil. Besides a broad literature review, evaluation of conceptual and item equivalences involved expert discussion groups focusing on the existence and pertinence of the underlying theoretical concepts and corresponding component items in the Brazilian context. Semantic equivalence involved the following steps: two translations and respective back-translations; an evaluation regarding referential and general (connotative) equivalence between the original instrument and each version; further discussions with experts in order to define the final version; and pre-testing the latter on 774 women. It was possible to establish high-quality conceptual, item, and semantic equivalence between the Portuguese-language version and the original CTS2. Acceptability of the version was excellent. Although the results were encouraging, they should be reevaluated in the light of forthcoming psychometric analysis (measurement equivalence).
139 citations
TL;DR: In general, individuals in the lowest income distribution deciles had less access to health insurance, greater need for medical care, and lower consumption of services and factors pointing to the capacity to supply these services in country.
Abstract: This paper studies the relationship between social inequality and health in Brazil. The strategy adopted by the authors was to analyze needs and uses of medical care as well as access to health insurance plans according to income distribution. Determinants of health care consumption were also studied by means of logistic regression. The main source of data was the 1998 National Sample Household Survey of the Brazilian Institute of Geography and Statistics (PNAD-IBGE). In general, individuals in the lowest income distribution deciles had less access to health insurance, greater need for medical care, and lower consumption of such services. Other determinants of health care consumption were heavily associated with the most privileged social strata (greater access to schooling, water supply, sewerage, electricity, garbage collection, and health insurance) and with factors pointing to the capacity to supply these services in country.
139 citations
TL;DR: This work cannot exclude a role for high level exposure to o,p'-DDE, particularly in post-menopausal ER+ breast cancer, but other organochlorine pesticides and triazine herbicides require further investigation for a possible etiologic role in some hormone-dependent cancers.
Abstract: Occupational exposure to some pesticides, and particularly DBCP and chlordecone, may adversely affect male fertility However, apart from the therapeutic use of diethylstilbestrol, the threat to human reproduction posed by "endocrine disrupting" environmental contaminants has not been supported by epidemiological evidence thus far As it concerns other endocrine effects described in experimental animals, only thyroid inhibition following occupational exposure to amitrole and mancozeb has been confirmed in humans Cancer of the breast, endometrium, ovary, prostate, testis, and thyroid are hormone-dependent, which fostered research on the potential risk associated with occupational and environmental exposure to the so-called endocrine-disrupting pesticides The most recent studies have ruled out the hypothesis of DDT derivatives as responsible for excess risks of cancer of the reproductive organs Still, we cannot exclude a role for high level exposure to o,p'-DDE, particularly in post-menopausal ER+ breast cancer On the other hand, other organochlorine pesticides and triazine herbicides require further investigation for a possible etiologic role in some hormone-dependent cancers
137 citations
TL;DR: According to this study, prenatal care proved to be an effective compensatory policy for the prevention of prematurity and low birth weight, especially among adolescent mothers.
Abstract: Este trabalho tem como objetivo comparar as caracteristicas socio-economicas, a assistencia pre-natal e o estilo de vida de tres grupos de puerperas, um composto por adolescentes (< 20 anos) e os demais por mulheres de 20-34 anos, categorizadas segundo experiencia (ou nao) de gravidez na adolescencia. Foram entrevistadas 3.508 puerperas no pos-parto em maternidades municipais e federais do Municipio do Rio de Janeiro. A analise estatistica consistiu em utilizar testes qui-quadrado (chi2) para testar hipoteses de homogeneidade de proporcoes. Ao comparar os tres grupos, observou-se uma situacao mais desfavoravel entre as maes de 20-34 anos com historia de gravidez na adolescencia. Estas tem pior nivel de instrucao, mostram com maior frequencia habitos de fumo e uso de drogas ilicitas durante a gestacao e apresentam menor numero de consultas de atendimento pre-natal. A assistencia pre-natal se apresentou neste estudo como uma politica compensatoria eficiente para a prevencao da prematuridade e do baixo peso ao nascer, sobretudo entre as puerperas adolescentes.
135 citations
TL;DR: This essay focuses on the evaluation of health programs and services, emphasizing the subjectivity emerging from the evaluation process, and recommends qualitative social research methodology as a productive instrument.
Abstract: This essay focuses on the evaluation of health programs and services, emphasizing the subjectivity emerging from the evaluation process. The text is a theoretical construction that targets the various meanings of evaluation, the influence of the positivist paradigm on the field of health program and service evaluation, the polysemous nature of the term "quality", and its close overlapping with subjectivity. In addition, the authors highlight the importance of studies that incorporate the perspectives of social actors into the evaluation processes, recommending qualitative social research methodology as a productive instrument.
124 citations
TL;DR: The study evaluated the available data to establish criteria for identifying municipalities with serious data deficiencies, proposing an adequacy index, and classified municipalities in strata according to geographic region and adequacy of information.
Abstract: A methodological approach to infant mortality estimation in Brazil based on vital information provided by Ministry of Health systems is presented. The study evaluated the available data to establish criteria for identifying municipalities with serious data deficiencies, proposing an adequacy index. All municipalities were classified in strata according to geographic region and adequacy of information. To estimate infant mortality by macro-geographic region, in 1998, direct calculation was performed in strata with adequate information. The United Nations model was used in the other geographic strata. The Brazilian North presented the most deficient information, with 63% of the municipalities presenting inadequate reporting (35% of the regional population), followed by the Northeast (29% of the population). In the South, only 1% of the population showed inadequate information. For the whole country, 12% of the population presented serious problems in completeness of death reports. The adequacy index varied from -28% in Maranhao to 94% in Rio de Janeiro. The infant mortality rate was estimated in the interval 30.7-32.6 per 1,000 live births and the completeness of infant deaths from 61.8% to 65.6%.
TL;DR: The results showed a significantly lower DMFT index in cities with fluoridated water supply and a negative correlation between the caries index and the proportion of households with running water in cities in the State of Parana.
Abstract: The aim of this research was to determine the correlation between dental caries and socioeconomic conditions in the State of Parana, Brazil. Caries prevalence was estimated for each city in the State by gathering data on the DMFT index (in 12-year-old schoolchildren) supplied by the State Health Department. Official socioeconomic data for the municipalities were also presented. Ordinary least squares regression analysis was performed, and significant correlation coefficients were observed between the dental caries index and various social development indicators. Maps highlighting the overlapping areas with poor outcomes for most of these variables were presented. The results showed a significantly lower DMFT index in cities with fluoridated water supply and a negative correlation between the caries index and the proportion of households with running water in cities with fluoridated water supply. This observation highlights the importance of fluoridated drinking water for the prevention of dental caries and as a measure to reduce the impact of socioeconomic inequalities on the prevalence of tooth decay.
TL;DR: In this article, the authors discuss survival analysis techniques, commenting and comparing their utilization, especially in the field of oncology, and discuss types of epidemiological studies and data sources to which this type of analysis is applied.
Abstract: Statistical methods known as survival analyses are useful for analyzing time-related events, in which time from a benchmark event to an endpoint is the focus of interest. Survival analysis describes not only patient survival statistics (as suggested by the name), but also other dichotomous outcomes such as time of remission, time of breastfeeding, etc. This paper discusses survival analysis techniques, commenting and comparing their utilization, especially in the field of oncology. It also presents and discusses types of epidemiological studies and data sources to which this type of analysis is applied. The authors take into account the difference between hospital-based or clinical series and population-based approaches. Interpretation of results is also discussed.
TL;DR: The authors analyzes the main positions in the political debate on racial inequalities in Brazil, identifying recent initiatives by both the Brazilian government and civil society to deal with racial discrimination and racial inequalities.
Abstract: This article aims to systematize and analyze social data that reveal the dimension of racial inequalities in Brazil. The point of departure is that racial inequalities affect the capacity for integration of Blacks into Brazilian society and jeopardize the proposal to build a democratic society with equal opportunities for all. Such inequalities are present at different moments in the individual life cycle, beginning in childhood and continuing through school years, in access to urban infrastructure, and crystallizing in the labor market, consequently determining the income and living conditions of Afro-Brazilians as a whole. The article also analyzes the main positions in the political debate on racial inequalities in Brazil, identifying recent initiatives by both the Brazilian government and civil society to deal with racial discrimination and racial inequalities. The article concludes by identifying key challenges for health policy-makers in this context.
TL;DR: The authors conclude that prevention or intervention policies can be more successful if a theoretical/practical understanding is achieved, and that it is necessary to integrate each unique case with the knowledge based on care for thousands of families involved in child abuse both in Brazil and worldwide.
Abstract: This article analyzes the factors related to child abuse that have been published in three of the main Brazilian pediatrics journals. The literature was assessed by content analysis. Fourteen studies were analyzed. The main explanatory factors were: (a) reproduction of violence; (b) family and psychological disorders and alcohol abuse; and (c) the structural or macro-social order. The authors conclude that prevention or intervention policies can be more successful if a theoretical/practical understanding is achieved, and that it is necessary to integrate each unique case with the knowledge based on care for thousands of families involved in child abuse both in Brazil and worldwide.
TL;DR: A review of epidemiological studies published in the last 10 years on the disease's prevalence, severity, and risk factors suggests that there are already more cases than expected, although few studies refer to major severity.
Abstract: This paper discusses dental fluorosis as a relevant public health problem, using a review of epidemiological studies published in the last 10 years on the disease's prevalence, severity, and risk factors. The results suggest that there are already more cases than expected, although few studies refer to major severity. Thus, measures are needed for the prevention and surveillance of dental fluorosis.
TL;DR: The evaluation of primary health care policies based on a case study of the Family Health Program in Florianopolis, Santa Catarina, Brazil suggests that such proposals for reorienting health care models tend towards rationalization, political legitimization, or democratization of services.
Abstract: This article discusses the evaluation of primary health care policies based on a case study of the Family Health Program in Florianopolis, Santa Catarina, Brazil. The results are presented in two stages. First, the Program is placed in the context of the Municipality's policies, identifying perceptions of the Program at the administrative level. Second, the author studied the Program's practices based on a sample of five family health care teams using an evaluative framework including variables on accessibility and comprehensiveness. The Program began relatively late in the State capital, but developed a unique model. There is a greater supply of services available to the population not covered by private health plans, although there is a major diversity of practices. The degree of implementation is moderately adequate: the care provided is more comprehensive, but there are problems with access (in the ratio between staff and number of families covered). It is suggested that such proposals for reorienting health care models tend towards rationalization, political legitimization, or democratization of services. The accessibility policy can set the predominant direction.
TL;DR: Couning on sexuality should be a continuing process and requires interdisciplinary training for the professional team working in health care services, with an emphasis on sexual and reproductive rights.
Abstract: The social and cultural setting which increases female vulnerability to HIV does not disappear when women living with HIV/AIDS discover that they are infected. Following diagnosis, new challenges arise in their emotional lives, an issue which has received little attention in the literature. This study interviewed 1068 women living with HIV/AIDS using a questionnaire consisting of both open and closed questions, aimed at describing aspects of their sexual and reproductive lives and how they perceive counseling at Reference Centers in two cities in the State of Sao Paulo, where they have access to free antiretroviral therapy. Of the women with stable sexual partners, 63% used condoms in all their sexual relations, or three times the national average; 43% of the partners were HIV-negative and 14% had unknown serological status; 73% of the women had children and 15% were considering becoming pregnant. Knowledge on mother-to-child transmission was less than expected, and the interviewees complained of limited space and receptiveness for discussing sexuality, especially with regard to their childbearing wishes. Counseling on sexuality should be a continuing process and requires interdisciplinary training for the professional team working in health care services, with an emphasis on sexual and reproductive rights.
TL;DR: There is a trend towards consolidating traditional inequities and to further restrict opportunities for achieving the right to health with full, equitable, universal guarantees in the Colombian health system reform.
Abstract: The author develops a long-term perspective to assess advances in equity and the right to health in the Colombian health system reform. In a restricted political system, actors in the field of health in Colombia have chosen individualistic alternatives to legalize inequities in individual purchasing power for services. Despite the complex regulations established in the General System for Social Security in Health, there is a trend towards consolidating traditional inequities and to further restrict opportunities for achieving the right to health with full, equitable, universal guarantees.
TL;DR: The principal means used by youth in Brazil to commit suicide were hanging, strangling, and suffocation (Porto Alegre), followed by firearms and explosives (Belo Horizonte), and the average suicide rate among young Brazilians in nine metropolitan areas was 5.0 per 100,000 inhabitants 15-24 years old.
Abstract: This study analyzes suicide among young Brazilians (15-24 years old) in nine metropolitan areas. Mortality data for 1979-1998 were obtained from the Mortality Information System of the Ministry of Health. External causes are the main causes of death among youth, and suicide is the sixth most frequent of these causes. The distribution is heterogeneous, varying according to the social stratum, specific age group, sex, and means used to commit suicide. All cities analyzed showed increased suicide rates from 1979 to 1998 (from 3.5 to 5.0 per 100,000 inhabitants 15-24 years old). Salvador and Rio de Janeiro had the lowest suicide rates, while Porto Alegre and Curitiba had the highest. The principal means used by youth to commit suicide were hanging, strangling, and suffocation (Porto Alegre), followed by firearms and explosives (Belo Horizonte).
TL;DR: This essay proposes a review of the issues of equity and reform in Latin America and the Caribbean in the context of changes in recent decades, emphasizing the discussion of health systems reform.
Abstract: This essay proposes a review of the issues of equity and reform in Latin America and the Caribbean in the context of changes in recent decades, emphasizing the discussion of health systems reform. The economic, political, and social context prevailing in the critical 1970s extensively favored budget cuts for public expenditures, cost containment, changes in the health sector power structure, and health services reorganization from an 'economicist', pragmatic, and restrictive perspective. An inventory of the Latin American economic and social situation is markedly negative, and efforts to recover from the damage done in the 1980s were largely unsuccessful in the 1990s. The reforms implemented in some paradigmatic countries (Chile, Colombia, Costa Rica, Argentina, and Brazil), in light of their specific characteristics, demonstrate the dissemination of a common agenda, adapted to the various national conditions. Some positive results of these processes were diluted in new problems caused by the reforms themselves, especially in countries with more radical adherence to the new reformist model; meanwhile, in the country where the public, universal system based on solidarity was most consolidated, the management changes have obtained the best results. However, overcoming inequalities is still a distant goal.
TL;DR: Results of an epidemiological ecologic study carried out to explore population data on pesticides exposure in selected Brazilian states in the eighties and human reproductive outcomes in the nineties are presented.
Abstract: The observation of reproductive disturbances in humans and in the wildlife has been reported in the last decade in different countries. Exposure to different chemicals possibly acting in the endocrine system or endocrine disruptors, including pesticides, has been a hypothesis raised to explain the observed changes. This paper aimed to present results of an epidemiological ecologic study carried out to explore population data on pesticides exposure in selected Brazilian states in the eighties and human reproductive outcomes in the nineties. Pearson correlation coefficients were ascertained between available data pesticides sales in eleven states in Brazil in 1985 and selected further reproductive outcomes or their surrogates. Moderate to high correlations were observed to infertility, testis, breast, prostate and ovarian cancer mortality. Despite the restrains of ecologic studies to establish cause-effect relationships, the observed results are in agreement with evidence supporting a possible association between pesticides exposure and the analyzed reproductive outcomes.
TL;DR: The history of the PAISM (Program for Integral Health Care for Women) reveals the complex articulation of this national public health program which, although strongly influenced by the Brazilian women's movement, has been infiltrated by heterogeneous interests in the international context.
Abstract: This article discusses the modernization of gender inequalities which has occurred in Brazil in the last 20 years under the hegemony of neo-liberal macro-economic policies. A concept of gender as transversal is applied to questions of reproductive health (contraception and abortion, prenatal care and birthing, adolescent pregnancy, maternal and reproductive mortality, STIs/AIDS, and violence, among others), permitting analysis by both gender and social class. The history of the PAISM (Program for Integral Health Care for Women), on the other hand, reveals the complex articulation of this national public health program which, although strongly influenced by the Brazilian women's movement, has been infiltrated by heterogeneous interests in the international context. PAISM serves as an example of the appropriation of proposals and principles that were generated by this social movement, but re-articulated to gloss over the process of deepening gender and class inequality.
TL;DR: In this article, a case-control study was conducted on the use of certain drugs as a risk factor for hospitalization due to fractures after falls among individuals aged 60 years or over in the city of Rio de Janeiro, Brazil.
Abstract: Falls leading to fractures among the elderly are a major public problem. A case-control study was conducted on the use of certain drugs as a risk factor for hospitalization due to fractures after falls among individuals aged 60 years or over in the city of Rio de Janeiro, Brazil. One hundred sixty-nine cases and 315 in-patient controls were matched by age, sex, and hospital. Odds ratios (OR) adjusted for potential confounders were calculated using conditional logistic regression. Increased risk of such accidents was found for calcium channel antagonists (OR = 1.96, 1.16-3.30) and benzodiazepines (OR = 2.09, 1.08-4.05), and decreased risk was associated with diuretics (OR = 0.40, 0.20-0.80). Antacids, digitalis, and laxatives were associated with reduced risk of fractures after falls that reached borderline statistical significance (0.05 < p < 0.10). The findings highlight the need to weigh risks and benefits of medication in the elderly. It is also important to advise such individuals and their families on how to avoid falls when such medication proves necessary.
TL;DR: In this article, a prevalencia e severidade da carie dental and necessidade de tratamento odontologico for 6-12-year-olds in do two pequenos municipios of Brazil, Treviso and Sao Joao do Sul, were investigated.
Abstract: O objetivo deste estudo foi conhecer a prevalencia e severidade da carie dental e necessidade de tratamento odontologico na populacao escolar de 6 a 12 anos de idade em dois pequenos municipios brasileiros. Utilizaram-se os criterios de diagnostico da Organizacao Mundial de Saude (1986) para se obter a prevalencia e severidade da carie, e realizou-se censo dos escolares de 6 a 12 anos de idade de Sao Joao do Sul (n = 803) e de Treviso (n = 382), ambas as cidades em Santa Catarina. As prevalencias de carie encontradas foram: 62,1% em Sao Joao do Sul e 63,6% em Treviso. Os indices CPO-Ds (numero de dentes cariados, perdidos e restaurados) foram de 1,91 para Sao Joao do Sul e de 1,84 para Treviso, para a faixa etaria de 6 a 12 anos. Em ambos os municipios a principal necessidade foi de tratamentos simples, principalmente o restaurador. Conclui-se que a prevalencia de carie em Sao Joao do Sul e Treviso e inferior a de outros pequenos municipios onde se realizaram estudos com metodologias semelhantes, com dados publicados na literatura, e que as necessidades de tratamento odontologico sao de pequena magnitude.
TL;DR: Overall, the findings suggest that the Portuguese version of Revised Conflict Tactics Scales can be used in the Brazilian context, although further investigation should be carried out to unveil some important remaining issues.
Abstract: Following a previous evaluation of concept, item and semantic equivalences, this paper assesses the measurement equivalence between a Portuguese version of Revised Conflict Tactics Scales (CTS2) and the original instrument conceived in English. The CTS2 has been widely used to tap violence between couples. An intra-observer reliability evaluation involved 165 replications carried out within a 24-48 hour period. Kappa point-estimates were above 0.75 for all scales except sexual coercion. The analysis of internal consistency concerned 768 subjects with complete sets of items. Kuder-Richardson-20 estimates ranged from 0.65 to 0.86. Results were similar to those found in the original instrument in English for the negotiation, psychological aggression and physical violence scales, yet not so for the sexual coercion and injury scales. Factor analysis identified factors with a recognizable correspondence to the underlying dimensions, although a few inconsistencies were detected. For the assessment of construct validity (n = 528) associations between the instrument's scales were evaluated, as well as the relationships between violence and putative underlying dimensions. Overall, the findings suggest that the version can be used in the Brazilian context, although further investigation should be carried out to unveil some important remaining issues.
TL;DR: This article focuses on key elements contributing to the public social policy debate, specifically from the perspective of promoting distributive justice, in Brazil and its relation to recent changes in national health policy and the literature on the issues of equity and social justice.
Abstract: This article focuses on key elements contributing to the public social policy debate, specifically from the perspective of promoting distributive justice. The reference is the Family Health Program in Brazil and its relation to recent changes in national health policy and the literature on the issues of equity and social justice. This concern is due to recent changes in social interventions by the Brazilian state, where targeting assumes a central place in the reform process. Specifically concerning health policy, the issue of equity has gained visibility, linked to the discussion on the profile of health expenditures. One of the central aspects in this context lies in the debate between notions such as the regressive and inequitable nature of targeted measures and programs, on the one hand, and the expanded perspective of access by what have traditionally been socially excluded sectors, on the other. The debate between such perspectives highlights the controversies concerning the effectiveness of health measures, equity, and the distributive concept of social justice, with the latter as the central discussion in this study.
TL;DR: In this paper, the authors highlight the epidemiological surveillance of venomous bites and stings according to four national information systems: SINAN (National Databank of Major Causes of Morbidity), SINITOX (National Information System on Poisoning), SIH-SUS (Hospital Information System of the Unified Health System), and SIM (Mortality Information System).
Abstract: This paper highlights the epidemiological surveillance of venomous bites and stings according to four national information systems: SINAN (National Databank of Major Causes of Morbidity), SINITOX (National Information System on Poisoning), SIH-SUS (Hospital Information System of the Unified Health System), and SIM (Mortality Information System). The authors conclude that each information system has specific characteristics and addresses different demands. Although they contain large amounts of data, even if combined they fail to reflect the real magnitude of disorders caused by venomous bites and stings in the country.
TL;DR: In this article, the authors examined the risk perception of health problems associated with anabolic steroid consumption among young working-class adults engaged in body-building practices in a poor neighborhood in the city of Salvador, Bahia.
Abstract: Recent studies in different countries have shown an increase in anabolic steroid consumption among young people and the harm caused by indiscriminate use. In Brazil, research on steroid abuse is scarce. The present study examines the risk perception of health problems associated with anabolic steroid consumption among young working-class adults engaged in body-building practices in a poor neighborhood in the city of Salvador, Bahia. The methodology involved an anthropological approach based on qualitative research techniques consisting of ethnography, in-depth interviews, and a focus group with steroid users. The data describe the most common substances consumed and highlight the lack of information among interviewees concerning potential related health hazards, showing that for many steroid consumers the quest for muscle-mass development to achieve an idealized body supersedes the risk of harmful side effects. The results indicate the need for culturally sensitive measures to prevent steroid abuse among youth.
TL;DR: In this paper, an amostra aleatoria was used to identify possiveis associacoes entre condicoes de trabalho and saude de agentes penitenciarios of Salvador, Bahia, Brazil.
Abstract: Estudo transversal para identificar possiveis associacoes entre condicoes de trabalho e saude de agentes penitenciarios de Salvador, Bahia, Brasil, utilizou uma amostra aleatoria estratificada proporcional de 311 individuos, que responderam, sem identificacao, questionario auto-aplicavel. Obteve-se os seguintes resultados na regressao logistica: (a) ambiente de trabalho psicologicamente inadequado, condicoes infra-estruturais insuficientes, falta de tempo para lazer, ausencia de esporte, mais de nove anos no Sistema Penitenciario (SP), dobra de turno, jornada > 48 horas semanais e organizacao do trabalho inadequada, foram associados positivamente com disturbios psiquicos menores (DPM); (b) falta de treinamento, sexo feminino, jornada > 48 horas semanais, ambiente de trabalho psicologicamente inadequado, falta de tempo para lazer e ausencia de esporte, foram associados positivamente com estresse persistente; (c) idade £ 45 anos, ³ nove anos no SP, dobra de turno, ausencia de esporte, ambiente de trabalho psicologicamente inadequado, condicoes infra-estruturais e organizacionais inadequadas e presenca de DPM, foram associados positivamente com queixas de saude.