Alba Idaly Muñoz Sánchez

Pode o conceito de vulnerabilidade apoiar a construção do conhecimento em Saúde Coletiva

The term vulnerability has been frequently used in scientific literature, especially after the 80s, in some epidemiologic studies, mainly focusing the risk perspective. The purpose of this article is to review the vulnerability concept through a systematic study of national and international circulation newspapers, to support knowledge and practices in the collective health care field. Furthermore, it indicates how this concept has been revisited in studies conducted in Brazil, mentioning issues which support the structural dimension of reality, linking them to the needs of a program for patients, health care users and their families. It is important to study the vulnerability concept due to the fact that an understanding of this concept will contribute to support the delivery of care, of collective health care including individual health care programs and health care policies.

Operacionalização do conceito de vulnerabilidade à tuberculose em alunos universitários

O objetivo do presente estudo foi identificar aspectos que caracterizam a vulnerabilidade a tuberculose em moradores do Conjunto Residencial da Universidade de Sao Paulo (CRUSP). A populacao do estudo foi conformada por uma amostra estatisticamente significativa dos alunos universitarios. Os dados relativos a vulnerabilidade individual foram coletados junto aos alunos no periodo de outubro a novembro de 2002. O referencial teorico para analisar a questao da tuberculose esta pautado no quadro teorico de vulnerabilidade. A amostra totalizou 106 alunos, sendo 69,8% de graduacao e 30,2% de pos-graduacao. A proporcao de migrantes (internos e externos) alcancou 43,4%. Sobre o conhecimento da tuberculose, 84 estudantes (79,2%) responderam que sabiam o que era tuberculose e 79 (74,5%) responderam que a doenca tinha cura. Cerca de 60 (56,6%) sabiam qual e o agente causal da doenca e 72 (67,9%) referiram ja ter ouvido falar sobre a doenca, sendo que para 5 (6,9%) isso havia ocorrido em instituicoes de saude. Indagou-se se sabiam onde recorrer para fazer exames para verificar a presenca da enfermidade; 48 (45,3%) responderam desconhecimento. Identifica-se a vulnerabilidade desses alunos, principalmente tendo em vista que constituem um grupo aparentemente diferenciado, pois em tese teriam condicoes mais favoraveis para acessar a informacao a respeito da doenca.

Beyond DOTS (Directly Observed Treatment Short-Course) in tuberculosis' control: interfacing and sharing needs

This study analyzes meanings that health workers attribute to DOTS and points out alternatives that contribute to its performance. After the Research Ethics Committee approved the project, a semi-structured interview was applied to 15 health workers from the central region of the city of Sao Paulo, SP, Brazil between August and December 2004. This study used hermeneutic-dialectic reference and the theory of social determinants of the health-disease process. DOTS contributes to treatment adherence and promotes interfacing in encounters and conversations between workers and users at the institutional and territorial levels, which permits identifying health needs and implementing appropriate interventions. One of the main challenges to its implementation is to become a space that enables grasping, decoding and reconstructing meanings in relation to the healthdisease process including the treatment and life projects of patients with tuberculosis.This study analyzes meanings that health workers attribute to DOTS and points out alternatives that contribute to its performance. After the Research Ethics Committee approved the project, a semi-structured interview was applied to 15 health workers from the central region of the city of São Paulo, SP, Brazil between August and December 2004. This study used hermeneutic-dialectic reference and the theory of social determinants of the health-disease process. DOTS contributes to treatment adherence and promotes interfacing in encounters and conversations between workers and users at the institutional and territorial levels, which permits identifying health needs and implementing appropriate interventions. One of the main challenges to its implementation is to become a space that enables grasping, decoding and reconstructing meanings in relation to the health-disease process including the treatment and life projects of patients with tuberculosis.

Além da DOTS (Directly Observed Treatment Short-Course) no controle da tuberculose: interface e compartilhamento de necessidades

This study analyzes meanings that health workers attribute to DOTS and points out alternatives that contribute to its performance. After the Research Ethics Committee approved the project, a semi-structured interview was applied to 15 health workers from the central region of the city of Sao Paulo, SP, Brazil between August and December 2004. This study used hermeneutic-dialectic reference and the theory of social determinants of the health-disease process. DOTS contributes to treatment adherence and promotes interfacing in encounters and conversations between workers and users at the institutional and territorial levels, which permits identifying health needs and implementing appropriate interventions. One of the main challenges to its implementation is to become a space that enables grasping, decoding and reconstructing meanings in relation to the healthdisease process including the treatment and life projects of patients with tuberculosis.This study analyzes meanings that health workers attribute to DOTS and points out alternatives that contribute to its performance. After the Research Ethics Committee approved the project, a semi-structured interview was applied to 15 health workers from the central region of the city of São Paulo, SP, Brazil between August and December 2004. This study used hermeneutic-dialectic reference and the theory of social determinants of the health-disease process. DOTS contributes to treatment adherence and promotes interfacing in encounters and conversations between workers and users at the institutional and territorial levels, which permits identifying health needs and implementing appropriate interventions. One of the main challenges to its implementation is to become a space that enables grasping, decoding and reconstructing meanings in relation to the health-disease process including the treatment and life projects of patients with tuberculosis.

Conhecimento sobre a tuberculose por estudantes universitários

Resumo O objetivo do presente estudo foi identificar aspectos relacionados a vulnerabilidade a tuberculose em moradores do conjunto residencial da Universidade de Sao Paulo (CRUSP), especificamente no que se refere ao seu conhecimento em relacao a enfermidade. A partir da adocao de referencial teorico-metodologico sobre a vulnerabilidade, desenvolveu-se este estudo descritivo e quantitativo, sendo a populacao selecionada por amostra estatisticamente significativa dos alunos de graduacao e de pos-graduacao, perfazendo 106 estudantes (69,8% de graduacao e 30,2% de pos-graduacao). Os dados foram coletados atraves da aplicacao de um questionario, no periodo de outubro a novembro de 2002. Apresentam-se resultados em relacao ao perfil de caracteristicas pessoais dos alunos, identificando-se que 84 estudantes (79,2%) sabiam o que era tuberculose, fazendo mencao correta a enfermidade, 63% conheciam a sintomatologia, 84% responderam que a doenca pode ser transmitida pessoa a pessoa e 78,3% responderam que havia possibilidade de cura. Entretanto, 56,6% desconheciam o agente causal da doenca. Dos 72 (67,9%) que referiram ja ter ouvido falar sobre a doenca, para aproximadamente um quarto isto havia ocorrido em instituicao de ensino. Os estudantes foram, ainda, indagados sobre o conhecimento do local a que deve-se recorrer para realizacao de exames a fim de verificar a presenca da enfermidade; 45,3% nao souberam responder. Chama a atencao que 20,8% dos alunos referiram nao saber sobre a doenca, apontando, inclusive, a sua inexistencia no cenario epidemiologico. O estudo evidencia pontos de vulnerabilidade a respeito do conhecimento sobre a enfermidade, principalmente tendo em vista que constituem um grupo aparentemente diferenciado, pois em tese teriam condicoes mais favoraveis para acessar informacoes a respeito da doenca.

Health promotion in the workplace: between ideal and unreal

espanolLa Promocion de la Salud en los Lugares de Trabajo constituye una estrategia importante para abordar integralmente la salud y la seguridad en el trabajo, no obstante las actuales condiciones de precarizacion y flexibilizacion laboral interfieren con los principios promovidos por la estrategia. Objetivo: describir la aplicacion de principios como participacion, justicia social, integralidad, sostenibilidad y multisectorialidad en la implementacion de los programas de salud ocupacional en hospitales de tercer nivel de Bogota, durante el segundo semestre de 2009. Materiales y metodo: estudio de caso, descriptivo y transversal, basado en los principios que fundamentan la Promocion de la Salud, aplicando cuestionarios desarrollados para describir aspectos como politica organizacional, recursos de apoyo, planificacion, desarrollo y resultados alcanzados con la aplicacion de la estrategia. Resultados: las politicas definidas concuerdan con los propositos de la estrategia analizada, pero, no hay coherencia con su aplicacion en la practica, pues se observan limitaciones en asignacion de recursos, escasa participacion del personal, falta de reconocimiento por la labor desempenada, planificacion tradicional de actividades y la desarticulacion con otras instituciones del sector, entre otros. Conclusiones: limitaciones conceptuales y de recursos para implementar la estrategia, al igual que el trabajo desarticulado de sectores como educacion, empresas aseguradoras, etc.; conllevan al desaprovechamiento de mejores posibilidades para adecuar ambientes de trabajo. EnglishWorkplace Health Promotion is an important strategy to address holistically the health and safety at work, despite the conditions of precariousness and labor flexibility, hampering the principles advocated by the strategy. Objective: to describe the application of principles such as participation, social justice, integrity, sustainability and multi-sectoral in the implementation of occupational health programs in third-level hospitals of Bogota, during the second half of 2009. Materials and methods: a case study, descriptive and cross-sectional, based on the fundamental principles of Health Promotion, using questionnaires developed to describe aspects such as organizational policy, support resources, planning, implementation and results achieved with the implementation of the strategy. Results: The defined policies are consistent with the purposes of the strategies analyzed; however there is no consistency in their application in practice as seen in resource allocation constraints, lack of staff participation, lack of recognition for the work performed, traditional planning and dismantling activities with other sector institutions, among others. Conclusions: conceptual limitations and resources to implement the strategy, as disjointed work in sectors such as education, insurance companies, etc.; involves the wastage of better possibilities to adapt the work environment.

Más allá del DOTS (Directly Observed Treatment Short-Course) en el control de la tuberculosis: medio que promueve la comunicación y la identificación de las necesidades

This study analyzes meanings that health workers attribute to DOTS and points out alternatives that contribute to its performance. After the Research Ethics Committee approved the project, a semi-structured interview was applied to 15 health workers from the central region of the city of Sao Paulo, SP, Brazil between August and December 2004. This study used hermeneutic-dialectic reference and the theory of social determinants of the health-disease process. DOTS contributes to treatment adherence and promotes interfacing in encounters and conversations between workers and users at the institutional and territorial levels, which permits identifying health needs and implementing appropriate interventions. One of the main challenges to its implementation is to become a space that enables grasping, decoding and reconstructing meanings in relation to the healthdisease process including the treatment and life projects of patients with tuberculosis.This study analyzes meanings that health workers attribute to DOTS and points out alternatives that contribute to its performance. After the Research Ethics Committee approved the project, a semi-structured interview was applied to 15 health workers from the central region of the city of São Paulo, SP, Brazil between August and December 2004. This study used hermeneutic-dialectic reference and the theory of social determinants of the health-disease process. DOTS contributes to treatment adherence and promotes interfacing in encounters and conversations between workers and users at the institutional and territorial levels, which permits identifying health needs and implementing appropriate interventions. One of the main challenges to its implementation is to become a space that enables grasping, decoding and reconstructing meanings in relation to the health-disease process including the treatment and life projects of patients with tuberculosis.

Classroom acoustics conditions at public University in Bogotá

espanolIntroduccion: En el sector de la docencia una situacion frecuente son las precarias condiciones acusticas de las aulas. Objetivo: Caracterizar las condiciones acusticas de algunas aulas de una universidad publica en Bogota. Material y Metodos: Durante el I semestre del 2009 se realizo un estudio descriptivo transversal, se evaluaron 25 salones de una universidad publica de Bogota, los cuales fueron seleccionados de forma aleatoria segun los reportes de docentes previamente entrevistados. Resultados: De los 25 salones medidos en la facultad 1 el 63,63% de los salones medidos presento muy mala acustica segun el indice de Acustica Total, mientras que en la Facultad 2 el 40% de los salones tuvo mala acustica, y en la Facultad 3 el 33,3% presento acustica mala. Conclusiones: La ausencia de estudios en los que se reporten mediciones objetivas de tiempo de reverberacion (TR) e inteligibilidad evidencia la necesidad de realizar disertaciones de este tipo buscando generar herramientas que permitan mejorar las condiciones de salud, trabajo y vida de este grupo ocupacional. EnglishIntroduction: Teachers complain about bad acoustic conditions in their classroom frequently. Aim: to describe some classroom acoustic conditions at Colombian Estate University in Bogota city. Material and Methods: a transversal descriptive study was development in the first semester of 2009, 25 classrooms was measured at Colombian University in Bogota City, this classroom was selected randomized way according preview teachers evaluated reporting. Results: about 25 measured classroom at Faculty 1 63.63% of classroom had acoustic bad according Total Acoustic Index, while at Faculty 2 40% of classroom has bad acoustic, and Faculty 3 33.3% had bad acoustic. Conclusions: studies to report reverberation time (TR) and intelligibility objectives measurements are a few, this exposed it is necessary to do dissertations to investigate and to contribute tools according to determinate better health, job and life conditions in this occupational group

Promoción de la salud en los lugares de trabajo: un camino por recorrer

It is necessary to transcend barriers with respect to the conceptual development and implementation of Workplace Health Promotion (WHP), given that workplaces are priority settings for health promotion. This study consists of a qualitative analysis that adopts a hermeneutic approach using a state-of-the-art technique. A total of 131 documents consisting of guidelines produced by national and international organizations and articles contained in the Embase, ScienceDirect, and Scielo databases were analyzed. Three main categories emerged from this analysis: conceptual development, study methodologies, and measurement of the results and impacts of WHP. Research output was concentrated mainly in North America, Europe, and Brazil. The studies document the positive impacts of WHP interventions on health, productivity and costs. The reach of WHP interventions is restricted to the formal sector. The working environments of informal workers are minimally addressed. WHP interventions should be geared towards improving work organization, working conditions, active participation and worker personal development; however, research has tended to focus on specific actions that address risk reduction, disease prevention, and workers’ habits.

Estudio bibliométrico sobre tuberculosis en trabajadores de la salud

espanolLa tuberculosis se considera una problematica en la salud publica y representa una prioridad en los trabajadores del sector salud. Objetivo: Realizar descripcion sobre la produccion cientifica del tema de exposicion de los Trabajadores de la Salud al agente Mycobacterium Tuberculosis. Materiales y Metodos: Se efectuo estudio Bibliometrico sistematico y organizado sobre el tema, cuantificando la produccion en cuatro bases de datos cientificas desde el ano 2000 al 2011. Resultados: Se realizo la revision de 132 publicaciones principalmente generadas en paises como Estados Unidos 24%, Brasil 13%, Inglaterra 9%, Francia 5% entre otros. En el caso de America Latina, los estudios en el tema son limitados. Se encontro que mas del 50% de publicaciones trataban temas de incidencia y prevalencia de casos de Tuberculosis en los trabajadores de la salud, un 25,7% hablan sobre la deteccion de infeccion latente mediante prueba de Tuberculina, Interferon Gama y Genotipificacion. Un 6,8% abordaban estudios sobre metodos de control de la infeccion en hospitales. Los estudios correspondieron en mas de un 50% a metodologias de tipo cuantitativas. Conclusion: Las investigaciones en paises en vias de desarrollo, y en particular en Colombia, son limitadas y se requiere mayor investigacion hacia la formulacion de politicas publicas, la vigilancia ocupacional y en la salud y seguridad en los trabajadores que cuidan la salud. EnglishTuberculosis is considered a public health issue and a priority in health care workers. Objective: the scientific description of the issue of exposure of Health Workers agent Mycobacterium tuberculosis. Materials and Methods: We performed a systematic and organized Bibliometric study on the subject, quantifying the production of four scientific databases from 2000 to 2011. Results: We performed a review of 132 publications primarily generated in countries like the U.S. 24%, Brazil 13%, England 9%, France 5% among others. In the case of Latin America, studies on the subject are limited. We found that over 50% of publications addressed issues of incidence and prevalence of TB cases in health workers, 25.7% speak on the detection of latent infection by tuberculin test, Interferon Gamma and Genotyping. 6.8% studies on methods of addressing infection control in hospitals. The studies were for more than 50% of such quantitative methodologies. Conclusion: Research in developing countries and particularly in Colombia, are limited and more research is needed into the formulation of public policy, occupational surveillance and the health and safety in health care workers.