Municipality In Southern Brazil Research Articles

<b>Tuberculosis in primary health care: identifying priority cases in a municipality in southern Brazil

The objective of this study was to analyze the performance of a Typical Primary Health Care Unit (TPHCU) and Family Health Unit (FHU) in the cases of TB detection and verify the capacity of health services for respiratory symptomatic (RS) care according to two types of organization. The study was carried out in Pelotas, Rio Grande do Sul, from April to August 2012. Two hundred and seventy-six health professionals from 51municipal units of Primary Health Care (PHC) participated in the study; they answered a pre-tested structured questionnaire. The data were analyzed using frequencies and multiple correspondence analyses. The FHU was associated with: professionals qualified to identify the RS, availability of container for sputum collection and request forms for baciloscopy; clinical evaluation and request for baciloscopy; collective actions in the community. The TPHCU was connected with: professionals out of date for clinical practices and tests and uncertainty in identifying RS; lack of container to collect sputum and request form for baciloscopy; professionals who did not perform clinical evaluation and did not request baciloscopy. Therefore, the detection of TB cases in primary health care center, especially in the TPHCU, was poor in structuring and developing actions to detect cases of the disease in the city.

2010 A(H1N1) vaccination in pregnant women in Brazil: identifying coverage and associated factors.

We studied vaccination coverage and its associated factors in the 2010 pandemic influenza vaccination of Brazilian pregnant women. A cross-sectional study of pregnant women who had given birth was performed in a municipality in southern Brazil, in 2010. Data about vaccination against A(H1N1) and sociodemographic characteristics, morbidities and prenatal care were collected. Statistical analysis was performed using a Poisson regression. Coverage was 77.4%. Most were vaccinated in the public sector (97.6%) and in the second trimester (47%). Associated factors that increased vaccination were marriage, older age, first income quartile, prenatal care and influenza before pregnancy. Education and skin color were not significantly associated with vaccination. The vaccination campaign was extensive and exhibited no inequality. Prenatal care was the factor that most affected vaccination coverage, reflecting its importance for vaccination campaign success.

Factors associated with lack of prenatal care in a large municipality.

OBJECTIVETo analyze the factors associated with a lack of prenatal care in a large municipality in southern Brazil.METHODSIn this case-control age-matched study, 716 women were evaluated; of these, 179 did not receive prenatal care and 537 received prenatal care (controls). These women were identified using the Sistema Nacional de Informação sobre Nascidos Vivos (Live Birth Information System) of Pelotas, RS, Southern Brazil, between 2009 and 2010. Multivariate analysis was performed using conditional logistic regression to estimate the odds ratios (OR).RESULTSIn the final model, the variables associated with a lack of prenatal care were the level of education, particularly when it was lesser than four years [OR 4.46; 95% confidence interval (CI) 1.92;10.36], being single (OR 3.61; 95%CI 1.85;7.04), and multiparity (OR 2.89; 95%CI 1.72;4.85). The prevalence of a lack of prenatal care among administrative regions varied between 0.7% and 3.9%.CONCLUSIONSThe risk factors identified must be considered when planning actions for the inclusion of women in prenatal care by both the central management and healthcare teams. These indicated the municipal areas with greater deficits in prenatal care. The reorganization of the actions to identify women with risk factors in the community can be considered to be a starting point of this process. In addition, the integration of the activities of local programs that target the mother and child is essential to constantly identify pregnant women without prenatal care.

Anthropometric indices among schoolchildren from a municipality in Southern Brazil: a descriptive analysis using the LMS method

OBJECTIVE: To describe the percentile values for body mass index (BMI), waist circumference (WC) and waist-to-height (WHtR) of children from Colombo, Brazil, and compare them with data of children from other countries.METHODS: This was a cross-sectional study with a random sample of 2,035 children aged 6-11 years. Age- and sex-specific smoothed percentiles curves for BMI, WC and WHtR were created using the LMS method. Values of 10th, 50th and 90th percentiles from Brazilian children were compared with data from other countries.RESULTS: There was a trend of increasing BMI and WC with age in both sexes. WHtR remained constant with advancing age in boys and girls. Comparison of the growth pattern among countries showed clear differences. Southern Brazil boys and girls had elevated 90th percentile values for BMI, which was similar to German children and higher than the North American and World Health Organization percentile values. However, children from this study had intermediate values for WC and WHtR in comparison to children from other countries.CONCLUSIONS: Elevated BMI values were observed among southern Brazilian children, but WC and WHtR percentile values were lower in southern Brazilian children than in children from other countries. Interventions at different levels should be made to avoid a probable increase of nutritional disorders (especially general obesity) in the next years.

Anthropometric indices among schoolchildren from a municipality in Southern Brazil: a descriptive analysis using the LMS method

ObjectiveTo describe the percentile values for body mass index (BMI), waist circumference (WC) and waist-to-height (WHtR) of children from Colombo, Brazil, and compare them with data of children from other countries. MethodsThis was a cross-sectional study with a random sample of 2,035 children aged 6–11 years. Age- and sex-specific smoothed percentiles curves for BMI, WC and WHtR were created using the LMS method. Values of 10th, 50th and 90th percentiles from Brazilian children were compared with data from other countries. ResultsThere was a trend of increasing BMI and WC with age in both sexes. WHtR remained constant with advancing age in boys and girls. Comparison of the growth pattern among countries showed clear differences. Southern Brazil boys and girls had elevated 90th percentile values for BMI, which was similar to German children and higher than the North American and World Health Organization percentile values. However, children from this study had intermediate values for WC and WHtR in comparison to children from other countries. ConclusionsElevated BMI values were observed among southern Brazilian children, but WC and WHtR percentile values were lower in southern Brazilian children than in children from other countries. Interventions at different levels should be made to avoid a probable increase of nutritional disorders (especially general obesity) in the next years.

Collective efficacy and depressive symptoms in Brazilian elderly

The objective was to investigate the association between depressive symptoms and collective efficacy among the elderly in a municipality in southern Brazil. A cross-sectional population-based design was carried out. Structured interviews were held at the homes of 1007 elderly individuals. The presence of depressive symptoms was measured using the Geriatric Depression Scale, exposures were a standard 8-item collective efficacy scale and a single item about elderly participation in groups. Data were analyzed using Poisson regression to obtain the crude and adjusted prevalence ratios (PRs). The sample consisted mostly of female (63%), white (96%) and married (64%) elderly individuals. The mean age, income and educational level were, respectively: 73 years (SD=4), R$ 1836 (SD=2170) and 5 years of education (SD=4). After controlling for demographic, socioeconomic, behavioral and health-related variables, participants who reported low collective efficacy at the places where they lived presented a prevalence of depressive symptoms that was twice as high as the prevalence among those who reported high collective efficacy. In the same way, elderly individuals who did not participate in groups presented prevalence of the outcome around 64% higher than among those who took part in one or more groups. The study suggests that creation of and participation in social networks and community groups may be an important strategy for promoting mental health among the elderly.

A new third-order sequence stratigraphic framework applied to the Triassic of the Paraná Basin, Rio Grande do Sul, Brazil, based on structural, stratigraphic and paleontological data

The Santacruzodon assemblage zone was originally defined as a vertebrate fossil assemblage composed basically of non-mammalian cynodonts found in Santa Cruz do Sul and Venâncio Aires municipalities in Southern Brazil. This assemblage zone was positioned at the top of the Sequence I, in the Triassic Santa Maria Supersequence, Paraná Basin. However, the Santacruzodon assemblage zone does not occur across the entire area of the Santa Maria Supersequence. Based on new paleontological, structural and sedimentological data, we propose the existence of a new third-order sequence (Santa Cruz Sequence) between Sequences I and II in the Santa Maria Supersequence. Satellite image analysis was used to identify regional, NW- and NE-oriented lineaments that limit the occurrence zone. Outcrop data allowed the identification of a regional, angular unconformity that bounds the new sequence. The faunal content allowed the correlation of the new Santa Cruz Sequence with Madagascar's Isalo II fauna, corresponding to the Ladinian (Middle Triassic). New names were suggested for the sequences in the Santa Maria Supersequence, since the Santa Cruz Sequence was deposited between the former Sequences I and II. This unit was deposited or preserved exclusively on the hanging wall of normal faults, being absent from the adjacent structural blocks.

EPA-0449 – Profile of psychiatric emergency visits in a university hospital in south of brazil

Over the Last decades outpacients services become a substitute for psychiatric hospitals in Brazil. For most patients, Psychiatric emergency Services represents the entry point into health care system and an essential source of treatment. The Psychiatric Emergency Service of the University Hospital of Santa Maria (SEP/HUSM) has operated since 1972 and serves the 537,745 inhabitants of 31 municipalities in southern Brazil. To describe the profile of SEP/HUSM visits in the years 2010 and 2011. Define the profile and the quality of care of visits to SEP/HUSM. Evaluate the characteristics of the visitas in SEP/HUSM during the years 2010 and 2011 to compare the statistics with other services. This is a cross-sectional study of 7853 visitas, with the data of a questionnaire defined in the SEP/HUSM, associated with the records of the HUSM and using demographics and clinical variables. Research approved by the ethics committee HUSM. The majority of the patients are from Santa Maria (83,9%), male (52%), 25-44 years old, had Mood Disorders (39%) and Substance Dependence (28,3%), came to the SEP/HUSM during the weekdays, and were sent to the observation room (21.5%) or hospitalized (18,9%). The profile of the care provided in the SEP/HUSM is similar to other centers. There is a great demand by patients without the appropriate profile of treatment in the SEP/HUSM, probably due to problems in the other units of the mental health system.

Informal strategizing in a public organization

Strategy as Practice analyzes what people do in relation to the development of strategy in organizations, providing insights into current issues in strategy that require a more micro level of understanding (JOHNSON et al., 2007). Considering the perspective of strategy as practice arising from the emerging strategies, we noticed the lack of studies to understand how these activities occur in a daily basis of organization characterizing as informal strategies (WHITTINGTON, 2007). Therefore, this study proposes to address this issue, showing the occurrence of informal strategizing at a public organization under the strategy-as-practice perspective. For this we held a qualitative research through a single case study (EISENHARDT, 1989) in a municipality in southern Brazil. Data were collected through semi-structured interviews with officials of different levels of the organization; direct observation, with notebook guide and analysis of documents provided by the organization, encouraging the triangulation of data. Informal strategies were mainly identified on customer service activities when an applicant’s request is not strictly met under the law or the legislation is dubious and opens room for double-meaning surveying, interpretation and information communication.

MANEJO DE RESÍDUOS SÓLIDOS NA REGIÃO SUL DO BRASIL

A large amount of solid waste generated by the population leads to social, environmental and health problems, so it is important that the Brazilian municipalities have programs for solid waste management in order to reduce the effects of the mismanagement of these materials. Thus, the aim of this study was to characterize the solid waste management in southern Brazil. For data analysis, was used descriptive statistics. The data were obtained from IBGE, referring to the National Survey of Sanitation year 2008. With this study, it was revealed that all the municipalities in southern Brazil have solid waste management, but there is no selective collection in 52.4% of the municipalities of Parana State, 66.6% of the municipalities of Santa Catarina State and 66.5% the municipalities of Rio Grande do Sul State. In Brazil, the largest daily quantity of solid waste is destined for landfills, corresponding to 64.6%. Therefore, it is necessary constantly invest in solid waste management, with the aim of improving the services provided to the population and minimize social, environmental and health damage caused by improper management of solid waste.

Simulação baseada em System Dynamics para avaliação de cenários sobre geração e disposição de resíduos sólidos urbanos

O artigo apresenta o desenvolvimento, validação e experimentação de um modelo de simulação utilizando a metodologia System Dynamics, a qual permite avaliar e analisar cenários acerca da geração e disposição final dos resíduos sólidos urbanos (RSU). Para tanto, levou-se em consideração: a taxa de crescimento vegetativo populacional (nascimentos e mortes), percentual de resíduo sólido urbano enviado para cada tipo de destino final e a quantidade de resíduos gerada por habitante. A validação do modelo foi através da análise de cenários futuros para um determinado município da região sul do Brasil. Para a modelagem e execução do sistema foi utilizado o software Vensim, da Ventana Systems. Com os resultados gerados pelo modelo de simulação, os gestores da área podem, antecipadamente, discutir, avaliar e decidir possíveis medidas necessárias para melhorias ou adaptações na gestão de resíduos sólidos urbanos.

Assessment of Energy Saving in Waste Recycling using System Dynamics

DOI: 10.5902/198346597166 Recycling is a topic of great importance in integrated waste management, evidence of this is verified in the National Policy of Solid Waste, decreed in 2010, where it is considered one of the priorities. In this article is presented a computer simulation model, since their development until its validation, which aims to support environmental managers in their decisions regarding the definition and / or maintenance of solid waste policies recycling, as well as evaluating the benefits of process in the environment (in this article we evaluated the energy savings). For the model development was considered: the rate of natural population growth (births and deaths), percentage of solid waste recycled (for each type of material), gravimetric composition of the material in the total waste generated, the amount of waste generated per inhabitant and energy savings caused by each distinct type of material. Through the model results generated, end users (environmental managers) thereof may, for example, set incentives to reduce the total generation of solid waste, produce campaigns enhancing reuse and recycling and to assess the relative benefits of energy savings caused by recycling. Model validation was through analysis of future scenarios for a given municipality in southern Brazil. For modeling and system validation was used Vensim from Ventana Systems.

Risk factors for foot ulcers—A cross sectional survey from a primary care setting in Brazil

AimsTo identify the prevalence of higher risk of foot ulceration and associated factors among patients with diabetes mellitus (DM) at primary health care services. MethodsIndividuals with DM, registered at primary health care services in a municipality in southern Brazil, were interviewed and underwent foot examinations. Their risk of ulceration was classified in accordance with the recommendations of the International Working Group on the Diabetic Foot. Poisson bivariate and multivariate analyses were performed and adjusted prevalence ratios (PR) and 95% confidence intervals (CI) were calculated. ResultsThe prevalence of higher risk of foot ulceration among the 337 interviewees was 27.9% (95% CI 23.1–32.9). The following factors were associated with this risk: having been diagnosed with DM for more than 10 years (Adjusted-PR 1.669; 95% CI 1.175–2.373; p=0.004); having had previous diagnoses of acute myocardial infarction (Adjusted-PR 1.873; 95% CI 1.330–2.638; p<0.001) and stroke (Adjusted-PR 1.684; 95% CI 1.089–2.604; p=0.019); presenting interdigital mycosis (Adjusted-PR 1.539; 95% CI 1.030–2.300; p=0.035) and calluses (Adjusted-PR 1.654; 95% CI 1.117–2.451; p=0.012). ConclusionsThe prevalence of higher risk of ulceration was high, which reinforces the importance of continued education for health care professionals in order to prevent complications in the feet of these patients.

Physical Inactivity and Associated Factors Among Women From a Municipality in Southern Brazil

Physical inactivity is one of the most important modifiable risk factors that is raising the global burden of chronic diseases. This is a cross-sectional, population-based study of 790 women aged 20 years or older living in the urban area of a municipality in Southern Brazil. The level of physical activity was measured using the International Physical Activity Questionnaire, short form. Inactivity was defined as fewer than 150 min/wk-1 spent in moderate or vigorous physical activities. Prevalence ratios were calculated by robust Poisson regression. The prevalence of physical inactivity was 48.7% (95% CI, 43.3%-54.1%). After adjusting for confounders, we found a linear trend for increasing prevalence of physical inactivity with increasing body mass index (P = .008). Women who were married or in a domestic partnership were 29% less physically active than single women (P = .044). A borderline association was detected between the presence of minor psychiatric disorders (MPD) and physical inactivity (P = .058). There was a high prevalence of inactivity. Obese women, those married or in domestic partnerships and those with MPD were more likely to lead an inactive lifestyle. These results suggest that strategies are required for breaking down barriers to physical activity in this demographic group.

Risk factors for infant mortality in a municipality in southern Brazil: a comparison of two cohorts using hierarchical analysis

This study compared risk factors for infant mortality in 2000-2001 and 2007-2008 in Londrina, Paraná State, Brazil. Data on live births and infant deaths were linked in a single database, and a hierarchical regression model was used. Distal risk factors for infant mortality in 2000-2001 were maternal age < 20 or ≥ 35 years and lower maternal schooling. In 2007-2008, maternal age ≥ 35 or < 20 years were risk factors, while low schooling appeared as a protective factor. The following intermediate factors were associated with increased infant mortality in 2000-2001: multiple pregnancy, history of stillbirth, and insufficient number of prenatal visits, while cesarean delivery was a protective factor. Multiple pregnancy was the only intermediate risk factor in 2007-2008. All of the proximal factors were associated with higher infant mortality in 2000-2001, but only gestational age and 5-minute Apgar in 2007-2008. The risk factors for infant mortality changed from the first to the second cohort, which may be related to the expansion of social policies and primary care and changes in the reproductive and social patterns of Brazilian women.

Acadêmicos da Unochapecó na interação com sistema único de saúde e ESF através do Projeto Pró-Saúde

O presente artigo relata reflexões sobre possibilidades e desafios de implantação da Estratégia Saúde da Família em um município do sul do Brasil, a partir da experiência de uma acadêmica da 2a fase do curso de Medicina da Universidade Comunitária da Região de Chapecó - Unochapecó. A experiência se deu no contexto de um dos projetos aprovados no Pró-Saúde, Vivências Interdisciplinares e Multiprofissionais, que inclui tutorias e atividades de observação no âmbito da atenção básica do município, envolvendo estudantes e professores de dez cursos de graduação e profissionais da rede de serviços da Secretaria de Saúde de Chapecó. A partir dessa observação foram identificadas as seguintes dificuldades: equipe de saúde restrita em relação à diversidade de profissionais, que é necessária para as ações de promoção da saúde na comunidade; baixo comprometimento dos usuários; déficits na relação médico-paciente; e baixo nível de satisfação de alguns profissionais no trabalho. Como avanços foram percebidos o comprometimento da equipe e a aproximação da unidade de saúde com o setor da assistência social em prol do trabalho intersetorial.

Factors Associated with Road Accidents among Brazilian Motorcycle Couriers

The objective of the study was to identify factors associated with reports of road accidents, among motorcycle couriers in two medium-sized municipalities in southern Brazil. A self-administered questionnaire was answered by motorcycle couriers that had worked for at least 12 months in this profession. The outcomes analyzed were reports on accidents and serious accidents over the 12 months prior to the survey. Bivariate and multivariate analyses by means of logistic regression were carried out to investigate factors that were independently associated with the outcomes. Seven hundred and fifty motorcycle couriers, of mean age 29.5 years (standard deviation = 8.1 ), were included in the study. Young age (18 to 24 years compared to ≥25 years, odds ratio [OR] = 1.77) speeding (OR = 1.48), and use of cell phones while driving (OR = 1.43) were factors independently associated with reports of accidents. For serious accidents, there was an association with alternation of work shifts (OR = 1.91) and speeding (OR = 1.67). The characteristics associated with accidents—personal (young age), behavioral (use of cell phones while driving and speeding), and professional (speeding and alternation of work shifts)—reveal the need to adopt wide-ranging strategies to reduce these accidents, including better work conditions for these motorcyclists.

Condições de trabalho e renormalizações nas atividades das enfermeiras na saúde da família

Este artigo tem como objetivo analisar a influência das condições de trabalho nas atividades das enfermeiras na Saúde da Família e nas renormalizações que produzem. Trata-se de um estudo qualitativo realizado em um município do sul do Brasil, envolvendo uma amostra intencional de dez enfermeiras. Utilizou-se triangulação metodológica com dados colhidos através de estudo documental, observação e entrevistas de autoconfrontação. Para tratamento e análise dos dados, usaram-se recursos do software Atlasti 5 e os fundamentos do materialismo histórico dialético e da ergologia. Os resultados mostraram que condições de trabalho inadequadas, como força de trabalho insuficiente e precariedade dos instrumentos de trabalho, contrariam ou impedem o alcance dos objetivos de promoção da saúde e integralidade prescritos pela Saúde da Família. Conclui-se que, nessas condições, as enfermeiras renormalizam suas atividades com base nos valores de direito à saúde, acesso e integralidade, acarretando sobrecarga de trabalho.

The prosthetic need WHO index: a comparison between self‐perception and professional assessment in an elderly population

The purpose of this study was to consider the criteria for establishing the need for prosthesis, by comparing the need perceived subjectively by a patient (self-perception) with that assessed by an examiner according to the WHO diagnosis criteria. The proposed domiciliary sample comprised 270 elderly (aged 60 years or older) residents in a municipality in southern Brazil. The interviews and oral examinations were conducted by two dentists following a period of training and calibration. The criteria used conformed to the WHO and FDI standards. Statistical treatment of data included bivariate and multivariate analysis using SPSS 10.0. Only five patients identified the need for a prosthesis when not identified by the examiner. In the case of 172 elderly subjects, there was agreement in the self-perceived and observed treatment needs. The need for prosthesis was found in 93 elderly subjects who did not perceive any need for prosthetic treatment. The multivariate analysis showed that the variables age, gender, residential area and form of service most sought after during their lives were significantly associated with a better self-perception of oral health. The professional criteria based on WHO guidelines differed from the self-perceived need. Elderly male subjects who lived in a rural area and were 70 years of age or more, who did not participate in third age groups, and who had not sought dental services for most of their lives were the least likely to perceive the need for prosthetic treatment, thereby underestimating their oral health needs.

Infecção pelo HIV entre gestantes atendidas nos centros de testagem e aconselhamento em Aids

To estimate HIV prevalence and identify high-risk sexual behavior for infection in pregnant women who were given prenatal assistance. Cross-sectional study based on attendance records of 8,002 pregnant women (25% of all municipalities) who lived in 27 municipalities in Southern Brazil in 2003 and had anti-HIV tests done in a testing and counseling center that performed prenatal assistance. Sociodemographic and behavioral data were gathered, as well as syphilis and HIV test results, during the individual counseling sessions registered in the data bank of the Sistema de Informações dos Centros de Testagem e Aconselhamento (Information System on Testing and Counseling Centers). Women who sought the centers for confirmation of previous serology or were referred to this service due to the presence of AIDS symptoms were excluded from the data base. A total of 0.5% of all the pregnant women analyzed (CI 95%=0.3;0.6) were HIV positive. The only variable associated with HIV seropositivity was schooling. The majority of them were basically exposed through unprotected sexual intercourse with the only partner they had a steady relationship with. Younger pregnant women who were single, unemployed and had lower level of education constituted the group with highest exposure. The Sistema de Informações dos Centros de Testagem e Aconselhamento turned out to be useful for the epidemiological surveillance of HIV infection and high-risk behavior among pregnant women and could also be useful as regards other populations.