The purpose of this study was to describe factors associated with noncompliance to hand hygiene standards among nurses in one public hospital in Windhoek, Namibia. A quantitative, descriptive, cross-sectional research design was employed using a stratified sample comprising three categories of nurses (registered, enrolled and auxiliary nurses). Data collection was done using a structured questionnaire. Based on the results, there were more institutional than individual factors associated with noncompliance to hand hygiene. Compliance to hand hygiene was found to be lowest when nurses provide care for patients in non-isolation rooms, when the perceived risk of acquiring infection from patients was low and following brief encounters with patients. Dryness of the skin caused by hand hygiene agents and lack of active participation in hand hygiene promotion at individual level contributed to noncompliance to hand hygiene among nurses. In addition, the results showed that, institutionally there were no rewards/encouragement for hand hygiene, no sanctions for non-compliers and no workshops, seminars and continuing educational courses on hand hygiene. The study produced interesting insights into the vital role that good leadership plays in the implementation of hand hygiene policy guidelines. The key recommendations for this study included development of good leadership, characterized by dedication for hygiene standards to encourage staff to maintain hygiene practice and to ensure that there are adequate resources for the implementation of hand hygiene policy as well as rewards/incentives for compliers and sanctions for noncompliers / Health Studies / M.A. (Nursing Science)

Landuse for farming purposes in specially protected areas could be characterised as a longterm process of seeking balance between the concerns of environmental protection and farming activities. This is also true for agriculture. Precautions to protect the environment mean certain limitiation, however, on the other hand, suitable forms of farming a large protected area can be supported by the state. Farmers can gain the government support not only for their own agricultural production but also to carry out various environmental task to maintain the landscape. This diploma thesis evaluates the use of governmental support in the protected area Třeboňsko. It analyses the structure of farms and agriculture companies, the system of farming activities, structure and development of farmland. According to the system of farming, it evaluates the use of financial support from the Ministry of Agriculture with the emphasis on the environmental protection and its improvement. It also finds out about the importance of the subsidies for the farmers. Based on the analyses that were carried out it is possible to say that all types of farming companies make use of the subsidy support from the Ministry of Agriculture. The farmers use the Programme for Rural Areas Development to permanently develop the country and improve the environmment. They use mainly the payments for natural disadvantage compensation and for agroenvironmental precautions. The subsidies often form a substantial source of the farming subjects' income.

My diploma work is focusing on the health problems of selected factors in the working enviroment of grinding the metal castings. There are high-risk factors, which are harmful to worker´s health, especially physical stress, noise, dust and vibrations, which are passed on hands. The employer is under the obligation to take precautions to carry on worker´s health, in consideration of exceed the health limits. The aim of this diploma work was setting the efficiency of precautions to health protection in work enviroment. The situation had been monitoring in a company in the South Bohemia over ten years. There were used results of factor´s precautions (noise, dust, vibrations) in work enviroment, where workers grind the metal castings by hand grinders. The monitoring ensemble was created by employess in a company, which makes the metal castings by hand grinders in its work enviroment. To data collecting were used the following methods: non-aligned observation, conversation with the chief of the company, studying of positive law and technical literature incl. test codes of the health institute (department Ceske Budejovice). The data of the test codes were processed by the secundary analysis and summarized to tables and graphs. Within qualitative analysis I determinated four research questions, which were answered gradually in my work: 1)Which precautions are carry out by employers to particular factors of employee´s health protection? 2)What is the factor´ s efficiency? 3)What impact do the precautions have on results of factor´s measuring? 4)Which precautions can I recommend on the grounds of the evalutation of the work enviroment? Both means of collective and individual protection belong to the precautions of worker´s health protection today. The technical, technologiacal and organisational precautions are included to collective protections. The individual precautions are focusing especially on employees and offer the substitute solutions. All precautions are specific to individual factors. I found out, that all precautions, which are used by the employers in work enviroment of metal casting, are effective. Especially we can talk about the precautions to protection of employee´s health against excessive dust (instalation of air ventilation with strong effect), which caused the exceed of dust concetration in work enviroment of grinding. Finally I can say, that this branch of metal casting has been connecting with certain high-risk factors all the time. Although all the protective precautions has been realized, the health limits given for noise, vibrations passed on hands and dust are still exceed. For this reason it´s very important to regularly inform the workers of high-risk factors, which they could meet in their work enviroment of cast grinding.

Made available in DSpace on 2014-07-29T15:04:35Z (GMT). No. of bitstreams: 1 Keyti Cristine Alves Damas Rezende.pdf: 1269546 bytes, checksum: b946d7bf22d7590bcb5094c9cefe91d0 (MD5) Previous issue date: 2011-03-30 / Infections in health care services, among which include primary care, have represented a serious problem and with several repercussions in the context of human health. The activities conducted in primary care are potential source of biological risk, both for users of these services and for their workers. Thus, this study aimed to analyze the biological risk for professionals and users during the execution of procedures in the Health Units in the catchment area of a Health District of Goiânia - GO. This is a descriptive, exploratory and cross-sectional study with quantitative approach. Data collection occurred among January and May of 2010, through direct not participant observation, being the data recorded in specific check list for each procedure. A questionnaire, with closed and open questions, was used to characterize the professional involved in the procedure followed and their qualification for the job. The data were processed using SPSS (Statistical Package for Social Sciences) version 16.0 for Windows and, then grouped in tables and figures. There were around 280 hours of observation, a total of 149 procedures, being 77 vaccinations, 28 bandages, 24 vaginal smears, 11 neonatal screening and 9 Mommy test. The procedures were performed by 28 professionals, 5 (17.8%) were nurses and 23 (82.1%) were nursing technicians, most females (95.3%).The results showed the possibility of exposure to biological material, because, in these procedures there is handling is sharp, the possibility of contact with blood, secretions, and immunobiological, aerosol formation, the proximity of the face and punched a member of the professional, agitation and/or reaction unexpected user. We found that there is poor adhesion to Hand Hygiene - HH and on the use of Personal Protective Equipment - PPE. The low rates of HH, in addition to non-adhesion to proper technique form a risk behavior that endangers health professionals and users. Failures related to the availability of PPE in the services studies here can influence the low adhesion to them and enable greater exposure to biological risk. Educational and management actions, aimed at consolidating a practical aware of the potential biological relevance and the availability of resources, are necessary for a greater adherence to this Standard Precautions. The nurse, as leader of this team, should be encouraged to develop actions based for security and commitment to minimize the risk inherent in biological practice, still working with educational activities. We point out the need for infection control committees to act in several health districts, directing and supervising the use and provision of these resources. More studies should be done in this area so that a deeper understanding of the topic, seeking alternative solutions to the specific and primary care. / As infecções nos serviços de assistência à saúde, dentre os quais se incluem os da atenção básica, têm representado um problema grave e de repercussões diversas no contexto da saúde humana. As atividades desenvolvidas na atenção básica são, potencialmente, geradoras do risco biológico, tanto para os usuários desses serviços quanto para os seus trabalhadores. Diante disso, este estudo teve como objetivo geral, analisar o risco biológico para profissionais e usuários durante a realização de procedimentos nas Unidades de Saúde, na área de abrangência de um Distrito Sanitário da cidade de Goiânia GO. Trata-se de um estudo do tipo descritivo, exploratório e transversal, com abordagem quantitativa. A coleta de dados ocorreu no período de janeiro a maio do ano de 2010, por meio de observação direta, não participante e as informações registradas em check list específico a cada procedimento. Um questionário, com questões fechadas e abertas, foi utilizado para caracterização do profissional envolvido no procedimento observado e sua qualificação para o trabalho. A análise dos dados ocorreu por meio de estatística descritiva, utilizando freqüência simples e esses foram apresentados em forma de tabelas e figuras. Os procedimentos observados foram teste do pezinho, teste da mamãe, exame colpocitológico, vacinação e curativos. Foram realizadas 149 observações, sendo referentes a 77 vacinações, 28 curativos, 24 exames colpocitológicos, 11 testes do pezinho e nove testes da mamãe. Durante o estudo, foram realizadas 280 horas de observação a um total de 149 procedimentos realizados por 28 profissionais. Desses, 18,8% eram enfermeiros e 81,2% eram técnicos em enfermagem e o sexo feminino foi predominante (95,3%). Os resultados mostraram a ocorrência de exposição ao risco biológico, pois, nesses procedimentos, há manuseio de perfurocortantes, possibilidade de contato com sangue, secreções e imunobiológicos, de formação de aerossóis, proximidade entre membro puncionado e a face do profissional, agitação e/ou reação inesperada do usuário. Verifica-se que há adesão insatisfatória à Higiene de Mãos - HM e ao uso de Equipamentos de Proteção Individual - EPI. Os baixos índices de HM, somados a não adesão à técnica correta compõem um comportamento de risco que pode afetar profissionais e usuários. Falhas relativas à disponibilidade dos EPI, nos serviços integrantes do estudo, podem influenciar a baixa adesão aos mesmos e possibilitam uma maior exposição ao risco biológico. Acredita-se que ações educativas, voltadas à consolidação de uma prática profissional, consciente do risco biológico, são necessárias para que ocorra uma maior adesão a essas Precauções Padrão. O enfermeiro, como líder dessa equipe, deve ser estimulado a desenvolver ações pautadas na segurança e compromisso de minimizar o risco biológico inerente à sua prática, atuando ainda com ações educativas. Aponta-se a necessidade de comissões de controle de infecção para atuar nos diversos distritos sanitários, orientando e supervisionando o uso e a provisão desses recursos. Mais estudos devem ser feitos nessa área para que ocorra um maior aprofundamento do tema, buscando alternativas e soluções às especificidades presentes.

Made available in DSpace on 2014-07-29T15:04:40Z (GMT). No. of bitstreams: 1 Dulcelene Melo.pdf: 680160 bytes, checksum: 55d8a4c2a66fae3c908abe807d75735e (MD5) Previous issue date: 2005-03-31 / This was a qualitative study done in a big-sized general public hospital in the city of Goiânia Goiás The aims was to analyze nurses´ adherence to standard precautions according to Rosenstock´s health belief model (HBM) (1974) Data were collected using a semi-structured interview guide based on principles of Critical Incidence Technique (CIT) The instrument was validated by judges and was then pre-tested The ethical-legal research principles were observed Among 90 nurses selected to participate in the study 82 agreed to take part in this study Inclusion criteria were nurses who were either in direct contact with patients or in supervisory positions in the hospital cleaning, laundry or sterilization services Data were analyzed in accordance with CIT The analysis categories were constructed using the dimensions of the HBM A total of 139 critical incidents were identified of which 66 were considered positive and 73 negative HBM dimensions were identified within 131 situations: 74 (56,5%) related to perceived susceptibility; 17 (13,0%) to perceived benefits and 40 (30,5%) to perceived barriers The majority of the reported critical incidents related to situations of occupational exposure to biological materials Among the Standard Precautions (SP) use of protective barriers was most frequently utilized Denial of susceptibility was indicated by the lack of use of protective barriers improper management of sharp objects and non-adherence to SP related to patients with multi-resistant pathogens Moderate perceived susceptibility was associated with partial adherence to SP in cases of patients requiring more complex levels of care; in situations following occupational exposure; and when patients needs took priority over personal protection High perceived susceptibility was observed in situations of caring for patients suspected or diagnosed with infections due to pathogens of epidemiological importance and those related to nurses responsibility Perceived seriousness was evident in behaviors and consequences related to critical incidences after occupational exposure in moments when nurses expressed feelings experienced psychosomatic symptoms and were diagnosed with an infection. Perceived benefits emerged above all from positive critical incidente with focus on protective barriers understood as protection strategies which lead to safety while procedures are executed Perceived barriers were: lack of personnel preparation lack of material resources insufficient personnel improper physical structure patient emergencies psychosocial factors lack of personnel policies for cases of exposure to biological material These barriers contribute to lower adherence of SP but they could be addressed by the Health Care Facilities since nurses have demonstrated adequate perception of susceptibility and benefits HBM dimensions were associated with nurses adherence to SP suggesting that plans should be developed to improve the nurses actions and decision-making in day-to-day nursing cars prioritizing the safety of those individuals involved in this process / Estudo qualitativo desenvolvido em um hospital público geral de grande porte de Goiânia-Go Teve como objetivo analisar a adesão dos enfermeiros às precauções padrão (PP) à luz do modelo de crenças em saúde (MCS) de Rosenstock (1974) Os dados foram coletados por meio de entrevista com roteiro semi-estruturado e conforme preconizado pela técnica de incidentes críticos (TIC) O instrumento foi validado por juizes seguido do pré-teste Foram observados os aspectos ético-legais da pesquisa Fizeram parte do estudo 82 enfermeiros dos 90 eleitos que estavam em atividade assistencial direta ao paciente ou atuavam nos setores: de higienização hospitalar reprocessamento de roupas e materiais odonto-médico-hospitalares Procedemos a análise de conteúdo dos dados conforme a TIC As dimensões do MCS foram utilizadas como categorias prévias de análise Obtivemos 139 incidentes críticos sendo que 66 foram positivos e 73 negativos de acordo com a polaridade referida Destes 131 situações remetiam às dimensões do modelo de crenças em saúde: 74 (56,5%) eram relacionadas à suscetibilidade percebida; 17 (13,0%) aos benefícios percebidos e 40 (30,5%) às barreiras percebidas Os incidentes críticos relatados predominantemente relacionavam-se às situações de exposição ocupacional a material biológico O uso de barreiras protetoras foi a PP que obteve maior freqüência de indicação A negação da suscetibilidade foi observada pelo não uso das barreiras protetoras no manuseio inadequado de perfurocortante e não adesão às PP relacionadas ao paciente portador de patógeno multi-resistente A moderada suscetibilidade percebida associou-se à adesão parcial às PP no atendimento a pacientes com maior complexidade nos cuidados assistenciais Estes comportamentos adotados sinalizam limitada percepção da necessidade de intervenção nos cuidados pós-exposição ocupacional priorizando o atendimento às necessidades dos pacientes A alta suscetibilidade percebida foi observada nas situações de atendimento ao paciente sob suspeita ou com diagnóstico de infecção por patógenos de importância epidemiológica e àquelas relacionadas à responsabilidade do enfermeiro nesta particularidade da assistência A severidade percebida foi evidenciada somente nos comportamentos e conseqüências dos incidentes críticos relatados nos momentos de pós-exposição ocupacional expressa em sentimentos alterações psicossomáticas e experiência de infecção Os benefícios percebidos emergiram sobretudo dos incidentes críticos positivos com enfoque no uso das barreiras protetoras que foram compreendidas como estratégia de proteção ratificando a segurança na execução dos procedimentos As barreiras percebidas foram: falta de preparo do profissional falta de material de consumo e permanente número insuficiente de profissionais estrutura física inadequada atendimento a pacientes em situações de urgência/emergência fatores psicossociais e falta de fluxo para o atendimento ao profissional em situação de pós-exposição a material biológico; que poderiam ser minimizadas com a organização do Serviço de Assistência à Saúde pois se constituíram em impedimentos para a adesão às precauções padrão embora os enfermeiros apresentassem adequada percepção da suscetibilidade e benefícios Verificamos que as dimensões do modelo de crenças em saúde elucidaram a adesão dos enfermeiros às PP sugerindo que empreendimentos devam ser feitos para melhor instrumentalizá-los para a tomada e modalidade de ação no cotidiano da assistência que priorize a segurança dos sujeitos envolvidos nesse processo

Made available in DSpace on 2014-07-29T15:04:47Z (GMT). No. of bitstreams: 1 Heliny Carneiro Cunha Neves.pdf: 648693 bytes, checksum: 98e4038ff2462e0020c3bd6162246b7f (MD5) Previous issue date: 2009-05-14 / The recommendations from the standard precautions that included the concepts of universal precautions have been applied for more than 15 years. This primary prevention of occupational exposure remains efficient and effective in protecting professional health care (PHC). However, we found that adherence to these measures is sometimes discontinuous and contradictory and leads to an enhancement of the risks and substantial increase in exposure to biological material. This leads us to inquire about other factors that may contribute to this kind of behavior on the part of PHC. From this perspective, investigating the subjective aspects that influence the behaviors and attitudes of nursing professionals to join the personal protective equipment (PPE) becomes important. The objective of this study was to analyze the reasons, attitudes and beliefs of nursing staff regarding adherence to PPE. Qualitative study conducted in December 2008 in a large university hospital in the city of Goiania. We observed the ethical-legal aspects. Data were collected through focus group technique using guiding questions. The study included 15 professionals of nursing, which formed three focus groups with five participants in each group. Data were analyzed by the model of health beliefs (MCS) of Rosenstock (1974b) and the method of interpretation of meaning, according to security issues at work and Interpersonal Relationship. We could identify that interpersonal relationships interfere with issues of safety and personal protection at various levels in the workplace, both in the organizational and manage, and in relation to other professions and other sectors of the hospital. This relationship proved is a two-way process and we cannot ignore the factors and individual risk perception, which is connected with the work environment, influence the individual protection. Difficulties such as work overload, stress, lack of motivation, communication, and inadequate physical infrastructure, lack of availability and limited access to PPE, lack of routines and the assistance process after exposure to biological material, among others, interfere with adherence to such safety equipment, but not determine them. Joining the PPE is impregnated by the context as experienced in the workplace, but also by individual values and beliefs, but the decision to use the PPE is personal. The numbers of perceived barriers in the work environment are opposing forces that cancel the driving forces for adherence to personal protective equipment. We note that the qualitative and focus group technique provided us with input for analysis and reflection on the accession to the PPE as well as direct possible strategies and effective measures to prevent and control infections and improve adherence to safety equipment. / As recomendações das precauções padrão desde que incluíram os conceitos das precauções universais, têm sido aplicadas há mais de 15 anos. Essa prevenção primária das exposições ocupacionais continua sendo eficaz e eficiente na proteção dos profissionais da área da saúde (PAS). No entanto, verificamos que a adesão a essas medidas é, por vezes, descontínua e contraditória e leva a uma potencialização dos riscos e aumento substancial de exposições ao material biológico. Isso nos leva a indagar sobre outros fatores que podem contribuir para esse tipo de comportamento por parte dos PAS. Nessa perspectiva, investigar os aspectos subjetivos que influenciam nas condutas e atitudes dos profissionais da enfermagem à adesão ao equipamento de proteção individual (EPI) torna-se importante. Assim, o objetivo deste estudo foi analisar as razões, atitudes e crenças dos trabalhadores de enfermagem referentes à adesão aos equipamentos de proteção. Estudo qualitativo realizado em dezembro de 2008 em um hospital universitário de grande porte do município de Goiânia. Foram observados os aspectos ético-legais. Os dados foram coletados por meio da técnica do grupo focal utilizando-se de questões norteadoras. Participaram desse estudo 15 profissionais da área da enfermagem, os quais constituíram três grupos focais com cinco participantes em cada grupo. Os dados foram analisados à luz do Modelo de crenças em saúde, de Rosenstock e pelo Método de Interpretação de Sentidos, segundo os temas Segurança no trabalho e Relacionamento Interpessoal. Foi possível identificar que as relações interpessoais interferem nas questões da segurança e proteção individual, em vários níveis no ambiente de trabalho, tanto nos aspectos organizacionais e gerencias, quanto na relação com as outras categorias profissionais e com os outros setores do hospital. Essa relação mostrou-se uma via de mão dupla e não podemos desconsiderar os fatores individuais e a percepção do risco, que também interligadas com o ambiente de trabalho, influenciam na proteção individual. As dificuldades como a sobrecarga de trabalho, estresse, falta de motivação, comunicação e estrutura física inadequadas, não disponibilidade e difícil acesso ao EPI, falta de rotinas e do fluxograma de atendimento pós-exposição a material biológico, entre outros, interferem na adesão a esses equipamentos de segurança, porém não os determinam. A adesão ao EPI é impregnada tanto pelo contexto vivenciado no ambiente de trabalho, como também pelos valores e crenças individuais, mas a decisão do uso do EPI é pessoal. As inúmeras barreiras percebidas no ambiente laboral são forças contrárias que anulam as forças impulsoras para a adesão aos equipamentos de proteção individual. Verificamos que a abordagem qualitativa e a técnica do grupo focal forneceram-nos subsídios para a análise e reflexão em relação à adesão ao EPI, além de direcionar possíveis estratégias e medidas eficazes na prevenção e controle de infecções e na melhora da adesão aos equipamentos de segurança.

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No. of bitstreams: 2 Dissertação - Marielle Sousa Vilela Bernardes - 2015.pdf: 1981134 bytes, checksum: 8a18ebb5d661b2ad5d695f1f143436c9 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2015-06-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Primary health care workers are exposed to many occupational hazards related to its activities, among them those biological. Understanding and identifying these risks by workers promote behavior change and can make them adhere to safety measures. GOAL: To identify multidisciplinary team workers beliefs of primary health care related to worker safety, the biological risk at workplace. METHODOLOGY: Descriptive study with qualitative approach, performed in seven units of primary health care in the city of Goiânia-GO, in 2014. The study included 43 workers, seven nurses, seven dentists, four doctors, five technicians / assistants in oral health, eight nursing technicians, six administrative assistants and six auxiliary hygiene and cleanliness. We used the technique of critical incident data collection, with semi-structured interviews with two parts: the first looked at data from the subjects characterization and, second, information on the subject. It was conducted content analysis, according to Bardin, discussed based on Health Belief Model of Rosenstock. RESULTS: As to gender, 88.4% were female, aged between 24 and 66 years, mean 46 years. According to vocational training, 16 (37%) were post-graduates; 12 (28%) completed high school; seven (16%) incomplete higher graduation course; four (9%) complete graduation course, and four (9%) primary school. The training ranged from four to 34 years. It was identified that the workers still lack clarity about their vulnerability to biological hazards at workplace. Understanding these workers, on such risks leads to other health facilities as hospitals and emergency services. However, they realized the beliefs related to preventive measures as benefits. This severity was unveiled from previous experiences of workers in working accidents. CONCLUSION: The beliefs of workers in primary health care, related to worker safety at the workplace, expressed basic concepts and are often inconsistent on the subject. These difficulties show health policies of poor investment in human resources on safety perspective. The workers were not able to enter the labor everyday life, a culture of appreciation of biological risks and adherence to preventive measures recommended by the Brazilian guidelines. The evidences in this study make us to rethink the interfaces involved in the work process and biological hazards in low and medium level complexity. Therefore, we propose a continuing education program in health, which instigates the technical improvement and security of organizational culture at the workplace in all health care levels by emphasizing the worker's beliefs. / Los trabajadores que trabajan en la atención primaria de la salud están expuestas a diversos riesgos laborales inherentes a sus actividades, entre las que destacan biológica. La comprensión y la identificación de estos riesgos por los trabajadores a promover el cambio de comportamiento y puede impulsarlos a que se adhieran a las medidas de seguridad. OBJETIVO: identificar las creencias de los trabajadores equipo multidisciplinario de atención primaria de salud con respecto a la seguridad de los trabajadores, fuera del riesgo biológico en el ambiente laboral. METODOLOGÍA: Estudio descriptivo con enfoque cualitativo, realizado en siete unidades de atención primaria de salud en la ciudad de Goiânia-GO, en 2014. El estudio incluyó a 43 trabajadores, siete enfermeras, dentistas siete, cuatro médicos, cinco técnicos / asistentes en salud oral ocho técnicos de enfermería, seis, seis auxiliares administrativos y auxiliares de limpieza y limpeza.Utilizou la técnica de recolección de datos de incidentes críticos, que se produjo a través de entrevistas semi-estructuradas que contienen dos partes: la primera analizaron los datos de la caracterización de los sujetos y el segundo, la información sobre el tema. RESULTADOS: En cuanto al género, el 88,4% eran mujeres, con edades comprendidas entre 24 y 66 años, con una media de 46 años. De acuerdo a la formación profesional, 16 (37%) eran posgraduados; 12 (28%) completaron la escuela secundaria; siete (16%) superior incompleta; cuatro (9%) completan la parte superior, y cuatro (9%) de la escuela primaria. El entrenamiento varió de cuatro a 34 años. Fue identificado que los trabajadores aún no tienen claridad acerca de (a) su vulnerabilidad a los riesgos biológicos en el lugar de trabajo; La comprensión de estos trabajadores en tales riesgos conduce a otros centros de salud como hospitales y servicios de emergencia. Sin embargo, las creencias relacionadas con las medidas preventivas fueron percibidos por ellos como beneficios. La gravedad percibida revelado de las experiencias anteriores de los trabajadores accidentes frontales en el trabajo y una fuente de inseguridad que el ámbito de la atención sanitaria. CONCLUSIÓN: Las creencias de los trabajadores de atención primaria de salud, relacionados con la seguridad de los trabajadores en el lugar de trabajo, expresan conceptos básicos y, a menudo inconsistentes sobre el tema. Estas dificultades se refieren las políticas de salud en la inversión enfocados debilidades en recursos humanos desde la perspectiva de la seguridad. Dado que los trabajadores no fueron capaces de entrar en la vida cotidiana de trabajo, una cultura de apreciación de los riesgos biológicos y la adhesión a las medidas preventivas recomendadas por las directrices brasileñas. Evidencia aprovechado este estudio en la unidad de repensar las interfaces que participan en el proceso de trabajo y los riesgos biológicos en el de bajo nivel y mediana complejidad. Por lo tanto, se propone un programa de educación para la salud, que solicita la mejora técnica y la seguridad de la cultura organizacional en el ambiente de trabajo en todos los niveles de atención de salud, haciendo hincapié en las creencias de los trabajadores. / Os trabalhadores que atuam na atenção primária à saúde estão expostos a diversos riscos ocupacionais intrínsecos às suas atividades, entre eles, sobressaem os biológicos. A compreensão e a identificação desses riscos pelos trabalhadores favorecem a mudança de comportamento e podem impulsioná-los a aderir às medidas seguras. OBJETIVO: Identificar as crenças de trabalhadores da equipe multiprofissional da atenção primária à saúde, em relação à segurança do trabalhador, frente ao risco biológico na ambiência laboral. METODOLOGIA: Estudo descritivo com abordagem qualitativa, realizado em sete unidades de atenção primária à saúde do município de Goiânia-GO, em 2014. Participaram do estudo 43 trabalhadores: sete enfermeiros, sete cirurgiões dentistas, quatro médicos, cinco técnicos/auxiliares em saúde bucal, oito técnicos em enfermagem, seis auxiliares administrativos e seis auxiliares de higienização e limpeza. Utilizou-se a técnica do incidente crítico para a coleta dos dados, que ocorreu por meio de entrevistas semiestruturadas contendo duas partes: a primeira contemplou dados da caracterização dos sujeitos e, a segunda, informação sobre a temática. Realizada Análise de Conteúdo, segundo Bardin, discutida sob o referencial do Modelo de Crenças em Saúde de Rosenstock. RESULTADOS: Quanto ao gênero, 88,4% eram do sexo feminino, com faixa etária entre 24 e 66 anos e média de 46 anos. De acordo com a formação profissional, 16 (37%) eram pós-graduados; 12 (28%) concluíram o ensino médio; sete (16%) superior incompleto; quatro (9%) superior completo, e quatro (9%) ensino fundamental. O tempo de formação variou de quatro a 34 anos. Identificou-se que os trabalhadores ainda não têm clareza sobre sua vulnerabilidade aos riscos biológicos no ambiente de trabalho. A compreensão desses trabalhadores, sobre tais riscos remete a outros estabelecimentos de saúde, como, hospitais e serviços de emergência. Porém, as crenças relacionadas às medidas preventivas foram por eles percebidas como benefícios. A severidade percebida desvelou-se a partir de experiências prévias dos trabalhadores frente aos acidentes de trabalho. CONCLUSÃO: As crenças dos trabalhadores da atenção primária à saúde, relacionadas à segurança do trabalhador no ambiente laboral, expressaram conceitos elementares e muitas vezes inconsistentes sobre a temática. Essas dificuldades remetem as fragilidades de investimentos em políticas de saúde focadas nos recursos humanos sob o olhar da segurança no trabalho. Os trabalhadores não foram capazes de incorporar no cotidiano laboral, uma cultura de valorização dos riscos biológicos e de adesão às medidas preventivas recomendadas pelas diretrizes brasileiras. As evidências alavancadas nesse estudo nos impulsionam a repensar as interfaces envolvidas no processo de trabalho e os riscos biológicos no nível de baixa e média complexidade. Assim sendo, propõe-se um programa de educação permanente em saúde, que instigue o aprimoramento técnico e a cultura organizacional de segurança no ambiente laboral em todos os níveis de atenção à saúde, mediante a valorização das crenças do trabalhador.

Introduction. La détection précoce des infections par un système de surveillance efficace permet de mettre en œuvre des mesures de prévention et de contrôle adaptées. L’objectif de cette thèse était d’évaluer les performances d’un système de détection automatique, type syndromique, des patients à risque épidémique à partir des données du dossier médical informatisé des urgences. Population d’étude. 101001 patients ayant consulté aux urgences du groupement Nord des Hospices Civils de Lyon, entre le 01/06/2007 et le 31/03/2011, dont 10895 patients hospitalisés dans l’établissement à l’issue de la consultation. Méthode. Trois étapes ont été nécessaires. 1) Évaluation de la faisabilité d’utiliser les données structurées et textuelles, à l’aide d’une application de traitement automatisé des données textuelles. 2) Construction et évaluation d’algorithmes de repérage, pour les syndromes respiratoire, cutané et gastro-intestinal, de patients avec une infection à risque épidémique à partir des données du dossier médical informatisé des urgences. 3) Évaluation des données du dossier médical des urgences pour la détection d’épidémies communautaires de grippe, comparées aux données régionales de surveillance de la grippe. Résultats et Discussion. Cette thèse a montré que qu’il est possible de repérer des patients à risque épidémique avec une balance raisonnable entre la sensibilité et la spécificité pour des syndromes respiratoires et cutanés. Les algorithmes pour des syndromes gastro-intestinaux n'étaient pas assez spécifiques pour une utilisation de routine. Les données d’urgences ont permis aussi de détecter les épidémies communautaires dès le début de l’épidémie locale / Introduction. The early detection of the infections by an effective surveillance system allows implementing adapted measures of prevention and control. The objective of this thesis was to estimate the performances of an automatic system syndromic-like to detect the patients with potentially transmissible infectious diseases from the emergency department computerized medical record data. Study population. 101,001 adults, who were admitted to the emergency department and hospitalised of the North Hospital In University Hospital of Lyon, between 01/06/2007 and 30/03/2011. Method. Three steps were necessary. 1) Evaluation of the feasibility to use the structured and textual data with an application which automatically extracts and encodes information found in narrative reports. 2) Different algorithms were built for the detection of patients with infectious respiratory, cutaneous or gastrointestinal syndromes, and assessed. 3) Evaluation of the data of the electronic medical record of emergency department for the detection of flu community epidemics, compared with regional surveillance networks for flu. Results and discussion. This thesis showed that it is possible to detect patients with potentially transmissible infectious diseases with reasonable balance between sensitivity and specificity for respiratory and cutaneous syndromes. The algorithms for gastrointestinal syndromes were not specific enough for their routine use. Emergency department data enabled the detection of community outbreaks for flu

Diploma thesis "Supervision of a probation officer over criminal irresponsible children" deals with juvenile delinquency, juvenile justice law adaptation for criminal responsible children younger 15 years of age and concerns with the ways by which society can react to the juvenile delinquency according to valid law adaptation. In its theoretical part this thesis focuses on definition of the keywords such are 'child', 'age limits of criminal responsibility', 'delinquency'. Thesis includes also description of juvenile delinquency as such where the law adaptation related to this issue is taken into consideration as well as the discipline precautions which can be ordered by court of law as a reaction to the unlawful behaviour. The goal of the practical part is to map the obstacles which discourage effective usage of discipline precautions supervision of a probation Office and suggest possible solving. The analytical part of the thesis was realised by two techniques, namely, questioning technique and document analysis.

Standard precautions are a set of guidelines that aim to protect health care workers from infections from blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes while providing care to patients. However, compliance to the standard precautions is often low in low-income countries in spite of the greater risk of infection. This study examined the knowledge and practice of standard precautions among health care workers in public secondary health facilities in Abuja, the Federal Capital Territory of Nigeria. A quantitative descriptive survey was conducted with 83 doctors and 194 nurses using a structured questionnaire. Findings show suboptimal knowledge and practice of the standard precautions among the health care workers. Knowledge of post-exposure prophylaxis for HIV was low as well as hepatitis B immunization among the respondents. A lack or irregular supply of essential materials, such as personal protective equipment, was the main reason the respondents did not comply to the precautions. This report recommends the development and implementation of a comprehensive infection prevention and control program in health facilities in order to ensure compliance to the standard precautions by health care workers. / Public Health / M.A. (Public Health)