O uso de álcool entre motoristas é tema preocupante devido às graves conseqüências e aos altos índices de acidentes de trânsito que tem gerado. O presente estudo teve como objetivo identificar o uso do álcool entre motoristas nas estradas, bem como avaliar as condições de saúde entre os participantes da Campanha Saúde na Estrada em Ribeirão Preto, SP. A amostra foi composta por 1014 participantes, a maioria homens, com idade de 30 a 45 anos, casados, com baixo nível de escolaridade, procedente da Região Sudeste, religião católica. Entre os participantes, 81,5% são caminhoneiros. Quanto ao uso do álcool, 738 (72,7%) bebem de 2 a 4 vezes por mês, de 3 a 4 doses numa única ocasião e se embriagam semanalmente, índices considerados altos quando se trata de motoristas. Esses apresentam uso de bebidas alcoólicas em níveis de risco e de baixo risco. Entre os 229 (31%) motoristas que sofreram acidentes de trânsito, 19 (2,5%) acidentes ocorreram após o beber. Em relação às condições de saúde, 33% que apresentam hipertensão fazem uso de risco, quase 30% apresentam diabetes e também fazem uso de risco, no entanto, aqueles que expressaram ter pancreatite foram 74,5% e apresentaram colesterol acima de 200mg/dL 39,1% fazem uso de baixo risco. Na análise dos dados, avaliados através da pontuação do AUDIT maior que 8, ter idade menos que 30 e entre 30 e 45 anos, ser do sexo masculino, não ter religião, sobrepeso e obesidade foram considerados as características que contribuíram para os fatores de riscos entre os participantes. Ao passo que, ser evangélico, praticar religião, estar casado/amasiado e possuir nível superior foram os fatores de proteção para o uso abusivo de álcool. Esses dados nos fornecem subsídios para o desenvolvimento de campanhas preventivas pontuais sobre o beber e dirigir, como também ações educativas e informativas permanentes para essa clientela expostas aos riscos nas estradas. / The use of alcohol among drivers is a matter of concern because the serious consequences and the high rate of traffic accidents which has created. This study aims to identify the use of alcohol among drivers on the roads, as well as assess the health conditions among participants of the Campaign Health on the Road in Ribeirao Preto-SP. The sample was composed of 1014 (85.5%) participants, mostly men, aged 30 to 45 years old, married, with low level of education, founded the Southeast, Catholic religion. Among the participants 81.5% are truck drivers. Regarding the use of alcohol 738 (72.7%) drink from 2 to 4 times per month, 3 to 4 doses in a single occasion and that numbing weekly, indices considered high when it comes to drivers. They have use of alcohol at levels of risk and low risk. Among the 229 (31%) drivers who suffered traffic accidents, 19 (2.5%) occurred after drinking. Regarding the conditions of health 33% have hypertension make use of risk, almost 30% have diabetes also make use of risk, however those answered pancreatitis and 74.5% had cholesterol above 200 mg / dL 39.1% make use of low risk. In the analysis of the data, assessed by the AUDIT scores greater than 8, have less than age 30 and between 30 to 45 years old, being male, not having religion, overweight and obesity were contributing to the factors of risk between participants. While be evangelical, practicing religion, be married / roommate and Higher Education have been factors to protect the abuse of alcohol. These data give us subsidies for the development of preventive campaigns spot on the drinking and driving, as well as educational and informative permanent shares to this clientele at risk on the roads.

Background. Studies that examined community samples have reported several risk factors for the development of depressive episodes. The few studies that have been performed on primary care samples were mostly cross-sectional. Most samples had originated from highly developed industrial countries. This is the first study that prospectively investigates the risk factors of depressive episodes in an international primary care sample. Methods. A stratified primary care sample of initially non-depressed subjects (N = 2445) from 15 centres from all over the world was examined for the presence or absence of a depressive episode (ICD-10) at the 12 month follow-up assessment. The initial measures addressed sociodemographic variables, psychological/psychiatric problems and social disability. Logistic regression analysis was carried out to determine their relationship with the development of new depressive episodes. Results. At the 12-month follow-up, 4·4% of primary care patients met ICD-10 criteria for a depressive episode. Logistic regression analysis revealed that the recognition by the general practitioner as a psychiatric case, repeated suicidal thoughts, previous depressive episodes, the number of chronic organic diseases, poor general health, and a full or subthreshold ICD-10 disorder were related to the development of new depressive episodes. Conclusions. Psychological/psychiatric problems were found to play the most important role in the prediction of depressive episodes while sociodemographic variables were of lower importance. Differences compared with other studies might be due to our prospective design and possibly also to our culturally different sample. Applied stratification procedures, which resulted in a sample at high risk of developing depression, might be a limitation of our study.

Objektas – 5-8 ir 9-12 klasių mokinių požiūris į sveikatos ugdymą. Tikslas – ištirti 5-8 ir 9-12 klasių mokinių nuomonių skirtumus apie sveikatos ugdymą. Uždaviniai: 1. palyginti 5-8 ir 9-12 klasių mokinių nuomonę apie socialinės aplinkos įtaką rūpinantis sveikata. 2. palyginti 5-8 ir 9-12 klasių mokinių sveikos gyvensenos būdus, įvertinant balais. 3. palyginti 5-8 ir 9-12 klasių mokinių nuomonę apie sveiką gyvenseną įtakojančius veiksnius. 4. palyginti 5-8 ir 9-12 klasių mokinių nuomonę apie sveikos gyvensenos temų aptarimą pamokų metu. Svarbiausi rezultatai - Tyrimo duomenys parodė, kad 5-8 klasių mokiniams sveikatos ugdymas tiek mokykloje, tiek neformalaus ugdymo veikloje yra prastesnis, lyginant su 9-12 klasių mokiniais. Statistiškai matoma, kad 5-8 klasių mokiniai mažiau užsiima sportu, nes anketoje pateiktus sveikatai ir sveikam gyvenimo būdui veiksnius jie vertina labiau nereikšmingais, nei 9-12 klasių mokiniai. Galima drąsiai teigti, kad 5-8 klasių mokiniai iš dalies neįsisavina informacijos apie sveikatos ugdymą, kuriuos aptaria per mokykloje dėstomus dalykus. Išvados - Pagal gautus rezultatus galima teigti, kad tiek 5-8, tiek 9-12 klasių mokinių požiūris į sveikatos ugdymą nėra pakankamas ir šią situaciją reiktų pradėti keisti nuo sveikos gyvensenos temų aptarimo, jo dažnumo pamokų metu. Atsižvelgiant į 5-8 klasių mokinių požiūrį derėtų jų ugdymo programą padaryti paprastesnę, kad mokinys į sportą pažvelgtų su didesniu noru, kad informacija jam būtų lengviau... [toliau žr. visą tekstą] / Object - 5-8 and 9-12 grade students approach to health education. Purpose - to investigate the 5-8 and 9-12 grade students about the differences between health education. Objectives: 1. compare 5-8 and 9-12 grade students about the social environment to health. 2. compare 5-8 and 9-12 grade students a healthy lifestyle means of evaluating scores. 3. compare 5-8 and 9-12 grade students about healthy lifestyles influencing factors. 4. compare 5-8 and 9-12 grade students about healthy living areas to the classroom. The most important results - the study showed that students in grades 5-8 in school health education and non-formal education activities are inferior compared to 9-12 grade students. Statistically seen that 5-8 students less engaged in the sport because of a health questionnaire and a healthy lifestyle factors are the more trivial than 9-12 students. It is safe to say that 5-8 students partly assimilate information about health education, which are discussed within the school subjects. Conclusions - The results suggest that both the 5-8 and 9-12 grade students approach to health education is not sufficient and that the situation should begin to change from a healthy lifestyle topics discussion, the frequency of lessons. Given the 5-8 grade students should approach their curriculum to make simpler the student insights into the sport with a greater willingness to get the information he would be more easily understood. Suggestions - analysis of the 5-8 and 9-12... [to full text]

<p>Uvod. Kardiovaskularne bolesti kao deo grupe hroničnih nezaraznih bolesti predstavljale su i predstavljaju vodeći uzrok obolevanja i umiranja u svetu. Brojni naučni dokazi potvrđuju da je arterijska hipertenzija glavni kardiovaskularni faktor rizika, a da postignute vrednosti krvnog pritiska niže od 140/90mmHg značajno smanjuju kardiovaskularni rizik, odnosno pojavu kardiovaskularnih događaja, prvenstveno infarkta miokarda i moždanog udara. Arterijska hipertenzija je najzastupljenije stanje koje se viđa u ustanovama primarne zdravstvene za&scaron;tite, a mere prevencije, rano dijagnostikovanje, lečenje i kontrola arterijske hipertenzije predstavljaju javno-zdravstveni izazov u svim zemljama sveta. Ciljevi. Ciljevi istraživanja su utvrđivanje prevalencije arterijske hipertenzije koja je pod kontrolom; utvrđivanje prevalencije i povezanosti metaboličkih faktora sa ishodom u kontroli krvnog pritiska; utvrđivanje prevalencije i povezanosti nezdravih stilova života sa ishodom u kontroli krvnog pritiska; utvrđivanje prediktora lo&scaron;e kontrole krvnog pritiska i izračunavanje 10-godi&scaron;enjeg kardivaskularnog rizika. Metode. U studiju preseka (prevalencije) uključeno je 373 ispitanika oba pola starosti od 45 do 75 godina sa dijagnozom arterijske hipertenzije u kartonu koji su u periodu od oktobra 2015. godine do februara 2016. godine dolazili kod svog izabranog lekara. Prikupljanje podataka obavljeno je merenjem krvnog pritiska, antropometrijskim merenjima, biohemijskim analizama i anketiranjem popunjavanjem upitnika. Rezultati. Uzorak ispitanika je činilo 55% žena i 45% mu&scaron;karaca prosečne starosti 59&plusmn;6,3 godine. Utvrđena je niska učestalost arterijske hipertenzije pod kontrolom od 39,1%, a visoka učestalost metaboličkih faktora (44,5% predgojaznosti, 34% gojaznosti, 29% &scaron;ećerne bolesti, 88,2% povi&scaron;enih masnoća i 41,8% metaboličkog sindroma) kao i njihova povezanost sa ishodom u kontroli krvnog pritiska jer su ispitanici sa nekontrolisanim krvnim pritiskom najče&scaron;će imali dva faktora rizika (40,5%), dok su ispitanici sa kontrolisanim krvnim pritiskom najče&scaron;će imali jedan faktor rizika (45,9%). Utvrđeno je da su prosečne vrednosti sistolnog, dijastolnog pritiska i pulsa bile značajno (p&lt;0,001) niže u grupi sa kontrolisanim pritiskom kao i da su ispitanici sa nekontrolisanim pritiskom imali značajno veći obim struka (p=0,006), metabolički sindrom (p&lt;0,001) i značajno če&scaron;će pili veći broj lekova (p&lt;0,001). Utvrđena je visoka učestalost pu&scaron;enja (26,3%) i visoka učestalost sedentarnog načina života (76,7%) kao i da znanja, stavovi i pona&scaron;anja ispitanika u vezi faktora rizika (pu&scaron;enja, konzumiranja alkohola, fizičke neaktvnosti i prekomerne upotrebe soli) nisu na zadovoljavajućem nivou. Kao nezavisni prediktori arterijske hipertenzije koja nije pod kontrolom dobijeni su obim struka, telesna masa, indeks telesne mase, starost, vrednost pulsa, broj lekova koje ispitanici piju, pasivno pu&scaron;enje, nesvesnost o postojanju arterijske hipertenzije, neznanje o &scaron;tetnosti konzumiranja prekomerne količine alkohola, nepreležan infarkt miokarda i moždani udar. Izračunato je da je u visokom i veoma visokom riziku od neželjenih kardiovaskularnih događaja u desetogodi&scaron;njem periodu 2,7% ispitanika sa arterijskom hipertenzijom bez dijabetesa i 22,2% hipertenzivnih ispitanika sa dijabetesom. Zaključak. Potrebno je sprovođenje javno-zdravstveno vaspitnih i promotivnih aktivnosti u cilju povećanja znanja, promene stavova i pona&scaron;anja kod populacije sa arterijskom hipertenzijom usled lo&scaron;e kontrole krvnog pritiska i prisustva visoke učestalosti pridruženih faktora rizika koji utiču na njegovu kontrolu.</p> / <p>Introduction. Cardiovascular diseases, as part of a group of chronic noncommunicable diseases, have been and still are the leading cause of morbidity and mortality in the world. Numerous scientific proofs confirm that arterial hypertension is a major cardiovascular risk factor and that the achieved blood pressure values lower than 140/90mmHg significantly reduce cardio-vascular risk, or the appearance of cardio-vascular events, mainly myocardial infarction and stroke. Arterial hypertension is the most common condition that is seen in primary health care institutions and preventive measures, early diagnosis, treatment and control of arterial hypertension are a public health challenge in all countries of the world. Objectives. The objectives of the research were to determine the prevalence of arterial hypertension which is controlled; to determine the prevalence and correlation of the metabolic factors with the outcome in blood pressure control; to determine the prevalence and correlation of unhealthy lifestyles with the outcome in blood pressure control; to determine the predictors of poor blood pressure control and calculate a 10-year cardiovascular risk. Methods. The cross-sectional study (of prevalence) included 373 respondents of both sexes aged 45 to 75 years diagnosed with arterial hypertension who in the period from October 2015 to February 2016 visited their chosen doctor. Data collection was performed by measuring blood pressure, anthropometric measurements, biochemical analyses and surveying by filling out a questionnaire. Results. The sample consisted of 55% women and 45% men, of mean age of 59&plusmn;6.3 years. The results showed low incidence of arterial hypertension under control of 39.1%, and high incidence of metabolic factors (44.5% of overweight, 34% of obesity, 29% of diabetes mellitus, 88.2% of elevated fat and 41.8% of the metabolic syndrome) as well as their association with the outcome in blood pressure control as the respondents with uncontrolled blood pressure usually had two risk factors (40.5%), while the group with controlled blood pressure usually had one risk factor (45.9%). It was found that the average values of systolic, diastolic blood pressure and heart rate were significantly (p&lt;0.001) lower in the group with controlled blood pressure, as well as that the respondents with uncontrolled pressure had a significantly greater waist circumference (p=0.006), the metabolic syndrome (p&lt;0.001) and more often drunk greater number of medicines (p&lt;0.001). There was a high prevalence of smoking (26.3%) and a high incidence of sedentary lifestyle (76.7%) and it was found that knowledge, attitudes, and behaviors of the respondents related to risk factors (smoking, alcohol consumption, physical inactivity and excessive use of salt) were not satisfactory. As independent predictors of arterial hypertension which was not under the control, the study obtained waist circumference, body weight, body mass index, age, heart rate value, the number of medicines that the respondents drunk, second-hand smoking, unawareness of the existence of arterial hypertension, inexperience on the harmful effects of excessive amounts of alcohol, not overcome myocardial infarction and stroke. It was calculated that 22.2% of hypertensive respondents with diabetes and 2.7% of respondents with arterial hypertension without diabetes were in the high and very high risk of adverse&nbsp; Conclusion. It is necessary to implement public-health educational and promotional activities in order to increase the knowledge, changes in the attitudes and behavior of the population with arterial hypertension due to the poor control of blood pressure and the presence of the high incidence of associated risk factors affecting its control.</p>

Aim of the study to evaluate adolescent health and factors influencing it in boarding schools of Vilnius city. Objectives to evaluate adolescent health; to estimate the prevalence of behavior and psychosocial environmental factors influencing health; to identify and evaluate the peculiarities of health services provided to adolescents. Methods. An anonymous survey of 191 pupils aged 11-18 and interview method of health care specialists in two boarding schools were applied in the study. State of pupils’ health was analysing medical records. Results were compared between two boarding schools. SPSS statistics software was used for date analyze. Values were considered significant, when p<0.05. Results. Most of disorders reported were attributed to respiratory diseases. Almost half of adolescents from both institutions reported facing health problems. 36.1 % of adolescents were reported not being involved in extra curricular physical activities, 42.9 % indicated being smoking, 27.7 % frequent alcohol abuse. 42.8 % of adolescents reported that their interaction with teachers was not satisfactory. 59.7 % of adolescents experienced bullying; one in every two pupils felt not being safe. The analysis of inter-institutional comparison points to the significant differences in smoking, alcohol abuse and bullying prevalence. Adolescents lack knowledge regarding stress coping and readiness to live on their own. Data gathered from adolescents demonstrated general satisfaction with... [to full text]

Made available in DSpace on 2016-12-08T15:59:04Z (GMT). No. of bitstreams: 1 TESE SILVIO WEISS.pdf: 1948768 bytes, checksum: 639c23896ad219f4f5387f6cfbcf75fc (MD5) Previous issue date: 2013-03-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research evaluated the motor fitness multidimensional factors associated with the health of the elderly in different contexts sociodemographic and attending promotional programs and rehabilitation of health. Descriptive research, was characterized by a cross-sectional comparison between groups, development. Participated elderly over age 60, including any kind living in Florianópolis. The sample was non-probabilistic convenience (intentional), composed of 70 elderly, divided into two groups, one consisting of 35 people from a cardiopulmonary rehabilitation program and metabolic and another for 35 elderly residents in the metropolitan area of Florianópolis. Was used EMTI (Motor Scale for Third Age), and the Questionnaire BOAS. Sheet for information on risk factors and physical activity. Data collection was extended for a total period of 7 months. The average age of the elderly group Cardiac Rehabilitation (GRC) was 70.8 (&#963; = 6.8) years and the Reference Group for the Elderly (GIR) of 68.1 (&#963; = 5.9) years, with the vast majority of GRC (71.3%) with at least 2 risk factors, the most common being hypertension (54.2%) and heart disease (42.8%). In GIR, 60% reported having only one risk factor (23%). 100% of GRC reported physical activity, while in GIR 65.8% are inactive. The elderly participants PRCM indicated greater satisfaction with health services and adherence to daily life activities. The motor fitness of the GIR was higher than the GRC in all areas of motor function in some cases as AM2 and AM4 with significant differences (p = 0.041 and p = 0.00009). The comparison between GRC/GIR was X² = 13.32 with a significant difference between groups (p =0.02). Almost half of elderly GRC (48.6%) were classified as Bottom (I) or Very Low (MI), while elderly GIR were classified as normal (80%), Low (11.4%), Middle ( 54.3%) and high (14.3%). It has been shown that the smaller amount of ingested drugs is related to better fitness motor. Also confirmed the trend of men having better motor fitness women, despite the disadvantage in relation to other health factors. The general motor ability (p = 0.006), fine motor (p = 0.051), gross motor control (p = 0.005) and body image (p = 0.038) was higher than the elderly labor, as well as other results of motor fitness and factors health. Significant difference in overall motor fitness (p = 0.039) and balance (p = 0.02) of the elderly with and without self-reported weakness, for the elderly without weakness. The study concluded that no direct relationship between motor fitness better the various multidimensional factors of health, indicating that this relationship may represent better health, less morbidity and intake of medicines, among others fatores.O study also concluded about the clear benefits the PRCM gives patients in stages III and IV of rehabilitation, for recovery of health, improved self-esteem, change in lifestyle and social integration. / Esta pesquisa avaliou a aptidão motora associada aos fatores multidimensionais da saúde de idosos em diferentes contextos sociodemográficos e que frequentam programas de promoção e reabilitação de saúde. De natureza descritiva, foi caracterizado por um delineamento transversal comparativo entre grupos, de desenvolvimento. Participaram idosos com idade acima de 60, inclusive, de qualquer gênero, residentes na Grande Florianópolis. A amostra foi do tipo não-probabilística por conveniência (intencional), composta por 70 idosos, subdivididos em 2 grupos, um composto por 35 idosos de um programa de reabilitação cardiopulmonar e metabólica e o outro por 35 idosos residentes na Região Metropolitana de Florianópolis. Foi utilizada a EMTI (Escala Motora para Terceira Idade), o Questionário BOAS e a Ficha para informações sobre fatores de risco e atividade física. A coleta de dados estendeu-se por um período total de 7 meses. A idade média dos idosos do Grupo de Reabilitação Cardíaca (GRC) foi de 70,8 (&#963;=6,8) anos e do Grupo de Idosos de Referência (GIR) de 68,1 (&#963;=5,9) anos, com a grande maioria do GRC (71,3%) com no mínimo 2 dos fatores de risco, sendo os mais comuns a hipertensão arterial (54,2%) e a doença cardíaca (42,8%). No GIR, 60% informou possuir apenas um fator de risco (23%). 100% do GRC declararam praticar atividade física, enquanto no GIR 65,8% são inativos. Os idosos participantes do PRCM indicaram maior satisfação com serviços de saúde e adesão às atividades de vida diária. A aptidão motora do GIR foi superior a do GRC em todas as áreas da motricidade, em alguns casos como AM2 e AM4 com diferenças significativas (p=0,041 e p=0,00009). A comparação entre GRC/GIR, foi X²=13,32 com uma diferença significativa entre os grupos (p=0,02). Quase a metade dos idosos do GRC (48,6%) foi classificada como Inferior (I) ou Muito Inferior (MI), enquanto idosos do GIR foram classificados como Normal (80%), Baixo (11,4%), Médio (54,3%) e Alto (14,3%). Demonstrou-se que a quantidade menor de medicamentos ingeridos, está relacionada com a melhor aptidão motora. Também confirmou-se a tendência dos homens apresentarem melhor aptidão motora que as mulheres, apesar da desvantagem em relação a outros fatores de saúde. A aptidão motora geral (p=0.006), motricidade fina (p=0,051), motricidade global (p=0,005) e o esquema corporal (p=0,038) dos idosos laborais foi superior, bem como as outros resultados da aptidão motora e fatores de saúde. Houve diferença significativa na aptidão motora geral (p=0,039) e no equilíbrio (p=0,02) dos idosos com e sem fraqueza autorreferida, a favor dos idosos sem fraqueza. O estudo concluiu, que há relação direta entre uma aptidão motora melhor os diversos fatores multidimensionais de saúde, indicando que essa relação pode representar melhores condições de saúde, menos morbidades e ingestão de remédios, entre outros fatores.O estudo também concluiu acerca dos benefícios inequívocos que o PRCM proporciona aos pacientes nas fases III e IV da reabilitação, em relação recuperação da saúde, melhora da autoestima, mudança no estilo de vida e integração social.

The title of thesis: Influence of regular physical activities on the health of younger school children Aims of thesis: The main aim of this thesis is find out the reality, whether the regular physical activity influences on the health of younger school children. Nowadays, there is an increase of diseases caused by inactive way of life. It's because of today's hurried time and therefor there is a need to aware and stress the influence of regular physical activity on the health of each person, whether children or the adults. Hypokinetic way of life causes problems since the early childhood. At present, one third of people are obese and that's very alarming at these times where there is enough of healthy food and where every person has a chance to attend lots of sports centers. The next aims of this thesis is to find out children's attitude to sport and physical activities, whether they do any sport in their free time together with their parents and whether they are aware of influence of regular physical activity on their health. Method of thesis: A quantitative method was used to elaborate the research in this thesis, questionnaire that contained 15 questions. I distributed this questionnaire to the third and fourth grade pupils. The survey included closed, semi-closed, and open questions. A total of...

Orientador: César Tadeu Spadella / Resumo: Bases científicas: O controle dos riscos associados à utilização dos equipamentos nos hospitais é de crucial importância na garantia da segurança dos pacientes e na qualidade dos serviços prestados pelos profissionais da saúde. Para este fim, é necessário conhecer todo o ciclo dos equipamentos nos hospitais, desde a sua seleção, aquisição, manutenção e uso, bem como das falhas e eventos adversos a eles associados. Monitores multiparamétricos (MM), bombas de infusão (BI) e ventiladores pulmonares mecânicos (VPM) são equipamentos de uso frequente em Unidades de Terapia Intensiva sendo, todavia, muito sujeitos a falhas técnicas, humanas e de processos, as quais podem causar sequelas e mesmo a morte dos pacientes. Objetivo: Avaliar os riscos assistenciais relacionados ao uso de MM, BI e VPM na Unidade de Terapia Intensiva de Adultos (UTI-A) de um hospital público da cidade de São Paulo, Brasil, procurando investigar as causas e providências relacionadas às queixas técnicas e eventos adversos a eles associados. Métodos: Foi realizado na UTI-A um estudo prospectivo, quantitativo, descritivo e observacional, durante um período de 12 meses, tendo por base a análise resultante de busca ativa e passiva dos processos envolvendo o uso dos equipamentos médicos hospitalares, incluindo: estrutura física e organizacional do ambiente, recursos humanos e recursos materiais disponíveis; programa de treinamento e educação continuada dos profissionais; etapas de higienização, desinfecção, esteril... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Scientific background: Risk control associated to device use in hospitals has major importance to ensure patient safety and quality in service delivered by healthcare professionals. For doing so, it´s necessary to know all the device cycle in the hospitals, from its selection, acquisition, maintenance and use, as well as its failures and the adverse events related to them. Multiparameter Monitors (MM), infusion pumps (IP) and mechanical ventilators (MV) are devices of frequent use in Intensive Care Units, being however subject to technical, human and process failures, which may pose harm and even cause death of patients. Objective: To evaluate care risks related to the use of MM, IP, and MV at an Adult Intensive Care Unit (AICU) of a public hospital in Sao Paulo city, Brazil, seeking to investigate the causes and providences related to technical complaints and adverse events associated to them. Methods: It was made an observational, descriptive quantitative prospective study through 12 months, based on an analysis resulting from active and passive search of processes involving the use of medical devices in hospitals, including physical and organizational structure of work environment, available human resources and material resources; training program and continuing education of professionals; sanitization, disinfection, sterilization and assembling stages of devices; planning on preventive and corrective maintenance of the devices; and management of hospital sanitary risk reg... (Complete abstract click electronic access below) / Doutor

Submitted by LORAINE MARTINS DIAMENTE null (loramdi@terra.com.br) on 2016-04-28T20:34:25Z No. of bitstreams: 1 Doutorado Loraine _28_2016_ (3) (1).pdf: 2798219 bytes, checksum: 0e28cd272eca61ac1f596d83701237bb (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-05-02T13:40:27Z (GMT) No. of bitstreams: 1 diamente_lm_dr_bot.pdf: 2798219 bytes, checksum: 0e28cd272eca61ac1f596d83701237bb (MD5) / Made available in DSpace on 2016-05-02T13:40:27Z (GMT). No. of bitstreams: 1 diamente_lm_dr_bot.pdf: 2798219 bytes, checksum: 0e28cd272eca61ac1f596d83701237bb (MD5) Previous issue date: 2016-02-22 / Bases científicas: O controle dos riscos associados à utilização dos equipamentos nos hospitais é de crucial importância na garantia da segurança dos pacientes e na qualidade dos serviços prestados pelos profissionais da saúde. Para este fim, é necessário conhecer todo o ciclo dos equipamentos nos hospitais, desde a sua seleção, aquisição, manutenção e uso, bem como das falhas e eventos adversos a eles associados. Monitores multiparamétricos (MM), bombas de infusão (BI) e ventiladores pulmonares mecânicos (VPM) são equipamentos de uso frequente em Unidades de Terapia Intensiva sendo, todavia, muito sujeitos a falhas técnicas, humanas e de processos, as quais podem causar sequelas e mesmo a morte dos pacientes. Objetivo: Avaliar os riscos assistenciais relacionados ao uso de MM, BI e VPM na Unidade de Terapia Intensiva de Adultos (UTI-A) de um hospital público da cidade de São Paulo, Brasil, procurando investigar as causas e providências relacionadas às queixas técnicas e eventos adversos a eles associados. Métodos: Foi realizado na UTI-A um estudo prospectivo, quantitativo, descritivo e observacional, durante um período de 12 meses, tendo por base a análise resultante de busca ativa e passiva dos processos envolvendo o uso dos equipamentos médicos hospitalares, incluindo: estrutura física e organizacional do ambiente, recursos humanos e recursos materiais disponíveis; programa de treinamento e educação continuada dos profissionais; etapas de higienização, desinfecção, esterilização e montagem dos equipamentos; planos de manutenção preventiva e corretiva dos aparelhos; e o gerenciamento do risco sanitário hospitalar, ligado à notificação e providências tomadas em relação às falhas técnicas, humanas e de processos, bem como os eventos adversos e incidentes a elas associados. Todos os dados coletados foram confrontados com a legislação brasileira e manuais técnicos vigentes, com a investigação da causa-raiz das falhas e dos eventos adversos ocorridos. Resultados: O estudo mostrou que o hospital apresenta falhas de infraestrutura e também, dos processos envolvidos nas diversas etapas do ciclo dos equipamentos as quais prevalecem sobre as falhas humanas. Dentre as nãoconformidades observadas estão incluídas: falhas no processo de licitação, que não tem a participação direta de profissionais médicos e de enfermagem da UTIA, para auxiliar na elaboração do edital, visando à melhor seleção e especificação dos produtos a serem adquiridos; inexistência de atuação do setor de Engenharia Hospitalar para monitorar as etapas de aquisição, recebimento, aceitação, manutenção e uso adequado dos instrumentos; inadequações da área física e das instalações dos equipamentos; deficiências na quantidade, qualificação, treinamento e capacitação dos profissionais para o manuseio correto dos aparelhos e cuidados aos pacientes; falhas no processo de higienização/desinfecção de componentes internos dos VPM; dificuldade de acesso a manuais técnicos dos aparelhos e aos procedimentos operacionais padrão pelos profissionais de saúde; inexistência de um inventário histórico e funcional dos equipamentos existentes; e a falta de programas de manutenção preventiva e corretiva com relações contratuais efetivas com os fabricantes e fornecedores. Os profissionais da UTI-A, não tem o hábito de notificar queixas técnicas e eventos adversos à Gerência de Risco Sanitário Hospitalar (GRSH), pois não foi registrada qualquer notificação espontânea advinda do setor no período analisado. Todavia, 74 notificações de queixas técnicas foram detectadas por busca ativa, sendo 64 relacionadas às BI, 6 aos MM e 4 aos VPM. No período, houve um único evento adverso relacionado a erro de medicação com BI, tendo sido atribuído à falha humana por erro na programação do sistema de infusão. Conclusões: O hospital apresenta oportunidades de melhorias para praticamente todas as etapas do ciclo dos equipamentos, uma vez que foram detectadas condições potencialmente capazes de acarretar riscos assistenciais relacionados à utilização dos MM, BI e VPM na UTI-A. As não-conformidades observadas elevam a probabilidade de ocorrência de falhas, incidentes e eventos adversos, colocando em risco a saúde e o bem-estar físico dos pacientes e dos profissionais da saúde. A falta de observação à legislação e normas técnicas e operacionais vigentes no país foi um evento sistemático, observado em todas as etapas do ciclo dos equipamentos no hospital, mas que se corretamente seguidas, poderá tornar esta UTI-A em ambiente mais seguro e com melhor qualidade na assistência à saúde dos pacientes. / Scientific background: Risk control associated to device use in hospitals has major importance to ensure patient safety and quality in service delivered by healthcare professionals. For doing so, it´s necessary to know all the device cycle in the hospitals, from its selection, acquisition, maintenance and use, as well as its failures and the adverse events related to them. Multiparameter Monitors (MM), infusion pumps (IP) and mechanical ventilators (MV) are devices of frequent use in Intensive Care Units, being however subject to technical, human and process failures, which may pose harm and even cause death of patients. Objective: To evaluate care risks related to the use of MM, IP, and MV at an Adult Intensive Care Unit (AICU) of a public hospital in Sao Paulo city, Brazil, seeking to investigate the causes and providences related to technical complaints and adverse events associated to them. Methods: It was made an observational, descriptive quantitative prospective study through 12 months, based on an analysis resulting from active and passive search of processes involving the use of medical devices in hospitals, including physical and organizational structure of work environment, available human resources and material resources; training program and continuing education of professionals; sanitization, disinfection, sterilization and assembling stages of devices; planning on preventive and corrective maintenance of the devices; and management of hospital sanitary risk regarding the report and actions towards technical, human and process failures occurred, as much as adverse events and incidents related to them. All the data collected was confronted to the current legislation and technical manuals. The root cause of failures and adverse events were investigated. Results: The study showed that Dr. Cármino Caricchio Municipal Hospital (HMCC) presents failures of infrastructure and/or the processes involved in the several stages of the device cycle which prevails on human failures. Among the non-conformities observed are included: failures in the bidding process, which doesn´t have the direct participation of AICU physicians and nurses, to provide support to elaborate Public Notice, focusing the best selection and specification of products to be acquired; lack of acting from the hospital engineering sector in order to monitor the stages of acquisition, receiving, acceptance, maintenance and appropriate use of devices; inadequacy of physical area and equipment installation; deficiencies in quantity, qualification, training, and capacitation of professionals for the correct handling of devices and patient care; failure in the process of sanitization/disinfection of MV internal accessories; the absence or difficulty to access the technical manuals of the equipments and the standard operating procedures by healthcare professionals; the absence of a historical and functional inventory of the current devices; and lack of preventive and corrective maintenance programs establishing effective contractual relations with manufacturers and suppliers. AICU professionals from HMCC also lack the practice of reporting technical complaints and adverse events to Gerência de Risco Sanitário Hospitalar (GRSH – Hospital Health Hazard Management), which hadn´t registered any spontaneous report from the sector throughout the period in analysis. Nevertheless, 75 reports on technical complaints were detected through active search, which 65 were related to IP, 6 to MM and 4 to MV. One single adverse event related to medication error with IP was observed in the period, which was rather attributed to human failure as for system programming error. Conclusions: HMCC presents failures and deficiencies in virtually all stages of hospital equipment cycle, that bring together conditions potentially capable to increase care risks regarding the use of MM, IP and MV at the AICU. This fact raises the probability of failure occurrence, incidents and adverse events, placing risk to patients´ as well as healthcare professionals´ health and physical wellness. Lack of compliance to legislation and technical and operational norms in the country was a systematic event observed in all the stages of hospital equipment cycle, but if they were strictly followed, it might turn the AICU of HMCC a safer place with better quality of healthcare for patients.

Diploma thesis deals with the creation and use of worksheets in the subject of Health Education. The worksheets are focused on a nutritional behavior of students in the second grade. In the theoretical part there is defined how the worksheets are created and what sort of requirements they have. The practical part contains a research conducted among pedagogues of Health education, three specific worksheets for students and three specific teachers methodology. The survey was conducted by quantitative method, where thirty teachers responded in the questionnaire to determine their view on the use of worksheets in the classroom and on the necessity of making comprehensive set of worksheets in the teaching of Health education. The worksheets are made for the students of the second degree with a focus on a nutritional behavior and methodology for teachers, how to work with the worksheets in the classroom. The worksheets contain learning tasks with a focus on food components, determinants of health and eating disorders. The practical part also includes supplementary material for teachers with information about topics that worksheets contain. KEYWORDS worksheets, Health education, nutritional behavior of students, food components, factors affecting health, eating disorders, obesity