The main focus of this study was the effect of chronic disease (hypertension, diabetes mellitus, heart disease, lung disease, cancer, and arthropathy)

The evaluation of the culture of patient safety in hospitals is nowadays considered as a management too, since it helps to identify problem areas and provide valuable information for planning improvements. This study explored the reliability and validity of the Brazilian version of the Hospital Survey on Patient Safety Culture, an instrument that evaluates characteristics of patient safety culture among hospital staff. The reliability of the instrument was evaluated by analyzing the internal consistency of each dimension. The validity of the tool was carried out by means of exploratory and confirmatory factor analysis. The sample was made up of 322 questionnaires that were collected in two Brazilian hospitals in 2012. Cronbach's alpha ranged from 0.52 to 0.91 for the different dimensions, with the exception of two, for which it was much lower. After excluding four items, the exploratory factor analysis presented adjusted indices that were appropriate for a 10 factor model.

O estudo do perfil sociodemográfico, história penal, uso de drogas e doenças sexualmente transmissíveis da população carcerária do Estado do Rio de Janeiro, em 1998, permitiu conhecer diferentes características da população prisional por sexo. O objetivo deste estudo é identificar se o perfil de exclusão social a que essa população é submetida difere quanto ao sexo. Foram entrevistados 2.039 presos por estudo seccional, e utilizada a razão de prevalência como medida de associação entre sexo e as demais variáveis. A análise multivariada, através de regressão logística, compõe um modelo final de explicação dessas diferenças. A população é jovem, de baixa escolaridade, e apresenta ruptura de vínculos da vida social em várias dimensões para ambos os sexos. Fatores mais fortemente associados ao sexo masculino: visita íntima na prisão, estar preso por sete anos ou mais, ser casado, condenação por roubo, ter ainda três anos ou mais a cumprir de pena e uso de maconha antes de ser preso; para o sexo feminino: doença sexualmente transmissível, ser viúva, estrangeira, usar tranqüilizante na prisão, ter visitado alguém na prisão antes de ser presa e ter 35 anos ou mais. A análise dos dados permitiu concluir que embora esses homens e mulheres sejam igualmente excluídos da "vida social" muito antes e também depois da prisão, existem algumas características que os diferenciam nesse processo de injustiça social.

This ecological study investigated the associations between dental caries, socioeconomic indicators, and the supply of dental services in the State of Paraná, Brazil, for the year 1996. Two types of information were collected: (1) data on caries prevalence (DMFT at 12 years) for the municipalities (or counties) in the State; (2) data on socioeconomic conditions and the supply of dental services. Based on simple linear regression analysis, the study demonstrated a significant correlation between the caries index in municipalities and various social and dental services supply indicators. Results of the analysis of multiple linear regression showed that one indicator of income inequality remained significantly associated with dental caries, demonstrating that the worst oral health conditions cannot be dissociated from income disparities. A significant negative correlation was observed between DMFT and the proportion of the population that received fluoridated water, principally in the municipalities with the worst income inequality indicators. This highlights the importance of fluoridation for the reduction of caries rates, as well as to attenuate the impact of socioeconomic inequalities on the prevalence of dental caries.

Proposta de modelo hierarquizado aplicado à investigação de fatores de risco de óbito infantil neonatal Proposal for a hierarchical framework applied to investigation of risk factors for neonatal mortality

OBJECTIVE:To assess rates of offering and uptake of HIV testing and their predictors among women who attended prenatal care. METHODS:A population-based cross-sectional study was conducted among postpartum women (N=2,234) who attended at least one prenatal care visit in 12 cities. Independent and probabilistic samples were selected in the cities studied. Sociodemographic data, information about prenatal care and access to HIV prevention interventions during the current pregnancy were collected. Bivariate and multivariate analyses were carried out to assess independent effects of the covariates on offering and uptake of HIV testing. Data collection took place between November 1999 and April 2000. RESULTS:Overall, 77.5% of the women reported undergoing HIV testing during the current pregnancy. Offering of HIV testing was positively associated with: previous knowledge about prevention of mother-to-child transmission of HIV; higher number of prenatal care visits; higher level of education and being white. HIV testing acceptance rate was 92.5%. CONCLUSIONS:The study results indicate that dissemination of information about prevention of mother-to-child transmission among women may contribute to increasing HIV testing coverage during pregnancy. Non-white women with lower level of education should be prioritized. Strategies to increase attendance of vulnerable women to prenatal care and to raise awareness among health care workers are of utmost importance.

This study evaluates the validity and reliability of the Work Ability Index (WAI) in Argentina. An instrument was applied to 100 workers, all agents of Primary Health Care in the county of General Pueyrredón. In the construct validity, the dimensional structure was studied by means of exploratory factor analysis, based on a polychoric matrix and parallel analysis to obtain the number of factors. In the correlation validation, the Spearman correlation was estimated between the WAI and the dimensions of the 36-Item Short Form Health Survey (SF-36). The reliability assessment was measured by Cronbach's alpha estimate. The result of the internal consistency of the scale was 0.80, indicating acceptable reliability. The WAI score yielded the following results: 12% moderate, 50% good and 38% optimal. In the validation process, a three-dimensional structure was identified which accounts for 66% of the total variance of the data through the main components. The theoretical assumptions of the construct validity confirmed the direct and significant correlation between WAI scores and the dimensions of health status assessment, with the highest value in the physical functioning dimension (0.478) and the lowest in the bodily pain dimension (-0.218). It was concluded that the WAI, translated and adapted into Spanish, showed adequate psychometric properties and can therefore be used in association studies between aspects of work and their impact on health.

OBJETIVOS: avaliar a assistência prestada a parturientes HIV+ e seus recém-nascidos (RN), e determinar os coeficientes de transmissão vertical (TV) do HIV em quatro capitais brasileiras. MÉTODOS: foi realizado um estudo de coorte cuja população correspondeu a 1475 parturientes HIV+ e seus RN, assistidas de 1996 a 2003, em 17 maternidades públicas. As informações foram obtidas, retrospectivamente, a partir dos prontuários médicos e de um questionário estruturado (fase prospectiva) aplicado em 274 mulheres. RESULTADOS: quanto à assistência dispensada, verificou-se respectivamente nas fases retrospectiva e prospectiva do estudo, que cerca de 24% e 27% das gestantes não tiveram acesso sequer ao AZT oral; 19% e 10% das parturientes não receberam o AZT intravenoso; 8% e 7% dos bebês não foram medicados com o AZT solução oral. O coeficiente de TV foi de 5,6% variando de 2,9% a 7,5% nas cidades, e sendo maior no parto vaginal (8%) e na cirurgia cesariana não-eletiva (7%). CONCLUSÕES: o Programa Brasileiro de Redução da TV do HIV se revela frágil no que diz respeito à sua organização, administração e avaliação nos serviços de saúde. Para melhor entendimento dessas etapas, nos vários níveis de gestão, um modelo-guia é sugerido.