Is there association between human development index and tuberculosis mortality risk? Evidence from a spatial analysis study in the south of Brazil.

The goal of this study was to analyse the spatial pattern of tuberculosis (TB) mortality using different approaches, namely: mortality rates (MR), spatial relative risks (RR) and Bayesian rates (Global and Local) and their association with human development index (HDI), Global and its three dimensions: education, longevity and income. An ecological study was developed in Curitiba, Brazil based on data from Mortality Information System (2008-2014). Spatial scan statistics were used to compute RR and identify high-risk clusters. Bivariate Local Indicator of Spatial Associations was used to assess associations. MR ranged between 0 and 25.24/100.000 with a mean (standard deviation) of 1.07 (2.66). Corresponding values for spatial RR were 0-27.46, 1.2 (2.99) and for Bayesian rates (Global and Local) were 0.49-1.66, 0.90 (0.19) and 0-6.59, 0.98 (0.80). High-risk clusters were identified for all variables, except for HDI-income and Global Bayesian rate. Significant negative spatial relations were found between MR and income; between RR and HDI global, longevity and income; and Bayesian rates with all variables. Some areas presented different patterns: low social development/low risk and high risk/high development. These results demonstrate that social development variables should be considered, in mortality due TB.

Basic life support knowledge of first-year university students from Brazil

We aimed to evaluate knowledge of first aid among new undergraduates and whether it is affected by their chosen course. A questionnaire was developed to assess knowledge of how to activate the Mobile Emergency Attendance Service - MEAS (Serviço de Atendimento Móvel de Urgência; SAMU), recognize a pre-hospital emergency situation and the first aid required for cardiac arrest. The students were also asked about enrolling in a first aid course. Responses were received from 1038 of 1365 (76.04%) new undergraduates. The questionnaires were completed in a 2-week period 1 month after the beginning of classes. Of the 1038 respondents (59.5% studying biological sciences, 11.6% physical sciences, and 28.6% humanities), 58.5% knew how to activate the MEAS/SAMU (54.3% non-biological vs 61.4% biological, P=0.02), with an odds ratio (OR)=1.39 (95%CI=1.07-1.81) regardless of age, sex, origin, having a previous degree or having a relative with cardiac disease. The majority could distinguish emergency from non-emergency situations. When faced with a possible cardiac arrest, 17.7% of the students would perform chest compressions (15.5% non-biological vs 19.1% biological first-year university students, P=0.16) and 65.2% would enroll in a first aid course (51.1% non-biological vs 74.7% biological, P<0.01), with an OR=2.61 (95%CI=1.98-3.44) adjusted for the same confounders. Even though a high percentage of the students recognized emergency situations, a significant proportion did not know the MEAS/SAMU number and only a minority had sufficient basic life support skills to help with cardiac arrest. A significant proportion would not enroll in a first aid course. Biological first-year university students were more prone to enroll in a basic life support course.

Basic life support knowledge of first-year university students from Brazil.

We aimed to evaluate knowledge of first aid among new undergraduates and whether it is affected by their chosen course. A questionnaire was developed to assess knowledge of how to activate the Mobile Emergency Attendance Service - MEAS (Serviço de Atendimento Móvel de Urgência; SAMU), recognize a pre-hospital emergency situation and the first aid required for cardiac arrest. The students were also asked about enrolling in a first aid course. Responses were received from 1038 of 1365 (76.04%) new undergraduates. The questionnaires were completed in a 2-week period 1 month after the beginning of classes. Of the 1038 respondents (59.5% studying biological sciences, 11.6% physical sciences, and 28.6% humanities), 58.5% knew how to activate the MEAS/SAMU (54.3% non-biological vs 61.4% biological, P=0.02), with an odds ratio (OR)=1.39 (95%CI=1.07-1.81) regardless of age, sex, origin, having a previous degree or having a relative with cardiac disease. The majority could distinguish emergency from non-emergency situations. When faced with a possible cardiac arrest, 17.7% of the students would perform chest compressions (15.5% non-biological vs 19.1% biological first-year university students, P=0.16) and 65.2% would enroll in a first aid course (51.1% non-biological vs 74.7% biological, P<0.01), with an OR=2.61 (95%CI=1.98-3.44) adjusted for the same confounders. Even though a high percentage of the students recognized emergency situations, a significant proportion did not know the MEAS/SAMU number and only a minority had sufficient basic life support skills to help with cardiac arrest. A significant proportion would not enroll in a first aid course. Biological first-year university students were more prone to enroll in a basic life support course.

Intersetorialidade: uma vivência prática ou um desafio a ser conquistado? O Discurso do Sujeito Coletivo dos enfermeiros nos núcleos de Saúde da Família do Distrito Oeste - Ribeirão Preto / Intersectoral approach: a practical experience or a challenge to be met? The Collective Subject Discourse of nurses in the Family Health Centers of the Western District - Ribeirao Preto, Brazil

O objetivo do trabalho foi apreender como os enfermeiros dos Núcleos de Saúde da Família do Distrito Oeste - Ribeirão Preto compreendem a intersetorialidade e buscam articulação com os equipamentos sociais na assistência à saúde da população de suas áreas adstritas. No percurso metodológico utilizou-se o Discurso do Sujeito Coletivo como técnica de ordenação dos dados. Os resultados mostram que a intersetorialidade é um desafio a ser conquistado, pois os profissionais e setores ainda trabalham de forma fragmentada. Percebe-se, nos depoimentos, uma confusão conceitual sobre intersetorialidade pois tomam-na como responsabilidade individual a partir das demandas individualizadas dos usuários. Desta forma, identificam a intersetorialidade como um processo de trabalho penoso e solitário. Entendem, ainda, a necessidade da criação de uma rede de apoio para a efetivação desse princípio e acreditam que é preciso começar a entender e escutar a opinião de outros profissionais e setores.

[International health: various current concepts]. / Saúde internacional: alguns aspectos conceituais contemporâneos.

This study is a theoretical approach on international health with the purpose to point out some aspects which can enhance the understanding of the International Health field and its operational and conceptual elements in the socio-economic process of integration of neighboring countries.

[Program of community integration: search for new strategies and new life styles]. / Programa de integração comunitária: em busca de novas estratégias e novos sentidos à vida.

The Program of Community Integration of the Municipal Bureau of Health of the city of Ribeirão Preto aims at promoting health, directing its actions for the change of life styles. The purpose of this study is to look, in the light of the framework of Health Promotion and through declarations of users of the program, how it has been formed as an important strategy to increase the autonomy and emancipation of the population. The analysis reveals that the program has improved the autonomy and emancipation of the population, as an important instrument for life defence.

Nursing and the health system in Brazil.

The purpose of this article is to describe nursing in the Brazilian health system and to analyze the characteristics of nursing personnel in Brazil. This description includes types of health institutions, services rendered, and the distribution of nursing personnel by professional categories in 1956, 1982, and 1995. Discussion of the challenges facing Brazilian nurses is presented using data from the Brazilian Institute of Geography and Statistics (IBGE), Federal Nursing Board (COFEn), Regional Nursing Board (COREn), and the Brazilian Nursing Association (ABEn). An increase in the number of outpatient units and in diagnostic and therapeutic examinations has led to an increased the demand for nurses. Public health nurses participate in planning, management, sanitary education, health promotion, and supervision of nursing care provided by nursing technicians, assistants, and other helpers.

[Public health literature: teaching of a new look in the health-illness process]. / A literatura em saúde pública: o ensino de um "novo olhar" sobre o processo saúde-doença.

This paper presents the use of Brazilian literature in public health nursing courses at the University of São Paulo at Ribeirão Preto College of Nursing. The goal is a preliminary report about experiences that intend to keep the students in touch in order to wide their view of reality, in which relationships between the men and health-illness process are established in the complexity and singularity of human being (ill and life) in each place and time. In the first stage, this experience is based on New History conceptual framework (Ecolle des Annale), in the complexity's paradigm (MORIN) and circularity concept and sign's paradigm (GINZBURG).