A notifi cação da violência doméstica pelos profi ssionais de saúde contribui para o dimensionamento epidemiológico do problema, permitindo o desenvolvimento de programas e ações específi cas. O objetivo do trabalho foi verifi car a responsabilidade desses profi ssionais em notifi car a violência, especialmente a doméstica e as possíveis implicações legais e éticas a que estão sujeitos. Assim, foi realizada pesquisa na legislação brasileira e códigos de ética da medicina, odontologia, enfermagem e psicologia. Quanto à legislação, as sanções estão dispostas na Lei das Contravenções Penais, Estatuto da Criança e Adolescente, Estatuto do Idoso e na lei que trata da notifi cação compulsória de violência contra a mulher. Também existem penalidades em todos os códigos de ética analisados. Conclui-se que o profi ssional de saúde tem o dever de notifi car os casos de violência que tiver conhecimento, podendo inclusive responder pela omissão. DESCRITORES: Violência doméstica, ética. Violência doméstica, estatística e dados numéricos. Notifi cação de abuso. Atitude do pessoal de saúde. Comunicação sigilosa. ABSTRACTDomestic violence reporting by health providers contributes to the epidemiological assessment of the magnitude of the problem, which allows the development of specifi c programs and actions. The aim of the study was to assess the level of responsibility of these providers towards reporting violence, especially domestic violence, and potential related legal and ethical implications. The Brazilian legislation and ethics code of Medicine, Dentistry, Nursing and Psychology were studied. Legal sanctions are found in the Criminal Law of Misdemeanor Offenses, the Child and Adolescent Statute, the Elderly Statute and in the law establishing mandatory reporting of violence against women. There are also penalties in all ethics codes reviewed. It is concluded that health providers have the legal duty of reporting known domestic violence cases and they can even be charged with omission.
The knowledge of ergonomics postural requirements and their clinical application among the dental students surveyed were not satisfactory. The reasons for the learning difficulties encountered by the students should be identified to improve the learning process. The didactic use of digital images in this study may help in this endeavour.
Desafios do profissional de saúde na notificação da violência: obrigatoriedade, efetivação e encaminhamentoChallenges facing health professionals in the notification of violence: mandatory implementation and follow-up procedures
BackgroundThe use of potentially inappropriate medications (PIM) among the elderly is a serious public health problem because it is intrinsically linked to increased morbidity and mortality, causing high costs to public health systems. This study’s objective was to verify the prevalence of and the factors associated with the use of PIMs by elderly Brazilians in institutional settings.MethodsWe performed a transversal study, by consulting the case files of elderly people living in Long Term Care for the Elderly (LTC) in towns in the State of São Paulo, Brazil, as well as structured interviews with the nurses responsible for them.We identified PIMs using the list of recently updated Beers criteria developed by a group of specialists from the American Geriatrics Society (AGS), who reviewed the criteria based on studies with high scientific evidence levels. We defined the factors studied to evaluate the association with PIM use prior to the statistical analyses, which were the chi-square test and multiple logistic regression.ResultsAmong the elderly who used drugs daily, 82.6% were taking at least one PIM, with antipsychotics (26.5%) and analgesics (15.1%) being the most commonly used. Out of all the medications used, 32.4% were PIMs, with 29.7% of these being PIMs that the elderly should avoid independent of their condition, 1.1% being inappropriate medication for older adults with certain illnesses or syndromes, and 1.6% being medications that older adults should use with caution. In the multivariate analysis, the factors associated with PIM use were: polypharmacy (p = 0.0187), cerebrovascular disease (p = 0.0036), psychiatric disorders (p < 0.0001) and dependency (p = 0.0404).ConclusionsThe results of this study showed a high prevalence of PIM use in institutionalized elderly Brazilian patients. and the associated factors were polypharmacy, psychiatric disorders, cerebrovascular diseases and dependency.
BackgroundThe increased prevalence of malocclusions represents a secular trend attributed to the interaction of genetic and environmental factors. The analysis of factors related to the causes of these changes is essential for planning public health policies aimed at preventing and clinically intercepting malocclusion. This study investigated the sucking habits, nocturnal mouth breathing, as well as the relation of these factors with malocclusion.MethodsThis is a longitudinal study in which 80 mother-child pairs were monitored from the beginning of pregnancy to the 30th month after childbirth. Home visits for interviews with the mothers were made on the 12th, 18th and 30th months of age. Finger sucking, pacifier sucking, bottle feeding, breastfeeding and nocturnal mouth breathing, were the variables studies. On the 30th month, clinical examinations were performed for overjet, overbite and posterior crossbite. A previously calibrated single examiner (Kappa coefficient = 0.92) was responsible for all examinations. Data were analyzed using the chi-squared or Fisher’s exact tests, at a significance level of 5%.ResultsBottle feeding was the most prevalent habit at 12, 18 and 30 months (87.5%; 90% and 96.25%, respectively). Breastfeeding was 40%, 25% and 12.50% at 12, 18 and 30 months, respectively. Nearly 70% of the children in this study had some sort of malocclusion. Pacifier sucking habit at 12, 18 and 30 months of age was associated with overjet and open bite; and at 30 months, an association with overbite was also observed. Finger sucking habit and breastfeeding at 12, 18 and 30 months were also associated with overjet and open bite. The posterior crossbite was associated with bottle feeding at 12 and 30 months, and nocturnal mouth breathers at 12 and 18 months.ConclusionsSucking habits, low rates of breastfeeding, and nocturnal mouth breathing were risk factors for malocclusion.
This study aimed to evaluate the prevalence of head and neck injuries in females based on complaints registered as bodily harm or cruel and unusual punishment at the Women's Defense Precinct in Araçatuba, São Paulo State, Brazil, in 2002. A total of 204 police inquiries were conducted in 2002, resulting in 33 police reports of bodily harm and cruel and unusual punishment to females. The police reports were examined as to victim's age and site of injury. The results showed that injuries are inflicted on various age brackets, with a higher prevalence in children and adolescents. In addition, the highest prevalence of injuries was in the head and neck, encompassing the area where dentists work and where they should be prepared to treat victims of such violence.
The relationship between mother and child in the context of oral health has traditionally been exposed by the scientific literature in microbiology, which lacks a broad and necessary discussion of health and illness seen as processes, both biological and social. ObjectiveInvestigate the family social determinants associated with the caries history of children and the need for dental treatment (NDT) among their mothers was the objective of this study. Material and methodsThis research employed a cross-sectional study of mother-child pairs living in southern Brazil. Data collection occurred in public institutions of early childhood education. The instruments included a structured questionnaire administered to mothers and clinical oral examinations of the mothers and children. The social variables considered were marital status, maternal education, number of children, income, employment status, and frequency of visits to a dental professional. The measured outcomes were the maternal NDT and child caries history. Data were analyzed by the chi-square test (χ2) and by discriminant analysis. ResultsThe final sample consisted of 272 mother-child pairs and it was found that the greatest need for treatment was among mothers with low educational level and low family income who rarely or never visited a dentist. Tooth decay was less frequent in only child, and most frequent in children of mothers with low educational attainment, and in children in lower income households who rarely or never visited the dentist. The social determinants of caries in children and of the maternal NDT were similar. It follows that the maternal NDT and caries history among children were strongly associated with maternal education (p<0.0001), household income (p<0.0001), and frequency of visits to a dental professional (0.0018). Caries history among children was also associated with number of children in the household (p<0.0001).ConclusionsThe results suggest that the caries experience in children depended less on the family social variables than on the maternal NDT.
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