Introdução: Muitas doenças podem ser transmitidas quando não se seguem os hábitos adequados de higienização das mãos e esterilização de materiais em atividades que podem gerar ferimentos ou traumas na pele, como ocorrem nos salões de beleza. Os profissionais da beleza precisam conhecer e ter a consciência em relação a atitudes simples de higienização e cuidados com o compartilhamento de instrumentos, pela interação com muitas pessoas e pela possibilidade de ocorrer a transmissão de doenças, incluindo as doenças sexualmente transmissíveis, como as verrugas, as hepatites B e C, e o HIV, durante a realização de seus procedimentos. O Serviço Brasileiro de Apoio à Micro e Pequena Empresa apontou, em fevereiro de 2013, a existência de 265 mil estabelecimentos, abertos por pessoas que formalizaram a situação como microempreendedores individuais. Os salões de beleza são, numericamente, expressivos e apesar de não haver dados oficiais sobre o número de trabalhadores no Brasil, estima-se um grande número de pessoas envolvidas. Este estudo objetivou estruturar um curso aplicado por meio de uma dinâmica por teleducação interativa e avaliar o efeito educacional neste segmento profissional. Métodos: Foram selecionadas 4 categorias temáticas (doenças sexualmente transmissíveis, saúde indoor nos salões de beleza, lavagem das mãos e esterilização de materiais) a partir de uma Matriz de Objetivos e Competências, e o curso foi inserido numa plataforma educacional baseada no Moodle, com ambientes interativos de aprendizagem e ferramenta de gestão educacional. A sistemática das atividades foi organizada com metas semanais, encontros síncronos via web e acesso a materiais de forma assíncrona (materiais de leitura, de aprendizagem complementar, áudios e vídeos educacionais, fóruns de discussão, Simulador de Situações Práticas e vídeos do Projeto Homem Virtual sobre as DST/AIDS, higienização das mãos e lavagem, transmissão de doenças por cera depilatória reutilizável e alicate de unha contaminado). A abertura do curso foi realizada a partir de dois encontros presenciais e, para a avaliação do conhecimento prático, foi criado o simulador de situações práticas, que foi um teste online aplicado nas fases pré-curso, pós-curso imediato e 6 meses após o término do curso. Foram desenvolvidos objetos educacionais de aprendizagem do Projeto Homem Virtual por meio de vídeos utilizando computação gráfica 3D para facilitar a explicação de alguns assuntos. Resultados: Cinquenta e cinco profissionais da beleza foram matriculados no curso, sendo 46 do sexo feminino e 9 do sexo masculino, tendo sido ofertadas bolsas de estudos para 34 profissionais que justificaram dificuldade de pagamento da taxa de inscrição. A idade média dos participantes foi de 38,2 ± 8,67 anos de idade com mediana de 37,3 anos, sendo a idade mínima de 18,5 anos e a máxima de 59,1 anos de idade. Foram produzidos diversos materiais educacionais digitais utilizando múltiplos meios de comunicação: áudios, vídeos, objetos educacionais de aprendizagem utilizando computação gráfica 3D e um sistema de avaliação denominado simulador de situações práticas. Quarenta e cinco participantes foram aprovados e certificados conforme os critérios estabelecidos, e 40 alunos concluíram o simulador aplicado 6 meses após o término do curso. Como resultado de performance geral, houve melhora estatisticamente significativa do rendimento dos alunos no simulador pós-curso imediato em relação ao pré-curso e não houve retenção de conhecimento estatisticamente significativa sobre as condutas corretas na fase pós-curso tardio. Quando se isolou o grupo de estudantes que tiveram participação ativa nas listas de discussão (30% dos alunos que foram responsáveis por 75% das postagens totais) foi observada essa diferença de forma estatisticamente significativa. Discussão: Para avaliar o conhecimento dos profissionais da beleza foi criado o simulador de situações práticas baseado em situações cotidianas que podem gerar a transmissão de doenças. Não foram incluídas avaliações de detalhamento conceitual científico. Dessa forma, o objetivo principal foi mensurar a percepção do aluno sobre o que é correto em relação a situações práticas do dia a dia. Detectou-se que os alunos que não tiveram uma interação ativa nos fóruns de discussão não apresentaram retenção de conhecimento 6 meses após o término do curso, e os que participaram ativamente apresentaram essa retenção. O curso na modalidade a distância teve alto índice de aceitação pelos alunos e a distribuição das atividades de acordo com a rotina profissional resultou em maior taxa de participação nos eventos síncronos. A redução do tempo de duração do curso para 1 mês, em relação a edições anteriores deste curso, teve maior aprovação dos alunos. Conclusão: Foi estruturado um curso com duração de 1 mês aprovado pela Pró-Reitoria de Cultura e Extensão Universitária, direcionado para profissionais da beleza e realizado na modalidade a distância. O curso gerou retenção de conhecimento a longo prazo para quem teve maior participação ativa nos fóruns de discussão e foi bem aceito pelos profissionais que atuam nos salões de beleza / Introduction: Many diseases can be transmitted when professionals do not follow the proper habits of hand washing and material sterilization in activities that may cause skin injury or trauma, as is the case in beauty salons. Beauty professionals need to know and be aware of simple steps to cleaning care and instruments sharing, as they interact with many people, thus increasing the possibility of disease transmission, including sexually transmitted diseases such as warts, hepatitis B and C, and HIV, while carrying out their procedures. The Brazilian Service of Support for Micro and Small Enterprises pointed out the existence of 265,000 establishments in February 2013, opened by people who formalized their business as individual microenterprises. Beauty salons are numerically significant, and although there are no official data on the number of workers in Brazil, a large number is estimated. This study aimed to structure a distance-learning course via interactive tele-education dynamics, and to evaluate the educational effect in this professional segment. Methods: Four thematic categories were selected (sexually transmitted diseases, indoor health in salons, hand washing and material sterilization) from a matrix of objectives and competences. The course was inserted in an educational platform based on Moodle, with interactive learning environments and educational management tools. The activities systematics was organized with weekly goals, synchronous web meetings, and asynchronous access to materials (readings, discussion forums, situation simulator, audio and educational videos as well as 3-D Virtual Human video animation on sexually transmitted infections, hand washing and disease transmission from reusable depilatory wax and contaminated nail pliers). The course started with two face-to-face meetings and, in order to assess participants\' practical knowledge, a simulator to practical situations was created, which was an online test applied before, immediately after course end, and 6 months later. Educational learning objects associated to 3-D Virtual Human Project video animation were also developed to facilitate the explanation of some topics. Results: Fifty-five beauty professionals enrolled in the course, out of whom 46 females and 9 males; 34 students were granted scholarships due to justified registration fee payment difficulty. Mean age of participants was 38.2 ± 8.67 years old with median of 37.3, the minimum age at 18.5 and the maximum at 59.1 years old. Different digital learning materials using multiple media were produced, such as audios, videos, educational learning objects using 3D computer, and an evaluation system called simulator to practical situations. Forty-five participants were approved and certified according to agreed criteria, and 40 students accomplished the simulator tasks applied 6 months after the course end. As a result of overall performance, there was a statistically significant improvement in student performance in the immediate post-course simulator compared to the pre-course one; however, there was no statistically significant retention of knowledge on the correct behavior in the later post-course phase. When the group of students who actively participated in discussion lists (30% of students accounted for 75% of total posts) was isolated, this statistically significant difference was observed. Discussion: To evaluate the knowledge of beauty professionals, a simulator to practical situations was developed, based on everyday situations that can lead to disease transmission. Scientific conceptual detail reviews were not included. Thus, the main objective was to measure the students\' perception of what is correct in relation to day-to-day practical situations. It turned out that the students who didn\'t have an active interaction in the discussion forums had no knowledge retention, six months after the course end, and those who actively participated showed that retention. The distance education course had a high rate of acceptance by students, and the distribution of activities in accordance with professional routine resulted in a higher rate of participation in synchronous events. Due to the reduction of course time to one month, if compared to previous longer editions of this course, students had highly approved it. Conclusion: A one-month course was structured and approved by the Dean of Culture and University Extension, targeted to beauty professionals and carried out via distance education mode. The course had generated knowledge retention in the long term for those who had higher active participation in the discussion forums, and was also well accepted by professionals who work in beauty salons

Introdução: Muitas doenças podem ser transmitidas quando não se seguem os hábitos adequados de higienização das mãos e esterilização de materiais em atividades que podem gerar ferimentos ou traumas na pele, como ocorrem nos salões de beleza. Os profissionais da beleza precisam conhecer e ter a consciência em relação a atitudes simples de higienização e cuidados com o compartilhamento de instrumentos, pela interação com muitas pessoas e pela possibilidade de ocorrer a transmissão de doenças, incluindo as doenças sexualmente transmissíveis, como as verrugas, as hepatites B e C, e o HIV, durante a realização de seus procedimentos. O Serviço Brasileiro de Apoio à Micro e Pequena Empresa apontou, em fevereiro de 2013, a existência de 265 mil estabelecimentos, abertos por pessoas que formalizaram a situação como microempreendedores individuais. Os salões de beleza são, numericamente, expressivos e apesar de não haver dados oficiais sobre o número de trabalhadores no Brasil, estima-se um grande número de pessoas envolvidas. Este estudo objetivou estruturar um curso aplicado por meio de uma dinâmica por teleducação interativa e avaliar o efeito educacional neste segmento profissional. Métodos: Foram selecionadas 4 categorias temáticas (doenças sexualmente transmissíveis, saúde indoor nos salões de beleza, lavagem das mãos e esterilização de materiais) a partir de uma Matriz de Objetivos e Competências, e o curso foi inserido numa plataforma educacional baseada no Moodle, com ambientes interativos de aprendizagem e ferramenta de gestão educacional. A sistemática das atividades foi organizada com metas semanais, encontros síncronos via web e acesso a materiais de forma assíncrona (materiais de leitura, de aprendizagem complementar, áudios e vídeos educacionais, fóruns de discussão, Simulador de Situações Práticas e vídeos do Projeto Homem Virtual sobre as DST/AIDS, higienização das mãos e lavagem, transmissão de doenças por cera depilatória reutilizável e alicate de unha contaminado). A abertura do curso foi realizada a partir de dois encontros presenciais e, para a avaliação do conhecimento prático, foi criado o simulador de situações práticas, que foi um teste online aplicado nas fases pré-curso, pós-curso imediato e 6 meses após o término do curso. Foram desenvolvidos objetos educacionais de aprendizagem do Projeto Homem Virtual por meio de vídeos utilizando computação gráfica 3D para facilitar a explicação de alguns assuntos. Resultados: Cinquenta e cinco profissionais da beleza foram matriculados no curso, sendo 46 do sexo feminino e 9 do sexo masculino, tendo sido ofertadas bolsas de estudos para 34 profissionais que justificaram dificuldade de pagamento da taxa de inscrição. A idade média dos participantes foi de 38,2 ± 8,67 anos de idade com mediana de 37,3 anos, sendo a idade mínima de 18,5 anos e a máxima de 59,1 anos de idade. Foram produzidos diversos materiais educacionais digitais utilizando múltiplos meios de comunicação: áudios, vídeos, objetos educacionais de aprendizagem utilizando computação gráfica 3D e um sistema de avaliação denominado simulador de situações práticas. Quarenta e cinco participantes foram aprovados e certificados conforme os critérios estabelecidos, e 40 alunos concluíram o simulador aplicado 6 meses após o término do curso. Como resultado de performance geral, houve melhora estatisticamente significativa do rendimento dos alunos no simulador pós-curso imediato em relação ao pré-curso e não houve retenção de conhecimento estatisticamente significativa sobre as condutas corretas na fase pós-curso tardio. Quando se isolou o grupo de estudantes que tiveram participação ativa nas listas de discussão (30% dos alunos que foram responsáveis por 75% das postagens totais) foi observada essa diferença de forma estatisticamente significativa. Discussão: Para avaliar o conhecimento dos profissionais da beleza foi criado o simulador de situações práticas baseado em situações cotidianas que podem gerar a transmissão de doenças. Não foram incluídas avaliações de detalhamento conceitual científico. Dessa forma, o objetivo principal foi mensurar a percepção do aluno sobre o que é correto em relação a situações práticas do dia a dia. Detectou-se que os alunos que não tiveram uma interação ativa nos fóruns de discussão não apresentaram retenção de conhecimento 6 meses após o término do curso, e os que participaram ativamente apresentaram essa retenção. O curso na modalidade a distância teve alto índice de aceitação pelos alunos e a distribuição das atividades de acordo com a rotina profissional resultou em maior taxa de participação nos eventos síncronos. A redução do tempo de duração do curso para 1 mês, em relação a edições anteriores deste curso, teve maior aprovação dos alunos. Conclusão: Foi estruturado um curso com duração de 1 mês aprovado pela Pró-Reitoria de Cultura e Extensão Universitária, direcionado para profissionais da beleza e realizado na modalidade a distância. O curso gerou retenção de conhecimento a longo prazo para quem teve maior participação ativa nos fóruns de discussão e foi bem aceito pelos profissionais que atuam nos salões de beleza / Introduction: Many diseases can be transmitted when professionals do not follow the proper habits of hand washing and material sterilization in activities that may cause skin injury or trauma, as is the case in beauty salons. Beauty professionals need to know and be aware of simple steps to cleaning care and instruments sharing, as they interact with many people, thus increasing the possibility of disease transmission, including sexually transmitted diseases such as warts, hepatitis B and C, and HIV, while carrying out their procedures. The Brazilian Service of Support for Micro and Small Enterprises pointed out the existence of 265,000 establishments in February 2013, opened by people who formalized their business as individual microenterprises. Beauty salons are numerically significant, and although there are no official data on the number of workers in Brazil, a large number is estimated. This study aimed to structure a distance-learning course via interactive tele-education dynamics, and to evaluate the educational effect in this professional segment. Methods: Four thematic categories were selected (sexually transmitted diseases, indoor health in salons, hand washing and material sterilization) from a matrix of objectives and competences. The course was inserted in an educational platform based on Moodle, with interactive learning environments and educational management tools. The activities systematics was organized with weekly goals, synchronous web meetings, and asynchronous access to materials (readings, discussion forums, situation simulator, audio and educational videos as well as 3-D Virtual Human video animation on sexually transmitted infections, hand washing and disease transmission from reusable depilatory wax and contaminated nail pliers). The course started with two face-to-face meetings and, in order to assess participants\' practical knowledge, a simulator to practical situations was created, which was an online test applied before, immediately after course end, and 6 months later. Educational learning objects associated to 3-D Virtual Human Project video animation were also developed to facilitate the explanation of some topics. Results: Fifty-five beauty professionals enrolled in the course, out of whom 46 females and 9 males; 34 students were granted scholarships due to justified registration fee payment difficulty. Mean age of participants was 38.2 ± 8.67 years old with median of 37.3, the minimum age at 18.5 and the maximum at 59.1 years old. Different digital learning materials using multiple media were produced, such as audios, videos, educational learning objects using 3D computer, and an evaluation system called simulator to practical situations. Forty-five participants were approved and certified according to agreed criteria, and 40 students accomplished the simulator tasks applied 6 months after the course end. As a result of overall performance, there was a statistically significant improvement in student performance in the immediate post-course simulator compared to the pre-course one; however, there was no statistically significant retention of knowledge on the correct behavior in the later post-course phase. When the group of students who actively participated in discussion lists (30% of students accounted for 75% of total posts) was isolated, this statistically significant difference was observed. Discussion: To evaluate the knowledge of beauty professionals, a simulator to practical situations was developed, based on everyday situations that can lead to disease transmission. Scientific conceptual detail reviews were not included. Thus, the main objective was to measure the students\' perception of what is correct in relation to day-to-day practical situations. It turned out that the students who didn\'t have an active interaction in the discussion forums had no knowledge retention, six months after the course end, and those who actively participated showed that retention. The distance education course had a high rate of acceptance by students, and the distribution of activities in accordance with professional routine resulted in a higher rate of participation in synchronous events. Due to the reduction of course time to one month, if compared to previous longer editions of this course, students had highly approved it. Conclusion: A one-month course was structured and approved by the Dean of Culture and University Extension, targeted to beauty professionals and carried out via distance education mode. The course had generated knowledge retention in the long term for those who had higher active participation in the discussion forums, and was also well accepted by professionals who work in beauty salons

Text in English / The purpose this study was to explore food habits and nutritional behaviours of adolescents in a school in Lenasia South, in Gauteng Province. Qualitative, explorative research was conducted in order to recommend effective prevention strategies of non-communicable diseases. Adolescents from the selected secondary school formed the sample of the study. Data collection was done using focus groups’ discussions. Three focus group discussions were conducted in the study. The first group comprised of thirteen male adolescents, followed by ten female adolescents and the final group was a combination of both female and male learners to produce a homogenous group. Specific common eating habits and nutritional behaviours emerged from the focus group discussions which included skipping meals, high consumption of high energy dense foods and sweetened beverages. Consequently, when developing intervention programs and policies to improve health of adolescents, environmental influences that undermine efforts to improve adolescent’s dietary behaviours must be addressed. / Health Studies / M.P.H.

Introdução. As doenças cardiovasculares constituem a principal causa de morbimortalidade na população brasileira. Desta forma, o Ministério da Saúde apresentou o HiperDia, um sistema de cadastramento e acompanhamento de portadores de HAS e DM atendidos na rede ambulatorial do SUS. Objetivo. Descrever o perfil dos hipertensos e diabéticos cadastrados no sistema HiperDia das oito unidades básicas do município de Rio Claro/RJ, no período de janeiro a dezembro de 2012. Métodos. Os dados de óbitos foram obtidos a partir do Sistema de Informações de Mortalidade (SIM), e as populações estimadas pelo IBGE, foram também obtidas na página do MS. As demais informações foram coletadas por meio de uma planilha de dados agregados, elaborada a partir da própria ficha de cadastramento do HiperDia e distribuído às unidades. Resultados. Pôde-se observar que a grande maioria dos pacientes cadastrados no HiperDia era portadora de hipertensão (95%) e que mais de 1/5 (21%) dos pacientes tinham as duas doenças concomitantemente. Além disso, mais de 4/5 (82%) dos pacientes com DM também apresentou HAS. As mulheres cadastradas foram maioria em ambas as doenças, tendo sido 63,2% e 71%, para HAS e DM, respectivamente. No que diz respeito à idade, ambas as doenças tiveram ocorrência mais elevada em grupos etários mais velhos, embora a prevalência de DM pareça ter se mantido constante para aqueles com 60 anos de idade ou mais. O fator de risco mais relevante para as duas doenças foi o sedentarismo, referido por 76% e 69% daqueles com HAS e DM, respectivamente. Conclusão. Conclui-se sobre a necessidade de modificar a ficha de coleta de dados do HiperDia e de monitoramento mais assíduo dos pacientes. Sugestões de Saúde Pública. Sugere-se inclusão de informações na ficha de coleta de dados do HiperDia sobre os níveis de glicemia e amputação de extremidades dos membros inferiores depois de três anos matriculados no programa, no caso de DM, e informação sobre a manutenção de níveis de pressão arterial sob controle, no caso de HAS, além de informações mais detalhadas sobre os fatores de risco referidos. / Introduction. Cardiovascular disease is the leading cause of morbimortality in the Brazilian population. Recently, the Ministry of Health introduced Hiperdia, a system of registration and monitoring people living with Systemic Hypertension and Diabetes mellitus treated in the out patient facilities of the Public Health System, SUS hereafter. Main Goal. To describe the profile of hypertensive and diabetic patients enrolled in HiperDia treated in one of the eight basic units of the Rio Claro city, during the period between January and December 2012. Methods. The mortality data were obtained from Mortality Information System (SIM), and the population was estimated from the Brazilian Agency for Geography ans Statistics IBGE, both available at Brazilian Health Ministry (MS). Other data were collected from a consolidated data table distributed to all eight basic units and it was based on the registration form of HiperDia. Results. It was observed that the great majority of patients registered in HiperDia were living with hypertension (95%) and more than 1/5 (21%, precisely) had both diseases simultaneously. In addition, for those with Diabetes melittus, more than four fifths (82%) patients also had systemic hypertension. Women are the majority of the cases for both diseases, namely 63.2% for hypertension and 71 % for Diabetes melittus. Considering the age of the patient, both diseases had occurred more frequently among elders, although the prevalence of Diabetes melittus appears to have remained constant for those with 60 yrs and older. The most important risk factor for both diseases was sedentarism, as mentioned by 76 % and 69 % of those with hypertension and Dabetes melittus, respectively. Conclusions. It is needed to modify the form to collect data from HiperDia and also to increase the frequency of the monitoring of patients. Suggestions to Public Health Policies. It is suggested to include in the Hiperdia registration form, information about blood glucose levels and about the amputation of the lower extremities after three years for those enrolled in the program, in the case of Diabete mellitus. For the case of hypertension, information about the maintenance levels of the blood pressure control, and to add more detailed informations about the risk factors.

Introdução. As doenças cardiovasculares constituem a principal causa de morbimortalidade na população brasileira. Desta forma, o Ministério da Saúde apresentou o HiperDia, um sistema de cadastramento e acompanhamento de portadores de HAS e DM atendidos na rede ambulatorial do SUS. Objetivo. Descrever o perfil dos hipertensos e diabéticos cadastrados no sistema HiperDia das oito unidades básicas do município de Rio Claro/RJ, no período de janeiro a dezembro de 2012. Métodos. Os dados de óbitos foram obtidos a partir do Sistema de Informações de Mortalidade (SIM), e as populações estimadas pelo IBGE, foram também obtidas na página do MS. As demais informações foram coletadas por meio de uma planilha de dados agregados, elaborada a partir da própria ficha de cadastramento do HiperDia e distribuído às unidades. Resultados. Pôde-se observar que a grande maioria dos pacientes cadastrados no HiperDia era portadora de hipertensão (95%) e que mais de 1/5 (21%) dos pacientes tinham as duas doenças concomitantemente. Além disso, mais de 4/5 (82%) dos pacientes com DM também apresentou HAS. As mulheres cadastradas foram maioria em ambas as doenças, tendo sido 63,2% e 71%, para HAS e DM, respectivamente. No que diz respeito à idade, ambas as doenças tiveram ocorrência mais elevada em grupos etários mais velhos, embora a prevalência de DM pareça ter se mantido constante para aqueles com 60 anos de idade ou mais. O fator de risco mais relevante para as duas doenças foi o sedentarismo, referido por 76% e 69% daqueles com HAS e DM, respectivamente. Conclusão. Conclui-se sobre a necessidade de modificar a ficha de coleta de dados do HiperDia e de monitoramento mais assíduo dos pacientes. Sugestões de Saúde Pública. Sugere-se inclusão de informações na ficha de coleta de dados do HiperDia sobre os níveis de glicemia e amputação de extremidades dos membros inferiores depois de três anos matriculados no programa, no caso de DM, e informação sobre a manutenção de níveis de pressão arterial sob controle, no caso de HAS, além de informações mais detalhadas sobre os fatores de risco referidos. / Introduction. Cardiovascular disease is the leading cause of morbimortality in the Brazilian population. Recently, the Ministry of Health introduced Hiperdia, a system of registration and monitoring people living with Systemic Hypertension and Diabetes mellitus treated in the out patient facilities of the Public Health System, SUS hereafter. Main Goal. To describe the profile of hypertensive and diabetic patients enrolled in HiperDia treated in one of the eight basic units of the Rio Claro city, during the period between January and December 2012. Methods. The mortality data were obtained from Mortality Information System (SIM), and the population was estimated from the Brazilian Agency for Geography ans Statistics IBGE, both available at Brazilian Health Ministry (MS). Other data were collected from a consolidated data table distributed to all eight basic units and it was based on the registration form of HiperDia. Results. It was observed that the great majority of patients registered in HiperDia were living with hypertension (95%) and more than 1/5 (21%, precisely) had both diseases simultaneously. In addition, for those with Diabetes melittus, more than four fifths (82%) patients also had systemic hypertension. Women are the majority of the cases for both diseases, namely 63.2% for hypertension and 71 % for Diabetes melittus. Considering the age of the patient, both diseases had occurred more frequently among elders, although the prevalence of Diabetes melittus appears to have remained constant for those with 60 yrs and older. The most important risk factor for both diseases was sedentarism, as mentioned by 76 % and 69 % of those with hypertension and Dabetes melittus, respectively. Conclusions. It is needed to modify the form to collect data from HiperDia and also to increase the frequency of the monitoring of patients. Suggestions to Public Health Policies. It is suggested to include in the Hiperdia registration form, information about blood glucose levels and about the amputation of the lower extremities after three years for those enrolled in the program, in the case of Diabete mellitus. For the case of hypertension, information about the maintenance levels of the blood pressure control, and to add more detailed informations about the risk factors.

As creches estão relacionadas ao aumento do risco de doenças transmissíveis e programas de controle de infecção são necessários. Foi realizado estudo descritivo para identificar normas de controle de doenças em creches hospitalares do município de São Paulo. Rotina escrita para a lavagem de mãos foi encontrada em 36% e para a troca de fraldas em 24%. Havia luvas descartáveis em 68%, porém rotina escrita para o descarte de luvas usadas em 12% e instruções sobre precauções padrão em 28%. Normas para o afastamento por doença transmissível existiam em 16%. Treinamento padronizado em controle de infecção era oferecido em 12%. As creches hospitalares não possuem normas suficientes para reduzir a transmissão de doenças. Padronização dos procedimentos e regulamentação são necessárias para promover o controle de infeccção / Child day-care centers (DCC) are known for the spread of infectious diseases. Standards for infection control in child care have been established worldwide. A study was conducted to obtain policies used to reduce disease in hospital day-care centers in São Paulo, Brazil. Written handwashing procedures were available at 36% and written instructions on diapering at 24%. Gloves were used in 68% but written disposal procedures were available in 12% and at 28% were instructions offered on standard precautions. A policy for exclusion due to communicable illness was obtained in 16%. Standard staff training on infection control was offered in only 12%. Hospital DCC's lack policies and routine procedures for reducing the spread of disease. Child care standards and regulation are needed in order to promote disease control

Dietary intake is a strong determinate of the health of an individual. Healthy eating is an important prevention to non-communicable diseases. If behaviour is to be changed insight into what the attitudes and barriers are to eating healthily amongst adolescents is imperative. This can provide knowledge for future prevention campaigns for healthy eating to prevent overweight and obesity. The purpose of the study was to quantitatively describe what attitudes adolescent females have towards healthy eating and what potential barriers omits them from adopting healthy eating behaviours. Data collection was done using structured questionnaires. Girls (N=73) from 3 public all girls’ high schools within Durban, KZN, participated in this study. The findings revealed that overall adolescent girls have a positive attitude to healthy eating. A lack of time, the foods sold in the school shop and the conveniences of less healthy food have been identified as barriers to healthy eating. / Health Studies / M.A. (Public Health)

Due to their contagiousness, communicable disease require healthcare staff to not only see to the needs of their patient, but also to the protection of themselves and other people from getting infected. Ethical issues and dilemmas tied to the patient’s anatomy and confidentiality arise as interventions to prevent further spread of the disease necessarily involve informing others about the risk of infection. Knowledge of and about communicable disease is necessary for acts of caution to be taken by both the person carrying it and those who are at risk of becoming infected. The Swedish communicable disease control system is regulated mainly with the Communicable Diseases Act (smittskyddslag, SFS 2004:168) and confidentiality within healthcare is regulated by the Public Access to Information and Secrecy Act (offentlighets- och sekretesslag, SFS 2009:400). In this thesis we identify dilemmas and concessions in the taking of measures to prevent the spread of communicable diseases, focusing especially on these two laws. This is done from the perspective of social work in healthcare settings with some focus on healthcare counsellors. For this purpose we have used content analysis with a deductive approach, produced a coding schedule, and analyzed relevant data in official documents. To discuss identified dilemmas and concessions further, we have used a theory of care ethics and utilitarianism. In our results we describe dilemmas consisting of situations where it is impossible to both maintain secrecy regarding the patient’s status as ill while informing others about their risk of infection, situations where differing interests arise, and situations where several principles which need to be followed differ from one another. These dilemmas are ethical in nature rather than legal, although professionals must make decisions regarding what information to share and what to keep secret. This makes for situations where practical answers to ethical dilemmas are necessary, and the contagious nature of the patient’s disease makes work more difficult. / I arbetet med smittsamma sjukdomar ska hälso- och sjukvårdspersonal inte enbart värna om patienten, utan även andra människor. Sjukdomarnas smittsamhet medför försvårande omständigheter och medför andra etiska frågor än andra sjukdomar. Inte minst uppstår etiska problem kopplade till patientens autonomi och sekretesskydd vid smittsamma sjukdomar på grund av risken för att också andra kan bli sjuka. Vetskap om sjukdomen är ett måste för att rimliga försiktighetsåtgärder ska kunna vidtas av både den smittade och osmittade personer. Smittskyddet i Sverige regleras främst genom smittskyddslagen (SFS 2004:168) och hälso- och sjukvårdens sekretess genom offentlighets- och sekretesslagen (SFS 2009:400). Vi identifierar dilemman och avvägningar i det praktiska arbetet med att besluta om och vidta smittskyddsåtgärder utifrån lagstiftningen, och diskuterar sedan dessa. Vårdetik lyfts och appliceras. Uppsatsens utgångspunkt är socialt arbete i hälso- och sjukvård, och delvis rollen som hälso- och sjukvårdskurator. Metoden består av innehållsanalytisk bearbetning, kodning, av lagtext och förarbeten med en deduktiv ansats. I resultatet redovisar vi hur balans mellan olika rättigheter och skyldigheter genomsyrar smittskyddslagen (2004), vars primära syfte är att tillgodose befolkningens behov av skydd mot smittsamma sjukdomar. För att uppnå detta görs flera avsteg från sekretessen som annars gäller i hälso- och sjukvård. Vi identifierar och beskriver de dilemman och avvägningar som uppstår som situationer där det är omöjligt att både hemlighålla patientens sjukdomsstatus och skydda andra från smitta, då det råder skilda intressen, och situationer då skilda principer behöver följas. Dessa dilemman är främst etiska och praktiska i och med att den som fattar beslut om och vidtar smittskyddsåtgärder måste besluta vilka uppgifter som ska röjas och på vilket sätt. Etiska riktlinjer är inte irrelevanta och kan utgöra både vägledning genom olika dilemman och avvägningar, men också försvåra det praktiska arbetet i och med de verkliga konsekvenser smittskyddsåtgärder har för människorna de berör. Dessutom väger alltid lagen tyngre när det gäller att instruera professionella i hur de ska agera. Skyddet mot spridning av vissa sjukdomar prioriteras över skyddet av patientens sekretess.

【研究緣起與問題】2003年春季，SARS在全球造成一陣轟動，同時也重創全球的經濟，如今SARS會不會再來？政府如何因應？政府如何監測疫情？如何防治疫情？如果SARS等新興及再浮現感染症 （Emerging and Re-emerging Infectious Diseases）出現時，負責全國傳染病防治任務的行政院衛生署疾病管制局是如何作好全國傳染病防治工作呢？中央及地方主管機關之溝通，如何共同消除指責與誤會，發揮團隊精神，如何共同作好全國傳染病防疫任務，爭取公眾對政府之瞭解並加以支持，同時防止任何可能之攻擊，才是全民之福祉。故以「全國傳染病通報系統」的績效，其所仰賴之溝通通路之問題研究，是本研究的動機。了解「傳染病通報管理系統(WEB版)」最大的問題及新興傳染病（如SARS）防治通報的問題及「傳染病通報管理系統」最需要改進之的地方，是本研究的目的。 【研究方法與資料】本研究採取量化與質化並重的方法，以網路問卷方式的進行問卷調查，問卷對象為全國使用傳染病通報管理系統之相關人員，問卷問題內容的設計主要的型式含有開放式問卷（Open –Ended Question）、封閉式問卷（Close-Ended Question）及混合型問卷（Mixed Question）三種。同時以九十二年針對新興傳染病SARS期間為例，深度訪談當時任職於中央與地方負責傳染病防治權責具代表性者五位主管進行訪談，瞭解受訪者對新興傳染病如SARS防治的問題及「傳染病通報管理系統」最需要改進之的地方，以彌補問卷調查法無法深入瞭解到問題之缺點。 【研究結論與建議】 一、根據筆者初步研究經問卷的實證調查之後，從問卷分析資料顯示，使用者使用電腦的時間愈久，對以新版為溝通工具滿意度愈低；而愈瞭解通報系統的使用者，其以新版為溝通工具滿意度愈高，愈滿意新版改進之電腦網路溝通效果。顯示新版的通報系統在設計的操作介面與程序上，沒有人性化，作業內容繁多、需輸入的項目、資料太繁瑣、版面太繁瑣等，反而徒增使用者的困擾；而愈瞭解通報系統的使用者，其對新版的滿意度越高，表示對於使用者在操作上的教育訓練仍須加強，才能發揮新版通報系統的成效。 二、從敘述統計分析中發現： 受訪者對「訊息異動通知作業流程滿意」的使用滿意度的平均數最高，平均數為2.8095表示：較為滿意。「通報作業流程滿意嗎」的使用滿意度的平均數最低，平均數為2.3934，受訪者表示：較為滿意。以新版為溝通工具整體溝通滿意情形，平均數為2.558滿意。 三、開放式問卷分析資料顯示，花太多時間、速度太慢、網路的頻寬過窄又不穩定或無法登錄、作業內容繁多、作業流程問題、資訊管理問題及功能增添與建議等部分。 四、根據筆者初步研究深度訪談之後，彙整中央主管機關及地方主管機關的訪談核心二部分的問題與建議。 五、研究建議： 綜合問卷調查及深度訪談結果，提出政策層面、組織溝通層面、管理層面、實務操作層面等之建議。 【關鍵字】傳染病通報系統、嚴重急性呼吸道症候群(severe acute respiratory syndrome, SARS)、組織溝通、溝通通路、行政院衛生署疾病管制局 / 【Background and Issues】 In the spring of 2003, SARS outbreaks devastated the whole world; they also heavily damaged the world economy. Will SARS come back? How can governments manage it? How can government monitor the epidemics? How can we control the infection? When emerging and re-emerging infectious diseases such as SARS appear, how can the Center for Disease Control of the Department of Health, an organization in charge of national disease control, plan and execute measures for the control of communicable diseases? Effective communication between the central and the local competent authorities to remove together blames and misunderstanding, to develop team spirit, to attain jointly the goal of disease control, to solicit understanding and support of the public to the government, and to prevent any likely attack are some of the considerations in improving the welfare of the public. The reason of the present study was to understand, through the achievements thus far of the National Communicable Disease Reporting System, issues involved in the communication channels. The purposes of the study were to understand the major problems of the Communicable Disease Reporting and Management System (the Web version), issues involved in the reporting of emerging infectious diseases, and areas of the Communicable Disease Reporting and Management System where improvement was most urgently needed. 【Method and Materials】 Both the quantitative and qualitative methods were used. Questionnaire interview was conducted through the web to persons using the Communicable Disease Reporting and Management System throughout the country. The questionnaire contained open-end questions, closed-end questions and questions of mixed types. At the same time, to understand in depth areas not properly covered by the questionnaire interview, five key persons responsible for disease control at the time of the SARS outbreaks in 2003 at the central and the local levels were interviewed to understand their attitudes toward the control of emerging infectious diseases such as SARS, and the improvement most urgently needed for the Communicable Disease Reporting and Management System. 【Results and Recommendations】 1. Preliminary findings from analysis of the questionnaire interview showed that users became less satisfied with the new version communication means the longer they were in use of computers. Users who knew more about the use of the reporting system were more satisfied with the new communication means, were at the same time, more satisfied with the communication effects of the improved version. These facts suggested that the new reporting system was less user-friendly in the designing of interface and procedures. The system required more work, more detailed inputs, and thus added additional burdens on the part of the users. The more the users understood the reporting system, their satisfaction was higher, indicating that, for the new version reporting system to function in full, training of the users in the use of the system should be strengthened. 2. From the descriptive analysis, it was found that the average score of user satisfaction on the “information change reporting procedures” was as high as 2.8095, suggesting that the users were fairly satisfied. The satisfaction score on “reporting procedures” was the lowest at 2.3934. The overall satisfaction score on the use of the new version as a communication means was 2.558. 3. Findings from the open-end questions gave the following recommendations: taking too much time, too slow, frequency of the web too narrow, unstable, and unable to load, too detailed, issues related to operational procedures, issues related to information management and additional functions, etc. 4. By analysis of the in-depth interview, some issues were raised and recommendations made to the central and the local competent authorities. 5. Through questionnaire survey and in-depth interview, some recommendations concerning policies, organizational communication, management and practical operation were made. 【Key Words】 Communicable Disease Reporting System, SARS (Severe Acute Respiratory Syndrome), organizational communication, communication channels, Center for Disease Control, the Department of Health

Heuristic qualitative research techniques (Moustakas,1990) were used to explore the dynamic of the help-seeking / helping relationship in illegal drug use from the perspective of the professional. Six professionals, expert in helping people living with an addiction, shared their opinions and insights, analyzed problems, explained the rewards, and made recommendations for improvement, based on their own practices within the health care and social services systems. These professionals identify stigma as a major barrier to the provision of quality care in addictions, and analysis shows that a cultural predilection for scapegoating underlies the application of stigma. The many layered social purposes served by the designation of certain substances as illegal and the utility of scapegoating to hegemonic, vested interests is surveyed. This thesis reviews the true social costs of addictions, the entrenched and enmeshed nature of the alternate economy, and the many above ground institutions and professions sustained by the use of drugs designated as illegal. Prohibition and imprisonment as a response to illegal drug use is exposed as costly, inhumane, dangerous, and overwhelmingly counterproductive in terms of limiting harm from illegal drug use. A recent example of drug prohibition propaganda is deconstructed. Consideration is given to the role of the Drug War as a vehicle to accelerate social creep toward a fragmented self-disciplining surveillance society of consumer-producers in the service of economic elites. Classism is brought forward from a fractured social ground characterized by many splits: sexism, racism, age-ism, able-ism, size-ism, locationism, linguism, and others, to better track the nature of the social control that illegal drugs offer to economic elites. The moral loading that surrounds illegal drug use is deconstructed and the influence of religion is presented for discussion. The primitive roots of human understanding that endorse the ritual Drug War and its supporting mythology, leading to the demonization of illegal drugs and the people who use them, are uncovered. Direction is taken from Benner and Wrubel’s Primacy of Caring (1989) and other leaders in the professions as a means to move practitioners away from their roles as agents of social control into a paradigm of social change.