Abstract The complex epidemiological profile of Brazil, the aging population and the proportion of individuals with disabilities have led to a substantial increase in the demand for rehabilitation. The spatiotemporal distribution of the offer of physiotherapy, speech therapy and occupational therapy in the Brazilian public healthcare system from 2007 to 2019 was analyzed for the five macro-regions of the country. Data from the National Register of Health Establishments and census estimates from the Brazilian Institute of Geography and Statistics were used. Indicators of the offer of professionals in these fields services and relative changes in the offer were calculated. The spatial distribution of the relative change in the offer was also determined. A regression model with inflection points was adopted for the analysis of the temporal trend. A growing temporal trend was found in the offer of the three professionals in Brazil as a whole and in all regions of the country, but with a slowdown in growth. Differences were observed in the offer among the regions of the country, revealing healthcare inequality that needs to be overcome. The present findings can assist in planning to expand access to rehabilitation services in the country.

Resumo O complexo perfil epidemiológico do país, o envelhecimento populacional e a proporção de pessoas com deficiência apontam para o aumento substancial da demanda por reabilitação. Nesse contexto, foi analisada a distribuição espaço-temporal da oferta de profissionais de fisioterapia, fonoaudiologia e terapia ocupacional no Sistema Único de Saúde (SUS) de 2007 a 2019 nas cinco regiões do Brasil. Foram utilizados dados do Cadastro Nacional de Estabelecimentos em Saúde, as estimativas censitárias do Instituto Brasileiro de Geografia e Estatística e calculados os indicadores da oferta potencial de profissionais e sua evolução relativa. Foi realizada a distribuição espacial da evolução relativa da oferta potencial de profissionais. Para a análise da tendência temporal, adotou-se o modelo de regressão por pontos de inflexão. Houve tendência temporal crescente na oferta potencial das três categorias profissionais no Brasil e em todas as regiões, mas com uma desaceleração do crescimento. Observaram-se diferenciais entre as profissões e as regiões do país, representando um quadro de desigualdade de oferta que precisa ser superado. Resultados que podem subsidiar o controle social e o planejamento nacional para a ampliação do acesso aos serviços de reabilitação

Abstract The complex epidemiological profile of Brazil, the aging population and the proportion of individuals with disabilities have led to a substantial increase in the demand for rehabilitation. The spatiotemporal distribution of the offer of physiotherapy, speech therapy and occupational therapy in the Brazilian public healthcare system from 2007 to 2019 was analyzed for the five macro-regions of the country. Data from the National Register of Health Establishments and census estimates from the Brazilian Institute of Geography and Statistics were used. Indicators of the offer of professionals in these fields services and relative changes in the offer were calculated. The spatial distribution of the relative change in the offer was also determined. A regression model with inflection points was adopted for the analysis of the temporal trend. A growing temporal trend was found in the offer of the three professionals in Brazil as a whole and in all regions of the country, but with a slowdown in growth. Differences were observed in the offer among the regions of the country, revealing healthcare inequality that needs to be overcome. The present findings can assist in planning to expand access to rehabilitation services in the country.

Resumo O complexo perfil epidemiológico do país, o envelhecimento populacional e a proporção de pessoas com deficiência apontam para o aumento substancial da demanda por reabilitação. Nesse contexto, foi analisada a distribuição espaço-temporal da oferta de profissionais de fisioterapia, fonoaudiologia e terapia ocupacional no Sistema Único de Saúde (SUS) de 2007 a 2019 nas cinco regiões do Brasil. Foram utilizados dados do Cadastro Nacional de Estabelecimentos em Saúde, as estimativas censitárias do Instituto Brasileiro de Geografia e Estatística e calculados os indicadores da oferta potencial de profissionais e sua evolução relativa. Foi realizada a distribuição espacial da evolução relativa da oferta potencial de profissionais. Para a análise da tendência temporal, adotou-se o modelo de regressão por pontos de inflexão. Houve tendência temporal crescente na oferta potencial das três categorias profissionais no Brasil e em todas as regiões, mas com uma desaceleração do crescimento. Observaram-se diferenciais entre as profissões e as regiões do país, representando um quadro de desigualdade de oferta que precisa ser superado. Resultados que podem subsidiar o controle social e o planejamento nacional para a ampliação do acesso aos serviços de reabilitação

RESUMO Objetivo: avaliar a implantação do programa de conservação auditiva em duas empresas de grande porte. Métodos: trata-se de uma pesquisa avaliativa de análise de implantação do tipo 1b. O estudo foi conduzido em três etapas, sendo: determinação do grau de implantação do Programa de Conservação Auditiva das empresas avaliadas; análise dos contextos políticos e estruturais das empresas avaliadas; e, por fim, uma análise da influência dos contextos políticos e estruturais no grau de implantação nas empresas avaliadas. Foram realizadas as seguintes análises para coleta dos dados: entrevistas, análise documental e observacional. Resultados: o Programa de Conservação Auditiva na 'empresa A' foi classificado como ‘implantado’ (91,1%) e na 'empresa B' como ‘parcialmente implantado’ (62,7%). O contexto de implantação da 'empresa A' se apresentou favorável à implantação do programa. Já na 'empresa B' o contexto foi considerado desfavorável, tendo categorias não favoráveis. Foi possível relacionar, também, que as características do contexto de implantação influenciaram positiva ou negativamente na implantação do programa. Conclusão: houve resultados satisfatórios quanto à implantação do Programa de Conservação Auditiva em ambas as empresas avaliadas.

ABSTRACT Purpose: to assess the implementation of hearing conservation programs in two large companies. Methods: an evaluative research that analyzed a type 1b implementation. The study was conducted in three stages, namely: establishing the company’s degree of implementation, analyzing the companies’ policies and structures, and lastly, analyzing the influence of the companies’ policies and structures on their degree of implementation. The following analyses were conducted to collect data: interviews, document analysis, and observation. Results: the hearing conservation program in Company A was classified as implemented (91.1%), while in Company B, it was partially implemented (62.7%). The context in Company A was favorable to implementing the program, whereas in Company B, the context was considered unfavorable, due to disadvantageous categories. Also, the characteristics of the implementation context influenced the placement of the program either positively or negatively. Conclusion: there were satisfactory results regarding the implementation of the hearing conservation program in both companies assessed.

Knowledge about hepatotropic viruses is crucial for pediatricians because of the high prevalence of viral hepatitis during childhood. The multiplicity of hepatotropic viruses, the spectrum of acute and chronic infections, and the sequels of viral hepatitis result in a need for physicians to better understand the clinical and epidemiological context of patients with viral hepatitis, as well as the importance of prevention measures for hepatitis. A descriptive cross-sectional study was made of pediatrician's knowledge about viral hepatitis, through questionnaires to 574 pediatricians, with no obligation of identification. The pediatricians were recruited among those who attended a national Congress of Pediatrics in Brasília, Brazil. Among these pediatricians, 50.1% frequently treated cases of hepatitis, and 74.7% indicated that they had knowledge of the existence of five hepatotropic viruses; 14.5% knew about at least four types of hepatitis complications, while only 7.7% and 4.3% were able to correctly diagnose viral hepatitis A and B, respectively. Many (28.4%) did not know how to treat the patients adequately. Only 37.5% had already recommended vaccination against hepatitis B. Only 50.2% of the pediatricians had been vaccinated against hepatitis B. We concluded that it is crucial to make pediatricians more knowledgeable about viral hepatitis, through continued education programs, especially emphasizing prevention procedures.