Considering the inequalities and the areas of low socioeconomic status in Brazil, access to health services is a challenge and the delay between diagnosis and treatment represents an important factor of worse prognosis in patients with breast cancer. Herein, we describe the clinical and epidemiological profiles of women with breast cancer and evaluate their access to health services, as well as treatment delays, at a reference centre of the Cariri region, Ceará, Brazil. This is a retrospective study that included 473 women treated with breast cancer between 2009 and 2011 at the Oncology Centre of the Cariri. The majority of these patients were aged between 40 and 69 years old (65.7%), without a completed high school degree (89.2%). They were married (62.9%) and were already diagnosed but had not yet been subjected to any previous treatment (77.8%). It was observed that 91.8% were referred from the public health service, and treatment was paid for by the public health service in 92.9% of the cases. The patients whose source of referral was the public system waited longer between diagnosis and the treatment initiation (p = 0.031; Mann–Whitney’s test), with a median waiting time of 71.5 days versus 39 days for those receiving referrals from private services. In addition, those with public referrals prior to diagnosis also experienced a longer waiting time between the first medical visit and treatment initiation (77 days vs. 37 days; p = 0.036; Mann–Whitney’s test), with the waiting time for the biopsy being an important factor in this delay. Late diagnosis was often the result of inefficiency of the prevention policies coupled with difficulty accessing the public health network. It was commonly observed that, even after diagnosis, the patients needed to wait too long before entering the Oncology Service because of long waiting queues in the public health system.

Emergency situations occur anywhere and at any time, however, schools generate a significant concern because accidents happen routinely and teachers are the first ones to perform the assistance measures. Given this reality, a training course or even the inclusion of first aid knowledge in the curriculum of schools is made necessary. Based on what is exposed, this study aimed to understand the role of teachers facing urgency and emergency situations in the school context. Descriptive study with a qualitative approach developed in the city of Juazeiro do Norte, Ceara, Brazil, having as scenario a kindergarten, elementary and high school from a private network and eighteen active teachers from this institution as informants. The empirical material was collected from semi-structured interviews and analyzed following the steps of technical analysis of content proposed by Minayo (2010). It was evident that teachers have a perception that is very close to the first aid concepts; however, it is still very restricted to the concept of disease prevention and not the health promotion in the school context. The same study also revealed the importance of maintaining a calm behavior in front of an urgency and emergency situation; however, many teachers do not feel fully prepared to act when facing an accident. Teachers also highlighted the facilities and difficulties in carrying out these actions, emphasizing the access to materials that are required to realize the first aid, however, having these material is not enough, since the lack of knowledge still prevails as the greatest difficulty, revealing that having the materials is not sufficient and teachers need to know how to use them. It was clear that teachers act in urgency and emergency situations to ensure the student’s lives; however, it is necessary to have the qualification for this role. The need to explore strategies in schools aimed to promote specific knowledge regarding first aid actions for the teachers is revealed. Thus, teachers will become more confident in the provision of care avoiding future consequences.

Community health agent and the interface with the educational actions

Introduction: Economic growth and the increase of credit power in Brazil, especially in the Northeast region, allow the population to increase the acquisition of vehicles, mostly motorcycles. On the other hand, while facilitated this sale, little is invested in traffic enforcement measures, in an alarming increase of traffic accidents associated with causes that could be avoided, resulting in several members and head traumas or can lead to death. Objective: To describe the profile of motorcycle accident victims admitted in emergency service. Methods: This is a descriptive, retrospective, documentary and quantitative study carried out with 270 victims of brain trauma involved in motorcycle accidents admitted in a referral hospital in Ceará, Brazil. Data collection happened between 2013 and 2014, analyzing medical records of patients and answering a basic form for data optimization. Results: Motorcycle accidents that occurred in the period 2013-2014 registered in the referral hospital of the city of Cariri, Ceará, Brazil, affecting mostly males (88.1%) and a high number of young people and adults (55%). There has been a reduction of accidents from 2013 (65%) and 2014 (34.1%). There was a predominance of accidents over the weekend (41%), having as a contributing factor alcoholism (61%) and the non-use of a helmet (86%), providing the skull trauma injury as the most present (40.7%). Conclusion: The characterization of patients shows that the brain and facial traumas are related directly to the use of the helmet, not associated with other causes such as age group, alcohol use and lack of supervision in the municipalities, also is important to stand out the need to to strengthening and creating public policies in order to prevent damages.

O presente trabalho trata-se de um estudo descritivo de abordagem qualitativa, que objetivou compreender o processo de trabalho de enfermeiros e médicos da Estratégia Saúde da Família (ESF), do município de João Pessoa-PB, e identificar as estratégias e táticas alternativas desenvolvidas. O material foi analisado por meio da técnica de análise de discurso. Evidenciou-se a desarticulação entre os elementos do processo de trabalho aliada à possibilidade de transformação pela superação da invisibilidade dos sujeitos e seus saberes nos serviços de saúde. Conclui-se que as estratégias e táticas alternativas visualizadas constituem embrião para transformação dos processos de trabalho e superação dos modelos de atenção à saúde hegemônicos, demandando problematização contínua de concepções e práticas.

Descrever conhecimento e aceitabilidade dos profissionais de saúde na Amazônia Ocidental da vacina para Papillomavírus Humano (HPV). Estudo descritivo realizado no Sistema Assistencial à Saúde da Mulher e da Criança, no Acre entre janeiro e março/2017. Participaram do estudo 196 profissionais de saúde, com aplicação de instrumento de coleta contendo 31 questões divididas em seis domínios. Estatística descritiva foi realizada pelo programa Stata^® 11.0. Os profissionais de saúde entrevistados eram 73% do sexo feminino e 41,3% da área médica. Demonstraram 98% (IC95% 94,5; 99,3) de conhecimento sobre o HPV ser causa câncer de colo do útero. Houve lacuna de conhecimento sobre a vacina para o HPV em relação ao esquema vacinal com 61,2% (IC95% 54,0; 68,0) de acerto e sobre a relação entre tabagismo e risco de câncer do colo do útero com 71,9% (IC95% 65,0; 78,0) acertos. Não foram identificadas barreiras à vacinação, onde 95,4% (IC 95% 91,2; 97,7) referem que a vacina não estimula o início precoce da vida sexual. Nas questões: “pacientes que vivem com HIV podem tomar a vacina?” e “pacientes gestantes podem tomar a vacina?”, evidenciaram-se lacunas de conhecimento com 48,5% (IC95% 41,3; 55,7) e 39,8% (IC95% 33,0; 47,0) de acertos, respectivamente. A aceitabilidade e o conhecimento sobre o HPV e sua vacina foram adequados entre profissionais de saúde com lacunas de conhecimentos específicos em relação ao esquema vacinal, uso em indivíduos que vivem com HIV e de cofatores não virais (tabagismo) relacionados à etiologia do câncer do colo uterino.