Experiências de abortos provocados em clínicas privadas no Nordeste brasileiro / Personal experiences with induced abortions in private clinics in Northeast Brazil / Experiencias de abortos practicados en clínicas privadas del nordeste brasileño

Resumo Baseado numa investigação qualitativa desenvolvida em 2012, o artigo analisa experiências de abortos provocados de pessoas de estratos sociais médios realizados em clínicas privadas. Foram narradas 34 histórias de gravidezes interrompidas em clínicas por 19 mulheres e cinco homens, residentes em duas capitais do Nordeste brasileiro. Uma análise temática revela que existem diferentes tipos de clínicas e de atendimento prestados pelos médicos. O artigo mostra que a realização de um aborto em uma clínica privada não é garantia de um atendimento humanizado e seguro. As narrativas fornecem descrições de diversas situações e práticas, desde aquelas com algumas falhas, como a falta de informações sobre os medicamentos, até outras com abusos graves, como procedimentos realizados sem anestesia. Assim, conclui-se que a ilegalidade da prática do aborto, no Brasil, permite que as clínicas funcionem sem qualquer tipo de regulação do Estado, não impedindo que as mulheres realizem abortos, mas as expondo a situações de total vulnerabilidade e de violação dos direitos humanos.

Abstract Based on a qualitative study conducted in 2012, the article analyzes middle-class individuals' experiences with induced abortions performed in private clinics. Thirty-four stories of induced abortions were narrated by 19 women and five men living in two state capitals in Northeast Brazil. Thematic analysis revealed differences in types of clinics and care provided by the physicians. The article shows that abortion in private clinics fails to guarantee safe or humane care. The narratives furnish descriptions of diverse situations and practices, ranging from flaws such as lack of information on medicines to others involving severe abuses like procedures performed without anesthesia. The article concludes that criminalization of abortion in Brazil allows clinics to operate with no state regulation; it does not prevent women from having abortions, but exposes them to total vulnerability and violation of human rights.

Resumen En base a una investigación cualitativa, desarrollada en 2012, el artículo analiza experiencias abortivas practicadas en personas de estratos sociales medios, realizadas en clínicas privadas. 19 mujeres y cinco hombres residentes en dos capitales del nordeste brasileño narraron 34 historias de embarazo interrumpido en clínicas de estas zonas. El análisis temático revela que existen diferentes tipos de clínicas y de atención, donde ejercen su labor los médicos. El artículo muestra que la práctica de un aborto en una clínica no es garantía de una atención humanizada y segura. Las historias describen diversas situaciones y prácticas, desde aquellas con algunos fallos tales como la falta de información sobre los medicamentos, hasta otras con abusos graves como procedimientos abortivos realizados sin anestesia. Por ello, se concluye que la ilegalidad de la práctica del aborto en Brasil permite que las clínicas funcionen sin ningún tipo de regulación del Estado, lo que no impide que las mujeres realicen abortos, exponiéndolas a situaciones de total vulnerabilidad y violación de sus derechos humanos.

Evaluation of common operator errors in panoramic radiography in Trinidad and Tobago: a comparison of formally vs informally trained operators / La evaluación de los errores comunes de los operadores de radiografía panorámica en Trinidad y Tobago comparación de los operadores adiestrados formalmente frente a los adiestrados informalmente

AIM: To evaluate and compare the frequency of common operator errors seen on panoramic radiographs in dental private practices and in the dental hospital (taken by informally and formally trained operators, respectively) in Trinidad and Tobago. METHOD: One thousand panoramic radiographs of patients over the age of 10 years were included in this study. These comprised 500 from the dental hospital and 500 from dental private practices. The radiographs were reviewed using standardized criteria to identify the most common operator errors. RESULTS: There were only 21 (4.2%) error free radiographs in the dental private practice sample and 29 (5.8%) in the dental hospital sample. Frequencies of specific errors were significantly higher in the dental private practice sample in each category except for "Chin tipped too low" (Chi-square p < 0.05) CONCLUSION: This study supports the need for the introduction of statutory guidelines with respect to the use of ionizing radiation in dentistry in Trinidad and Tobago and in particular, the implementation of formally assessed dedicated dental radiography training for all operators of dental X-ray equipment.

OBJETIVO: Evaluar y comparar la frecuencia de los errores comunes de los operadores, observados en las radiografías panorámicas en las clínicas dentales privadas y en el hospital de odontología (tomadas por operadores adiestrados formalmente e informalmente, de forma respectiva) en Trinidad y Tobago. MÉTODO: Mil radiografías panorámicas de pacientes de más de 10 años de edad, fueron incluidas en este estudio. Las mismas comprendían 500 provenientes del hospital odontológico y 500 provenían de las prácticas privadas de dentistas. Las radiografías fueron examinadas a partir de criterios estandarizados, a fin de identificar los errores más comunes de los operadores. RESULTADOS: Hubo sólo 21 (4.2%) radiografías sin errores en la muestra de la clínica dental privada, y 29 (5.8%) en la muestra del hospital de odontología. Las frecuencias de errores específicos fueron significativamente más altas en la muestra de la clínica dental privada en cada categoría, salvo el caso del "mentón inclinado excesivamente hacia abajo" (Chi-cuadrado p < 0.05) CONCLUSIÓN: Este estudio subraya la necesidad de introducir pautas reglamentarias con respecto al uso de la radiación ionizante en la cirugía dental en Trinidad y Tobago, particularmente en lo que concierne al adiestramiento especializado en radiografía dental, formalmente evaluado, para todos los operadores de equipos de rayos x para el trabajo dental.

Standards of teeth preparations for anterior resin bonded all-ceramic crowns in private dental practice in Jordan

OBJECTIVES: To investigate if general dental practitioners (GDPs) in private practice in Jordan follow universal guidelines for preparation of anterior teeth for resin bonded all-ceramic crowns (RBCs). MATERIAL AND METHODS: A sample (n=100) of laboratory models containing 208 tooth preparations for IPS Empress and In Ceram, featuring work from different GDPs, was obtained from 8 commercial dental laboratories. Aspects of preparations were quantified and compared with accepted criteria defined following a review of the literature and recommendations of the manufactures' guidelines. RESULTS: Subgingival margins on the buccal aspect were noticed in 36 percent of the preparations, 54 percent demonstrated overpreparation with a tendency to overprepare the teeth on the mesiodistal plane more than buccolingual plane. Twenty percent of samples presented a shoulder finish line while a chamfer margin design was noticed in 39 percent. Twenty-nine percent and 12 percent of samples had either a feathered or no clear margin design respectively. Incisal underpreparation was observed in 18 percent of dies of each type. Only 17 percent of all preparations were found to follow the recommended anatomical labial preparations while 29 percent of the RBC preparations were found to have the recommended axial convergence angle. In total, 43 percent of preparations were found to have the recommended depth of the finish line. CONCLUSIONS: It was found that relevant guidelines for RBC preparations were not being fully adhered to in private practice in Jordan.

Evaluation of resources for contact lens practice in private contact lens clinics of Muscat, Oman

The integration of the contact lens [CL] practice with the VISION 2020 initiative is important. We assessed the facilities at the private CL clinics of Muscat. Accordingly, we suggested the appropriate eye care for CL wearers in Oman. This was a descriptive study. This study was conducted between May and July 2006. A team of optometrists and health inspectors visited clinics and collected information about the infrastructure, available human resources, and materials used in the CL practice. We used a pre-tested close-ended questionnaire to collect responses of the practitioners and observations of the field staff. Univariate parametric type of analysis. The team visited 67 CL clinics and interviewed 75 CL practitioners. Proper hand washing facility was available at 61 clinics. Thirty-nine practitioners had >10 years of experience in dispensing contact lenses. Only 13 clinics had a bio-microscope. None of the clinics had legal documents signed by both providers and end users of the contact lens. Contact lens has received less attention in areas outside the developed world. The CL practice in the private sectors of Oman needs to be strengthened. Minimum standards, standard operating procedures for CL practice, and its periodic supervision would be useful

Do private doctors follow national guidelines for managing pulmonary tuberculosis in Pakistan?

As private medical practitioners play a major role of in providing care to pulmonary tuberculosis [TB] patients, a survey was made of knowledge and practice in 2 cities in Pakistan. Only 1 of the 245 physicians was aware that cough > 3 weeks alone is the main symptom suggesting pulmonary TB. The majority diagnosed [80%] and treated [83%] cases themselves without referral. Less than 1% relied on sputum microscopy alone for diagnosis. None of the practitioners were following National TB Control guidelines for prescribing drugs and none ensured compliance with anti-TB treatment under supervision of a doctor/health worker. Only 3% kept records of pulmonary TB patients. None of the physicians assessed the effectiveness of treatment with sputum microscopy alone; the majority [76%] used only clinical assessment