Nursing workers' exposure to chemical products at a public universitary hospital in São Paulo city

This study aimed to identify exposure to chemical loads as perceived by nursing workers at the studied institution, disclose their health problems in dealing with chemical products and analyze their suggestions for the decrease or elimination of exposure-related health problems. This research was carried out at the S?o Paulo University Hospital, Brazil--HU-USP. 430 nursing workers were studied. A questionnaire was used for data collection. Results showed that health workers detected 145 chemical substances. The most frequent health problems were related to skin problems (58.14%). 23.72% of the study participants proposed the use of self-protection equipment to decrease or eliminate exposure to these products.     

Situations related to drug misuse in public schools in the city of São Paulo, Brazil

OBJECTIVE: To explore situations, attitudes and behavior of public elementary school education supervisors concerning psychoactive substance misuse. METHODS: The study was carried out in the city of S?o Paulo, Southeastern Brazil, in 2002. Data were collected using a semi-structured questionnaire applied to eight key informants in the administrative area experienced in education supervision. Qualitative content analysis with ethnographic reference was conducted. RESULTS: Most discourses show that knowledge transmission is thought as essential for drug use prevention, though supervisors reported being ill-informed on this subject. The most frequent attitudes toward drug users are impotence and inability to act and sometimes a repressive attitude. These are motivated by misinformation and fear due to mistaken association of drug users and criminals. In situations indirectly related to drug abuse (family and behavior problems) more understanding and inclusive attitudes are reported, following the harm reduction paradigm. CONCLUSIONS: Theoretical capacity building of educators for preventive attitudes would support their skills developed through dealing with situations (in)directly related to drug abuse in schools. Thus, educators would feel more confident to make interventions for harm or risk reduction among drug users.     

Humanization of care from the perspective of the family health strategy teams in a city in the interior of São Paulo, Brazil

This study analyzes the understanding of professionals composing teams of the Family Health Strategy concerning humanization of care. This qualitative survey was carried out in a city in the interior of S?o Paulo through interviews with 20 professionals. The data analysis method used was Interpretation of Meanings based on the hermeneutic-dialectic perspective. The meaning of humanization according to the interviewed professionals includes an enlarged view, respect for ethical principles and facilitated access. The difficulties refer to the lack of prepared professionals, excessive demand and deficiencies in service organization. The professionals propose to educate and qualify professionals, make activities adequate given the professionals' roles and improve the organization of services. The professionals demonstrate understanding of the meaning of humanization and acknowledge the need to cope with difficulties.     

Public perception of depression in the city of São Paulo

OBJECTIVE: To assess how the population identifies symptoms of depression as well as its causes. METHODS: A household survey with a probabilistic sample of 500 individuals, residing in the city of S?o Paulo and aged between 18 and 65 years, was conducted in 2002. A structured questionnaire including sociodemographic data and a vignette presentation describing a person with depression, according to the Diagnostic and Statistical Manual of Mental Disorders-IV and the International Classification of Diseases-10 was used during the in-person interviews carried out by trained, qualified interviewers. Two questions about the vignette's symptom identification were subsequently asked. The results were analyzed by means of logistic regression and variance analysis. RESULTS: Symptoms presented were identified as "depression" by less than half of the sample. About 20% of respondents believed it was a mental illness. Low level of education was the only variable associated with identification as mental illness (OR=2.001, 95% CI: 1.275; 3.141, p=0.003). The most relevant causes were "unemployment" and "isolation". Biological, spiritual and moral causes were considered to be less relevant. Factors that most influenced the responses about causes were level of education, gender, personal experience with mental problems and identification as mental illness. CONCLUSIONS: The population of the city of S?o Paulo in general, especially those with a higher level of education, views depression in terms of a psychosocial model that somewhat differs from the biomedical model.     

Opinions of students and educators concerning health: the public school perspective in a peripheral area of the city of São Paulo

This study focused on prevailing concepts in society concerning adolescents' health problems and needs. Based on concerns in the field of Collective Health in relation to public policies for social protection, the study attempted to grasp the public school perspective concerning these issues. The study's theoretical reference was the social determination of the health-disease process and the view that health needs are translated into demands for changes in the harmful processes resulting from relations in the production process. Data were gathered through interviews with pedagogical coordinators and focus groups with adolescents in public schools from the Raposo Tavares School District (Municipality of S o Paulo). The results showed that the participants recognized: (1) the sphere of social determinants at the base of adolescents' health problems and (2) in addition to disease processes, a set of social problems impacting the health-disease process, highlighting drug use and violence. Health needs are translated as demands for cross-sector public social policies.     

The establishment of bonds between professional and patient in TB treatment: the performance of primary health care services in a city in the interior of São Paulo

This study evaluated the performance of health care services implementing TB control actions in relation to the establishment of bonds between health professionals and patients in S?o José do Rio Preto, SP, Brazil from the perspective of patients, health professionals, and managers. A total of 108 patients, 37 health professionals and 15 managers were interviewed through a questionnaire containing 10 indicators of bond-establishment based on the instruments of the Primary Care Assessment Tool, adapted to evaluate tuberculosis control in Brazil. The three groups of actors considered the establishment of bonds satisfactory, though opinions of patients and managers differed in almost all indicators. This fact indicates that the view of managers is still predominantly focused on bureaucratic and administrative aspects, which shows the need for managers to integrate more management and care actions.     

Asthma mortality in the city of São Paulo,Brazil

OBJECTIVE: To quantify and compare asthma mortality rates as the main cause of death, taking into consideration the following variables: sex, age and seasonality. METHODS: Data was collected from all death certificates coded 493 of people aged 5 to 34 years in the periods of 1983-5 and 1993-5 in the city of S?o Paulo, SP, Brazil. Data analysis was performed by directly comparing death rates and identifying the odds ratio trend and directly comparing the numbers of asthma deaths. RESULTS: There was no increase in asthma mortality rates for the study periods. There was no difference between men and women. A greater number of deaths in the age group 20 to 34 years were observed. Seasonality was more evident in the first period studied. CONCLUSIONS: Differing from reports in other countries, the results did not show any increase in asthma mortality rates, The variable sex didn't seem to interfere with mortality. Deaths are more frequent among young adults, and their risk may be 9 times greater than that of young children. Deterioration of social and economic issues and health care services and even climatic changes may have been implicated in the absence of seasonality as a risk factor for asthma mortality. The disease by itself is not considered by many health professionals as critical in order to explain the chain of events that lead to death.     

Mental health and violence among sixth grade students from a city in the state of São Paulo

OBJECTIVE: To analyze risk and protective factors for mental health problems among adolescents. METHODS: Cross-sectional study with a random sample (N=327; attrition rate=6.9%) of sixth grade students from all public and private schools in the city of Barretos, Southeastern Brazil, conducted in 2004. The factors studied were: exposure to intrafamilial and urban violence, family socioeconomic level, sex, motherless household, participation in social activities (protective factor). All the independent risk and protective factors were included in the initial logistic regression model. Only the variable with a significance level of p<0.05 remained in the model. RESULTS: It was observed that exposure to violence was the only factor associated with mental health problems in the final logistic regression model (p=0.02, 95% CI: 1.12;4.22). In addition, adolescents exposed to intrafamilial violence were three times more likely to have problems than those exposed to urban violence (p=0.04; 95% CI: 1.03;7.55). CONCLUSIONS: Intrafamilial violence was associated with mental heath problems among adolescents studied and it could be more important than urban violence in medium-sized cities.     

Hypertension control and related factors at primary care located in the west side of the city of São Paulo, Brazil

The objective of this study was to characterize blood pressure control of 440 hypertensive patients. The subjects were interviewed and had their blood pressure measurement by means of an automatic device. The results showed that 45.5% had an adequate blood pressure control. People under control were different (p<0.05) from those without control: the ones under blood pressure control were mainly women, younger, with a shorter time of disease, with previous treatment for hypertension, less interruptions in treatment and more conscious about the importance of physical activities. They also rarely forgot to take the medicines in the right time, generally using less than, 3 or more antihypertensive drugs, with family history of cardiovascular diseases, reporting physical activity more frequently and less sadness. The multivariate analysis revealed a statistically significant association of uncontrolled hypertension with previous treatment (OR = 2.26; IC 95%, 1.4-3.6), no family history of cardiovascular diseases (OR = 2.2; IC 95%, 1.3 3.5) and unaware of the importance of physical activities for blood pressure control (OR = 3.5; IC 95%, 1.1 10.8). Blood pressure control was associated with biological variables, behavior and information about hypertension as a risk factor and its treatment.     

Prevalence of trachoma in preschool and schoolchildren in the city of São Paulo

OBJECTIVE: To assess the prevalence of trachoma among preschool and school children of public schools to give new focus to control programs. METHODS: An epidemiological survey was carried out in S?o Paulo City in 1999. Children between four and 14 years old were selected by a cluster sampling where school shift was the sampling unit. External eye examination was conducted to detect trachoma. RESULTS: A total of 27,091 children were examined and 597 cases of trachoma were found (2.2%; 95% CI: 1.86-2.55). The prevalence ranged from 0.4% to 4.2% in 10 city areas. The trachoma detection rate in the household contacts examined was 8.7%. Follicular trachoma was found in 99% of the cases and intense trachoma in 1.0%. It was observed that 21.8% of the cases were asymptomatic. CONCLUSIONS: Though the trachoma prevalence was low, the occurrence of severe cases points out to the likelihood of cicatricial trachoma cases in the future if they are not adequately treated and controlled. The great difference in the prevalences in different city areas indicates the need for strengthening epidemiological surveillance activities.     

Anthropometry of elderly residents in the city of São Paulo, Brazil

The article presents gender and age-specific selected anthropometric data for a representative sample of elderly Brazilians in the city of S?o Paulo. This was a cross-sectional, population-based household survey. A total of 1,894 older adults (men and women, > 60 years) were examined from January to March 2001. Data were presented as means and percentiles for body mass (BM); height or stature (ST); body mass index (BMI); waist (WC), hip (HC), arm (AC), and calf (CC) circumferences; triceps skinfold thickness (TST); and arm muscle circumference (AMC), and differences were described according to age (all variables) and gender (BMI). Except for HC (men), all anthropometric variables were lower in the oldest than in the youngest individuals (p < 0.01) in both genders. BMI was significantly higher (p < 0.01) in women than men (all age groups). The observations suggest that there is loss of muscle mass and redistribution and reduction of fat mass with age (both genders). The data can be used in clinical practice and epidemiological studies based on interpretation of anthropometric measurements in the elderly in S?o Paulo.     

Utilization of community mental health services in the city of Santos, São Paulo, Brazil

To report on the clientele treated at community mental health services (CAPS) in the city of Santos, S?o Paulo, Brazil, a census was conducted of the patients examined at the services from June 1, 2001, to June 30, 2001. The patient's initial contact with the service was registered, and data were recorded on a standardized form, using the medical case history as a source of information. Among the 1,673 patients, average age was 46 years, 59.0% were female, 58.0% lived with their families, and mean duration of treatment was three years. Some 38.0% were schizophrenic, schizotypical, or in acute delusional states, 31.0% presented mood disorders, and 17.0% were neurotic. Treatment modalities included out-patient psychiatric (81.0%), individual (23.0%), group (13.0%), and psychosocial rehabilitation (4.3%). In Santos, CAPS treat all categories of mental disorders (and frequently those considered the most severe cases) expected at this type of service. The treatment model is that of an out-patient psychiatric clinic.     

Occupational asthma in the city of São Paulo, 1995-2000, with special reference to gender analysis

BACKGROUND: Occupational asthma (OA) is the leading occupational respiratory disease in the area of S?o Paulo Municipality. Understanding its characteristics can provide useful information for better interventions. METHODS: From a joint registry of OA from five outpatient public clinics for occupational respiratory diseases, data on occupation, with job titles corrected by an expert evaluation, agents, exposure and symptom duration, and spirometry were analyzed by gender. Data on employment for S?o Paulo Municipality were used to calculate expected ratios for men/women in broad economical sectors. RESULTS: Three hundred and ninety four OA cases were reported with a ratio of men/women of 1.5. Women had significantly shorter exposure duration (5.6 +/- 5.2 vs. 8.9 +/- 9.0 years, P = 0.0005), shorter symptoms duration (2.6 +/- 3.7 vs. 3.2 +/- 3.5 years, P = 0.1270), and higher prevalence of previous atopy (27.0 vs. 18.4%, P = 0.0485). The main occupations related to OA cases were cleaning activities, working in plastics manufacture and in chemical and pharmaceutical plants. Women reported significantly more exposures to cleaning products, biologic agents, and textile fibers, whereas men reported more exposures to isocyanates, metal dusts and fumes, oil mists, wood dusts and anhydrides. Women presented an increased risk of OA in the service sector (odds ratio (OR) = 1.77, confidence interval (CI) = 1.61-1.96). CONCLUSIONS: Cleaning services was the main reported occupation and cleaning products the main reported agents. Women had significantly shorter exposure duration possibly due to difference in exposures, previous atopy, and behavior. There was an excess of cases of women in the service sector.     

Home care: the experience of a private hospital in the state of São Paulo

Home care is defined as a group of hospital procedures that can be developed at home, encompassing health actions developed by a multiprofessional team. This study aims at disseminating the experience of a home care service offered by S?o Francisco Hospital, located in the city of Ribeir?o Preto, presenting the results of a 12-month period (from September 2001 to August 2002). During the analyzed period, the service provided care mainly to women (57%), with age between 70 and 80 years (30%), with diagnosis of neurological diseases (27%) and tumors (17%). The sector is coordinated by nurses, who are also responsible for bringing in clients. The work is performed by an interprofessional team that performs procedures of collecting material for lab examinations, dressing, deliver care with catheters and ostomies, as well as home hospitalization.     

Aedes albopictus seasonality in a protected area in the city of São Paulo, Brazil

The study had the objective of assessing the seasonality of Aedes albopictus and the impact of environmental factors on breeding sites in a protected urban area. Immature individuals were collected through fluid aspiration from nine tree holes, in the Ecological Park of Tietê in the city of S?o Paulo, Southern Brazil, from 2001 to 2002. The index of positivity and number of individuals results were as follows: positivity x precipitation (rho=0.69, p<0.001), positivity x temperature (rho=0.35, p<0.001), number of individuals x precipitation (rho=0.29, p<0.001) and number of individuals x temperature (rho=0.13, p<0.05). These correlations suggest rainfalls had greater impact than temperature.