Dissertation/Thèse

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2024
Thèses
1
  • JEOVANI ALMEIDA DO NASCIMENTO
  • ASSOCIATION BETWEEN POLYPHARMACY USE AND THE OCCURRENCE OF FALLS IN NON-INSTITUTIONALISED ELDERLY PEOPLE

  • Leader : ANA ELZA OLIVEIRA DE MENDONCA
  • MEMBRES DE LA BANQUE :
  • ANA ELZA OLIVEIRA DE MENDONCA
  • FABIA BARBOSA DE ANDRADE
  • SANDERSON JOSÉ COSTA DE ASSIS
  • Data: 25 janv. 2024


  • Afficher le Résumé
  • Introduction: The elderly population faces a triple burden of disease, predominantly chronic non-communicable diseases that require continuous treatment. Polypharmacy, characterized by the simultaneous use of five or more drugs, is increasingly common in this age group. Objective: To estimate the occurrence of falls and their association with polypharmacy use in the elderly. Method: This is divided into two studies: 1) an integrative literature review and 2) a cross-sectional study with multiple analyses of the factors associated with the occurrence of falls in the elderly, carried out from September to November 2023, in a municipality in the northeast of Brazil. Results: Article 1 - Brazil contributed with three publications and China, Thailand, Spain, and Italy, each with one publication respectively, in which 468,880 people using polypharmacy participated. Polypharmacy was more frequent in elderly people being treated for chronic diseases, especially systemic arterial hypertension (SAH) and diabetes mellitus, which were described in 71.4% of the studies. The frequency of polymedication in elderly people being monitored in primary health care ranged from 18.8% to 100.0%. The most commonly used drugs were for the cardiovascular and metabolic systems. Article 2 - The study involved 100 elderly people aged between 60 and 93, 68% female. The prevalence of falls was 42% and the factors associated with falls were polypharmacy, poor handgrip strength, and age 75. 61% of participants had one or more chronic diseases. Conclusion: Elderly people in polypharmacy require greater attention and care to prevent adverse events such as falls. The research data revealed that the prevalence of falls in the elderly was positively associated with polypharmacy, poor handgrip strength, and being 75 years old.



2
  • VANESSA FREIRES MAIA
  • FROM GRADUATION TO RESIDENCY: PERSPECTIVE AND ANALYSIS OF TRAINING PROCESSES FROM THE POINT OF VIEW OF HEALTH RESIDENTS

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • JANETE LIMA DE CASTRO
  • LUIZ ROBERTO AUGUSTO NORO
  • TALITHA RODRIGUES RIBEIRO FERNANDES PESSOA
  • Data: 5 févr. 2024


  • Afficher le Résumé
  • The transformations in society and in the health-disease process in Brazil highlight the importance of having professionals and services that act upon health needs, in order to strengthen the precepts of the Unified Health System. From this perspective, emphasis is placed on work interprofessional, collaborative, through emancipatory educational practices, which promote the theory-practice connection, to be developed in the undergraduate and postgraduate fields. It aims to analyze how academic training takes place in Higher Education Institutions and Multiprofessional Health Residency Programs in the Brazilian Northeast. The study population is made up of second-year residents linked to the Multiprofessional Health Residency Programs in Northeast Brazil. The research was developed in two interdependent phases, the first being a quantitative sectional study and the second a qualitative study. Data collection was carried out using a self-completed electronic questionnaire on the Google Forms platform and the qualitative study was carried out through interviews based on a semi-structured script, on an online meeting platform (Google Meet). Quantitative analysis was carried out using descriptive and inferential statistics, using contingency tables and statistical association using the Chi-Square test, at a significance level of p<0,05. For the qualitative analysis, Bardin's content analysis was used, with the support of the Atlas Ti software, finding the following categories: professional profile in the SUS; educational path: from graduation to residency; perception about the Multiprofessional Health Residency Program. According to the Higher Education Institution, a significant association was obtained for the variables related to insertion through quotas (p=0,001), retention policies (p<0,001), and curricular components together with other courses (p=0,014). It is noteworthy that most of the aspects evaluated by residents, highlighting interprofessionality (90,0%) and continuing education (85,6%), were experienced more intensely in PRMS, while in graduation the most significant aspects were those related to qualifications to carry out scientific research (43,5%) and the development of specific professional skills (35,6%). According to the Higher Education Institution and the relationship with educational aspects of graduation and residency, it was identified that active methodologies (p=0,001) and knowledge of the pedagogical project (p=0,001) were identified more frequently in residency, mainly by trained participants in private Higher Education Institutions; while the development of scientific studies was identified more frequently in the undergraduate environment (<0,001) by participants trained in public Higher Education Institutions. It was found that regarding the support and qualification of preceptors and tutors, the tutors obtained a better evaluation. Weaknesses in the support offered to residents are evident, especially due to the absence of certain professional categories in the Health Care Network, professional overload and the need for qualification. The participants also demonstrated that the weaknesses of the degree, such as the few experiences of living in the Unified Health System, multi-professionality and lack of activity with active learning methodologies made it difficult for them to be included in the Residency Programs, in addition to the organization of theoretical contents aligned with practical reality. The residency was identified as a unique opportunity in the development of interprofessionality, strengthening the Unified Health System and effective preparation as a health professional.

3
  • LOUISE NATÁLIA MESQUITA BELÉM
  •  

    SOCIAL SUPPORT NETWORK IN THE PUERPERIUM: A CASE STUDY IN A VIRTUAL GROUP

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • ARDIGLEUSA ALVES COELHO
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • FRANKLIN DELANO SOARES FORTE
  • LANNUZYA VERÍSSIMO E OLIVEIRA
  • Data: 26 févr. 2024


  • Afficher le Résumé
  • The puerperal period, understood as the period immediately after childbirth and of varying duration, is considered a critical time of transition, as changes occur in the woman's social role and identity, which will influence her routine and interpersonal relationships. During this phase, these mothers often experience psychological distress and need a social support network. The aim of this study was to understand the social support network in the puerperium through a virtual group. This is a case study with a qualitative approach. Data was collected between November and December 2023, using a semi-structured interview script. Ten (10) women were interviewed at home or online, depending on the availability and preference of the participants.  The study followed Resolution 466/12 of the National Health Council and was approved by the Research Ethics Committee of the Onofre Lopes University Hospital of the Federal University of Rio Grande do Norte (UFRN). Data analysis used Bardin's content analysis, which resulted in 3 thematic categories: Puerperium: from romanticization to reality; Virtual mothers' group: experiences of mothers in the covid-19 pandemic; Virtual support network: welcome amid adversity. The participants were women aged between 28 and 41, married or in a stable union, the majority identified themselves as brown or black (seven) and three as white. They all had some kind of support network, including husbands/partners, nannies, mothers, family members or friends. For mothers, the postpartum period is generally idealized, but the experience of being a mother presents many difficulties, with feelings such as fear, anguish, anxiety and psychological stress, as well as fatigue, insomnia and social isolation, weakening the women, who need to reorient their life context in this new phase. After coping with the initial months of the puerperium, and having suffered direct and indirect repercussions on their health, the women sought various protective strategies, including participation in a virtual support group, learning to deal with their fears, giving new meaning to the situations they had experienced and regaining their self-esteem and being a woman, a professional, a friend and not just a mother.  In the midst of current changes, the use of information technology has made its contribution, as the virtual support network has been a refuge for talking, exchanging experiences, feeling welcomed and minimizing the wear and tear of this transitional phase experienced by so many women.

4
  • JOHNATAN LUIS TAVARES GOES
  • MORTALITY FROM ORAL CANCER IN BRAZIL: TIME TREND ANALYSIS AND THE EFFECT OF SOCIOECONOMIC VARIABLES

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • PEDRO LUIZ DE CARVALHO
  • Data: 29 févr. 2024


  • Afficher le Résumé
  • Introduction: Oral cancer is a public health issue in Brazil and around the world. In addition to presenting significant incidence and mortality rates, the costs of its treatments substantially burden the public health service. Objective: To study the time trend in mortality rates from oral cancer in Brazil, between 2000 and 2020, and the relationship with demographic and socioeconomic characteristics. Method: This is an ecological study carried out with official mortality data from the Mortality Information System (SIM) of the Brazilian Ministry of Health, available on the website of the SUS Information Technology Department (DATASUS). Mortality data by sex, color/race, education were obtained for each municipality in Brazil and the rates were calculated based on the estimated population for the year equivalent to the midpoint of each period, using the base of 100 thousand inhabitants. For the aggregate calculation, as in the case of regions for example, population-weighted averages were calculated. For trend analysis, joinpoint regression was applied, with the calculation of APC and AAPC and respective confidence intervals (95%). Distribution in the territory was carried out using the QGis program and analyzed visually. The relationship with socioeconomic factors was made by comparing the mortality ratio with tertiles of income, education and inequality indicators. Results: Higher mortality was observed among men and black people, with different growth rates between regions. Higher growth rates were found for the group with higher education. The distribution in the territory showed a different distribution pattern for the analyzed variables. The association with socioeconomic indicators showed a significant “dose-response” effect, where the disparity in cancer mortality between black and white people is more pronounced in regions with unfavorable socioeconomic conditions. Conclusions: It is imperative that public policies are directed not only to prevention, but also to assistance for oral cancer, especially in more vulnerable populations. Prevention and control strategies must be adapted to the specific needs of each region and consider existing socioeconomic and racial disparities.

5
  • RICHIENNE THAILANE DO PATROCINIO DOVAL
  •  

    BEING A TUTOR: LIMITATIONS AND POTENTIALS WITH PLANNING PRIMARY HEALTH CARE IN A PILOT TERRITORY

  • Leader : ELIANA COSTA GUERRA
  • MEMBRES DE LA BANQUE :
  • ELIANA COSTA GUERRA
  • MARIA ANGELA FERNANDES FERREIRA
  • SEVERINA ALICE DA COSTA UCHOA
  • MAURA VANESSA SILVA SOBREIRA
  • RUDGY PINTO DE FIGUEIREDO
  • Data: 25 mars 2024


  • Afficher le Résumé
  • In the state of Rio Grande do Norte, the State Secretariat of Public Health of Rio Grande do Norte, in 2012, joined the Primary Care planning process in partnership with the Ministry of Health and the National Council of Health Secretaries in perspective of promoting moments of discussion and change in the operating modes of teams and services, in search of the correct operationalization of interconnected Care Networks, capable of meeting, with quality, the demand of each municipality in the State. The implantation of the project, with a priority network, has been developed in the 4th Health Region of the State since 2019, that of care for diseases and chronic conditions. Therefore, this work aims to analyze the structural and cyclical aspects pointed out by the actors participating in the activities of the pilot project to implement the care network for diseases and conditions chronicles in the 4th Health Region of Rio Grande do Norte. This is an exploratory, descriptive study, with a qualitative approach, which applied an electronic characterization questionnaire and a semi-structured interview, with open questions, via Google Meet. The data was analyzed according to the content analysis technique in the thematic modality, proposed by Laurence Bardin. From the results found, it was possible to understand the tutor's role in the Basic Laboratory Units, skills developed and the main difficulties seen in project implementation, including the work process, organizational factors related to local management, staff and population. The participants' speeches highlighted their satisfaction in working on the project, while revealing an overload of work to juggle the practice of tutoring and the demands related to services inherent to professional training. The results obtained in this study point to the need to strengthen the number of personnel, encourage professionals to remain on the team, avoiding turnover, raise awareness among the population on how to do health care and create spaces for dialogue between tutors and municipal management with a focus on effective communication. Such improvements are intended to strengthen the performance of the Health Regional at all levels of health care, improve professional care, as well as contribute to the use of information from the study to support SESAP/RN in decision-making

Thèses
1
  • ELIANE PEREIRA DA SILVA
  • Motivation and competencies for the success of health care quality improvement projects 

  • Leader : ZENEWTON ANDRÉ DA SILVA GAMA
  • MEMBRES DE LA BANQUE :
  • LAURA MARIA CÉSAR SCHIESARI
  • MARGARETH CRISÓSTOMO PORTELA
  • PAULO JOSE DE MEDEIROS
  • SEVERINA ALICE DA COSTA UCHOA
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 18 janv. 2024


  • Afficher le Résumé
  • Introduction: the success of health quality improvement projects depends on the engagement of professionals who work in patient care and knowledge of quality improvement methods and tools. The factors that modulate motivation and assessment of skills in these projects are still unclear. The objective of this study was to analyze barriers and facilitators to the motivation of healthcare professionals to participate in a large collaborative quality improvement project, creating and validating a quality improvement competency assessment tool. Methods: the motivation study was qualitative, based on content analysis of semi-structured in-depth interviews with healthcare professionals participating in the collaborative quality improvement project “Improving patient safety on a large scale in Brazil” involving 116 Brazilian hospitals. We carried out interviews via videoconference with 28 health professionals who participated in the project, using the saturation principle. Data was coded using NVivo software and analysis was based on the Capability, Opportunity, Motivation and Behavior (COM-B) model and the Model for Understanding Success in Quality (MUSIQ). The skills assessment questionnaire was constructed after a literature review and the content analysis was carried out by a panel of experts using the Delphi technique. The skills assessment questionnaire contained 43 items, distributed across four domains, covering hard and soft skills, and demographic information. 14 experts participated in the first round and 12 experts in the second. All experts had more than 5 years of experience in quality improvement. Results: the barriers found were non-involvement of senior management, demand for immediate results, lack of inputs, excessive bureaucracy for changes, work overload, lack of scheduled workload for the project, resistance from experienced health professionals, belief in that improvement increases the workload, difficulty in engaging night shift professionals, little involvement of doctors, lack of knowledge about quality improvement and collection of indicators. Active participation of senior management in rounds, institutional policy of continuous improvement, quality improvement team present, enthusiasm of the team leader, understanding the reason for changes, teamwork, participating in change tests, learning in practice, celebrating small results and feedback on results were facilitators for motivation. The questionnaire was validated in two rounds with a minimum CVI of 83% and a maximum of 100%. Two items were eliminated. One for CVI below 80% and the other was redundant and was condensed into a single item. The final questionnaire had 41 items. Conclusion: this study reinforced the importance of customizing large projects, involving motivation modulators, intervening in the factors identified as barriers and facilitators. The skills assessment questionnaire closes the link between motivation and capacity for improvement, which are proximal contextual determinants of the microsystem necessary for the success of quality improvement projects.

2023
Thèses
1
  • NATHALIA PRISCILLA MEDEIROS COSTA DINIZ
  • CHARACTERIZATION OF THE PROFILE OF USERS AND INTEGRATIVE AND COMPLEMENTARY PRACTICES IN HEALTH IN THE PRIMARY CARE NETWORK OF THE MUNICIPALITY OF NATAL/RN.
  • Leader : THAIZA TEIXEIRA XAVIER NOBRE
  • MEMBRES DE LA BANQUE :
  • ANA ELZA OLIVEIRA DE MENDONCA
  • JOÃO BOSCO FILHO
  • LUCIANA ARAUJO DOS REIS
  • THAIZA TEIXEIRA XAVIER NOBRE
  • Data: 15 févr. 2023


  • Afficher le Résumé
  • Introduction: In Brazilian history, Public Policies were achieved through social movements in different forms of struggles and political confrontations. In the field of health, the protagonists of the Sanitary Reform yearned for a health care model that would meet needs, democratize health as a universal right and consider the principle of integrality in care. Thus, the Unified Health System (SUS) was established and, in this context, the National Policy on Integrative and Complementary Practices (PNPIC) was published as one of the many achievements of users and health professionals. The insertion of Integrative and Complementary Health Practices (PICS) was marked by interests, such as recovering the knowledge and identity of popular groups, some historically marginalized, and by the State's interest in a new culture of care based on health promotion. Objective: Given this context, the present study aims to characterize the profile of adult and elderly users and the PICS developed in the context of the SUS in the municipality of Natal, Rio Grande do Norte. Method: This is a study with a quantitative approach, of the exploratory-descriptive type, whose format is field with a survey design in the Primary Health Care Network of the municipality of Natal, limited to the Basic Health Unit, Health Strategy of Family and Mixed Unit. Results: 522 medical records of enrolled users were analyzed, the highest frequency being adult females (83.0%); elderly people of non-white race/color (82.6%) and with low education (67.8%); arterial hypertension (30.4%) and diabetes (17.4%) were more frequent in elderly people, as well as the presence of body pain (71.3%) and tooth/gum disease (42.6%). Auriculotherapy (58.2%) was the most used integrative practice in treatment procedures; 53.4% of the population received at least one service and 39.3% were attended in the North I health district. Conclusion: The study reaffirms the position of PICS in health care in the SUS, as well as showing its use for the health of the population, contributing to the PICS studies for health promotion, prevention and protection, as well as providing important information in the context of the integrative health of this public for health planning and management at municipal, state and national levels.

2
  • ARTHUR ALEXANDRINO
  • FACTORS ASSOCIATED WITH MULTIMORBITY AND FUNCTIONALITY IN THE AGED IN THE RURAL AREA: 
    A POPULATIONAL STUDY BASED ON THE FAMILY HEALTH STRATEGY
  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • MATHEUS FIGUEIREDO NOGUEIRA
  • TAMIRES CARNEIRO DE OLIVEIRA MENDES
  • Data: 20 mars 2023


  • Afficher le Résumé
  • Introduction: The population set is identified as a worldwide phenomenon, which reflects the increase in population observation. Linked to this, note an increase in the number of chronic non-communicable diseases, as well as an increase in the decline in the functional capacity of elderly people, especially those who live in rural areas. Objectives: The general objective of this study is to investigate the multimorbidity and functionality of elderly people living in rural areas. As specific: to identify sociodemographic, clinical-therapeutic factors and those related to lifestyle and access to health services, associated with multimorbidity and objective functionality in elderly people living in rural areas. Method: This is an observational and cross-sectional epidemiological investigation with an observational approach. Descriptive procedure and deviation of a data analysis (univariate), using simple measures of absolute and relative frequency, in addition to measures of central tendency as mean and standard. Then, inferential statistics are used to relate the analysis to the independent variables, version 2.0 of the IBM SPSS software (Statistical Package for the Social Sciences). In the bivariate statistics, the data were analyzed using the chidrate test, being considered significant when the p-value < 0.05. Results: Most of the elderly have multimorbidity, independent as basic activities of daily living, the more dependent on instrumental and independent activities for the main displacements. When crossing the data independent and dependent variables, we observed as variable variables sex, significant, age group, state, family arrangement, work, religion, literacy, years studied, occupation, function, government, types of benefits, retirement, time living in rural areas, number of residents in the residence, number of rooms in the residence, BMI, family income, self-reported stress, physical activity, leisure activity, meals, access to treated water, smoking, consumption of alcohol, health status, quality of life, satisfied with life, enjoy living life, access to transportation, medication use, chronic pain, taking the COVID-19 vaccine, number of doses taken of the COVID vaccine - 19, access to serv. of health, use of serv. of health, companion, last consultation, last year, number of self-reported diseases and self-reported health problem. Final considerations: It is envisaged as a reinforcement of services and health care for the elderly population residing in rural areas. Thus, the study will allow better management of diseases and their intervention proposals and strategies within the scope of the health maintenance network, aiming to enhance the functional capacity of this segment. The findings of this study, therefore, may support the system as public health policies, empowerment of health professionals after caring for the elderly, as well as reducing the health burden by strengthening the promotion of active aging and well-being. Finally, it is expected to build articles to be published in journals with a high impact factor, as well as to take these findings to scientific events.

3
  • RITA XAVIER BARBOSA NETA SILVA
  • LEGAL DEMANDS FOR NUTRITIONAL FORMULAS AT THE CHRISTMAS MUNICIPAL HEALTH SECRETARIAT: DIAGNOSIS AND PERSPECTIVES

  • Leader : KARLA PATRICIA CARDOSO AMORIM
  • MEMBRES DE LA BANQUE :
  • KARLA PATRICIA CARDOSO AMORIM
  • MARIA ANGELA FERNANDES FERREIRA
  • YONARA MONIQUE DA COSTA OLIVEIRA
  • Data: 20 mars 2023


  • Afficher le Résumé
  • Introduction: The food thought of rights for health by the health proposal and the proposal of federal formulas through the constitution and nutritional measures are against the formulation of a management strategy of objectives: To analyze social health as benefits by formulas in the city of Natal/ RN assisted in the period from 2010 to 2020. Methods: This is a documentary study, with an exploratory descriptive approach with an analysis approach, in which the unit of analysis was the individual processes of requesting nutritional formula with the City of Natal as defendant . Results: For the sociodemographics related to the author, medical and legal profile of the sanitary characteristics of the city of Natal/RN, nutritional formulas between the years 2010, it can be seen that the highest percentage of males (52.0%) and aged under 18 (64.0%). Most of the origins came from the health districts Norte I (28.0%) and Norte II (22.0%). Most cases refer only to a disease or condition that requires the use of food formulas (54.0%). In most cases, the formulation of the nutritional formula came from the public sector (60.0%). The most requested type of food formula was modules and supplements for adults (32.0%). The majority of lawsuits originated from representation through a court decision (80.0%) and a court decision issued through a judgment (60.0%). The most common health problem was allergy to cow's milk protein (14.0%), followed by stroke (8.0%). As for the monthly cost to meet the demands of care, the total amount considering the fulfillment of all demands as guidelines for the processes in a single month was R$ 40,790.48. The amount required for the monthly cost of the formulas prescribed in the 2 follow-ups varied between R$ 3.36 and R$ 3366.00, with an average of R$ 815.00.

4
  • ÍSIS DE SIQUEIRA SILVA
  • DIGITAL HEALTH AND QUALITY OF OLDER ADULTS HOME-BASED PRIMARY CARE: A Scoping Review Protocol

  • Leader : SEVERINA ALICE DA COSTA UCHOA
  • MEMBRES DE LA BANQUE :
  • CLAUDIA SANTOS MARTINIANO SOUSA
  • RENAN CIPRIANO MOIOLI
  • SEVERINA ALICE DA COSTA UCHOA
  • TAMIRES CARNEIRO DE OLIVEIRA MENDES
  • Data: 21 mars 2023


  • Afficher le Résumé
  • Primary home care has been expanding, following the increase in the older adult population  and the need to respond to the greater demand of their chronic conditions and health fragilities. At this level of care, digital health is considered an important tool for improving care, whose expansion had greater momentum with COVID-19 and subsequent measures of social isolation/distancing, for this group considered at risk. The objective of this study is to design a scoping review protocol to identify, map and evaluate the uses and impacts of digital health on the quality of home-based primary care for older people around the world. This is a scoping review protocol developed from the theoretical perspective of Arksey and O'malley, with updates from Levac; Peters and respective collaborators. It will be based on the Joanna Briggs Institute manual and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). White literature data will be extracted from multidisciplinary health databases such as: Virtual Health Library, LILACS, PubMed, Scopus, Web of Science, CINAHL and Embase; while Google Scholar will be used for grey literature. No date limits or language restrictions will be determined. Quantitative data will be analyzed using descriptive statistics and qualitative data will be analyzed using thematic analysis. The results of the review will address impacts, challenges, opportunities and gaps found in publications related to the use of digital technologies in home-based primary care of older people and will be submitted to a stakeholder consultation for suggestions on other dissemination strategies beyond that in journals and scientific events as well as on applicability of the study. The organization of this protocol will increase the methodological rigor, quality, transparency and accuracy of the scoping review, reducing the risk of bias. As a contribution, it is expected that, well-founded, the review may bring to managers and caregivers relevant subsidies to improve primary home care through digital means as a public health policy.

     

5
  • MICARLA PRISCILA SILVA DANTAS
  • COVID-19 VACCINATION COVERAGE AND ITS IMPACT ON MORTALITY IN A NORTHEASTERN BRAZILIAN STATE

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • ANA ELZA OLIVEIRA DE MENDONCA
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • FABIA BARBOSA DE ANDRADE
  • Data: 24 mars 2023


  • Afficher le Résumé
  • The pandemic of COVID-19 brought with it numerous challenges regarding the discovery of conditioning factors for the worsening of the disease and its forms of treatment, as well as the search for the rapid development of safe and effective immunizers to combat the virus, to contribute to the reduction of mortality cases in Brazil. The study aims to evaluate the vaccination coverage of COVID-19 and its association with the mortality indicator in the adolescent, adult and elderly population in the state of Rio Grande do Norte, Brazil. This is an ecological, quantitative study on the vaccinated population in the state of Rio Grande do Norte, through data made available by the health information systems e-SUS Epidemiological Surveillance (e-SUS-VE), in the period from January 2021 to March 2022. The data were analyzed using Microsoft Excel software, used for data grouping, as well as JoinPoint software used for statistical analysis. The vaccination coverage goal set by the PNI is at least 90% of the target population vaccinated. The results revealed that the statewide average vaccination coverage in the period studied was 81.8%. The following regions had outstanding vaccination coverage: Alto Oeste - VI and Seridó - IV, with 91% and 83%, respectively. The region with the highest rate of cases during the study period was the Seridó - IV region, with 23.9%, followed by the Alto Oeste health region VI, with 19.1%. As for the number of deaths, the Metropolitan VII and Vale do Açu VIII regions had the most expressive numbers, with 1.8% and 1.6%, respectively. The results found showed that the lower the vaccination coverage, the higher the incidence of deaths, except for the metropolitan region (Regional VII), which even presenting the third highest percentage of vaccination coverage among the eight regions, recorded the highest percentage of deaths. Therefore, considering most of the findings, it can be said that there is a relationship between vaccination coverage and the number of cases and deaths from COVID-19 among the health regions of the state of Rio Grande do Norte (RN). It is concluded that in the period analyzed Rio Grande do Norte had a coverage below the national average of 90%, however, a positive impact on the reduction of mortality in the same period studied can be seen.

6
  • JÉFITHA KALINY DOS SANTOS SILVA
  •  

    WORK AND MENTAL HEALTH OF WORKERS AND WORKERS IN THE UNITS OF
    EMERGENCY SERVICE (UPAS) OF NATAL-RN IN THE CONTEXT OF COVID-19


  • Leader : ELIANA COSTA GUERRA
  • MEMBRES DE LA BANQUE :
  • ELIANA COSTA GUERRA
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • HIAGO TRINDADE DE LIRA SILVA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 31 mars 2023


  • Afficher le Résumé
  • The new forms of management, relationships and working conditions established within the framework of (re)
    configurations of the world of work, added to the regressive reforms operated in the Politics of
    Health has had repercussions on the living conditions and ways of living of the population, placing
    severe impacts on the health of male and female workers. This scenario worsened with
    the advent of the covid-19 pandemic, which is imprinting new rhythms and forms of
    work, accentuating mental illness, insofar as this disease caused by
    SARS-CoV-2 virus, has affected every aspect of human life, has disrupted the systems of
    attention to health around the world and aggravated the economic, political and social crisis, causing
    an unprecedented health crisis of planetary dimensions. Indeed, the environment of
    pandemic required that responses be taken quickly due to the potential
    of contagion and the overwhelming spread of the virus. Thus, health professionals who work
    on the front lines of COVID-19 are among the groups most vulnerable to the consequences
    emotional and psychological consequences of the pandemic. In view of this, the on-screen study aims to analyze how the
    relationships and working conditions have an impact on the mental health of workers and
    workers) of the UPAS of Natal-RN in the context of the COVID-19 pandemic, through a
    research with a mixed methodological focus, in the perspective of articulating qualitative techniques and
    quantitative to apprehend the object of the research in its totality, particularity and
    singularity. For this, different research procedures were used: observation
    non-participant, interviews, socio-occupational questionnaires. In this way, it is intended
    produce, along the investigative course, subsidies for the strengthening of the actions of the
    CEREST of the municipality of Natal-RN with the Urgency and Emergency Network, as well as for
    implementation of the Workers' and Workers' Health Policy in that municipality.

7
  • FELLIPE BATISTA DE OLIVEIRA
  • HEALTHY FOOD WITH ADOLESCENTS THROUGH INFORMATION TECHNOLOGY AND COMMUNICATION: SCOPE REVIEW

  • Leader : GRÁCIA MARIA DE MIRANDA GONDIM
  • MEMBRES DE LA BANQUE :
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • CLELIA DE OLIVEIRA LYRA
  • REGINA MÁRCIA SOARES CAVALCANTE
  • Data: 31 mars 2023


  • Afficher le Résumé
  • Adolescence is characterized by the period between 10 to 19 years old. This is a phase for
    interventions related to adopting a healthy lifestyle, as well as its importance and impact on
    health throughout life. Studies show that increasingly, teenagers do not meet
    recommendations for healthy eating, which is due, among other things, to the loss of interest
    in this type of habit, often not stimulated. In addition, inadequate lifestyle habits, unbalanced
    nutrition, and sedentary behavior become one of the main factors for chronic non-
    communicable diseases, negatively affecting adulthood. Therefore, the present study aimed to
    map national and international scientific production on healthy eating with adolescents,
    mediated by Information and Communication Technologies (ICT). This is a scoping literature
    review, structured in the methodology recommended by the Joanna Briggs Institute and
    PRISMA-ScR. Thus, the following steps were adopted: formulation of research questions,
    definition of inclusion and exclusion criteria, definition of the research strategy, selection of
    studies/evidence sources, data extraction and coding, analysis, and interpretation of results.
    The consulted databases were: Medline/Pubmed, Cumulative Index to Nursing and Allied
    Health Literature (CINAHL), Scopus, Embase, and Latin American and Caribbean Health
    Sciences Literature (LILACS). The entire study selection process also occurred in duplicate,
    independently. The database search resulted in 12,990 works, after the application of initial
    filters and removal of duplicates, resulting in 7,898 documents. In the end, the sample resulted
    in 20 articles published in journals. It was possible to verify that most of the scientific
    production occurred internationally, with emphasis on studies conducted in the United States
    of America and Canada, with only one study conducted at the national level. In addition, the
    review showed that ICT are tools that can assist in promoting healthy habits, especially in the
    field of nutrition. Despite this, a critical view is necessary regarding the use of these
    technologies, especially regarding the content addressed. Thus, from this study, it is intended
    to contribute to the construction of knowledge regarding the use of ICT aimed at promoting
    healthy eating with adolescents.

8
  • SONALY MELO DE MACEDO
  • SPIRITUALITY OF PATIENTS IN THE FACE OF CANCER: SCOPING REVIEW PROTOCOL

  • Leader : KARLA PATRICIA CARDOSO AMORIM
  • MEMBRES DE LA BANQUE :
  • KARLA PATRICIA CARDOSO AMORIM
  • JOÃO BOSCO FILHO
  • RODSON RICARDO SOUZA DO NASCIMENTO
  • Data: 28 avr. 2023


  • Afficher le Résumé
  • INTRODUCTION: Spirituality is valued as technology is no longer able to provide healing solutions. Spiritual well-being is a domain of quality of life when it is related to cancer. Spirituality is recognized for helping the individual feel better about themselves and the environment around them and being a source of support and hope after diagnosis and during treatment. OBJECTIVE: To map how spirituality is conceived by patients in the process of care and coping with cancer. METHOD: this is a scoping review protocol developed according to Arksey and O'Malley and Levac et al, based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The records will be mapped in the Virtual Health Library database. Data will be summarized qualitatively through thematic analysis. Preliminary results will be presented to interested parties for analysis of studies and development of strategies for improvement. ETHICS AND DISSEMINATION: The results will be disseminated through publication in an open access scientific journal. It can be extended to national and/or international congresses in the area of public health. Ethical approval will be obtained due to stakeholder consultation, but will not involve direct patient participation.

9
  • JULIANA ISCARLATY FREIRE DE ARAUJO
  • VACCINATION HESITATION AGAINST COVID-19 IN BRAZIL FROM THE DISCOURSE OF THOSE WHO HESITATE

  • Leader : KARLA PATRICIA CARDOSO AMORIM
  • MEMBRES DE LA BANQUE :
  • KARLA PATRICIA CARDOSO AMORIM
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • FABIA BARBOSA DE ANDRADE
  • ILANA MIRIAN ALMEIDA FELIPE DA SILVA
  • Data: 31 juil. 2023


  • Afficher le Résumé
  • The emergence of vaccine production is justified by the number of deaths caused by the respiratory syndrome, and the need to control these cases and their severe forms. Concomitantly with the advancement of immunization of the population, it was observed that the social movement of vaccine hesitation characterized by refusal or delay in accepting vaccination has taken on worldwide proportions in recent years, based on questions referring mainly to the efficacy and safety of immunizers. In view of this, it is important to discuss individuality versus collectivity, and to understand the justifications that are associated with the COVID-19 vaccine hesitancy process. This study aims to analyze the vaccine hesitation process against COVID-19 in Brazil, from the perspective of those who hesitate. This is a descriptive exploratory study, with a qualitative characteristic, and a snowball-type non-probabilistic sample approach. The methodology uses chains of references to build its sample population research subjects will be individuals who may have hesitated to take any of the immunobiologicals against COVID-19 that are currently offered by the National Immunization Program, be over 18 years old, reside in the geographic territory of Rio Grande do Norte, and have accepted participate in the research by signing the Term of Free and Informed Consent – TCLE, the content analysis used the Collective Subject Discourse technique, described by LEFEVRE & LEFEVRE, based on the Theory of Social Representations. The preliminary results were organized in a systematic way, where the subjects participating in the research were socioeconomically characterized, we listed categories according to the meaning of the central ideas to understand the individual as a social being regarding the process of vaccine hesitation of COVID-19, being them: Experiences and experiences about the pandemic and the COVID-19 disease; Perceptions about the COVID-19 vaccine and vaccination; Justifications associated with vaccine hesitancy against COVID-19 and other related factors. Evidencing findings regarding these perspectives, the main notes found associated with the vaccine hesitation process are related to various reasons, namely: immunization imposition, distrust of the effects of immunobiologicals, misinformation, fear of reactions, conspiracy theories, political influence and the infodemic. Therefore, knowing that the choice to be vaccinated goes beyond an individual criterion, it becomes necessary for health policy makers to dialogue about strategies that reinforce the safety, need, efficacy and importance of the vaccine for everyone.

10
  • JÉSSICA BARACHO DE SOUZA MORAIS
  • BARRIERS AND FACILITATORS FOR THE REGULAR FOLLOW-UP OF INDIVIDUALS WITH HYPERTENSION IN PRIMARY HEALTH CARE

  • Leader : ZENEWTON ANDRÉ DA SILVA GAMA
  • MEMBRES DE LA BANQUE :
  • Deivisson Vianna Dantas dos Santos
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 29 sept. 2023


  • Afficher le Résumé
  • Introduction: Systemic Arterial Hypertension (SAH) is a disease with high prevalence, and the regular monitoring of individuals with SAH has posed a significant challenge for Brazilian Primary Health Care (PHC). Objective: The aim of this study is to analyze the barriers and facilitators for conducting regular consultations and blood pressure measurements in PHC, to guide the improvement of implementing this essential process for SAH care. Method: The methodological design was descriptive with a qualitative approach from September 2022 to May 2023. Content analysis was used to analyze the discourse emerging from six focus groups (29 professionals) from five Basic Health Units (UBS) in Natal, Rio Grande do Norte. Results: The main barriers were high demand at UBSs, difficulty in using E-SUS (Unified Health System electronic platform), lack of specific training, and users with low literacy levels. The main proposed facilitators include: creating waiting rooms, implementing cardiovascular risk stratification, establishing a schedule of training sessions, and improving E-SUS reports. Final Considerations: The identified barriers and facilitators in this study provide guidance for planning improvements based on a systemic view of the root causes of the problem and multifaceted interventions to enhance SAH care.

11
  • SYLVIA PATRÍCIA DANTAS PEREIRA
  • CONTRIBUTION OF THE OPINIONS OF NATJUS/RN IN THE OUTCOME OF THE LEGAL PROCEEDINGS THAT REQUEST MEDICATION IN RIO GRANDE DO NORTE.

     

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • LINDEMBERG ASSUNÇÃO COSTA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 6 oct. 2023


  • Afficher le Résumé
  • With the advance of the judicialization of health in Brazil, in the 2000s, the National Council of Justice (CNJ) began to prepare studies and propose concrete measures with the objective of better understanding this phenomenon, as well as rationalizing the judicial demands involving assistance to health in the country. In this context, the CNJ then determined the creation of the Judiciary Technical Support Centers (NATJUS), by state and federal courts, with a view to producing technical opinions to support judicial decisions in the health area. In Rio Grande do Norte, under the aegis of CNJ Recommendation nº 31, of March 30, 2010, a Technical Chamber was created in 2014 by the State Committee on Health Demands, which later became known as NATJUS. This study aims to analyze the influence of opinions on medicines, prepared by NATJUS of Rio Grande do Norte, on the outcomes of lawsuits filed against public entities, as well as, and especially, the acceptability of these opinions by magistrates. The period of analysis is the triennium 2017-2019, period after the publication of CNJ Resolution No. 238, of September 6, 2016, which determined the formation of these nuclei. This is an exploratory, retrospective and descriptive study, with a quantitative-qualitative approach, in which an analysis was carried out of 212 opinions requested by magistrates from NATJUS, made available in the JUDSAÚDE system, as well as the judicial processes in the context of which they were requested. . Thus, in addition to the description and general characterization of all opinions requested from NATJUS and made available in the referred system, it was observed that there was a higher percentage of requests for opinions by the federal judiciary (81.6%), as well as a high percentage of court decisions that considered these opinions (81.6%). There was a greater number of favorable opinions to the author's request (65.1%), as well as that, for the most part, the opinions were of medicines not available within the scope of the Unified Health System (SUS) (81.0% ), notably antineoplastic and immunomodulatory drugs (38.3%), according to the ATC classification. It was also observed that the percentage of cases in which opinions were requested from the NATJUS, in the period considered, was very low (9.6%), as well as that the impact of the performance of the NATJUS, in the sense of reducing the number of convictions against of the State of Rio Grande do Norte, in the medication processes, was very low (2.1%). It is expected, therefore, that with the implementation of the e-natjus system, by the CNJ, there will be a greater adherence of the Norte-riograndense judiciary to the use of this important tool, since the judicial decision in health needs a technical basis. Finally, in addition to health issues, the judge, in order to decide fairly, considering the entire social and economic context of public health policy, should not do without this aid.

     

     

12
  • MARCIA ANDREIA PEREIRA DA SILVA
  • Paths for the implantation and implementation of the VII Regional Public Health Unit of Rio Grande do Norte: advances and challenges
  • Leader : JANETE LIMA DE CASTRO
  • MEMBRES DE LA BANQUE :
  • JANETE LIMA DE CASTRO
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • RAFAEL RODOLFO TOMAZ DE LIMA
  • Data: 20 oct. 2023


  • Afficher le Résumé
  • In the state of Rio Grande do Norte, based on the Regionalization Master Plan implemented in 2008, eight Health Regions were established. In order to supervise, coordinate and advise the health services belonging to the municipalities that make up these Regions, they were implemented the Regional Public Health Units (URSAP), being considered regionalized administrative structures. Therefore, this work aims to analyze
    the contributions of the VII Regional Public Health Unit (VII URSAP) in the process of technical support to the municipalities of the 7th Health Region. This is a descriptive study, with a qualitative approach, which applied an electronic questionnaire, semi- structured interview and document analysis. The data were analyzed according to the thematic content analysis technique, proposed by Laurence Bardin. From the results found, it was possible to identify the path, performance and main difficulties in implementing the VII URSAP, including its work process, its articulation with the municipalities and its main actions carried out with a view to strengthening the territories of the municipalities of the 7th. Health Region. The participants' speeches showed greater involvement in the actions of the VII URSAP, which is aimed at strengthening the role of Health Surveillance in the territory and the performance of Primary Health Care in the Previne Brasil indicators. The results obtained in this study point to the need to strengthen the number of personnel, physical structure, governance spaces, as well as the integration of VII URSAP with the technical areas of the State Secretariat for Public Health of Rio Grande do Norte, with focus on effective communication with municipalities. Such improvements aim to strengthen the performance of the Regional Health Department at all levels of health care, as well as consolidating the principles of the Unified Health System.

13
  • KELLEN CRISTINA MARQUES DE LIMA
  • JUDICIALIZATION OF HEALTH: ANALYSIS OF JUDICIAL DEMANDS FOR NUTRITIONAL FORMULAS IN THE STATE OF RIO GRANDE DO NORTE

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MARIA ANGELA FERNANDES FERREIRA
  • YONARA MONIQUE DA COSTA OLIVEIRA
  • Data: 6 nov. 2023


  • Afficher le Résumé
  • In Brazil, despite healthcare being a constitutionally recognized fundamental right and having
    the largest publicly funded healthcare system, there is chronic underfunding. As a result,
    healthcare litigation is used to hold the government accountable for meeting healthcare needs.
    Nutrition and diet play an essential role in health, supported by the National Food and
    Nutrition Policy and the 1988 Federal Constitution. However, nutritional formulas used to
    treat or prevent nutrition-related issues are often unattainable due to high costs and lack of
    free access through the healthcare system. This study aims to assess legal actions for the
    supply of demanded nutritional formulas against the state of Rio Grande do Norte between
    2017 and 2021. The study is of an exploratory descriptive nature, using a database of
    individual legal cases filed against the state during the mentioned period. A descriptive
    analysis of the data was carried out using Microsoft Excel version 2306. A total of 132 active
    cases were identified. The majority of claimants were female (52.3%), and the pediatric
    population accounted for 40.9% of the cases. Diseases of the nervous system accounted for
    40.2% of the total indications for nutritional formulas. Most claimants originated from the 7th
    health region of RN - Natal and the metropolitan area (42.9%). The seizure of funds was part
    of 54.5% of all cases, and nutritional formulas were prescribed by nutritionists in 66.7% of
    cases compared to medical prescriptions. Regarding the costs incurred through legal demands,
    the accumulated total during the evaluated period was R$ 3,828,262.00, with an annual
    average of R$ 765,652.50 spent. Modified and pediatric formulas represented the majority of
    costs in the evaluated period, accounting for 44.6% and 44.1%, respectively. The average
    time between litigation and the date of the judicial decision was 28.8 days, and the total time
    from litigation to receiving care was approximately 64.8 days. The research aimed to enhance
    understanding of the legal action regarding nutritional formulas in the state of RN,
    considering the lack of literature on the topic. Given the significance of the issue, it is
    necessary to provide technical assistance to the legal system to ensure equitable, regulated,
    and uninterrupted access that meets users&#39; needs and promotes rational use, considering that
    nutritional care is essential and a matter of bioethics.

14
  • CLÁUDIA MENDES DA SILVA
  • EVALUATION OF THE FUNCTIONAL CAPACITY OF THE ELDERLY POST-COVID-19

  • Leader : THAIZA TEIXEIRA XAVIER NOBRE
  • MEMBRES DE LA BANQUE :
  • THAIZA TEIXEIRA XAVIER NOBRE
  • ANA ELZA OLIVEIRA DE MENDONCA
  • SILVANA LOANA DE OLIVEIRA SOUSA
  • Data: 7 nov. 2023


  • Afficher le Résumé
  • Introduction: COVID-19 is recognized as a respiratory disease that has high transmissibility
     and global distribution, with elderly people being the group most at risk of developing complications,
     with the potential for weaknesses. Objective: To evaluate the implications of COVID-19 on the functional 
    status of elderly people after acute infection and identify factors associated with functional impairment. 
    Method: The study was divided into two stages: 1) scoping review, conducted according to the method 
    proposed by the Joanna Briggs Institute. The literature search took place from December 2022 to February 
    2023 in the Cochrane Library databases; PubMed; Scopus and Web of Science. The descriptors contained in 
    the Health Science Descriptors (DecS) and Medical Subject Headings (MeSH) were used; 2) descriptive, 
    cross-sectional study, carried out in a Primary Health Care unit in the city of Natal, Rio Grande do Norte, 
    with elderly people living in the post-covid-19 community. Data were collected regarding sociodemographic 
    characteristics, nutritional status, lifestyle habits and health conditions, as well as the level of functional 
    performance. Results: 1) 817 potentially eligible studies were identified. Of these, 12 were selected because
     they met the eligibility criteria. The complementary search allowed the inclusion of one more article, 
    totaling 13 studies that made up the final sample. Post-COVID-19 functional impairment was present in most 
    studies included in the sample. Factors associated with this decline included frailty and physical inactivity 
    prior to infection, older age, complications during infection, length of mechanical ventilation and 
    hospitalization, and comorbidities. 2) Among the 30 participants evaluated, a predominance of low functional 
    performance was observed, with correlated factors including advanced age, female gender, multimorbidities 
    and lack of physical activity. Final considerations: COVID-19 can cause negative outcomes in the 
    functionality of elderly people, even after recovery, leading to limitations in the physical performance of 
    activities of daily living. Therefore, the implementation of comprehensive care, structured in multidimensional 
    assessment, is essential.
15
  • ANA BEATRIZ GOUVEIA DE ARAÚJO
  • PERMANENT HEALTH EDUCATION IN THE WORK PROCESS IN PRIMARY CARE: A THEORY BASED ON DATA

  • Leader : ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • MEMBRES DE LA BANQUE :
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • JANETE LIMA DE CASTRO
  • MARIA APARECIDA SALCI
  • Data: 30 nov. 2023


  • Afficher le Résumé
  • Continuing Health Education presents itself as a powerful tool to promote transformations desired by managers and workers to improve services and the health system. This study's main objectives are to understand Permanent Health Education in the work process of Primary Health Care from the perspective of professionals who work in the current context of the Unified Health System and to develop a theoretical model on Permanent Health Education in the work process in Primary Health Care in the current context of the Unified Health System. The study participants were formed by health professionals from the Basic Health Units that are part of the Western Health District of the city of Natal, Rio Grande do Norte, Brazil. This is a research with a qualitative approach that has as its methodological reference the Grounded Theory, with a structuralist approach proposed by Strauss and Corbin. Grounded Theory was chosen because it is a methodological approach that is rigorous during data collection and analysis, considering that the research will study a professional training strategy inserted into the routine and work process of professionals in a procedural manner. Data collection took place between January and May 2023 through in-depth interviews, based on the following guiding question: Talk about continuing education in your work process in primary health care. Data collection followed theoretical sampling, being carried out from three sample groups, the first composed of 16 nurses, the second by five managers and the third by a nursing technician and four community health agents. Data analysis was carried out simultaneously with data collection, with constant raising of new questions and carrying out comparative analysis, following open, axial and selective coding. The Atlas ti software, version 8, was used as a technological tool, with the appropriate license acquired. With the coding of the interviews, 1391 citations, 824 codes, four memos, 27 groups of codes and 16 networks or analytical diagrams were obtained from the analysis. After data analysis, the theoretical model was validated by the following groups: two researchers selected for their expertise in investigations, discussions and practices in Continuing Health Education; three researchers with expertise in the GT method; five participants from the study sample groups. The results achieved were divided into categories according to paradigmatic circumstances, conditions, action/interaction and consequences. The following representative categories of the phenomenon studied were elucidated: Pointing out needs and paths for implementing EPS in PHC; Facing the adversities of working in health and the need for applied knowledge and adequate working conditions; Proposing strategies and relationships that enhance the materialization of EPS; Establishing the advances arising from EPS in the context of PHC; and Declaring the difficulties of not implementing EPS in the health work process. The results provided the construction of the theoretical model that represents the understanding of Continuing Health Education in the Primary Health Care Work Process from the perspective of professionals working in the current context of the Unified Health System.

     

16
  • PAULO HENRIQUE DO NASCIMENTO
  • HEALTH DAMAGES AND VULNERABILITY IN INSTITUTIONALIZED ELDERLY PEOPLE AFTER COVID-19 PANDEMIC
  • Leader : THAIZA TEIXEIRA XAVIER NOBRE
  • MEMBRES DE LA BANQUE :
  • THAIZA TEIXEIRA XAVIER NOBRE
  • ANA ELZA OLIVEIRA DE MENDONCA
  • SILVANA LOANA DE OLIVEIRA SOUSA
  • Data: 12 déc. 2023


  • Afficher le Résumé
  • Introduction: Population aging has been growing significantly around the world, one of the consequences is the increased demand for long-term care institutions for the elderly (LTCFs), institutionalization is also a contributing factor to the increase in health problems. Objective: To analyze health problems and their relationship with gender and identify the vulnerability profile and the relationship with stress and anxiety in institutionalized elderly people. Methods: Two analyzes were carried out: 1) Descriptive, observational, cross-sectional study, sample composed of 44 elderly people living in an LTCF located in the municipality of Maranguape, Ceará. The variables analyzed were studied based on data collected from the Elderly Person's Health Record (CSPI), using the electronic form (Google Forms) for data tabulation. The variables analyzed were: sociodemographic data, presence of NCDs, use of polypharmacy, anthropometric data and assessment of nutritional status; 2) Research carried out with 31 elderly people, the instruments used were data from the CSPI through the Vulnerable Elderly Identification Protocol (VES-13), the assessment of anxiety through the Beck Anxiety Inventory (IAB) and stress through of the Perceived Stress Scale (EEP). Results: It was observed in study 1 that 59.1% (n=26) of elderly people were female and 61.3% (n=27) of the total had some type of disability, where 68.2% (n= 30) of the elderly reported having four or more years of education, while 63.7% (n=28) did not use polypharmacy. From a nutritional perspective, 61.5% (n=16) of women had body mass index classification (≥ 22 and ≤ 27 kg/m²), while 33.3% (n=10) of men had adequate weight, the Women showed greater signs of loss of muscle mass than men, although SAH is more present in women 65.4% (17) and DM is more present in men 28% (5), 70.5% of the analyzed sample had history of chronic disease, with no association with nutritional profile. In study 2) the feminization of the sample was evident (58.1%), predominance of mixed race (74.1%), with (50%) of men using polypharmacy and (42%) having one or more disabilities. A significant predominance of vulnerable elderly people was found (90.3%), with fair or poor self-rated health (74.2%), with physical limitations (80.6%) and disability (67.7%) (p < 0.05). As for mental health, it was observed that for both anxiety and stress, the lowest levels predominated, 87.1 and 54.8%, with no correlation with the vulnerability profile. Final considerations: It was possible to identify that institutionalized elderly people may be susceptible to chronic diseases, mostly hypertension and DM, although they have an adequate nutritional status based on BMI, many elderly people are overweight, with a high percentage of fat and loss of mass. muscle mass that may indicate the diagnosis of sarcopenia, where the loss of muscle mass is one of the clues for the diagnosis, it was possible to identify the predominance of vulnerability, although the perception of anxiety and stress was considered low, with no relationship with elderly people being or not vulnerable.

     

17
  • MONIQUE LEIA ARAGÃO DE LIRA
  • EVALUATION OF VACCINATION COVERAGE IN BRAZIL: A TIME SERIES STUDY FROM 2000 TO 2022

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • ANA ELZA OLIVEIRA DE MENDONCA
  • DIANA PAULA DE SOUZA REGO PINTO CARVALHO
  • FABIA BARBOSA DE ANDRADE
  • Data: 19 déc. 2023


  • Afficher le Résumé
  • The mission of the National Immunization Program is based on the control and eradication of vaccine-preventable diseases. Insufficient campaigns and declining vaccination coverage can increase the burden of endemic infectious diseases and the risk of resurgence of eliminated pathogens. In view of this, this study aims to assess vaccination coverage in Brazil, based on the time series from 2000 to 2022. This is a national population-based ecological study, using secondary data obtained from the Department of Informatics of the Unified Health System of the Ministry of Health, collected from February to May 2023. The dependent variables used were vaccination coverage and immunobiologicals, and the independent variables were Brazilian regions, states, years and underage age group. The data was analyzed using Excel 2016 for Windows, Joinpoint Regression Program and Power Business Intelligence. The results obtained in this study point to overall vaccination coverage of the Brazilian population above 80% in 2001, 2004, 2011, 2014 and 2015 and a considerable decline from 2016 onwards, with the lowest rates recorded in 2016 and 2021. In the temporal analysis, the states of the North, Northeast and Southeast had the lowest overall average vaccination coverage rates for the period. In addition, the linear regression showed four temporal variations with straight line segments to explain the autocorrelation, showing equivalent breakpoints in the 2013-2016, 2016-2019 and 2019-2022 periods, following a decreasing, increasing and decreasing order. The Northern region shows a negative variation with statistical significance in the 2019-2022 segment, confirming the downward trend. As for immunobiologicals in children under two years of age, the BCG vaccine leads the highest rates in the Brazilian states, reaching parameters above expectations (90%). In the state of Espírito Santo, the rates developed by the polio vaccine surpass BCG, and in all the country's states the target against polio (95%) is reached, except in Amapá. Another immunobiological that performs well is dose one of the triple viral vaccine, with the states of Amazonas, Amapá and Acre failing to reach the target (95%). In the regions of Brazil, high rates of vaccination coverage were identified in 2015 in the Northeast, especially in the states of Ceará and Pernambuco. The same behavior in 2015 can be seen in the North, with emphasis on the state of Rondônia, in the Midwest with the state of Minas Gerais and in the South with visibility in the state of Santa Catarina. In the Southeast of the country, high vaccination rates are not identified in a specific year, so it can be seen that the Federal District leads the rates in the period from 2004 to 2010, followed by a downward trend in subsequent years, and the state of Mato Grosso do Sul recorded high vaccination rates in 2014 and 2015. The importance of the strategy of systematic updating of health professionals, training in information systems, as well as the microplanning of high-quality vaccination activities of the routine program, intensification and campaigns is essential for all stages of vaccination to be carried out properly and safely, reaching as many people as possible.

18
  • ANA ELISA BARBOZA DE SOUZA
  • EXTERNAL CAUSE MORTALITY IN BRAZIL: TIME SERIES FROM 2000 TO 2020

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • ANA ELZA OLIVEIRA DE MENDONCA
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • FABIA BARBOSA DE ANDRADE
  • Data: 19 déc. 2023


  • Afficher le Résumé
  • Mortality is one of the main health indicators in the world. External causes are among the leading causes of mortality in Brazil and worldwide, as well as being responsible for a large proportion of hospital admissions. In 2019, Brazil was the country with the 2nd highest number of deaths from injuries in the world. During the same year, the country ranked 1st in the Central and South American region.  They occupy 3rd place in the ranking of Brazilian deaths, in 2020 alone they were responsible for more than 146,000 deaths, even though they are tabulated in the list of preventable causes. Thus, this study aims to evaluate mortality from external causes in Brazil, as well as the most prevalent cause, considering a historical series from 2000 to 2020. This is an ecological study with a quantitative approach, using data on the number of deaths from external causes in Brazil between 2000 and 2020. Data was collected from the Information Systems of the Unified Health System, concentrated in the Department of Informatics of the Unified Health System, filtering deaths from external causes by dependent variable and year, education level, race, age group, place of occurrence, marital status and category as independent variables. Data was collected during the period September and October 2022, and Joinpoint software was used for data analysis to calculate linear regression and trends in Brazilian regions. The results showed an upward trend in mortality from external causes in Brazil and the regions in the early years, and a downward trend in the later years of the study. In addition, the majority of deaths are concentrated in the male population, aged 20 to 29, with 4 to 7 years of schooling. The Southeast region shows a difference when compared to Brazil and the other regions, demonstrating that even though it is a common and worrying cause of mortality, there are differences between the regions, both in terms of numbers and causality. At the same time that some groups show a significant increase in the number of deaths, others show a decline, thus changing the behavior of the total number of deaths from external causes throughout the country, as well as in the regions. In addition, the majority of external cause deaths occurred in the male population, among people aged between 20 and 29, brown and single. Among the main deaths are assault by gunshot or other firearm or unspecified, motor vehicle and non-motor vehicle accidents and other types of unspecified vehicles, assault by sharp or penetrating object and intentional self-harm, hanging, strangulation or suffocation. With regard to the most prevalent cause, i.e. aggression caused by the discharge of another firearm or other weapon, 712,475 deaths were recorded, with the highest number recorded in 2013, corresponding to a rate of 51 deaths per 100,000 inhabitants. In view of this, it is necessary to evaluate the application of protective public policies, as well as socio-educational measures and laws that deal with this issue, in order to protect these sensitive preventive conditions, helping to reduce mortality rates from external causes.

Thèses
1
  • VICTOR HUGO DE OLIVEIRA SEGUNDO
  • Attitude, Movement and Choices Program for a healthy life in adolescents: relationship between sedentary behavior and cognitive performance

  • Leader : GRASIELA PIUVEZAM
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • GILBERTO MARTINS SANTOS
  • GRASIELA PIUVEZAM
  • NAILTON JOSÉ BRANDÃO DE ALBUQUERQUE FILHO
  • PAULO MOREIRA SILVA DANTAS
  • Data: 16 févr. 2023


  • Afficher le Résumé
  •  

    Adolescence is a period marked by several neuroendocrine changes that influence brain development and behavior. Adolescents are more likely to adopt risky behaviors in their lifestyle, including sedentary behavior. In this sense, intervention studies have sought to develop efficient strategies to encourage adolescents to adopt a healthy lifestyle. However, although promising actions can be identified in the literature, the real mechanism that acts in the regulation of behavior in adolescents seems to be associated with the neurotrophin Brain-Derived Neurotrophic Factor (BDNF), and studying how risk behaviors influence its secretion are of great relevance to develop more effective interventions. Therefore, the objective of this thesis is to describe the theoretical foundation to the planning of a school-based multicomponent intervention with combined actions to promote physical activity, reduction of sedentary behavior and food and nutrition education, and the possible consequences for cognitive performance and adolescent health. The methodology of this thesis is described in the format of a collection of articles and was divided into four stages. The first stage describes a systematic review that was developed during the theoretical foundation studies for planning the intervention of the Attitude, Movement and Choices for a Healthy Life Program (AME Program), and it was possible to identify the need to implement a specific training stage for physical education teachers. In the second stage, was detailed the methodology of a systematic review that will be developed with the objective of investigating the association between sedentary behavior and BDNF in adolescents. The methodological protocol for the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the identifier CRD42022369220 and follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The third stage presents this completed systematic review, with all search results and analysis of information extracted from the included articles. The fourth step is a study of rationale and theoretical foundation for the methods addressed in the sedentary behavior axis of the AME Program intervention, which was registered on the Brazilian Registry of Clinical Trials platform under the number RBR-86xv46. The results of this thesis are based on the production of studies and, considering that part is still in the writing phase, the appreciation and suggestions of the examining board will contribute to the methodological and scientific quality of the articles. It can be said that the AME Program is an integrated, sustainable and low-cost proposal, with great potential to produce benefits in lifestyle, cognitive performance and health of adolescents. Finally, the results of these studies will strengthen evidence-based practice in research aimed at promoting health in the school context.


2
  • SUELY DEYSNY DE MATOS CELINO
  • EVALUATION OF PRIMARY HEALTH CARE IN THE CONTEXT OF THE COVID-19 PANDEMIC

  • Leader : ANA ELZA OLIVEIRA DE MENDONCA
  • MEMBRES DE LA BANQUE :
  • ANA ELZA OLIVEIRA DE MENDONCA
  • ARDIGLEUSA ALVES COELHO
  • FABIA BARBOSA DE ANDRADE
  • JOAO MARIO PESSOA JUNIOR
  • LUCIANA ARAUJO DOS REIS
  • Data: 28 avr. 2023


  • Afficher le Résumé
  • Primary Health Care (PHC) is essential in facing the COVID-19 pandemic, due to its characteristics of territorialization and bond, having as main responsibilities in this period: health surveillance in the territories; attention to suspected or confirmed users of the disease; social support to vulnerable groups and; continuity of its own actions. The general objective of the thesis was to evaluate the Primary Health Care (PHC) services during the Public Health Emergency period, due to the COVID-19 pandemic. The results are presented in three articles. The first and second contemplate the quantitative assessment of PHC, regarding its attributes, through the PCATool-Brasil instrument, from the perspective of users and professionals (doctors and nurses), respectively. The general and essential scores attributed by both users and professionals revealed services with little focus on PHC. For users, a high evaluation score was associated with low education, indicating that individuals with a lower educational level tend to be more satisfied with health services and; the highest average time of professionals in health units, an association also verified in the evaluation of professionals, which reflects the need for a bond between them and users to guarantee quality services. The attribute access to first contact had the lowest mean in both studies, which suggests that services do not meet the health needs of the population in a timely manner or comprehensively. The third article was developed through qualitative analysis, with the aim of understanding the work process of PHC teams during the pandemic and their role in coping with COVID-19. Semi-structured interviews were carried out, submitted to content analysis, and later, to the Descending Hierarchical Classification of the IRAMUTEQ software, which led to two thematic categories: Challenges in the work process of the teams and; The role of PHC in coping with the pandemic and the organization of the care network. The scarcity of personal protective equipment, with a limitation of active professionals and the lack of physical structure of the health units were aspects considered limiting in the work process, in addition to the suspension of continuous care. PHC is understood as the gateway to services and the users' main contact with the care network, although it was clearly underused in the scenario studied. It was possible to observe how much the pandemic impacted the services and these, in turn, must face new challenges: rescuing the monitoring of the chronically ill; intensify surveillance actions in the territory, through the work of community health agents; encourage vaccination of children, adults and the elderly, both for COVID-19 and for existing vaccines; and, mainly, to use strategies to improve user access.

3
  • JANMILLI DA COSTA DANTAS SANTIAGO
  • Temporal trend and spatial distribution of gestational and congenital syphilis in Brazil, period 2008-2018

  • Leader : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • MEMBRES DE LA BANQUE :
  • ANA ELZA OLIVEIRA DE MENDONCA
  • ELIÃ PINHEIRO BOTELHO
  • ELLANY GURGEL COSME DO NASCIMENTO
  • RICARDO ALEXSANDRO DE MEDEIROS VALENTIM
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: 4 mai 2023


  • Afficher le Résumé
  • Introduction: Syphilis has become a public health problem in several regions of the world. Objective: To analyze the temporal trend and spatial distribution of gestational and congenital syphilis in Brazil, from 2008 to 2018. Method: This is a study of different methods. 1) Time series study of the detection rate of gestational syphilis and correlation between socioeconomic and health service variables. Data were extracted from publicly accessible national databases. The Joinpoint Regression software and Pearson's correlation coefficient were used. 2) Ecological study of spatial analysis of the detection rate of gestational syphilis and spatial correlation between socioeconomic variables and health services. Extracted secondary data, aggregated in 482 Immediate Urban Articulation Regions. GeoDa software was used. 3) Ecological study of temporal trends and spatial distribution of the incidence rate of congenital syphilis and spatial correlation between socioeconomic variables and health services. Secondary data extracted. Joinpoint Regression and GeoDa software were used. 4) Protocol for a scoping review with the objective of proposing a protocol to identify and map the use of Spatial Analysis as a tool in research on syphilis in the health area. It was based on the Joanna Briggs Institute manual and guided by PRISMA-ScR. Results: In the first study, the South region showed the greatest trend; while the Midwest, smaller. Correlation detected with the Municipal Human Development Index, illiteracy rate, percentage of primary health care coverage and proportion of doctors, nurses and basic health units per inhabitant. In the second study, the detection rate of gestational syphilis was unevenly distributed and showed a spatial correlation with the Municipal Human Development Index, percentage of primary care coverage and proportion of physicians per population. In the third study, the incidence rate of congenital syphilis showed an upward trend and uneven distribution. It showed a spatial correlation with the percentage of individuals with inadequate water supply and sanitation and the percentage of live births with 1 to 3 prenatal consultations. The fourth study explained the research question, the databases for searches, inclusion and exclusion criteria, data extraction worksheet and the type of data analysis. Final considerations: Investments in health and social policies are necessary to mitigate social vulnerabilities and strengthen primary health care for syphilis control.

4
  • JULIANA PONTES SOARES
  • BURNOUT SYNDROME: AN ANALYSIS OF WORKERS WHO WORK IN HEALTH MANAGEMENT DURING THE COVID-19 PANDEMIC
  • Leader : JANETE LIMA DE CASTRO
  • MEMBRES DE LA BANQUE :
  • ANA CRISTINA DE OLIVEIRA E SILVA
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • ISABELA CARDOSO DE MATOS PINTO
  • JANETE LIMA DE CASTRO
  • MARIA APARECIDA DIAS
  • Data: 24 mai 2023


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  •  

    Introduction: Burnout is a work-related psychological syndrome. During the Covid-19 pandemic, its increase was observed in several work spaces. Objective: To investigate the use of the Maslach Burnout Inventory scale and the existence of Burnout Syndrome in health managers, with a view to understanding the influence of work on the mental health of these professionals during the COVID-19 pandemic. Method: Quantitative and qualitative study developed in five stages: 1) Integrative Review, carried out to understand the effects and consequences of working conditions during the COVID-19 pandemic on the mental health of health professionals, highlighting the factors that may be associated with the development of burnout syndrome. IRaMuTeQ was used and through Descending Hierarchical Classification a dendrogram with 6 classes was obtained. 2) Scope Review Protocol and 3) Scope Review. Through the protocol and the review, it was possible to identify and map studies that used the Maslach Burnout Inventory to assess Burnout Syndrome in health professionals who work in public health services. Developed in accordance with the criteria of the JBI Institute Reviewer’s Manual and guided by PRISMA-ScR. 4) Observational, cross-sectional, quantitative study, designed to investigate the prevalence of Burnout Syndrome and associated factors in public health managers during the COVID-19 pandemic. A sociodemographic/occupational questionnaire and the Maslach Burnout Inventory were used. Analysis performed using descriptive statistics with presentation of simple and absolute frequency. Bivariate statistics were performed using Pearson's chi-square test. Text data were analyzed and expressed visually by word clouds. 5) Descriptive, qualitative study to identify perceptions of professional health managers regarding the repercussion of their position on their mental health and strategies used to deal with adversities at work. Remote interviews were conducted. IRaMuTeQ was used and through Descending Hierarchical Classification a dendrogram with 6 classes was obtained. Results: The first study showed professional experience, working conditions, financial situation, relationship between work and family, fear of contamination and transmission of the disease as factors associated with Burnout. The protocol guided the scope review, 55 studies were selected, published between 1999 and 2021 in 32 countries, developed mostly in Brazil, with physicians, 22 versions of the Maslach Burnout Inventory were identified with different items, likerts and cutoff points. Included studies had recommendations and implications for clinical practice. Fourth study showed a prevalence of Burnout of 12.6%. Not having children, being partially qualified for the position, not feeling valued at work, were factors associated with the syndrome. A fifth study showed insufficient human resources, inadequate work environment and excessive demands, as stressors. As strategies to deal with adversities: participatory management, listening to people, meetings and access to Worker's Health Assistance Services. Conclusion: Studies have shown a higher prevalence of Burnout in managers, when compared to the pre-pandemic period, associated factors and strategies used to deal with adversities at work. The results may contribute to the development of strategies to promote and protect the mental health of these professionals.

     

5
  • MARIANA SILVA BEZERRA
  •  

     

    Food environment and its relationship with food insecurity and socioeconomic conditions


  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • ANA CLARA DA FONSECA LEITÃO DURAN
  • CLELIA DE OLIVEIRA LYRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • FABIO RESENDE DE ARAUJO
  • LARISSA MENDES LOURES
  • Data: 18 juil. 2023


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    Introduction: The food environment is the physical, economic, political and sociocultural context in which each consumer engages with the food system to acquire, prepare and consume food. This environment involves the availability, accessibility, convenience, promotion, quality and sustainability of food. Compromising access to and availability of healthy foods in sufficient quantities characterizes food insecurity. Objective: To analyze the food environment and its relationship with the occurrence of food insecurity at home and socioeconomic conditions. Method: It is a study of different methods. 1) Systematic review on the relationship between food environments and food insecurity, based on a systematic literature search in the PubMed, Web of Science, Science Direct, EMBASE and LILACS databases in January 2023. 2) Ecological study with census tracts of the city of Natal-RN, based on the identification of food acquisition establishments, grouped in the categories of in-natura or minimally processed, ultra-processed or mixed. Food deserts were calculated by the density of healthy establishments divided by 10,000 inhabitants and classified as less than or equal to the 25th percentile. We used socioeconomic data from the 2010 Census. Multiple Poisson regression was used to observe the relationship between the existence of food deserts and swamps and social infrastructure. 3) This is a quantitative and cross-sectional study with individual demographic, socioeconomic and food insecurity data from the Brazuca Natal Study and the relationship with the census tracts classified into deserts and food swamps. Results: In the systematic review, 22 articles were included, 18 of which found an association between food environments and food (in)security, the majority being in developed countries, in the global North. In the ecological study, it was identified that 51.45% of the food acquisition establishments in the city were of the ultra-processed type. There was a higher density of food establishments in regions with better socioeconomic conditions. The census tracts classified as food deserts (25%) were associated with household conditions and worse infrastructure in the sector. While 75% were identified as a food swamp, associated with better infrastructure in the sector. In the cross-sectional study, food insecurity was found in 42.3% of respondents, associated with individual and sector demographic and socioeconomic variables. Deserts and food swamps did not show a spatial distribution pattern and were not associated with food insecurity. Conclusion: There are inequalities in the distribution of different food acquisition establishments in the city of Natal/RN, with a predominance of food swamps. Thus, actions are needed to improve the sectors' infrastructure, decentralize the supply of healthy foods and limit the sale of ultra-processed foods, with a view to ensuring healthy food choices. It is important that new studies assess the different dimensions of the food environment, to allow a better identification of factors associated with food insecurity in different socioeconomic contexts.


6
  • ANA PATRICIA DE QUEIROZ MEDEIROS DANTAS
  • MENTAL HEALTH OF HEALTH PROFESSIONALS AT EMERGENCY CARE UNITS (UPAs) IN NATAL - RN IN THE CONTEXT OF COVID-19

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • ROSANA ROSSETO DE OLIVEIRA
  • ANNA CECILIA QUEIROZ DE MEDEIROS
  • CLECIO DE OLIVEIRA GODEIRO JUNIOR
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • JOÃO BOSCO FILHO
  • MARIA ANGELA FERNANDES FERREIRA
  • MARIA APARECIDA SALCI
  • Data: 22 sept. 2023


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  • The Covid-19 pandemic has had serious implications for individual and collective health and emotional and social functioning. At the same time, it triggered an overload on health systems around the world, directly affecting the mental health of health professionals, especially professionals in the urgent and emergency sectors who have higher levels of stress, anxiety and depression than the general population. In this sense, the present study proposes to analyze the prevalence and factors associated with mental illness among workers at Emergency Care Units in Natal-RN. This is a cross-sectional quantitative study, aimed at nurses, nursing technicians/assistants and physicians at the 04 Emergency Care Units in Natal-RN. The collection was carried out from July to December 2022 with the application of questionnaires, which contain socio-occupational data, personal clinical health data and personal and family history of mental disorders and specific questionnaires Maslach Burnout Inventory-Human Services Survey (MBI -HSS), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). The questionnaires were sent via whattsapp or accessed via QR code and answered after signing the Free and Informed Consent Form through the Google® forms platform. 172 participants were included in the survey. The sample consisted of 82% women, with a mean age of 39.63 years (SD 9.521) and mean time since graduation was 11.9 years (SD 7.68). The prevalence of Burnout in the sample was 51,2% and, 47.1% had high Emotional Exhaustion, 27.9% high Depersonalization and 24.4% low Personal Fulfillment. Regarding to anxiety symptoms, 28.5% had moderate to severe anxiety symptoms and the prevalence of depressive symptoms was 16 .3%. In view of the results found, it is urgent to create government actions that act at the management, organizational and individual levels to prevent new injuries in frontline health professionals, as well as in the treatment of disorders.

7
  • ANA GABRIELLA COSTA LEMOS DA SILVA
  • Nutritional status of vitamin E and cardiovascular risk factors among adults and older adults: Brazuca Natal Study

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • GRASIELA PIUVEZAM
  • RICARDO NEY OLIVEIRA COBUCCI
  • SORAIA PINHEIRO MACHADO ARRUDA
  • Data: 18 déc. 2023


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  • Introduction: Cardiovascular diseases (CVD) are the principal cause of morbidity and mortality in the world. Therefore, experts have studied strategies for preventing and treating cardiovascular events. One of this knowledge is vitamin E stands out for its antioxidant and anti-inflammatory properties, supported by findings that higher dietary intake of vitamin E and higher concentrations of serum α-tocopherol (α-TOH) are associated with a lower risk of cardiovascular events. Therefore, data on the nutritional status of vitamin E in the population and its relationship with cardiovascular risk factors are relevant strategies to support programs and public policies aimed at preventing and treating CVD. Objective: To evaluate the nutritional status of vitamin E and its association with cardiovascular risk factors in adults and older adults in the Brazuca Natal Study. Methods: This is a study of different methodological strategies. 1) The narrative review aimed to verify if surveys could demonstrate an association between serum vitamin E and the occurrence of CVD. Moreover, we would like to understand whether vitamin E deficiency (VED) should also be considered a public health problem. 2) Cross-sectional study, divided into two scientific articles. The first article evaluated the prevalence of VED and whether cardiovascular risk factors influenced serum α-TOH status in adults and older adults in the Brazuca Natal Study. We performed a multiple linear regression analysis between serum α-TOH (dependent variable) and cardiovascular risk factors. The second article aimed to evaluate vitamin E intake, and we would like to identify the principal food sources of this micronutrient intake. To this end, we analyzed socioeconomic and demographic conditions (sex, age, color/race, education, per capita income, and health district of residence), and vitamin E intake (dependent variable). Results: In the narrative review, we observed that VED could be a public health problem. The prevalence of VED varies from 0.6% to 55.5% in the world, with higher percentages in Asia and Europe, where the high mortality rates from CVD stand out. Population studies suggest the protective effects of vitamin E on CVD. However, intervention studies with α-TOH supplementation have not confirmed its cardioprotective action. In article 2 of the cross-sectional study, we observed that 24.8% of adults and older adults in Natal had VED, and 89% had low concentrations of circulating α-TOH (below 30 µmol/L). We found that females had higher mean serum α-TOH values. In addition, the cardiovascular risk factors that increased the individuals' serum α-TOH were a high visceral adiposity index and higher global risk score values. Article 3 demonstrated that 95.7% of individuals had a low intake of vitamin E, considering the Estimated Average Requirement (EAR) of 12 mg/day, with lower intake values among older adults, women, and those who have a per capita income of less than half minimum wage and with less education. Soybean oil, açaí pulp, and red meat provided the highest content of ingested vitamin E. Conclusion: the study demonstrated a high prevalence of VED and low consumption of vitamin E in the studied population. We verified an association between serum α-TOH and cardiovascular risk factors.

8
  • RAMON EVANGELISTA DOS ANJOS PAIVA
  • ACCIDENTS AT WORK IN BRAZIL AND THEIR IMPACT ON WORKER MORBIDITY AND MORTALITY: A TIME SERIES STUDY FROM 2011 TO 2021 

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • ANA ELZA OLIVEIRA DE MENDONCA
  • ARDIGLEUSA ALVES COELHO
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • FABIA BARBOSA DE ANDRADE
  • Data: 20 déc. 2023


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  • Introduction: It is clear that the greatest advance in workers' health in Brazil was its constitutional recognition as an area of public health. Understanding the impact of the work process on Workers' Health, the Unified Health System describes the promotion of a safe working environment as one of its objectives. In Brazil, according to the Social Security Statistical Yearbook published in 2019, around 582,000 accidents at work were recorded. General objective: To assess the morbidity and mortality of occupational accidents in Brazil between 2011 and 2021. Method: Ecological time series study, using secondary sources from the National Institute of Social Security, of workers registered through the Communication of Accidents at Work. After collecting the data, it was stored in Microsoft Excel® and Joinpoint® and Python software was used for regression and correlation analysis. Results: Brazil presented a rate of 61 deaths for every 100,000 formal work accidents in 2011 with a growth curve to 68 deaths for 100,000 work accidents in 2018 however, in 2021 the country presents a downward curve to 32 deaths for 100,000 work accidents, being a decrease of 52% in relation to the beginning of the study. Accidents to the upper limbs were found to be the most affected part of the body, with the highest rates in the south and southeast. When observed longitudinally, these rates showed an increase in cases between 2011 and 2021, in the South and Midwest regions. If analyzed in relation to the Brazilian Classification of Occupations, industrial workers stand out from the rest, followed by service providers and mid-level technicians. As for the International Classification of Diseases and Related Health Problems, in the chapter, Injuries, poisoning and certain other consequences of external causes, they stand out as the most prevalent pathologies among workers, with a temporal variation in the year 2013, then showing a downward curve until the year 2021. The drop is more pronounced in the Southeast and the Midwest shows a higher number of final cases than the initial number in 2011. Discussion: The global panel shows how Brazil is part of a scenario seen around the world, in which the occupation is linked to more than 2 million deaths, with 318,000 deaths due to accidents and 2 million due to work-related illnesses. Accidents at work account for 18% of deaths in low- and middle-income countries such as Brazil, compared to only 5% in high-income countries. onclusion: The creation of public policies such as the National Workers' Health Policy has corroborated other actions such as the strengthening of the National Comprehensive Workers' Health Care Network, as well as being related to the presence of more intersectoral actions as a result of the maturing of the sectors responsible for Workers' Health.

9
  • LAVINIA MABEL VIANA LOPES
  • MARKS OF A PANDEMIC IN BRAZIL: BIOETHICAL ANALYSIS OF FACTORS RELATED TO THE BRAZILIAN STATE'S POSTURE TOWARDS COVID-19

  • Leader : KARLA PATRICIA CARDOSO AMORIM
  • MEMBRES DE LA BANQUE :
  • KARLA PATRICIA CARDOSO AMORIM
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • ELIANA COSTA GUERRA
  • CECILIA NOGUEIRA VALENCA
  • VOLNEI CARAFFA
  • JOÃO BOSCO FILHO
  • SAULO FERREIRA FEITOSA
  • Data: 22 déc. 2023


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  • Brazil came to occupy second place in the absolute number of deaths from Covid-19 and, in March 2021, it was considered the global epicenter of the pandemic. The lack of adoption of alternatives for managing the health crisis that privileged the principles, methods and practices of epidemiological surveillance to combat it allowed this scenario. Added to this, scientific denialism on the part of the Brazilian federal government continued to be established in the country, with the perpetuation of discourses of contempt for universities and the rights of the most vulnerable populations. Thus, this thesis aims to analyze, in the light of Intervention Bioethics (BI), factors related to the Brazilian federal government's stance towards Covid-19. This is a Case Study with a qualitative approach. We opted for several sources of evidence, using the triangulation of data from documents relating to the period of the Covid-19 pandemic in Brazil and which were in accordance with the proposed objectives: (a) videos and texts of official statements by the federal government, carried out by the former President of the Republic, during the first year of the Covid-19 pandemic in Brazil, 2020; (b) the final report of the Covid-19 CPI, carried out in 2021 in Brazil; (c) journalistic/news articles that recount important events in Brazil at the time of the Covid-19 pandemic; and (d) publications by ANVISA about the health guidelines for containing Covid-19 in Brazil, that is, which ethical parameters should be followed, according to the regulations published by that body. The results were analyzed using Thematic Content Analysis and are arranged in three sections: (1) published article entitled “The Covid-19 CPI: a bioethical analysis of what was revealed in the management of the pandemic”. This article aims to discuss, based on the main findings of the Covid-19 CPI, the stance of the Brazilian federal government and its consequences in the management of the pandemic, in light of BI; (2) article accepted for publication entitled “Bioethics, Brazilian official pronouncements and the Covid-19 pandemic: irresponsibility and lack of protection”. This article analyzes the official statements of the Brazilian federal government, made by Bolsonaro in 2020, during the Covid-19 pandemic. For this critical analysis, the BI theoretical framework was used; (3) article under construction for subsequent submission entitled “Management of the Covid-19 Pandemic in perspective: bioethical inconsistencies between ANVISA and the Brazilian federal government”. This article presents data collected in ANVISA publications about health guidelines for combating the Covid-19 pandemic, and seeks to analyze, through BI, the bioethical inconsistencies between the measures proposed by the Agency and those adopted by the federal government. Based on the analysis carried out in this thesis, it is concluded that the bioethical precepts proposed by BI were not respected in confronting the Covid-19 pandemic in Brazil, highlighting the negligence, on the part of the Brazilian federal government, of ethical parameters such as solidarity, corporeality, responsibility, vulnerability, equity, justice and the 4 'feet' of BI that involve precaution, prudence, protection and prevention.

     

     

     

     

2022
Thèses
1
  • IZABELLE BEZERRA COSTA
  • CONGENITAL SYPHILIS IN BRAZIL AND INDICATORS PROPOSED BY THE CEGONHA NETWORK IN THE FRAMEWORK OF PRENATAL CARE

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANDRÉ LUIS BONIFÁCIO DE CARVALHO
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • TATYANA MARIA SILVA DE SOUZA ROSENDO
  • Data: 25 janv. 2022


  • Afficher le Résumé
  • Compared to other Latin American countries, Brazil has stood out over the years for presenting high rates of congenital syphilis notifications – denouncing, in particular, the evident deficit of health interventions during prenatal care. In 2011, in an attempt to improve maternal and child health conditions in the country, the “Rede Cegonha” programm was created, a policy that guides the implementation of a new model of health care for women and children, the organization of the care network and the reduction of maternal and child mortality. The objective of this research was to analyze the incidence of congenital syphilis in Brazilian cities according to indicators proposed by “Rede Cegonha” in the context of prenatal care. This is an observational ecological type study with an analytical character, whose sample consisted of 257 municipalities with a number of inhabitants equal to or greater than one hundred thousand (n = 257). Descriptive analysis of dependent and independent variables and bivariate analysis by Poisson Regression by Robust Variance were performed for the outcomes “incidence of congenital syphilis” and “ratio between congenital syphilis and syphilis in pregnant women”. In the trend analysis (2015-2019), marginal means were estimated using Split-Plot Analysis of Variance (ANOVA) for the outcomes chosen according to the independent variables. The cross-sectional analysis showed that the mean incidence of congenital syphilis was 42% higher in municipalities with HDI up to 0.785 (RM=1.42; p<0.001) and 36% higher among populations with availability of a rapid test below 50% (RM = 1.36; p<0.005). The ratio between congenital syphilis and syphilis in pregnant women was 33% higher among municipalities with a proportion of poor people above 6.9% (RM=1.33; p<0.001) and 24% higher among locations with less than 50% availability of rapid tests (RM=1.24; p<0.001). There was no statistical significance of the “Prenatal Quality Score” compared to the outcomes. Trend analysis showed a strong effect of time (years) on the incidence of congenital syphilis (F=0.146; p<0.001) and on the ratio between congenital syphilis and syphilis in pregnant women (F=0.192; p<0.001). In contrast, it was verified that the interaction between year and Human Development Index (HDI) and year and “Prenatal Quality Score” had low effects on outcomes. The findings of this study refer to a worrying national scenario with regard to the prevention and control of congenital syphilis. However, it is noteworthy that the availability of rapid tests and better living conditions and health of the population, especially regarding socioeconomic aspects, were associated with better outcomes. The present research highlighted the important features of inequality in the occurrence of congenital syphilis, drawing attention to strategies to reduce health inequities and improve prenatal care.

2
  • RICARDO AUGUSTO DE CARVALHO JANSEN FERREIRA CUNEGUNDES
  • Chikungunya Fever in the older adults in Rio Grande do Norte - Brazil

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • DIANA PAULA DE SOUZA REGO PINTO CARVALHO
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • KENIO COSTA DE LIMA
  • Data: 28 janv. 2022


  • Afficher le Résumé
  • INTRODUCTION: Chikungunya Fever is a disease that, in its acute phase, causes polyarthralgia, myalgia and fever, and its symptoms can last for a period of up to three years after its initial presentation. After the great national outbreak experienced in the year 2015, in Rio Grande do Norte, Brazil, more than 16,800 cases have been registered, until the year 2019. OBJECTIVE: Analyze the cases of elderly people affected by Chikungunya Fever in Rio Grande do Norte, between 2016 and 2020. METHODS: This is a hybrid analytical epidemiological study, part cross-sectional, part ecological. The data on disease notification and deaths of the elderly due to Chikungunya Fever were obtained from the Information System for Notifiable Diseases and the Mortality Information System, respectively. The population was composed of elderly people, aged 60 years or older, residing in Rio Grande do Norte, in the period between 2016 and 2020. The data were analyzed according to the dependent variables, disease notification and deaths, through the Software SPSS, version 20. An evaluation of the Epidemiological Surveillance Systems was performed, regarding their quality and acceptability. The ecological part will be composed of a spatial analysis, according to the municipalities of residence, done through the TerraView software; and a linear regression analysis, done with the Joinpoint software, to evaluate any change in the trend line. RESULTS: There were 4,994 cases of elderly people affected by Chikungunya Fever, between the years 2016 and 2020, predominantly females (63.3%), with an average age of 70.5 years (±8.2 years), black and brown (62.1%), with 49.4% without having completed elementary school. In the period, 47 deaths (0.94%) with Chikungunya fever as the cause of death were registered in the Mortality Information System. The completion of all data evaluated by the municipalities was considered regular (67.34%). There were 117 cases (2.29%) with duplicate notification. Regarding the dissonance of data among the three spheres, a discrepancy was observed by the low notification of cases by the headquarters city of VI URSAP, compared to data at state and national levels; and by the high number of notifications by the headquarters of VIII URSAP, also compared to state and national levels.

3
  • KARINY KELLY DE OLIVEIRA MAIA
  • HEALTH-RELATED BEHAVIORS OF ELDERLY PEOPLE IN LABOR ACTIVITY IN A PUBLIC UNIVERSITY
  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ELIANA COSTA GUERRA
  • KENIO COSTA DE LIMA
  • VANESSA DE LIMA SILVA
  • Data: 31 janv. 2022


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  • The increase in life expectancy is celebrated as a breakthrough for humanity, but it brings with it the aging of the population and consequently a great challenge for the contemporary world. Know the features and behaviors related to the health of the elderly population will allow the implementation of policies and actions aimed at the real needs of this public. To analyze the behaviors related to the health of elderly people in work activity in a public university. Descriptive and inferential cross-sectional study, with an approach quantitative. The sample consisted of 80 individuals and data were collected between months from May to December 2021. It was carried out from descriptive analyzes to Pearson's chi-square test or Fisher's exact test for a significance level of 95%, in addition to regression of Poisson and cluster analysis, through the IBM SPSS software. Most of the interviewed was male (n=45, 53.8%), mean age was 64 years, color/race that predominated was black (n=40, 50.0%). It is noteworthy that the technical servers administrative staff participated more (n=46, 57.7%) and in the length of service the vast majority have more than 41 years (n=36, 45.0) of service at UFRN. A significant association was found between position and up-to-date influenza vaccine (p<0.03), between religion and demand for care doctor in the last year (p<0.03), sexual intercourse in the last year and sex (p<0.001), marital status (p<0.001) and cohabitation (p<0.02). After creating two clusters, eight individuals did not clustered to no cluster and were considered to have health-related behaviors excellent. Cluster 1 was considered to have very good behavior and cluster 2 with regular behaviors. A significant association was found between the clusters and marital status (p<0.04) and cohabitation (p<0.05), with both present in cluster 1. Although the study shows that in general the individuals who participated in the research showed good health-related behaviors, there was still a portion that reported health risk behaviors, which highlights the challenges on self-care in the elderly population. With this, it is possible to perceive the importance of raising awareness of these older people towards health risk behaviors and their impacts on health and quality of life, mainly in providing information and actions for them to take decisions about your behaviors.

     

4
  • VICTOR HUGO DE FRANÇA DO NASCIMENTO
  • EVALUATION OF THE QUALITY OF MATERNAL AND CHILDREN'S CARE FROM THE PERSPECTIVE OF USERS IN PRIMARY CARE IN RIO GRANDE DO NORTE

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • MARIA ANGELA FERNANDES FERREIRA
  • SEVERINA ALICE DA COSTA UCHOA
  • PETRONIO JOSÉ DE LIMA MARTELLI
  • Data: 31 janv. 2022


  • Afficher le Résumé
  • The study aims to analyze the quality of Maternal and Child Health within the scope of
    Primary Care in Rio Grande do Norte in the three cycles of the PMAQ-AB from the
    perspective of users. This is an evaluative, cross-sectional, retrospective study using
    secondary data from the 1º, 2º and 3º cycle of the PMAQ-AB. The sample consisted of 7,787
    users, respectively, 1,085, 715 and 866 Basic Health Units participating in the external
    evaluation of the Program, in the 3 cycles. The dependent variables for evaluation in the three
    cycles were “satisfaction with care”, “material conditions”, “access to health services”,
    “inputs” and “drugs”. For the last three variables, scores were created using the
    interdependence technique (Exploratory Factor Analysis of the Principal Component Analysis
    (PCA) type and Item Response Theory (IRT) type, obtained to reduce the number of variables
    in each dimension and subdimension. Pearson&#39;s chi-square test and Kruskal-Wallis&#39; H test
    were used to compare quality scores, means of satisfaction with care and availability of
    materials, among the three PMAQ cycles. In the organizational dimension, when analyzing
    the quality of care, a significant difference (p&gt;0.001) between the 3 cycles was identified in
    the women&#39;s health subdimension, totaling 51% in the last cycle. Regarding satisfaction with
    care, 90.2% recommended the Basic Health Unit to a friend or family member (p&gt;0.001) and
    only 13.2% (p&gt;0.001) of the users would change their team or Basic Health Unit if had the
    option. The structural dimension showed improvement in the three sub-dimensions 44%
    (p&gt;0.001), drugs 52.4% (p&gt;0.001) and material 93.6% (p&gt;0.001). There is an improvement in
    Primary Care from the perspective of users in Rio Grande do Norte, especially in women&#39;s
    health. It is also evident the importance of investing in quality improvement programs to
    strengthen Primary Care.

5
  • DEBORAH ZULEIDE DE FARIAS MELO
  • Between the Health Crisis and Institutional Racism: The Covid-19 Scenario in the Black Population of the Northeast Region
  • Leader : JANETE LIMA DE CASTRO
  • MEMBRES DE LA BANQUE :
  • JANETE LIMA DE CASTRO
  • MERCES DE FATIMA DOS SANTOS SILVA
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • Data: 31 janv. 2022


  • Afficher le Résumé
  • INTRODUCTION: The covid-19 pandemic brought several challenges to the health sector for the control of the virus that spread throughout the world. Thus, when considering the social determination of health, it is observed that the vulnerable population may be more exposed to illness and worsening of diseases. In this case, the importance of understanding SUS management decision-making in relation to the protection of the health of the black population is highlighted. GOAL: Analyzes the measures of state health management in Northeastern States for the protection of the black population considering the control of covid-19. METHODOLOGY: This is an analytical and exploratory research, with a qualitative approach, with a cross-sectional nature, based on the Epidemiological Bulletins, the State Contingency Plan for the Control of Covid-19 and the State Health Plans of the State Health Departments in the Northeast Region. Data analysis was performed through content analysis and collectively through analytical frameworks. RESULT: About 2,495 Epidemiological Bulletins published in the period from February 27, 2020 to April 30, 2021, 09 State Contingency Plans of Covid-19 and 08 State Health Plans were identified, data from the bulletins show that the black population was the most affected by the pandemic in the Northeast Region compared to other populations. The protection measures for this population found, it was only in one Contingency Plan presented some type of action, and 5 Health Plans presented proposals. FINAL CONSIDERATIONS: According to the assumptions of institutional racism in health and the effects of covid-19 on the black population, negligence in the management of the health sector in planning measures to protect the health of the black population was observed.

6
  • ISAC DAVIDSON SANTIAGO FERNANDES PIMENTA
  • TRAINING OF NON-TECHNICAL SKILLS IN INTENSIVE CARE UNITS: A SYSTEMATIC REVIEW

  • Leader : GRASIELA PIUVEZAM
  • MEMBRES DE LA BANQUE :
  • DANIEL GUILLÉN MARTÍNEZ
  • GRASIELA PIUVEZAM
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • LILIANE PEREIRA BRAGA
  • Data: 10 févr. 2022


  • Afficher le Résumé
  • Non-technical skills are social, personal, and cognitive skills that can influence safety and efficiency in performing tasks. Studies show that in intensive care units, most safety incidents have low performance in these skills as their root cause, and training programs are an alternative to solving this problem. This study aimed to analyze the effect of implementing non-technical skills programs in intensive care units based on Kirkpatrick's evaluation model for training programs, which includes reaction to training, learning, behaviors, and organizational results. For this, we perform a systematic review, registered on the PROSPERO platform under the code: CRD42021244769. We review original articles published in the following databases/portals: Pubmed/Medline, Scopus, Web of Science, Science Direct, CINHAL, EMBASE, and PsycINFO. We include randomized clinical trials, quasi-experimental studies with a control group, or studies with a before and after design. The risk of bias for the included studies was assessed using the Risk of Bias 2, Risk of Bias in Non-randomized Studies of Interventions, and NHI Assessment Tool for Before and After Studies tools. Two pairs of reviewers independently selected and evaluated the works, and in case of disagreement, we consulted the fifth reviewer. From a universe of 3976 documents identified in the databases/portals, 14 studies were included in the review. In the reaction dimension, the participants evaluated the training programs as useful, even though the teaching strategies implemented were different.  Only one study explored the effect of the training program on the learning dimension, however, the difference was not significant. We identified a positive relationship between the adoption of non-technical skills training programs and the improvement of teamwork behaviors, situational awareness, leadership, and communication. In the organizational results, there were no significant changes observed in patient safety culture, as well in the length of stay and mortality rates, and the improvement of process indicators was limited. The analysis of the risk of bias indicated a low methodological quality, mostly linked to the way of measuring the outcomes, predominantly self-reported. The adoption of non-technical skills training programs in intensive care units shows limited effects, but they can contribute to the existing professional training curriculum.

7
  • MELISSA DE OLIVEIRA ARAUJO
  • WOMEN VICTIMS OF SEXUAL VIOLENCE: EVALUATION OF THE CARE OFFERED IN A PUBLIC SCHOOL MATERNITY

  • Leader : KARLA PATRICIA CARDOSO AMORIM
  • MEMBRES DE LA BANQUE :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • KARLA PATRICIA CARDOSO AMORIM
  • WAGLÂNIA DE MENDONÇA FAUSTINO
  • Data: 11 févr. 2022


  • Afficher le Résumé
  • Violence against women is the product of a historical construction that reinforces over the years the figure of women as a submissive object, which weakens and exposes them to the occurrence of numerous aggressions, in all spheres of social life. It has become a serious public health problem, in addition to a crime of violation of human rights, as it is associated with risks of physical and mental health problems, as well as the greater frequency of use of health services. This study is organized from a theoretical discussion, which brings the historical, legal and cultural aspects that permeate the theme of sexual violence, and a snippet of records of care provided in the health service that serves these victims, especially in reality. in the city of Natal, capital of the state of Rio Grande do Norte, located in the Northeast region of the country. This is a field research with a qualitative approach and an evaluative nature that seeks to understand and broaden understanding in order to achieve the proposed objectives, through a documental, field research with semi-structured interviews and direct participant observation of the context studied. The sample consisted of 449 medical records of sexually assaulted women who were assisted in the service from 2015 to 2020, 10 professionals linked to this type of service, 02 managers and finally, 07 women who suffered sexual violence and were assisted in the year 2021 . Respectively, a descriptive analysis of the data collected in the medical records was carried out, aiming to outline the profile of these women and, in relation to the interviews, a content analysis was carried out following the process of elaboration of categories that was based on the content of floating reading, through which the coding of the speeches occurred. The form of selection of registration units was the appearance of specific terms, that is, word repetition, which constituted the framework for the context units through which the categorization (grouping) took place. Through the previous organization of the results, there are three categories of discussion: 1) Profile of women attended at the Januário Cicco Maternity School; 2) Analysis of the care provided; 3) Advances, limits and possibilities of care. The results found suggest that the theme of comprehensive health care for women victims of sexual violence needs to be discussed, as well as the need to broaden the debate and publicize the services in civil society spaces.

8
  • TATIANA MARIA DE OLIVEIRA
  • Food insecurity and overweight among adults and older adults in the Brazuca Natal Study: what is the relationship with food purchase and consumption habits?

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • ALANDERSON ALVES RAMALHO
  • Data: 29 avr. 2022


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  • The right to food begins by guaranteeing all citizens daily access to food in sufficient quantity and quality. It is the right to food to have correct information about the content of food and preparations, healthy eating practices and lifestyle, which promote health and reduce risks for diseases and guarantee food security. Within the scope of Food and Nutrition Security (SAN) several aspects reflect the social reality; should be approached and analyzed simultaneously, establishing correlations. In this way, this research evaluated the occurrence of food insecurity and overweight, and the relationship with food purchase and consumption habits, among the adult and elderly population of the Brazuca Study - Natal/RN. This is a cross-sectional study, conducted with 411 adults and elderly people living at home. Household interviews were carried out using an electronic questionnaire (Epicollect5) to obtain demographic, socioeconomic, anthropometric (weight, height) and AI-related data. To measure the AI, the prevalence and confidence interval (95%) were calculated. The analysis of factors associated with food insecurity was performed using Poisson regression, with robust variance estimation, to obtain crude and adjusted prevalence ratios (PR) and their confidence intervals (95%). Variables with p<0.20 were included in the model and those with p<0.05 remained in the final model. In the BMI analysis, excess weight (overweight/obesity) was observed in 76.3% (CI: 70.3– 81.7%) of adults and 61.3% of the elderly (CI: 54.5 – 68.1%). AI was observed in 42.2% (CI: 37.6 – 47.3) of respondents. A total of 398 respondents were investigated, of which 80.2% (CI: 85.4 – 92.0) make their purchases in super/hypermarkets and 2.3% (CI: 2.0 – 5.8) in street markets. The habit of consuming powdered juice or soda, between 1 and 4 times a week, was indicated by 28.7% (CI: 24.5-33.3%) of the individuals surveyed. In this same weekly interval, 48.2% (CI: 43.5-53.0%) of the interviewees prefer cookies or sweet biscuits with or without filling. Super/hypermarkets are  requented by 37.4% of people considered in AI and 62.6% of those in SA. There was a significant association between the family income variable, between R$ 401 and R$ 998.00 RP = 3.56 (2.19- 5.78) and ≤ R$ 400.00 RP = 5.22 (3.30-5.78) 8,25) and the occurrence of AI. Per capita family income was the factor associated with the greatest effect on the prevalence of food insecurity. People with per capita family income between R$ 401.00 and R$ 998.00 have a prevalence of food insecurity 2.9 times higher than people with income equal to or greater than R$ 999.00. This effect is more pronounced in people earning up to R$ 400.00
    per capita, in which the prevalence of food insecurity is 4.13 (p<0,001) times higher. A higher prevalence of food insecurity was also observed among people with inadequate access to treated water PR=1.46 (CI: 1,19-1,78).As for the adjusted analysis, a 37% higher prevalence of food insecurity was observed among individuals who reported consuming fruits from 1 to 4 times a week, and 42% higher among those who reported consuming
    fruits never or almost never. The consumption of cookies or crackers, consuming 5 or more times was associated with a 30% higher prevalence of food insecurity. It is concluded that households in a situation of FI consume fruits less frequently, which can compromise the health and guarantee of SAN of the population studied. 

9
  • BÁRBARA LETÍCIA DE QUEIROZ XAVIER
  • HEALTH CARE FOR THE STREET POPULATION IN THE CONTEXT OF THE COVID-19 PANDEMIC

  • Leader : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • MEMBRES DE LA BANQUE :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • JEFERSON FALCÃO DO AMARAL
  • Data: 12 juil. 2022


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  • The homeless population is a group potentially vulnerable to the development of COVID-19, due to drug use, poor diet, barriers to accessing health services, difficulty in sheltering, causing them to crowd together, making them more susceptible to communicable diseases. Thus, we sought to analyze the care provided to the homeless population with Covid-19 in the perception of users and health professionals. This is a descriptive study with a qualitative approach. The data were processed with the support of the IRaMuTeQ 0.6 alpha 3 software, giving rise to similarity and word cloud analyses. Thematic analysis was also used, according to Bardin. The research was approved by the Research Ethics Committee of the Universidade da Integração Internacional da Lusofonia Afro-Brasileira, with opinion No. 4,787,355 and CAAE No. 42997021.7.0000.5576. The study was carried out from May to July 2021, in a capital city in northeastern Brazil. Five professionals from the Consultório na Rua and 31 people living on the streets participated in the research, through a semi-structured interview. The care provided to the homeless population with Covid-19 in the perception of health professionals was marked by difficulties and potential. It was identified that the difficulties in providing care were related to the lack of mobile transport for professionals to travel and provide health services; difficulty in the use of protective supplies, fear of the vaccine against Covid-19, resistance to social isolation and continuous use of drugs by the population living on the streets. As for the potential, the active search for respiratory symptoms stood out, in addition to strategies that minimize bureaucracy for care, health education provided and the offer of the anti-Covid-19 vaccine. The categories that emerged from the discourse of the homeless population with Covid-19, in relation to health care, were related to: providing assistance in the pandemic period; fear of getting sick from Covid-19 and acquisition of barrier measures; needs faced during the pandemic and implementation of hygiene measures. The way of life of the homeless population increased their vulnerability in the pandemic, however health care was enhanced by the availability of the office on the street, humanization of care and welcoming care. It is believed that the study will bring relevant contributions and collaborate in the delimitation of resolutive proposals for public policies related to the specifics of care for homeless people in the context of Covid-19, as well as in the face of the possibility of the emergence of new diseases of easy dissemination.



10
  • MARILANE VILELA MARQUES
  • COVID-19 PANDEMIC AND ELDERLY POPULATION IN BRAZIL: YEARS OF LIFE LOST AND EFFECTS ON LIFE EXPECTATION

  • Leader : GRASIELA PIUVEZAM
  • MEMBRES DE LA BANQUE :
  • EVA VEGUE PARRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • ELEONORA D' ORSI
  • GRASIELA PIUVEZAM
  • Data: 30 sept. 2022


  • Afficher le Résumé
  • The pandemic generated by the new coronavirus (SARS-CoV-2), which started in December 2019, has been characterized by severe acute respiratory syndrome (SARS), among other relevant health problems. The objective of this research is to analyze the burden of the Covid-19 pandemic on the elderly population in Brazil, by estimating the COVID-19 mortality curve for the year 2020, observing the years of life lost and effects on life expectancy. This is an ecological study of multiple groups, whose unit of analysis will be composed of the municipalities in Brazil. The study population is people aged 60 years and over. Death data were extracted secondarily through the Mortality Information System (SIM). The results of the present study show that there are differences in mortality from Covid-19 between regions in Brazil. The most affected age group was 80 years and over. And the male sex having a higher occurrence of deaths. From the spatial statistics, the correlation between PMR by Covid-19 and the socioeconomic variables of the study was verified. With regard to years of life lost, the Southeast and Northeast regions stood out with the highest absolute number of potential years lost. The estimates produced by the multiple decrement tables represented gains in years in life expectancy for all regions when excluding Covid-19 deaths. For both sexes, the greatest gains occurred in the North and Midwest regions, reaching more than 2 years in gains considering the absence of these deaths. The northern region still had the highest probability of death when including only deaths from Covid-19 (nqx) and a significant reduction when these deaths were eliminated (nqx-ix). This study may support strategic planning/actions aimed at fighting Covid-19.

11
  • GUSTAVO GOMES TORRES
  • ARTIFICIAL HEART STIMULATION: EPIDEMIOLOGICAL PROFILE IN A REFERENCE PUBLIC HOSPITAL IN THE STATE OF RIO GRANDE DO NORTE

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • SIMONE MARIA MUNIZ DA SILVA BEZERRA
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 8 nov. 2022


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  • Artificial Cardiac Pacing is an important tool in the treatment of heart rhythm disorders, as well as improving ventricular function in patients with heart failure. The present study aims to analyze the clinical and epidemiological profile of patients undergoing Artificial Cardiac Stimulation procedures in a reference service for the Unified Health System (SUS), as well as to evaluate the spatial distribution of patients in the state of Rio Grande. do Norte (RN) in terms of origin and to analyze the temporal evolution of the number of procedures in the service. We carried out an analytical observational study, with data obtained from a primary source, of patients undergoing Artificial Cardiac Stimulation procedures at the Onofre Lopes Hospital (HUOL), of the Federal University of Rio Grande do Norte (UFRN), between 2006 and 2021. Of a total of 885 patients analyzed, 533 (60.2%) were male, with a mean age of 65.5 years. 3rd degree Atrial Ventricular Block (AVB) was the indication for the procedure in 165 patients (20.5%). Only 55 patients (5.5%) required temporary pacemaker support. 141 patients had an ischemic etiology (24.8%) and 298 patients reported dyspnea as the main complaint (33.7%), 41.8% of patients are hypertensive, 11.9% diabetic, 19.4% dyslipidemic and 19.5 % smokers or ex-smokers. The population studied had a mean left ventricular (LV) Ejection Fraction of 33.6%. Mean creatinine levels of 1.04 mg/mL and potassium 4.19 mg/mL pre-procedure. We observed a homogeneity in relation to the referral of SUS patients to the service, regardless of the city of origin. The temporal analysis identified an increase of 1.1% per year in the number of procedures, which is related to the increase in procedures in male patients. We concluded that the characteristics of the service contributed to the differences in our population in relation to the findings in the literature. Despite the absence of a specific flowchart, access to the service occurred without the presence of clusters in relation to the municipality of origin. The temporal increase in procedures was discreet, despite partial interruptions of the structure and the presence of the pandemic in this period.

12
  • ANDERSON DA SILVA SOUSA
  • WORK IN THE COVID-19 PANDEMIC: coping strategies and repercussions on the lives of health professionals

  • Leader : ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • MEMBRES DE LA BANQUE :
  • ELIANA COSTA GUERRA
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • MARIA APARECIDA SALCI
  • Data: 22 déc. 2022


  • Afficher le Résumé
  • The main objective of this study was to develop a theoretical model on frontline care work in the COVID-19 pandemic, considering the ways of coping and the repercussions on the health of the professionals involved. The main researcher acted as a professional nurse on the front line within a COVID-19 sector in the research institution, a situation that aroused the search for understanding the suffering, as well as the learning caused by this disease. This is a qualitative research that uses Grounded Theory as its methodological framework in the structuralist approach of Strauss and Corbin. The Onofre Lopes University Hospital of the Federal University of Rio Grande do Norte was the research scenario. A theoretical sampling of the population of professional nurses, physiotherapists, doctors and nursing technicians was carried out, divided into two sample groups: one with health professionals who worked on the front lines of the COVID-19 pandemic and the other with managers of the COVID sectors -19 of the institution where the study was conducted. Data collection was carried out through in-depth interviews, which were carried out in person and online, according to the availability and preference of the participants. A total of 24 interviews were carried out, with six managers, nine nurses, four physicians, one physiotherapist and four nursing technicians. Data analysis was performed through open, axial and selective coding, using the Atlas Ti 22.0 software. The results achieved made it possible to elucidate the central category of the phenomenon, Working on the front line of care in the COVID-19 pandemic, based on the support of 21 subcategories and five categories, according to the paradigmatic circumstances, the conditions: Working in care during the pandemic by high transmissibility agent; the action/interaction: Facing the adversities of working in care during the COVID-19 pandemic; and Engaging with people involved in the care of patients with COVID-19; and the consequences: Dealing with the impact of work on one's own health and Reaching teachings and overcoming the adversities of working in the pandemic. By highlighting the articulation between the categories, it was possible to represent them through a theoretical model of the studied phenomenon. Working on the front line of care during the COVID-19 pandemic represented a challenge for health professionals and managers in various aspects of professional activity and the personal dimension, which had to adapt to the pandemic situation, facing feelings such as fear, anguish , impotence and experiencing situations that impacted positively and negatively on patient care and on the way of relating. After facing the worst moments of the pandemic, and having suffered direct and indirect repercussions on their health, they adopted different protective strategies, learning to deal with the public health emergency, re-signifying the situations experienced and achieving professional learning that propelled new work perspectives . The theoretical model developed will be able to contribute to the planning and development of institutional strategies to face critical periods, characterized by an increase in the demand for health services, the presence of a highly transmissible etiological agent and, mainly, the impact on the health of health professionals, with suffering and illness in those involved in the assistance front line.

13
  • VINÍCIUS RODRIGUES DE OLIVEIRA
  • PRACTICES FOR ADOLESCENTS WITH OBESITY IN PRIMARY HEALTH CARE

     

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • ANTONIO GERMANE ALVES PINTO
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • Data: 22 déc. 2022


  • Afficher le Résumé
  • The objective was to analyze care practices for adolescents with obesity within the scope of Primary Health Care in the municipality of Iguatu-Ceará. This is a single, integrated and qualitative case study, carried out with municipal and state health managers, nutritionists associated with the school lunch sector and professional nurses, doctors and nutritionists linked to Primary Health Care. Data collection was carried out from March to June 2022 and occurred in two stages: Analysis of official documents and legislation implemented in the municipality and aimed at combating obesity; Semi-structured interview with five municipal and state managers and 19 health professionals, totaling 24 participants. The analytical procedure adopted for the first stage was based on the proposal of document analysis, and the data from the interviews were processed through the software Interface de R pour les Analyzes Multidimensionnelles de Textes et de Questionnaires and appreciated from the perspective of Bardin's content analysis, which culminated in the elaboration of five thematic categories. This study was based on Resolution No. 466/12 of the National Health Council and was approved by the Research Ethics Committee of the University Hospital Onofre Lopes of the Federal University of Rio Grande do Norte (UFRN) through Opinion No. 5,272,685 . With the completion of the first stage of the study, 11 documents were found that were suitable for the profile sought by the researcher, that is, documents guiding actions aimed at combating obesity, this material consists essentially of legal documents and authored by the government federal, published between the years 1994 to 2021. The second stage revealed aspects about the care for adolescents with obesity, where fragile care practices were identified, carried out as the professional deems to be important, without clear directions and with few opportunities for access to health care. continuing education on the subject. Therefore, it was observed that the health of adolescents and obesity are not priorities in the scope of the health of the municipality and that the actions directed to the public happen, almost exclusively, through the Health at School Program, however the program is centralized in the health sector. health and has little articulation with education. As for the performance of managers, it was incipient, always based on the need for federal or state stimuli to carry out actions on obesity. The interviewees pointed out difficulties and potentialities in the area of care, where the difficulties were mainly associated with the actions of the adolescent, while the potentialities were primarily related to the practices of the multidisciplinary health team. It is concluded that the study presented an overview of care practices and made it possible to see the main weaknesses and challenges for consolidating care for adolescents with obesity. It is recommended that managers make obesity a priority issue for the municipality, giving it due attention, and that professionals act based on the principle of comprehensive care and co-responsibility. The need to align the actions of the Health at School Program is highlighted, so that they can be articulated from an intersectoral perspective. As a limitation, the fact that the study was carried out only in the context of Primary Health Care stands out.

Thèses
1
  • DANILA AUGUSTA ACCIOLY VARELLA BARCA
  • META-EVALUATION OF PHC IN BRAZIL: THE CASE OF THE EXTERNAL EVALUATION OF THE PROGRAM TO IMPROVE THE ACCESS AND QUALITY OF PRIMARY CARE – PMAQ-AB
  • Leader : SEVERINA ALICE DA COSTA UCHOA
  • MEMBRES DE LA BANQUE :
  • SEVERINA ALICE DA COSTA UCHOA
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • Cinthia Kalyne de Almeida Alves
  • MARCO AKERMAN
  • Tania Cristina Morais Santa Barbara Rehem
  • Data: 17 févr. 2022


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  •  

    The Primary Care Access and Quality Improvement Program (PMAQ-AB) implemented in 3 evaluation cycles (2011/2019), represents a turning point in the performance evaluation of Primary Health Care (PHC) in Brazil. The Program has 3 components: Voluntary adhesion of municipal managers and Contracting of teams; the External Assessment (AE/PMAQ-AB) and Certification; and Recontractualization, in addition to a transversal development axis. This study aims to assess the quality of AE/PMAQ-AB in light of internationally recognized standards. This is a summative meta-assessment using the qualitative Case Study method, preceded by an Indicator Content Validation Study. The matrix of indicators was prepared based on the 4 principles/standards of the Joint Committee on Standards for Educational Evaluations (utility, feasibility, propriety and accuracy) and articulated at each stage of the evaluation (stakeholder engagement, program description, evaluation design , systematization and analysis of evidence, justification of conclusions and sharing of lessons learned). Validation used the intentional sample with 2 groups of judges (7 experts and 16 evaluators) in 2 rounds of the Delphi technique with each group and analysis through agreement indices. The Case Study, between July/2018 and December/2019, had 54 participants. Semi-structured interviews (01 with a coordinator from the Ministry of Health (MS) and 6 from the universities) and focus groups (01 with a technical team from the MS and 6 from the universities) were used, in addition to the analysis of 07 formal documents of the Program. Data were categorized by dimensions and standards and their respective criteria/indicators adapted to the context of AE/PMAQ-AB. Categorization was performed using the Atlas ti software. 8.4.24 and followed by Bardin's content analysis. The “Involvement of Stakeholders” presented an agreement in the instances of the Unified Health System, expansion of the adhesion of the municipalities in the cycles, credibility of the evaluator and conciliation by the federal government of the interests of certification of the municipalities and of research by the universities, as strengths; and as a deficiency, the absence of users in the decision-making processes of formulating and executing the program. The “Program Description” was positive in the consistency of the AE/PMAQ-AB with the National Primary Care Policy/2011. The “Evaluation Design” portrayed the Brazilian PHC and construction of comparable standards and certification criteria. The use of Information Technology, logistics and guidelines for training the interviewers gave the collection homogeneity, pointing to the usefulness and feasibility. The "Systematization and Analysis of Evidence" had as strengths the online validation systems, offer of micro data, availability of electronic reports to stakeholders, but there were weaknesses in the transmission of the methodology to municipal managers, incipient strategies of technical empowerment for interpretation and applicability of results impacting negatively on the dimension “Justification of Conclusions”. In the “Sharing Lessons Learned”, the utility of AE/PMAQ-AB prevailed for a culture of evaluation in management, services, and academia. The meta-assessment presents a systemic view of the AE/PMAQ-AB, helping managers and professionals in the PHC assessment process. It raises awareness of user engagement in policy and program evaluations, making them more plural, participatory and democratic.

2
  • EDIENNE ROSANGELA SARMENTO DINIZ
  • ANALYSIS OF THE EFFECT OF THE STANDARDIZATION OF MEASURES TO PREVENT BLOOD CURRENT INFECTION RELATED TO THE CENTRALLY INSERTED CATHETER IN NEWBORNS IN THE NEONATAL INTENSIVE CARE UNIT

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • AUREAN DECA JÚNIOR
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • KÁTIA SUELY QUEIROZ SILVA RIBEIRO
  • NILBA LIMA DE SOUZA
  • RITA DE CÁSSIA SILVEIRA
  • Data: 24 mai 2022


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  • Introduction: The use of peripherally inserted central catheters (PICC) in neonatology has significantly contributed to the reduction of neonatal mortality in neonatal intensive care units (NICUs). This safe intravenous practice favors the hemodynamic stabilization of the newborn, allows the administration of vesicant drugs, irritants and parenteral nutrition (PN). Thus, this study aims to evaluate the effect of standardization of infection prevention measures during insertion and handling of peripherally inserted central venous catheters (PICC) by the catheter team on the incidence of CRBSI in newborns in the Unit of Neonatal Intensive Care. Methodology: it is divided into three studies. 1) Systematic review protocol, which addresses the prevalence of complications associated with the use of PICCs in newborns (NBs); 2) prospective cohort to assess risk factors for the development of catheter-related bloodstream infection (CRBIS) in newborns; 3) cohort with retro and prospective analysis, which will analyze the effect of standardization of infection prevention measures adopted by the PICC team on the number of CRBSI cases in neonates in the Neonatal Intensive Care Unit. Results: in article 1, the prevalence of complications resulting from the inadequate management of the PICC in NBs was observed, information considered important for the improvement of clinical practice. In article 2, it was found that the majority of the sample consisted of premature infants, with inadequate weight, respiratory disorders and heart disease, but there was no association of these variables with CRBSI. Neonates with PICC in the upper limbs had a higher risk of CRBSI (RR=2.84; 95%CI 1.02-6.85). Article 3 analyzed 365 newborns who used the PICC, who underwent 563 catheter insertion procedures, of which 69 had CRBSI, giving an incidence of CRBSI of 12.3%. In the analysis of characteristics related to the PICC insertion procedure in neonates as a result of CRBSI notification, the variables significantly associated with the occurrence of CRBSI were the vessel accessed (p=0.002) and catheter position (p=0.005). In the statistical analysis of the variables related to infusion therapy, statistical significance was observed in the association between the occurrence of CRBSI and the use of two ATBs during the first antibiotic therapy regimen, which presented a value of p<0.05. There was also a description of 8 groups of pathogens involved in 69 cases of CRBSI, with the most common pathogens related to CRBSI in newborns with PICC being the Enterobacteria (5.2%), Staphylococcus coaEnterobacteria (5.2%), Coagulase negative Staphylococcus (3.4%) and coagulase positive Staphylococcus (2.0%). Conclusion: the importance of catheter teams in the systematization of the monitoring process of risk factors related to the NB, surveillance during the procedure, and infusion therapy was observed. Such measures have impacted on reducing the development of catheter-related bloodstream infection (CRBIS).

3
  • MARIA HELENA RODRIGUES GALVÃO
  • FACTORS ASSOCIATED WITH THE USE OF DENTAL SERVICES BY ADULTS IN BRAZIL

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • FERNANDO JOSÉ HERKRATH
  • FRANKLIN DELANO SOARES FORTE
  • HELDER HENRIQUE COSTA PINHEIRO
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • SÔNIA CRISTINA LIMA CHAVES
  • Data: 27 mai 2022


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  • The present study aimed to understand the factors associated with dental services utilization by adults in Brazil. This is a quantitative, observational, cross-sectional, analytical study. Individual data from the National Health Surveys developed in 2013 and 2019 are available on the Brazilian Institute of Geography and Statistics website. Data were analyzed by adjusting the sample weights resulting from complex samples. For each study, multivariate analysis techniques addressed the study's objectives. The results will be discussed in 3 scientific papers accepted for publication in journals. It was noticed that the population subgroups comprising Blacks and those residing in the North or Northeast, with lower social class and education, had a greater chance of having irregular follow-up and never having been to the dentist. In addition, this population stratum also had a greater chance of undergoing surgical or emergency dental procedures in the last dental appointment. The outcome never had a dental appointment was significantly associated with illiterate, males, without private dental insurance, self-rated oral health as bad or very bad, household not enrolled in primary care teams, household in a rural area, high household crowding, and low household income per capita. The highest prevalence of public dental service utilization on an individual level was observed among unable to read or write people, indigenous, black or brown, with per capita household income of up to U$124, living in the rural area, and who self-rated oral health as regular or very bad/bad. On the contextual level, highest public dental service utilization was observed among those living in federal units with increased oral health coverage in primary health care. In general, we observe inequalities in dental services utilization in Brazil. This scenario occurs when social characteristics and facilitating aspects determine who uses the services, to the detriment of the need to use them. Despite this, we observed an important effect resulting from the provision of dental services in primary care as a mitigating factor for such inequalities, demonstrating a positive effect of the strategies adopted in the National Oral Health Policy.

4
  • RAFAEL RODOLFO TOMAZ DE LIMA
  • HEALTH CARE FOR TRANSVESTITES AND TRANSSEXUALS IN THE SINGLE HEALTH SYSTEM

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • PABLO CARDOZO ROCON
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • JOÃO BOSCO FILHO
  • LUIZ ROBERTO AUGUSTO NORO
  • NELSON FILICE DE BARROS
  • PAULO VICTOR LEITE LOPES
  • Data: 6 juin 2022


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  • Brazilian health, as attention to gender identity in the attention to issues related to social issues and determinations of the health-disease process. However, people in vulnerable situations, such as crossings and exuals, still do not face challenges for the right to health in an integral way, since their health needs are fully recognized. Therefore, this Doctoral Thesis in Public Health aims to characterize health care for transvestites and transsexuals in the Unified Health System. Therefore, it was decided to carry out a study on the methodological designs: bibliometrics, systematic and systematic review protocol. The bibliometric findings of the analysis and Brazilian dissertations of theses that studies on transvestism, transsexuality and health have been on the rise in recent years, with an increase in the focus on the illness of transvestites and transsexuals and an increase in the focus of social, organizational and policies that interfere in these people's access to health services. Despite the existence of the Transsexualizing Process program in the Unified Health System, the articles included in the systematic show that health care for transvestites and transsexuals is composed of a series of violations, including the lack of health preparation to welcome and care for transvestites and transsexuals. transsexuals. From their specific health, the weaving of the characterization results, the weaving of the characterization results to contribute to the attention to care for people as caregivers, within the Brazilian health system as fragmented, non-specialized and guided by curative actions, delimiting care Models of care that precede the Unified Health System that are selected by critics since the Brazilian Sanitary Reform Movement.

5
  • SAVIO MARCELINO GOMES
  • Vulnerability of transgender people to Food Insecurity

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • FABIO RESENDE DE ARAUJO
  • LUIZ ROBERTO AUGUSTO NORO
  • MARCOS PEREIRA SANTOS
  • RODRIGO MORETTI
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • Data: 9 juin 2022


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  • The gender is one of the factors associated with Food Insecurity (FI). Although people in gender minority groups are exposed to potential risk factors for FI, we do not have large-scale data on these groups. This is due to the way gender is classified in population surveys (i.e., male and female), leaving transgender populations “hidden” in a binary classification. In this thesis, we propose to explore the relationships between minority gender experiences and vulnerability to FI. In this way, we investigated the nexus between transgender experiences and the impact on dietary outcomes and verified the association of social, economic and prejudice factors with AI in a group of transgender people. We conclude that excluding gender diversity in research on food insecurity has possibly failed to reveal important demands for the transgender population. In this thesis, we present the relationships understood so far between AI in the transgender population, as well as possible challenges and alternative strategies for overcoming them. We hope that in doing so, we can guide food and nutrition policies and surveillance systems, as well as researchers around the world, to understand the hidden diversity in AI studies.

6
  • LIZIE EMANUELLE EULALIO BRASILEIRO
  • .

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • IVANOR VELLOSO MEIRA LIMA
  • DULCIAN MEDEIROS DE AZEVEDO
  • TIAGO ROCHA PINTO
  • Data: 28 juin 2022


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  • .

7
  • DAVID FRANCIOLE DE OLIVEIRA SILVA
  • THE COVID-19 PANDEMIC: REFLECTIONS FOR HEALTH SURVEILLANCE

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • FABIA BARBOSA DE ANDRADE
  • CLELIA DE OLIVEIRA LYRA
  • LUCIA DE FATIMA CAMPOS PEDROSA
  • ALTAMIRA PEREIRA DA SILVA REICHERT
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • Data: 14 déc. 2022


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  • The disease caused by the new coronavirus (COVID-19) is currently the most serious public health problem in the world. Evaluating the temporal distribution and factors associated with mortality from COVID-19 in different publics can provide evidence about the temporal dynamics and the groups with the highest risk of death. Furthermore, with the measures adopted to face the pandemic, changes were observed in the professional practice of health professionals and teachers, and it is important to assess the impact on mental health. In this context, the aim of this study was to assess morbidity and mortality from COVID-19 in Brazil and the impact of the pandemic on the mental health of health professionals and teachers. To respond to this objective, four studies were developed. In the first, a cross-sectional study, 8,402 children and adolescents aged 0 to 19 years with SARS due to COVID-19 were included. The incidence and mortality rates were 13.74 and 1.35 per 100,000, respectively, with a mortality rate of 9.81%. In the multivariate analysis using Poisson Regression with robust variance, the factors associated with a higher risk of death were age group < 1 year, heart disease, immunosuppressive diseases, neurological diseases and Down syndrome. In the second article, a systematic review, it was identified that the instruments Mini Nutritional Assessment (MNA), MNA-short form, the Geriatric Nutrition Risk Index, the Nutritional Risk Screening 2002, the Malnutrition Universal Screening Tool, the modified Nutrition Risk in Critically Ill (NUTRIC) score and the Subjective Global Assessmen have high sensitivity for identifying nutritional risk in older adults with COVID-19. In the third article, a systematic review on the mental health of teachers in times of COVID-19, it was found that the prevalence of anxiety ranged from ten to 49.4%, for depression, from 15.9 to 28.9%, and, for stress, from 12.6 to 50.6%. Working in schools (compared to universities), being female and experiencing a return to face-to-face classes were factors related to a higher risk of emotional changes. In the fourth article, a systematic review with meta-analysis on anxiety in health professionals, a prevalence of 35% (95%CI: 29-40) was identified, being higher in women and nurses. Working on the front lines, being infected with the coronavirus and having chronic illnesses were also factors associated with a higher risk of anxiety. The results of this thesis show that despite being less prevalent than in the elderly, COVID-19 also affects a considerable number of children and adolescents in Brazil. For the older adults, it was found that nutritional screening instruments are useful for identifying nutritional risk. A high prevalence of alterations in the emotional state was registered in health professionals and teachers, with the need for collective health measures aimed at preventing these alterations in these professionals. There is a need to include this agenda in Health Surveillance, specifically Occupational Health.

8
  • RAYSSA HORACIO LOPES
  • SURVEILLANCE OF WATER QUALITY FOR HUMAN CONSUMPTION: analysis of actions developed
  • Leader : SEVERINA ALICE DA COSTA UCHOA
  • MEMBRES DE LA BANQUE :
  • Miguel Ángel Fuentealba Torres
  • PAULO RUBENS GUIMARÃES BARROCAS
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • SEVERINA ALICE DA COSTA UCHOA
  • Data: 15 déc. 2022


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  • Drinking water is indispensable for life, recognized by the United Nations as a fundamental human right, it is one of the goals of the Sustainable Development Goals, as it guides access to safe water for all and the elimination of water-borne diseases until 2030. Water quality is a health protection factor and is given through essential requirements oriented by countries, or based on guidelines published by the World Health Organization, translated into the standard of quality and potability. It is recommended that drinking water be the object of surveillance actions and with that, it becomes relevant to analyze how these actions have been developed on the world stage. The objective is to analyze the actions of surveillance of the drinking water quality developed by governmental agencies or public health services of the countries. As specific objectives: a) Propose a scoping review protocol to identify and map global actions and initiatives to monitor the quality of drinking water implemented by government agencies or public health services; b) Identify and map drinking water quality surveillance actions and initiatives implemented worldwide by government agencies or public health services. This is a scoping review, based on recommendations from the Joanna Briggs Institute. The 9 steps were followed: definition and alignment of research objectives and questions; development and alignment of inclusion criteria; description of evidence selection; search for evidence; evidence selection; evidence extraction; evidence analysis; results presentation; summary of evidence, conclusions and implications of findings. Additionally, stakeholders were consulted to share the results of the review. The study was approved by the Research Ethics Committee of the Hospital Universitário Onofre Lopes. The results supported the writing of two articles, being (1) “Surveillance of Drinking Water Quality Worldwide: Scoping Review Protocol” and (2) “Worldwide surveillance actions and initiatives of drinking water quality: a scoping review”. The study protocol highlighted the characteristics and methodological steps that guided the review, favoring replicability and reliability of the research process, providing scientific rigor to the work. The scope review identified and mapped the drinking water quality surveillance actions developed, their impacts and results, producing four thematic classes: (1) evaluation of coverage, accessibility, quantity and quality of water for human consumption in situations routine and emergencies; (2) analysis of physical-chemical and microbiological parameters in public supply networks and alternative water supply solutions; (3) Identification of household water contamination, communication and education with the community and (4) Investigation of outbreaks of water-borne diseases, which detailed important actions and results in the countries, allowing the comparability and identification of the main challenges object of these actions. The study identified important issues that need to be analyzed so that drinking water quality surveillance actions can contribute to safe access to water.

     

9
  • ADRIANA AMORIM DE FARIAS LEAL
  • ACCESS TO MEDICINES BY THE BRAZILIAN POPULATION: DATA FROM THE 2019 NATIONAL HEALTH SURVEY

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • DANIELLE FRANKLIN DE CARVALHO
  • GABRIELA MARIA CAVALCANTI COSTA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 21 déc. 2022


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  • Introduction: Access to medication is a global challenge, especially in developing countries, so data from population surveys are essential to measure related factors. In addition, the high prevalence of people with chronic diseases and, consequently, who use continuous medication implies the need to guarantee this access through efficient public policies. Objective: To analyze access to medicines in Brazil and associated factors, based on data from the 2019 National Health Survey (PNS). Methods: This is a cross-sectional population-based study that used data from the PNS 2019, enabling the writing of three studies: 1 – general assessment of access to medicines by the Brazilian population, based on Andersen's behavioral model; 2 – analysis of factors associated with access to medication for the treatment of arterial hypertension and diabetes; 3 – study of factors associated with the use of medication for the treatment of depression. In the three studies, descriptive analysis was performed, followed by multivariate analysis, considering the independent variables that presented a significance level greater than 95%. Results: In article 1, it was observed that the greatest chances of not having access to medication at the individual level were observed in people aged between 40 and 59 years, women, people with complete elementary school and high school, with lower family income people who performed consultations in public services, individuals with a worse self-rated health and those who sought the health service for disease prevention and health promotion. In article 2, data regarding access via the Popular Pharmacy Program of Brazil (PFPB) and public service were analyzed. There was a higher prevalence of access to medication for hypertension and oral medication for diabetes via PFPB, and the factors that most influenced this access were a higher age group, lower income, lower education, not having a health plan and reporting a self-assessment of health too bad. Access to insulin, in turn, was more prevalent via the public health service, and the factors that most influenced this access were black/brown race, lower income, not having a health plan and reporting a very poor self-rated health. In article 3, it was found that the factors associated with not using medication prescribed for depression in the last two weeks were marital status, self-rated health, prevalence of sleep problems, routine medical appointments, and time since diagnosis of the disease. Conclusions: Access to medication in the Brazilian population is related to socioeconomic and health perception factors. In general, the importance of the PFPB as a policy to expand access to essential medicines in Brazil is proven, considering the free use of antihypertensive and antidiabetic drugs, as well as the weaknesses of the public health system in Brazil in the supply of medicines. Furthermore, these findings can guide the updating or formulation of public policies on medicines and pharmaceutical assistance, promoting better mechanisms for the purchase of medicines by the user and, consequently, reducing health inequities.

2021
Thèses
1
  • ROBERTA MACHADO ALVES
  • COMMON MENTAL DISORDER AND ABUSE OF ALCOHOL AMONG FARMERS IN CAICÓ-RN

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • JULIANE DE OLIVEIRA COSTA LIMA
  • DIMITRI TAURINO GUEDES
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • Data: 16 juil. 2021


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  • With regard to farmers and rural populations, the difficulty in accessing health services and the higher cost of psychiatric treatments contribute to the neglect of some care related to mental health. In addition, stressful characteristics of the work environment, such as long distances, isolation, difficulty in developing other work activities, economic decline, irregular income and exposure to pesticides reflect on the development of disorders. We sought to identify the prevalence and factors associated with Common Mental Disorder and alcohol abuse among farmers living in a medium-sized municipality in northeastern Brazil, during 2019 and 2020. Trained interviewers applied the standardized questionnaire to 450 participants. Sociodemographic, health, income and work characteristics were investigated. Screening for Common Mental Disorder (CMD) was carried out using the SRQ-20 questionnaire (Self-Reporting Questionaire, with a cutoff point ≥7 for women and ≥5 for men. the use of the CAGE questionnaire (Cut down, Annoyed by criticism, Guilty and Eye-opener), with the cutoff point ≥ 2. Poisson Regression with robust estimation was applied to verify the prevalence ratios (PR) in the bivariate and multivariate analysis. The prevalence of CMD among farmers was 55.1% (95%CI 50.4-59.6.) The variables that remained significant and associated with CMD were: being male (PR=1.7), having over 60 years old (PR=0.5), having poor or very poor self-rated health (PR=1.4), having undergone previous treatment for mental health (PR=1.2), having abused alcohol (PR =1.2) and having had loss of production (PR=1.3). The prevalence of alcohol abuse among farmers was 32% (95%CI 27.8- 36.4). Factors such as being male, having a diagnosis of mental disorder in the family, being a smoker and using drugs were associated with a higher prevalence of the outcome. Being 60 years old or more was associated with a lower prevalence of alcohol abuse. These results indicate the need for social support to this group of workers in the context of occupational health and point out that both CMD and alcohol abuse are associated with individual factors and the context of life and work of farmers, which demonstrates the importance social, economic and health services support to this group of workers.

2
  • MAYARA PRISCILLA DANTAS ARAÚJO
  • RISK FACTORS FOR SEVERE FORM OF COVID-19 IN INSTITUTIONALIZED ELDERLY

  • Leader : THAIZA TEIXEIRA XAVIER NOBRE
  • MEMBRES DE LA BANQUE :
  • LUCIANA ARAUJO DOS REIS
  • MEIRY FERNANDA PINTO OKUNO
  • THAIZA TEIXEIRA XAVIER NOBRE
  • Data: 29 juil. 2021


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  • Introduction:   COVID-19 is characterized  by a respiratory syndrome with variations  in the degree of severity. However, this disease has disproportionately affected institutionalized elderly people, leading to a high mortality in this population.  Objective:  To analyze the health conditions that make institutionalized elderly people more vulnerable to severe form and death by COVID-19. Methods:  Two analyses were performed: 1) descriptive study, cross-sectional approach, carried out in eight LSIEs of the Metropolitan region of Natal, Rio Grande do Norte, with a population of 267 elderly people, between February and December 2018, which used as an instrument to collect sociodemographic data, health and risk factors the Elderly Health Booklet, and pearson's chi-square and Chance Ratio tests were performed for the analysis of variables; 2) systematic review of the literature of observational epidemiological studies published between January 2020 and February 10, 2021, for which searches were performed in the databases Virtual Health Library (VHL), PubMed, Scopus and Web of Science, using mesh and DeCS descriptors, and evaluated the risk of  bias by instruments of the Joanna Briggs Institute. Results:  1) Of the 267 elderly people evaluated, the most prevalent risk conditions were cognitive impairment (57.5%), hypertension (55.6%) and diabetes (27.5%), with a higher frequency of low birth weight in elderly with cognitive impairment (24.6%), and overweight in those hypertensive (23.3%) diabetics (12.9%). Body mass index (BMI) was associated with the age group 80 years or more (p=0.013), hypertension (p<0.001) and diabetes (p=0.001). Hypertensive elderly people are more likely to have low weight when compared to non-hypertensive people (CR=3.6; IC95% 1.5-8.6). 2) A  total of  171 publications were identified, of which 9 met the eligibility criteria. The complementary search in the list of references of these studies resulted in two articles. With this, 11 articles were included in the review. Different risk factors were identified grouped into: sociodemographic factors - male gender, age over 80 years and institutionalization itself; clinical manifestations – presence of symptoms, loss of appetite, fever, diarrhea, altered mental status, lethargy, respiratory symptoms and shorthand; and  health conditions – cardiovascular diseases, diabetes, kidney disease, functional and cognitive decline, Parkinson's disease, frailty, depression and chronic obstructive pulmonary disease. Final considerations:  Institutionalized elderly people present health conditions that make them more vulnerable to progress to the severe form of COVID-19 if infected, which requires the adoption of protective measures for this population and the adoption of protocols for timely infected individuals and those at higher risk for severe form of the disease.

3
  • KEZAUYN MIRANDA AIQUOC
  • Scars of racism! Racial discrimination and exposure to violences in brazilian adolescents and young people according to the race / skin color

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • ANA PAULA NOGUEIRA NUNES
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • KARINA CARDOSO MEIRA
  • Data: 4 août 2021


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  • Introduction: Exposure to violence can result in injury, psychological damage, developmental disabilities and even death. However, violence affects the population in an unequal way, generating differentiated risks based on gender, race / color, social space and age, especially among adolescents and youth. Objective: To analyze perceived racial discrimination and exposure to various types of violence in Brazilian adolescents and young people, according to race / skin color differences. Methodology: Three analyzes were performed: 1) cross-sectional study with data 2015 National Student Health Survey (PeNSE) 2015, in which the prevalence of racial discrimination and its association with socioeconomic, health and school context factors were analyzed in a Poisson regression; 2) cross-sectional study that analyzed the prevalence of different types of violence according to race / skin color, in a multilevel Poisson Regression model adjusted for age, sex and maternal education using data from PeNSE 2015 and 3) ecological study that analyzed rates homicides of young people aged 15 to 29 years in Brazilian municipalities in the period 2015-2017, by sex and race and contextual variables related to education, income, schooling and vulnerability in a multilevel Linear Regression. Results: The prevalence of racial discrimination perceived among Brazilian schoolchildren was 2.58% (95% CI: 2.40-2.78) and was associated with the following factors such as male gender (PR 1.69; 1.40 -2.04), having black skin color (RP 7.39; 5.49-9.96), being indigenous (RP 4.95; 3.32-7.38), with an uneducated mother (RP 1 , 74; 1.25-2.42) and who has expected schooling up to high school (RP 1.50; 1.24-1.83). As for exposure to violence, black students were more involved in fighting with firearms and who were seriously injured (PR = 1.50; 95% CI: 1.27-1.76; and PR = 1.36; 95% CI : 1.22-1.52, respectively); indigenous people had a higher prevalence of being involved in physical fighting (PR = 1.23; 95% CI: 1.09-1.38) and of getting involved in fights with blunt weapons and sharps (PR = 1.38; 95% CI: 1.11 - 1.73). In the multilevel model, having black skin color was associated with studying at a school located in a risk area and studying at a school that interrupted or suspended classes for safety reasons. Regarding homicide mortality rates, the most pronounced relationship between homicides among young blacks and homicide rates in the adult population stands out. Conclusion: the results demonstrate that there is racial inequity in the exposure to violence in Brazil, with the main victims being adolescents and young people belonging to the black and indigenous population.

4
  • PAULA BEATRIZ DE SOUZA MENDONÇA
  •  

    GRADUATION IN HEALTH COLLECTIVE IN BRAZIL

  • Leader : JANETE LIMA DE CASTRO
  • MEMBRES DE LA BANQUE :
  • ANA TANIA LOPES SAMPAIO
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • ISABELA CARDOSO DE MATOS PINTO
  • JANETE LIMA DE CASTRO
  • Data: 3 sept. 2021


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  • The object of study of this dissertation is the training of the sanitarist at the undergraduate level. It is delimited in the historical recovery of undergraduate courses in Collective Health and drawing training carried out for the new profession. The objective is to analyze the graduate training in Collective Health of existing courses in Brazil in the light of the Pedagogical Projects of the Courses. This is a qualitative and exploratory study with a documentary approach, using the content analysis method, in the thematic modality according to the technique of Minayo (2014) contemplating three phases. In phase 1), the selection of 22 pedagogical projects of the course of undergraduate courses in Collective Health and organization of textual corpus; 2) the data were organized into 4 corpus from 4 record units; 3) was performed the encoding, later processing the 4 corpus in the Iramuteq software for obtaining the Descending Hierarchical Classification, to analyze, interpret and present the results through dendrograms. The results demonstrate an openness course, with a concentration between 2008-2009, the last in 2019. The courses are organized in the Brazilian regions in greater number in the northern region with 27.3%. Most courses follow or fit the National Curriculum Guidelines of the Course of Graduation in Collective Health (DCNCsGSC) 2017 with a predominance of workload equal to or greater than 3,200 hours, duration from eight to nine semesters and an average of four years, with night shift in 45.5% of courses. The average offer is 1,864 vacancies/year with entry through of Enem/SISU, with 68% of courses in federal universities and 77.3% with nomenclature Bachelor's Degree in Collective Health. Of the 22 courses, 18 were evaluated by the MEC, being 67% with concept 5. Training allows a gradual construction of knowledge from curricular components between 45 to 60 hours arising from epidemiology, from human and social sciences, surveillance, health sciences, education, planning, management, health services, and policies. The courses are articulated with health services and systems SUS publics and with the community through practical classes, internships, research, and projects extension and technical visits, strengthening the students' practical contact with real situations of the health of the population, as well as mitigating that the graduates can enter professionally in these spaces. It is concluded that the courses are consolidated based on the regionalization of courses, the number of vacancies, unification of the nomenclature, and the predominance of the concept of excellence. The training follows the DCNCsGSC regulations of the bases of Collective Health, so that the articulation with the SUS has contributed to its strengthening and training of human resources in health.

5
  • JÉSSICA LIMA MOURA
  • Repercussions of COVID-19 on the daily lives of women living in a rural settlement

  • Leader : RICHARDSON AUGUSTO ROSENDO DA SILVA
  • MEMBRES DE LA BANQUE :
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • MARIA ANGELA FERNANDES FERREIRA
  • SARA FITERMAN LIMA
  • Data: 27 sept. 2021


  • Afficher le Résumé
  • The COVID-19 pandemic is configured as the greatest health challenge of the 21st century, causing multiple impacts, affecting the world population both individually and collectively and being considered a Public Health Emergency of International Importance. This study aimed to understand the repercussions of COVID-19 on the daily lives of women in a rural settlement in Northeastern Brazil. Therefore, a qualitative approach research was carried out, whose data were analyzed using the Collective Subject Discourse method in the light of the epidemic disease framework proposed by Charles Rosemberg. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under opinion number 4,063,657. Forty-eight interviews were carried out with women in a rural settlement in northeastern Brazil, between January and March 2021, in the residences of the interviews in a reserved place. Participants reported concerns generated in dealing with the pandemic: lack of work; difficulty in supporting the family due to lack of resources; uncertainty in the future; contamination risk; fear of death; cancellation of children's classes; sadness; racism and prejudice. They unveiled opportunities in the experience of the pandemic: adoption of prevention measures for survival; solidarity and help received; inner and familiar strength; rethink life; belief in God and hope for a better future. The findings point to the need to implement public health actions and policies for women in the rural context, which are compatible with the demarcations presented socio-historically by this population.

     

6
  • JESSICA MARTINELLI MARTINS DE ASSIS
  • ABSENTEEISM AND ITS CAUSES IN THE CONTEXT OF ONCOLOGY WORKERS' HEALTH: A SCOPING REVIEW

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • FABIA BARBOSA DE ANDRADE
  • Data: 26 nov. 2021


  • Afficher le Résumé
  • The high rhythm of work added to the physical and psychological demands lead to a picture of stress in personal and work contexts. Stress is defined as a physiological, psychological and behavioral response of an individual in order to adapt to the demands of the environment and the internal ones, being seen as a stimulant and source of balance. In addition to this, other causes can be inserted, such as the professional's life habits, among them: cigarette, alcohol, lack of physical exercise, sleep deprivation, among others, which are harmful to health. This reality has been the most observed in the hospital scenario, possibly associated with problems related to the fatigue of compassion, where professionals end up discounting their special. The motivation for the study, it was understood why the high numbers of absenteeism in oncology, and if this occurs, the work process itself occurs, identifying them. Then the following research question was elaborated: analysis of published studies on absenteeism in oncology hospitals in the form of systematic review. This is a Systematic Literature Review (RSL). This type of study serves to guide the development of projects, indicating new directions for investigations and identifying which research methods were used in an area. A literature review was carried out to give robustness to the theme. This review was based on three pillars: 1) multidisciplinary work and; 2) absenteeism among professionals. Subsequently, the descriptors were elected and based on them, searches were carried out on the electronic databases PUBMED, LILACS and SCOPUS. After reading, those who did not answer the research question were excluded, thus obtaining a result from 11 studies. The main occupational diseases were listed by the authors of the selected studies. The main disorders were of psychic origin (depression and Burnout syndrome) and of musculoskeletal origin (RSI / WRMSD). It was discussed about each disorder presented by the authors in addition to contributions from other authors, in order to contextualize the research.

7
  • ANNA CLAUDIA SALES GOMES CALDAS
  • DEVELOPMENT OF PATIENT SAFETY INDICATORS FOR MONITORING SURGICAL CARE IN THE UNIQUE HEALTH SYSTEM

  • Leader : ZENEWTON ANDRÉ DA SILVA GAMA
  • MEMBRES DE LA BANQUE :
  • CARLA SIMONE DUARTE DE GOUVÊA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 9 déc. 2021


  • Afficher le Résumé
  • Monitoring healthcare is an essential activity for any continuous quality improvement activity. However, the Unified Health System (SUS) does not have a set of indicators to monitor the quality of surgical care, making health care management fragile and difficult, given the lack of information to carry out quality improvement cycles . This gap justifies the research carried out, which aims to validate a set of indicators for monitoring the quality of surgical procedures within the SUS. The methodological study of validation of quality indicators developed in 4 stages was used as method: 1) Literature review; 2) Selection of indicators for consensus; 3) Validation of the content of the indicators by the RAND/UCLA consensus method; and 4) Pilot study to analyze reliability and identify quality indicators that can be monitored via official information systems. From the literature review, 217 surgical quality indicators were identified. Indicators considered based on scientific evidence inferior to 1A, similar, specific indicators that corresponded to sentinel events and those that did not apply to the SUS context were excluded. Twenty-six indicators with a high level of scientific evidence were taken to the consensus of experts. After using the RAND/UCLA Consensus Method, 14 process indicators and 8 outcome indicators were validated. Six process indicators were considered substantially reliable (Kappa coefficient between 0.6 and 0.8; p<0.05) and 2 had almost perfect reliability (Kappa coefficient> 0.8, p<0.05) when analyzed the inter-rater agreement. It was possible to measure and establish a tabulation mechanism for 7 result indicators. The study contributes to the development of a set of quality indicators in the surgical field that translates into an effective mechanism for measuring the performance and quality of services offered by the network of hospital services in the State of Rio Grande do Norte and in Brazil.

8
  • VANESSA CRISTINA DE GÓES E SILVA FAUSTINO DA COSTA
  • MENTAL HEALTH OF THE ELDERLY IN THE PERIOD OF A PANDEMIC COVID-19
  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • MARIA ANGELA FERNANDES FERREIRA
  • ELIANA COSTA GUERRA
  • VANESSA DE LIMA SILVA
  • Data: 22 déc. 2021


  • Afficher le Résumé
  • The COVID-19 pandemic has led several countries, including Brazil, to adopt measures to contain the transmission of the disease. It has been identified that the elderly are among the most vulnerable individuals to the most severe forms of the disease, being considered a risk group. Given this scenario, the present study is justified by Knowing the negative affectivity which mainly involves emotional states such as depression, anxiety and stress of elderly people monitored during the COVID-19 pandemic in the territory of the Family Health Units (USF) in the city of Natal. This is a cross-sectional and analytical study. Secondary data from the surveillance forms of the extension project “Prevention of COVID-19: telesurveillance of the elderly in primary health care” were used. Of the elderly people monitored by the Telesurveillance and Telemonitoring project, 251 elderly people agreed to answer the DASS-21 completely, 63.3% of the sample was female. For data collection, the reduced version of the Depression, Anxiety and Stress Scale (DASS-21) was used. Quantitative data were processed and analyzed using the statistical package Statistical Package for Social Sciences (SPSS for Windows) in its version 22.0. The research project is in line with Resolution nº 466/2012 of the National Health Council and has been submitted for evaluation to the Research Ethics Committee nº 4.431.316. Data collected by the researcher indicate that elderly people have significant levels of anxiety, depression and stress (p<0.05) during the COVID-19 pandemic period. The average age corresponds to 71.09 years (SD=7.91). Regarding frequency and percentage, 57.8% had levels of depression; 52.6% had levels of anxiety; and 52.6% had stress levels. Elderly people reported that they (69.8%) already felt anxious, depressive and stressful symptoms before the COVID-19 pandemic. Regarding the prevalence of symptoms, there was no significant difference (p>0.05) between genders. It was observed that the fear of becoming infected with the disease, as well as the measures taken to reduce its contagion (quarantine, isolation and social distancing) can negatively impact the psychological of elderly people, thus triggering mental disorders, such as: depression , anxiety and stress, in addition to the fear of dying, sadness and loneliness.

Thèses
1
  • ARYELLY DAYANE DA SILVA NUNES ARAÚJO
  • SCHOOL HEALTH PROGRAM: PROTOCOLS OF HEARING LOSS IDENTIFICATION

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • ADRIANA BENDER MOREIRA DE LACERDA
  • HANNALICE GOTTSCHALCK CAVALCANTI
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • KENIO COSTA DE LIMA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 25 janv. 2021


  • Afficher le Résumé
  • It is essential to use instruments with adequate diagnostic accuracy to identify hearing loss in
    schoolchildren. Knowing and managing information in hearing health that covers school
    environment, individual and school information, helps the elaboration of individual and
    collective actions in the scope of Health and Education, as the Brazilian Health in School
    Program (PSE) aims. The objective of this thesis is to study protocols for identifying hearing
    loss in elementary school students I and II, developed from five studies. Two studies of
    diagnostic accuracy will be described, a systematic review, an experience report and an
    ecological study. 1) Study of diagnostic accuracy, comparing conventional hearing screening
    methods to the reference standard - audiometric, tympanometric screening and otoacoustic
    emissions with transient stimulus (TOAE); 2) Accuracy study comparing different TOAE
    failure criteria compared to the reference standard; 3) Systematic review of computerized
    methods of hearing screening; 4) Report on actions to promote hearing health in the school
    environment; 5) Ecological study on School Hearing Screening (TAE) within the scope of SUS.
    The results of the thesis include 1) TOAE as a protocol with better measures of accuracy for
    school hearing screening; 2) TEOAE with signal / noise ratio equal to or greater than 3dB in
    three of the five non-consecutive frequency bands with better accuracy; 3) Among the six
    instruments identified, three had sensitivity and specificity greater than 70% - teleaudiometer
    based on a P.E.T.I.T. tablet, HearScreen ™ application, computer-based audiometer; 4) The
    five proposed activities were effective, with engagement observed by the entire school
    community and changes in habits by the students; 5) There is no tendency for a significant
    increase in the rates of school hearing screening in Brazil, which are distributed unevenly in the
    national territory. With the completion of individual studies and their joint analysis, it is
    observed that different methods can be used to identify hearing loss in schoolchildren as long
    as they are valid, but this action should not be isolated, and local realities and the network must
    be considered hearing health, since there is low coverage of TAE under SUS. In this way, it
    will be possible to carry out the actions proposed by the PSE in the scope of hearing health,
    considering the intersectoral needs and health and education.

2
  • KÁLYA YASMINE NUNES DE LIMA
  • Inequalities in lung cancer mortality and staging in Brazil

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ARN MIGOWSKI ROCHA DOS SANTOS
  • CLELIA DE OLIVEIRA LYRA
  • CRISTIANE MURTA RAMALHO NASCIMENTO
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • Data: 28 janv. 2021


  • Afficher le Résumé
  • The objective was to analyze the stage of diagnosis and mortality from lung cancer and its relationship with socioeconomic factors and the provision of health services in Brazil. This is an ecological and cross-sectional study. Deaths (C33-34) were collected from the Mortality Information System for the period from 2011 to 2015. Individual data related to cancer diagnosis and socioeconomic conditions were obtained from the Integrator of Hospital Cancer Records for the period 2006 to 2015. The contextual variables were collected in the Atlas of Human Development in Brazil, in the National Register of Health Facilities and in the National Supplementary Health Agency. For analysis of mortality and late diagnosis of lung cancer, the Chi-Square test and the Poisson Regression with robust variance were applied to a 95% confidence level. The spatial dependence on mortality rates and the proportion of delayed diagnosis (PDD) were verified by the Moran Global index and the Local Spatial Association Indicator. Early diagnosis was analyzed using Pearson's chi-square test and multilevel Poisson regression. The average age-adjusted mortality rate between 2011 and 2015 was 12.8 deaths per 100,000 inhabitants. The high mortality rates from lung cancer were significantly associated with the density of general practitioners (PR = 1.68), establishments qualified in oncology (PR = 1.49) and inversely associated with % of poor (PR = 1.73) and, they presented spatial autocorrelation (Moran = 0.5; p = 0.01). The multivariate spatial model was constituted by the variables Establishments qualified in oncology, Income and Coverage of health plans and presented an explanatory power of 66% for lung cancer mortality. Between 2011 and 2015, the PDD was 85.49% for the population between 18 and 99 years old. PDD, combined for both sexes, showed low spatial autocorrelation, however significant (Moran = 0.37; p = 0.01) and correlation with Aging Rate (0.109; p = 0.010),% of Workers Exposed to carcinogenic agents (p = 0.019), Gini (p = 0.001) and Density of Primary Health Care Teams (p = 0.042). From 2006 to 2015, 87.71% of cases were diagnosed at an advanced stage. The age group of 50 to 59 years (PR = 1.04), male (PR = 1.02), non-white race / color (PR = 1.01), incomplete elementary education (PR = 1.05) and small cell tumors (PR = 1.08) are associated with advanced diagnosis. For the same period, the proportion of early lung cancer diagnosis was associated with an older age group (70 years or older - RP 1.30; CI 1.14-1.48), with higher education (RP 1.45 ; CI 1.24-1.69), female (PR 1.18; CI 1.10-1.26) and squamous cell tumor (PR 1.19; CI 1.10-1.29). Early diagnosis was not associated with contextual variables. There are inequalities in the distribution of lung cancer mortality rates related to the provision of health services and socioeconomic conditions. The absence of a direct relationship between the context and the stage of cancer in the diagnosis points to the greater influence that the individual and tumor characteristics have on the detection of cancer.

3
  • JOAO PAULO DAMASIO SALES
  • EVALUATION OF HEALTH PROMOTION PROGRAMS FOR THE ELDERLY: AN ANALYSIS OF THE QUALITY OF SERVICES IN SUPPLEMENTARY HEALTH

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ARDIGLEUSA ALVES COELHO
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • FABIO RESENDE DE ARAUJO
  • KENIO COSTA DE LIMA
  • RENATO PEIXOTO VERAS
  • Data: 28 janv. 2021


  • Afficher le Résumé
  • Rapid global population ageing is considered to be one of the major social and economic challenges of our time. Healthcare events and conferences, scientific investigations and conceptualization seek to elucidate the phenomenon and its political, social, economic, cultural and epidemiological impacts. In Brazil, the healthcare system needs to discover new ways to resolve these effects, since the increase in the number of elderly people dimension the demands for health services and modify the population's morbidity and mortality profile, requiring healthcare sector adaptations to new demands. Given this fact, health promotion emerges as a coping strategy, which seeks solutions to mitigate the effects imposed by this demographic phenomenon, such as the risks, fragility and vulnerability common to the aging process. This study aims to analyze the quality of health promotion services for the elderly through the evaluation of a health promotion program for old-aged in supplementary health. An integrative literature review on the evaluation of health promotion programs for the elderly was carried out between January and March 2020; a documentary research, developed through the study of secondary data requested from National Agency of Supplementary Health - Brazil, submitted to descriptive statistical analysis and Descending Hierarchical Analysis in the IRaMuTeQ® software; a consensus of experts, who used the Delphi technique in three rounds: a) open-ended questionnaire addressed through content analysis, b) closed-ended questionnaire, using the Likert scale and using a coefficient of variation to determine consensus , and c) sending the result and questionnaire of open-ended questions for final consensus; finally, a case study was carried out in a program of quality of life for the elderly in supplementary health, with the adoption of semi-structured interviews, treated by means of content analysis and institutional documents, submitted to documentary research. The results were crossed with the dimensions of health promotion practices for the elderly and guidelines from the National Agency of Supplementary Health – Brazil. Thus, a sequence of studies was developed, entitled: evaluation of health promotion programs for the elderly: an integrative review; profile of health promotion and risk and disease prevention programs, exclusive to the elderly, in supplementary health; dimensions of health promotion practices for the elderly: a consensus of specialists; evaluation of a quality of life program for the elderly in supplementary health. Most studies on the subject discuss the evaluation of the impact of health promotion actions on participants, however few have an emphasis on the evaluation of services, structure and work processes. It was found that there was a gradual commitment by the regulatory agency to establish guidelines, financial incentives, and qualification of programs for health operators, which resulted in an increase in the number of new programs. However, despite the efforts, the number of programs focusing on the elderly is still small, given the growing demand in the national territory. Eighteen dimensions of health promotion practices were found and resulted in guiding principles in the theoretical and practical fields, serving as a framework for the planning, execution and evaluation of health promotion practices for the elderly. These dimensions, when applied to a quality of life program for the elderly, enabled the identification of an adequate structure to offer the service, a favorable organizational climate and an integrated team formed by diverse professionals, is in accordance with the guidelines of the National Agency of Supplementary Health – Brazil, does not have a continuous professional training program and does not systematically evaluate the results. Information capable of supporting decision making and devising ways to achieve efficiency, effectiveness and effectiveness in the management of care for the elderly can be provided, through knowledge and evidence resulting from the application of the proposed dimensions.

     



4
  • ANDIARA ARAUJO CUNEGUNDES DE BRITO
  • INSTITUTIONALIZING CARES FOR ELDERLY PEOPLE IN RIO GRANDE DO NORTE
  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • VANESSA DE LIMA SILVA
  • JACILEIDE GUIMARAES
  • KARLA CRISTINA GIACOMIN
  • KENIO COSTA DE LIMA
  • VILANI MEDEIROS DE ARAUJO NUNES
  • Data: 29 janv. 2021


  • Afficher le Résumé
  • The Long-Stay Institution for the Elderly (ILPI) are a type of home assistance, collective and with longitudinal care, aimed at people aged 60 or over, with or without family support, where they must live in conditions of freedom , dignity and citizenship. However, in the history of the institutionalization of old age, these ILPI were also known as asylums that were sometimes configured as spaces for the exercise of Christian charity and for the protection of individual and family poverty, with rules to limit and homogenize the activities of sheltered elderly people. , depriving them of social and family life, which is observed in some ILPI even today. In this sense, questions arise about the care offered, whose reflection focuses on the process of asylum for institutionalized elderly people. The objective is to analyze the process of care provided to institutionalized elderly people, from the creation of ILPI to the present day. This research has a mixed approach, descriptive and exploratory and was carried out in public and philanthropic ILPI in Rio Grande do Norte, registered in the Unified Social Assistance System (SUAS) and recognized by the Health Surveillance. The fieldwork was carried out in the first half of 2019, using an instrument of direct observation, application of structured questionnaires and semi-structured interviews with actors involved in the foundation of the ILPI. The analysis of the data raised aspects that cross and condition the care offered to residents. Thus, the discussions are organized in three chapters, namely: 1- Profile of Long Term Care Institutions for the Elderly and residents' quality of life; 2- Institutionalization of the elderly: between curative and alienating care; and, 3- Live or coexist? Challenges and possibilities of care for the elderly in Long Term Care Institutions. Therefore, the reflection on the care offered at the ILPI shows a discontinuity in the dialogue between the social and health care networks, producing the need for transformation in the long-term care of the elderly. The networks need to come together for effective planning regarding public policies for the protection of the elderly, showing strategies that meet the needs of Brazilian society in aging, through services that support longitudinal care and promote the deinstitutionalization of elderly people in the ILPI who have the possibility of getting back together in their family and community.

5
  • NATALIA LOUISE DE ARAUJO CABRAL
  • Development of a Multidimensional Instrument for the evaluation of Food and Nutritional Insecurity - Brazuca Natal Study

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • ALANDERSON ALVES RAMALHO
  • CLELIA DE OLIVEIRA LYRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • MARIA CECILIA ROCHA
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • Data: 9 févr. 2021


  • Afficher le Résumé
  • The conceptual complexity of Food and Nutrition Security (FNS) makes its assessment a challenge. Full indicators, like the food and nutritional components and their different dimensions: availability, access, stability, and biological use, are necessary. Despite this, the main instrument used in Brazil, the Brazilian Food Insecurity Scale (EBIA), includes only the dimension of access. A global indicator formulation is necessary to optimize the screening of individuals at risk of food insecurity (FI), especially in Nutritional Surveillance (NS). Thus, the aim was to assess the factors associated with food and nutritional insecurity (FNI). In addition, to develop a multidimensional screening instrument (Vigi-INSAN). The formulation of Vigi-INSAN used data from the Brazuca Natal Study, a cross-sectional study, conducted with 411 adults and older adults living at home. Home interviews were conducted using an electronic questionnaire to obtain demographic, socioeconomic, anthropometric data (weight, height, body perimeters), food consumption (items on the scale of adherence to Dietary Guidelines for the Brazilian Population), and FI measured by EBIA. The construction of Vigi-INSAN occurred in three stages: 1- Organization of the theoretical basis and selection of items, based on bivariate analysis; 2- Multiple Poisson regression to select the instrument's variables. Variables with p <0.20 were included in the model and those with p <0.05 remained in the final model; 3 - Analysis of adjustment assumptions with Omnibus test and deviance, and ROC curve to analyze the model's efficiency. The 5th and 75th percentiles were used as cutoff points. The factors associated with FI in the elderly population (n = 191) were also investigated. For this, the crude and adjusted prevalence ratios were analyzed using Poisson Regression. The prevalence of FI was 42.1% (37.4% - 46.9%). Women (47.5%), adults (48.2%) and people of non-white color / race (52.7%) had significantly higher FI. After multiple analysis, the presence of children under 18 at home (ajPR = 1.3; 1.0 - 1.6), main income (<R$ 998.00) (ajPR = 1.6; 1.2 - 2.0), the work situation (ajPR = 1.2; 1.0 - 1.5), the type of drinking water treatment (ajPR= 1.4; 1.2 - 1.7), the presence of chronic non-communicable diseases (ajPR = 1.3; 1.0 - 1.7), the absence of the habit of eating fruit for breakfast (ajPR = 2.1; 1.5 – 3.0), the habit of eating meals on the living room sofa or bed (ajPR = 1.3; 1.1 - 1.6) and skipping at least lunch or dinner (ajPR = 1.4; 1.1 - 1, 7) were selected to compose Vigi-INSAN, with an area under the ROC curve of 80%. The proposed scores were: <0.3 = Low; 0.3 to 1.9 points = Moderate; > 1.9 = High probability of FNI. In older people, income below R $ 998.00 (ajPR = 1.47; 1.01 - 2.14), not having a job or retirement (ajPR = 7.39; 1.30 - 2.49), do not eating fruit for breakfast ajPR = 7.39; 2.478– 19.66) and skipping at least lunch or dinner (ajPR = 1.75; 1.27 - 2.40) made up the adjusted model. It is concluded that Vigi-INSAN has potential for use in NS, based on multidimensional indicators, at the household and individual level.

6
  • JOSILENE MARIA FERREIRA PINHEIRO
  • EVALUATION OF ASSISTANCE ACTIONS IN THE NEONATAL PERIOD

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • FABIA BARBOSA DE ANDRADE
  • CLELIA DE OLIVEIRA LYRA
  • FLAVIA ANDREIA PEREIRA SOARES DOS SANTOS
  • KENYA DE LIMA SILVA
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • Data: 10 mars 2021


  • Afficher le Résumé
  • The neonatal period requires qualified attention, given the newborn’s susceptibility to adversities. This study was intended to assess the accomplishment of the care actions recommended by the Brazilian Ministry of Health for the neonatal period and its associations with institutional characteristics and demographic partners. A longitudinal study was held in four public maternity hospitals in the city of Natal/RN, Brazil. The sample consisted of 415 mother/child binomials, being full-term newborns, weight ≥ 2.5 kg and Apgar ≥ 7.0. Data collection took place 48 hours after birth (in person), with seven days and 28 days of life (by telephone call). From the obtained data, five studies were developed, three cross-sectional, one longitudinal; and, in view of the current context of Covid-19, a reflective study. The studies addressed the following issues: (1) Care actions for the newborn and the continuity of care in the neonatal period; (2) Prevalence of the five neonatal screening tests; (3) Determinants of the supply of complement to breast milk in the first 48 hours of life; (4) Feeding practices in the neonatal period; (5) Challenges to maintain exclusive breastfeeding in view of the measures imposed to prevent transmissibility by the SARS-CoV-2 coronavirus. The statistical analysis included applications of Pearson’s chi-square and multiple Poisson regression, with a 95% confidence interval (95% CI). Of the 415 binomials initially assessed, there was a loss of 13.7% in the second period and 16.6% in the third period. The mothers, mostly, were in the age group of 20 to 29 years (46.5%), were married or lived in a stable relationship (79.0%) and had high school or higher education (65.3%). As for the newborn, most (52.5%) were male, with an average gestational age of 39.2 weeks and birth weight of 3.310g. The main results of the studies should be highlighted: (1) Of the 29 actions performed in the maternity ward and 11 in Primary Health Care, 22.5% were classified as satisfactory, 45% partial and 32.5% unsatisfactory. The adequacy of composite care indicators was associated with multiparous women undergoing vaginal delivery, and low complexity risk maternity hospitals. (2) The prevalence of the five tests (36.6%) was associated with mothers living in the state capital (PR = 1.36; 95% CI = 1.18-1.56) and with those who received guidance at the maternity hospitals (PR = 1.30; 95% CI = 1.08-1.67). (3) Half of the newborns received complementary breast milk, being 57.6% in the first hour of life and 92% with artificial formula, which was associated with maternal age ≤ 20 years (PR = 0.64; 95% CI = 0.47-0.86), primiparity (PR=1.37; 95% CI=1.11-1.60) and cesarean delivery (PR = 1.2; 95% CI = 1.00-1.45). (4) Regarding feeding practices, the prevalence of EBF was 48.7%, 91.6% and 83.3% at 48 hours, seven and 28 days, respectively. Early weaning was associated with the absence of paternal support (RR: 4.98; CI: 2.54-9.79) and the use of a pacifier (RR = 3.2, CI: 1.63-6.32) seven days, and only using a pacifier (RR = 2.48, CI: 1.53-4.02) at 28 days. (5) The mother/baby transmissibility by the new coronavirus is still a controversial issue that, given the uncertainties, may compromise team/family/mother/newborn interaction, as well as breastfeeding, in the first hours of life. The results underline the need to restructure care and readjust good practices that favor comprehensive and longitudinal care of the newborn.  

7
  • ERICO GURGEL AMORIM
  • REINVENTIONS IN THE LIFE OF PEOPLE WITH VISUAL DISABILITIES: WAYS TO INCLUSIVE REHABILITATION?
  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • FRANCISCO RICARDO LINS VIEIRA DE MELO
  • JACILEIDE GUIMARAES
  • LENINA LOPES SOARES SILVA
  • SEVERINA ALICE DA COSTA UCHOA
  • STELLA MARIS NICOLAU
  • Data: 9 avr. 2021


  • Afficher le Résumé
  • As a result of the advances in the conquest of rights for people with disabilities during the first years of the 21st century, a greater participation of people with different types of disabilities has been observed in various sectors of society, however this advance has not been observed with the same proportion in the subgroup of visual impairment. One path used by such individuals to reach new levels of life is rehabilitation. Assuming that the spaces and practices of rehabilitation enable the reinvention of life in the face of loss of vision, in this study we aim to analyze the reinventions of life of the person with visual impairment along the rehabilitational path. In this trajectory, we weave a dialogue with the deepening of interdependence based on the theoretical-conceptual contributions developed by Elias (1994), Kittay (2011) and Butler (2015). Methodologically, we undertake an exploratory research with a qualitative approach, supported by dialectics and reflectivity, aiming at potentializing different knowledges. The subjects of this research were fifteen people over eighteen years of age, blind or with low vision, who have undergone or are undergoing visual rehabilitation

     and members of a university extension group focused on people with disabilities, as well as a key informant linked to the management of the health care network for people with disabilities in the state of Rio Grande do Norte (SESAP) and also a member of the board of directors of the Institute of Education and Rehabilitation of the Blind of Rio Grande do Norte (IERC). To capture the empirical data, we conducted three sessions of heterogeneous focus groups that took place between the months of September and October 2019 and two semi-structured interviews with managers during the same period. Later, the data were analyzed with subsidy in the thematic contente analysis (MINAYO, 2008). The research obtained ethical approval for its execution in accordance with current regulations involving research with human beings. As for the results, the emerging categories emerged primarily from the inductive and ascending analysis of the data and were constituted in three main axes: 1) spaces and practices of rehabilitation for the constitution of new enclaves, 2) challenges to rehabilitation; and 3) subject's rehabilitation and reinvention. It was possible to know the extent to which reinventions constitute and permeate the material and symbolic daily lives of those who have lost their vision, and the advances and challenges in this construction. Additionally, we propose an inclusive model of rehabilitation with a view to better understand the instances for action between the subject-subject-society, whose main characteristics are: biopsychosocial, interdependence, accessibility, acceptance of diversity and appreciation of the protagonisms of the subjects. The findings of the research lead us to consider as necessary the refusal of the negative approach to visual disability, based on the ideas of lack, deficit and defect, transmuting it to a notion of inventive power that propels emancipation, in order to bring out a common and heterogeneous world open to dialogue with diversity and permeated by the model of social inclusion.

8
  • TAIANA BRITO MENEZES FLOR
  • TRAINING AND PROFESSIONAL INSERTION OF MULTIPROFESSIONAL RESIDENTS EGRESSED FROM PROGRAMS FOR BASIC ATTENTION
  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • LUIZ ROBERTO AUGUSTO NORO
  • CLELIA DE OLIVEIRA LYRA
  • MARCELO VIANA DA COSTA
  • PAULETTE CAVALCANTI DE ALBUQUERQUE
  • ANA ESTELA HADDAD
  • DANIELA LEMOS CARCERERI
  • Data: 5 mai 2021


  • Afficher le Résumé
  • This thesis aims to evaluate main aspects of health staff professional training in Primary Health Care Multiprofessional Programs (PHCMP) in Brazil and their employability in Unified Health System (SUS) from graduates from 2015 to 2019. In order to achieve this objective, three studies were developed: a systematic review (SR), an evaluability study and a cross-sectional study. The SR sought to understand how professional training in PHCMP has been provided. The review was performed on Scielo, BVS and PubMed databases in 2019. Thirteen articles were included, from whom the following categories emerged: Mechanisms contribution to training through work; Definer strategies for professional training; Potentialities of PHCMP to health professional training and Experienced difficulties during professional training process. The evaluability study aimed to build and validate a matrix of evaluation criteria for PHCMP, covering the stages of elaboration of a theoretical logical model, proposal of a preliminary criteria matrix and validation by the Delphi consensus technique. The study was carried out in three rounds of validation, with the participation of 16 experts. A matrix composed by 44 criteria, organized in 11 sub-dimensions, which are grouped in the dimensions Personal motivation, Pedagogical approach and In-service education scenarios was obtained. The crosssectional study was performed on 365 graduates from PHCMP from 2015 to 2019, whose programs were affiliated to Higher Education Institutions, Government Schools and Public Health Schools in Brazil. Data collection occurred through online tool application composed by structured form approaching graduate main characteristics, professional training during undergraduate, employability with emphasis to SUS; beyond the previously validated criteria matrix. The cross-sectional study results were organized in three articles. The first one approached employability in SUS and its associated factors, finding a proportion of 47.9% of graduate working in SUS, being this outcome associated to graduate Nurses and Dentists (RP 1,87; IC95% 1,54 – 2,28) and to no insertion in stricto sensu post-graduate courses (RP 0,77; IC95% 0,61-0,97). Employability also revealed a great part of graduate precariously inserted to labor market. The preliminary results from the second article point out as main motivations to seek PHCMP those related to increasement of practical skills in real settings, beyond associations of Nursery or Dentistry and Pet-Saúde program participation to the outcome high affinity with working process in primary care. The third article results, which is in process of formulation, suggest professional training in PHCMP in line with contemporaneous demands of health professional training, with focus on integrality and prevention, although limitations are identified in practical scenarios and within individuals involved in professional training. The thesis in progress supports the potential of PHCMP in training differentiated professionals, at the same time that signals to necessity of qualification processes and the proposition of a valorization Health Residencies policy.

9
  • CRISTIANE DA SILVA RAMOS MARINHO
  • CHILD MORTALITY IN BRAZIL,  RIO GRANDE DO NORTE AND THE PUBLIC POLICIES.

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • MARIA ANGELA FERNANDES FERREIRA
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • SILVIA WANICK SARINHO
  • PAULO GERMANO DE FRIAS
  • Data: 28 mai 2021


  • Afficher le Résumé
  • The mortality of children in Brazil showed a reduction considered in the last years, however, unevenly between the different regions and Brazilian states, due to the great and important national differences. A macro-regional analysis revealing the Northeast region of Brazil as the one that most reduced childhood mortality. The state of Rio Grande do Norte reached a reduction of more than 80% in child and the under-five mortality rate in the last four decades. It is emphasized that the monitoring of infant and childhood mortality rates makes it possible to develop preventive strategies aimed at reducing the risk of death through public policies related to children's health. This thesis aims to analyze infant and under-five mortality in Brazil and Rio Grande do Norte, their associated factors and the intervening public policies. Four studies were developed: 1) descriptive and reflective study about the trajectory of public health and social policies for children in Brazil. The different strategies, programs and public health and social policies developed over the years were essential to achieve reductions in infant and under-five mortality rates in Brazil; 2) ecological study using secondary data for Brazil according to Intermediate Urban Linkage Regions from 2001 to 2017. Analyses of tendencies were performed with joinpoint and multiple linear regression models. Low income (extreme poverty) in the children’s families and absence of maternal schooling were the variables most closely correlated with underfive mortality rate (r = 0.649, p < 0.001 and r = 0.640, p < 0.001, respectively); 3) a time-series ecological study for 1979 and 2019 was conducted with Rio Grande do Norte as the unit of analysis. The annual percentage change (APC) was calculated using the Joinpoint software. The study showed a significant reduce trend between the years 1979 and 2005, AAPC = -6.13; 95% CI: -6.8; -5.5, for the infant mortality rate, and AAPC = -5.87; 95% CI: -6.6; -5.1, for the children mortality rate of aged 1 to 4 years.  As for the basic causes of death, the complications of pregnancy, childbirth, puerperium / conditions originating in the perinatal period and external causes showed an increasing behavior in the proportionality of infant and children deaths from 01 to 04 years, respectively, over the period studied; 4) cross-sectional study in a secondary database of Epidemiological Surveillance Sub-coordinator (SUVIGE), of the State Health Secretariat of Rio Grande do Norte of children notified with COVID-19 during 2020. Mortality from COVID-19 in children predominated in those aged between 1 and 4 years old, male, race / brown color, who had some kind of comorbidity, who needed to use ventilatory support, needed ICU admission and lived in the metropolitan region of Natal, capital of Rio Grande do Norte. Infant and childhood mortality is directly influenced by public health and social policies, with a stronger impact on the integrated presence of these types of policies, however, being able to change its pattern even in the face of fragmented and / or isolated.

10
  • MAURICIO WIERING PINTO TELLES
  • Training in public health in speech-language-hearing undergraduate programs of public Higher Education Institutions

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • ELAINE CRISTINA DE OLIVEIRA
  • CARMEN FONTES DE SOUZA TEIXEIRA
  • JANETE LIMA DE CASTRO
  • LUIZ ROBERTO AUGUSTO NORO
  • MIRELLA BEZERRA RODRIGUES VILELA
  • SYLVIA HELENA SOUZA DA SILVA BATISTA
  • Data: 17 juin 2021


  • Afficher le Résumé
  • Introduction: The public health is constituted as a field of knowledge that aims to understand health and explain its social determinants, and the scope of practices aimed primarily at promoting it. Due to its characterization, public health is a field that has the potential to contribute to the reorientation of health practices of different health professions, such as speech-language-hering sciences. In Brazil, the speech-language-hearing therapists practice focused on school health, between the 1920s and 1940s, with practices based on health pedagogization and medicalization of education. Between 1950 and 1970, it directed it’s work to private offices and rehabilitation clinics. In the 1990s, with the recently created Unified Health System (SUS), public gaps were identified in the performance of the speech-language-hearing therapist, beginning studies to rethink their training in the health context. Purpose: To analyze public health training in speech-language-hearing undergraduate programs at public Higher Education Institutions (HEIs) in the Northeast. Methodology: For the production of the data, interviews were conducted with key informants, students and professors from seven public HEIs in the Northeast. The interviews were recorded, transcribed, categorized and analyzed through Content Thematic Analysis. In addition, a documentary analysis of the lattes curricula of the speech-language-hearing teachers responsible for the public health curricular components in the Brazilian public HEIs was identified using the “snowball” technique. This analysis allowed to characterize of the training, performance and publication of these teachers. The data produced were organized in IBM SPSS software version 20, generating descriptive statistics, and correspondence analysis was performed. Results: It was identified in the analysis of the students' interviews that they have training experiences in public health that favor learning in SUS, but that have weaknesses in interprofessionality and in the integration of content. In the interviews with teachers, it was observed that speech-language-hearing undergraduate programs have a heterogeneous approach to public health and a predominance of traditional methodology in curriculum, which favors a fragmentation of knowledge. In the analysis of the teacher education, performance and production characterization, it was possible to visualize the existence of teachers who did not have postgraduate training in public  health and who publish articles in the field of speech-language-hearing clinic. In addition, it is also possible to notice the existence of differences in the characterization of training and performance of teachers when analyzing this reality in the regions of the country, with the Northeast region having the most teachers with training, performance and publication in the area of public health. Final considerations: From the perspective of subjects involved with training, this work shows, in the context of the Northeast, the potentials and limits that speech-language-hearing undergraduate programs in public HEIs have for training in public health and SUS. Furthermore, the work expands the analysis to the national scope, through the identification of the characterization of performance, training and publication of teachers, aiming to stimulate reflection on how this profile can, in some way, influence the training in public health.

11
  • ANDREZZA DUARTE FARIAS
  • Population aging and potentially inappropriate medication: from selection to prescription in Primary Health Care

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • MONICA OLIVEIRA DA SILVA SIMOES
  • ARDIGLEUSA ALVES COELHO
  • CLAUDIA SANTOS MARTINIANO SOUSA
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • TALITHA RODRIGUES RIBEIRO FERNANDES PESSOA
  • Data: 18 juin 2021


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  • Population aging is a growing reality, and the elderly need medications, which often expose them to risks. Potentially inappropriate medications (PIMs) in the elderly are those in which risks outweigh benefits. Essential medications must meet health needs of a population, and medication prescription is one determinant for its use. This study aimed to analyze PIM in the elderly from the selection of essential drugs to prescription in primary health care (PHC). A descriptive and analytical study with quali-quantitative approach was conducted in PHC in Campina Grande (PB) between March and December 2019. The study was developed triangulating methods: 1) documentary research, which analyzed medicines of the National Essential Medicines List (RENAME) in 2010 and 2020 editions according to AGS/Beers criteria and essential medicines lists (EML) of the World Health Organization; 2) cross-sectional study, conducted using interviews with 458 elderly users of 71 basic health units. Independent variables were demographic and socioeconomic characteristics, health condition, and use of medication, whereas the dependent variable was prescribed medication classified as inappropriate by the Brazilian Consensus on Potentially Inappropriate Medications. Descriptive data analysis and Poisson regression were performed; and 3) case study, using interviews conducted with 10 PHC prescribers to observe perception of these professionals regarding prescription for the elderly. One thousand four hundred and forty-nine medications and 244 PIM (16.8%) were prescribed; of these, 91.6% and 70.5% were listed in RENAME, respectively. Most PIM acted in the central nervous system (54.4%) and gastrointestinal tract and metabolism (20.1%). RENAME lacked safer therapeutic alternatives for main PIMs. In the cross-sectional study, at least one PIM was prescribed for 44.8% (95%CI 40.2 ˗ 49.3) of the elderly. In the adjusted model, depression (PR=2.01; 95%CI 1.59 ˗ 2.55), use of medication other than those prescribed (PR=1.36; 95%CI 1.08 ˗ 1.72), and polypharmacy (PR = 1.80; 95%CI 1.40 ˗ 2.33) were associated with PIM, whereas self-reported hypertension was a protective factor (PR=0.65; 95%CI 0.49 ˗ 0.87). Two categories emerged in the qualitative analysis: 1) approach of prescribers to assist the elderly in PHC and 2) use of medication by the elderly: view of prescribers. Doctors reported preventive activities but emphasized treatment of prevalent chronic diseases among the elderly. They also highlighted polypharmacy and considered benzodiazepines to be inappropriate. Doctors lacked knowledge about inappropriate medication lists. Medicalization of the elderly and availability of essential medication were described as challenges. PIMs were highly prescribed for the elderly in PHC according to the RENAME and safer therapeutic alternatives were absent. Actions to qualify access of the elderly to medication are needed, such as elaborating a specific list of medication, inserting safer therapeutic alternatives for the elderly in RENAME, training prescribers, and monitoring the elderly. Access to medication and safety of the elderly must be guaranteed because of aging of the Brazilian population.

12
  • SANDERSON JOSÉ COSTA DE ASSIS
  • Factors associated with chronic spinal problems and the impact of Primary Health Care on the management of covid-19 and on the waiting time for the specialized physical therapy service

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • CAIO ALANO DE ALMEIDA LINS
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • JOSÉ PATRÍCIO BISPO JÚNIOR
  • MARCOS HENRIQUE FERNANDES
  • NEY ARMANDO DE MELLO MEZIAT FILHO
  • RICARDO OLIVEIRA GUERRA
  • Data: 7 juil. 2021


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  • Introduction: Chronic spine problems are strongly present in society and have a relevant impact on public health due to their high prevalence and the rate of disability and absenteeism that they cause in the population. Much has been discussed about the possible causes of these problems, however little emphasis has been given to the social context and public policies involved in its genesis. In addition, further research is needed on the influence of lifestyle habits, such as the use of technologies and the management of these cases in primary health care. In addition to these aspects, these conditions can generate high waiting lines, increasing the waiting time for the treatment of these conditions. An organized PHC can reduce this high number of cases, in addition to contributing to infectious and contagious conditions, such as Covid-19. This thesis aims to analyze in a broader way the factors that may be associated with chronic spinal problems, as well as the impact of Primary Health Care on Covid-19 management and on the waiting time for the specialized physiotherapy service. Methodology: it is divided into four studies. 1) cross-sectional study, with multilevel analysis of factors associated with chronic back problems, based on the National Health Survey; 2) case-control study, with analysis of factors associated with chronic neck pain in young adults, based on primary data; 3) cross-sectional study, with multilevel analysis of factors associated with waiting time for specialized physiotherapy services, based on the National Program for Improving Access and Quality of Primary Care; and 4) time series with data on diagnosed cases of COVID-19 and their deaths as outcomes in the capitals of the Northeast region of Brazil. Results: a higher prevalence of chronic spine problems was found in females (PR = 1.23; 95% CI 1.15-1.30), aged over 49 years (PR = 1.75; 95% CI 1.1 -1.90), and in individuals who perform heavy activities at work (PR = 1.37; 95% CI 1.28-1.46). It was associated with worse self-assessment of health status (PR = 3.92; 95% CI 3.03-5.07), greater number of days with perception of depression (PR = 1.70; 95% CI 1.50-1, 94), and the presence of smoking habits (PR = 1.37; 95% CI 1.27-1.48). There was also an association for chronic spine problems in cities with a higher proportion of NASF per inhabitants (PR = 1.28; 95% CI 1.07-1.54). For chronic neck pain in young adults, a greater association was observed in individuals with greater sedentary behavior (OR = 2.41; 95% CI 1.01-5.88) and with vision problems (OR = 2.83; 95% CI 1 , 26-6.38). No association was found between chronic neck pain and postural habits and use of a cell phone. As for the waiting time for the specialized physiotherapy service, less referral time was found in the health teams that received support for the planning and organization of the work process (p <0.0001), in those that provide information about the health situation. health (p <0.0016), in teams that have a counter-reference (p <0.0001) and in teams that are supported by the NASF physiotherapist (p <0.0001. In the management of Covid, a greater coverage of PHC (p=0.01), in addition to a higher rate of social isolation (p=0.001) were shown to be mitigating factors for the dissemination of COVID-19 and its deaths. Conclusion: There is an association of chronic spinal problems with both biological and behavioral factors, and an importance of organization and greater coverage of PHC, both for a reduction in the time of referral to the specialized physiotherapy service, and in the management of Covid-19 , with a greater attenuation of cases and deaths in locations with greater coverage of PHC.

13
  • OSVALDO DE GOES BAY JUNIOR
  • THE INCORPORATION OF INFORMATION TECHNOLOGY FOR THE PRIMARY HEALTH CARE  EVALUATION  IN BRAZIL: A META-EVALUATION STUDY

  • Leader : SEVERINA ALICE DA COSTA UCHOA
  • MEMBRES DE LA BANQUE :
  • SEVERINA ALICE DA COSTA UCHOA
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • LUÍS MIGUEL VELEZ LAPÃO
  • ISABELLA CHAGAS SAMICO
  • PAULO GERMANO DE FRIAS
  • Data: 9 juil. 2021


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  • Despite the ascendancy of evaluations in Primary Health Carewith possibilities for the development of

    meta-evaluations, as well as the increase in investments and access to InformationTechnologies, with an increase

    in its applicability in evaluationprocesses, mainly for the collection of data and Dissemination of results, so far, are

    incipient meta-evaluative studies  that show the consequences of the relationships established between

    technologies and evaluators in the quality of the assessment.

    Using the Scoping Review, the Case Study, and the conceptual structure of sociomateriality, this thesis sought tocontribute to this field of research and valuable practices, evaluating the incorporation of Information Technologyin the evaluation of Primary Health Care in Brazil considering international quality standards. The scoping reviewwas developed following the Joanna Briggs Institute manual tomap the uses of the meta-evaluation of evaluative studies carried out in Primary Health Care. 23 studies,published between 1999 and 2018, predominantly carried out in Brazil, were included.

    There was more emphasis on summative meta-evaluations, with a focus on health programs and on the

     management of Primary Care, which used the evaluative standards those recommended by the Joint Committee onStandards for Educational Evaluation.

    The Case Study had a qualitative approach. 07 technicians from the coordination of the Ministry of Health

     and 47 researchers from Education and Research Institutions participated, with a total sample of 54

    participants. Data collection took place between July 2018 and July 2019, using interviews, focus groups,

     and document analysis. Data were categorized by quality standards using the Atlas ti.8.4.24 software

    followed by Bardin's content analysis.

    For the case study on data collection, the results showed that the technology made it possible to assess

    the national territory; contributed to the operationalization of an assessment with a large thematic scope;

     provided resources for field activity management; minimized errors, streamlined and homogenized the

    collection; ensured the completeness of the necessary information with a minimum of inconsistency, allowing

    the achievement of useful and valid results for the certification of teams, health policies and research. 

    In addition, factors such as difficulty in handling, inoperability of the system, and lack of investment in

    equipment and human resources can represent possible restrictions for the efficiency of the application

    of technology in the assessment. As for the study on the dissemination of results, advances were found

     in data visualization and the implementation of open data initiatives, enabling its availability to professionals,

     policymakers and universities. Challenges related to reporting delivery time, access restriction, reference to

     lack of interest, and digital skills influenced the achievement of the objectives expected by the evaluation

    proponent. It is considered that the incorporation of Information Technology has the potential to reach quality

     standards, providing opportunities for the implementation of more effective assessments, with the production of better results, acting constructively in the process of improving the performance of health and management teams, inducing theredefinition of its priority work processes, to improve and strengthen Primary Health Care. 

    The thesis is part of the Project “Evaluation of the External Evaluation of the Program for Improving Access

    and Quality of Primary Care (PMAQ—AB) do Brasil: a Case Study" partially funded by the Ministry of Health

    (MS/UFRN/TED No. 106/2015 and the National Council for Scientific and Technological Development

     (public notice 09/2018) and approved by CEP-HUOL (CAAE: 84537418.1. 0000.5902).

     

     

14
  • MONIQUE RAMOS PASCHOAL DUTRA
  • EVALUATION OF CHILD HEARING HEALTH POLICY IN THE STATE OF RIO GRANDE DO NORTE

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • HANNALICE GOTTSCHALCK CAVALCANTI
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • MARIA ANGELA FERNANDES FERREIRA
  • SHEILA ANDREOLI BALEN
  • STELA MARIS AGUIAR LEMOS
  • Data: 16 juil. 2021


  • Afficher le Résumé
  • Hearing impairment compromises the child's language development and learning process. The Neonatal Hearing Screening programs aim to identify and treat children with disabilities early and must be integrated into the Care Network for People with Disabilities. This thesis aims to evaluate the Neonatal Hearing Screening programs and the Care Network for People with Hearing Impairment aimed at children born in the cities of Natal and Santa Cruz in the state of Rio Grande do Norte. This is a cross-sectional study, using secondary data. The target population are children born in three municipal public maternity hospitals studied in the period 2015 to 2019. Three studies were developed, of which the first two refer to the program in Santa Cruz. The first evaluated the quality indicators of the newborn hearing screening program and found that of the eight indicators, only three, retest and referral rates for auditory diagnosis and age at screening completion, are within the recommended range, the others are inferior or null. The second assessed access to child hearing health services and the factors that influence access to a newborn hearing screening program in the state of Rio Grande do Norte and found an evasion in access to the service and completion of the diagnosis and children are assisted at later ages. The mother's age and education and the distance between the municipality and the service did not influence access to and use of the service. The third study verified the quality indicators of the three neonatal hearing screening programs and analyzed access to the Hearing Health Care Network for children in the state of Rio Grande do Norte. Screening was not universal in maternity hospitals and access to the Network presents a high dropout rate, yet, therapeutic interventions were offered to children with hearing impairment. The results point to the need for improvements in screening programs both in maternity hospitals and in hearing health services, dropout is a problem and specialized assistance occurs late. The Network offered the treatment recommended by public policies for children with hearing impairment.

15
  • CAMILA ALVES DOS SANTOS SIQUEIRA
  • .

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • HELDER HENRIQUE COSTA PINHEIRO
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • JAVIER JEREZ ROIG
  • LIZA BARRETO VIEIRA
  • Data: 29 oct. 2021


  • Afficher le Résumé
  • .

16
  • WAGNER IVAN FONSECA DE OLIVEIRA
  • CONCEPTUAL MODEL OF CARE IN ATTENTION PRIMARY TO HEALTH FROM PROTAGONISM SOCIO POLITICAL OF THE OLDER ADULTS
  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ELIANA COSTA GUERRA
  • EWERTON WILLIAM GOMES BRITO
  • KENIO COSTA DE LIMA
  • MARILIA LOUVISON
  • VANESSA DE LIMA SILVA
  • Data: 30 nov. 2021


  • Afficher le Résumé
  • Even in an aging society, elderly people contribute to a restriction of individual experiences from the induction of universal old age, in which the extension of functional capacity and the need to justify its usefulness are premises of social approval. Objective: To develop a conceptual model based on Person-Centered Care and public policies for the protection of the elderly. Methods: This is an exploratory qualitative research with an analytical and documental approach, divided into five stages: (1) we carried out a documentary research on the factors involved in the process of formulating public policies for the protection of the elderly. We seek to understand the guidelines that establish its functioning and the power relations intrinsic to different sociopolitical and economic interests under the prerogative of biopolitics; (2) we conducted a Scoping Review, following the guidelines established by the Joanna Briggs Institute's (JBI) from the following research question: which initiatives are relevant to promote quality in Primary Health Care for the elderly in line with the dimension of quality PersonCentered Care; (3) documentary research to understand the power relations that determine the social construction of the elderly based on the National Health Promotion Policies; (4) qualitative research based on secondary data collected at the State Council for the Rights of the Elderly in the state of Rio Grande do Norte to understand the obstacles associated with the functioning of the rights councils for the elderly and (5) qualitative study considering the previous steps for the development of the conceptual model of care for the elderly with emphasis on the dimension of quality Person-Centered Care and Primary Health Care. Results and discussion: We found that the mechanisms of power implicit in the policies protect old age for better management and efficiency from the capitalist interests. The light of an uninterrupted youth ideal materialized by profit and productivity is denaturalized. Thus, the neoliberal ideology based on depoliticization and individualistic messages ignores the social aspects related to the elderly person's own trajectory to induce, according to a prescriptive and regulatory biomedical rationality, the utopia of achieving aging without old age and legitimizing the State's disaccountability as promoter of health and care for the elderly. Final considerations: In light of the above, we built a conceptual model for the care of the elderly, opposing the neoliberal precepts surrounding the commodification of health to the detriment of the sociopolitical role of the elderly and, therefore, the recognition of multidimensional aspects as essential social instruments of political emancipation and health promotion.

17
  • KESLEY PABLO MORAIS DE AZEVEDO
  • PHYSICAL ACTIVITY AND HEALTH IN ADOLESCENCE: PROTOCOL FOR A SCHOOL-BASED INTERVENTION

  • Leader : GRASIELA PIUVEZAM
  • MEMBRES DE LA BANQUE :
  • DANIEL GUILLÉN MARTÍNEZ
  • JOSÉ CARLOS GOMES DE CARVALHO LEITÃO
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • GRASIELA PIUVEZAM
  • PAULO MOREIRA SILVA DANTAS
  • Data: 13 déc. 2021


  • Afficher le Résumé
  • The literature indicates that adolescents are more likely to adopt health risk behaviors such as physical inactivity, sedentary behavior and inappropriate eating habits. These factors are presented as potential risk factors for chronic diseases worldwide. From a perspective focused on Health Promotion, having as a reference the Health Promoting Schools approach, evidence indicates that school-based interventions emerge as a promising strategy for producing positive effects on the health of children and adolescents. Therefore, the objective of this thesis is to present a school-based multicomponent intervention aimed at promoting physical activity and health in adolescents. The methods were organized in two stages: 1) first stage: methods and eligibility criteria incorporated in the Systematic Review (SR) and Meta-analysis (MA) protocol following the methods developed in RS and MA that addressed the mechanisms related to the effects of exercise on cognition (BDNF levels) in adolescents; 2) second stage: the conception, planning and methods described in the intervention of the Program Attitude, Movement and Choices for a healthy life (AME). The multicomponent intervention consists of 4 components: (I) Teacher training and planning of activities related to the themes (promotion of physical activity, sedentary behavior and food and nutrition education); (II) Training and specific planning for physical education teachers; (III) Provision of materials and strategies that encourage the adoption of healthy habits in the school environment; and (IV) Health education at school with lectures and actions aimed at students, parents and teachers. Information leaflets and use of social networks will be distributed in order to disseminate knowledge about the benefits of regular physical activity. The AME Program presents itself as an articulated, integrated, sustainable and low-cost proposal with great potential to produce benefits in the health and cognition of adolescents. Finally, it is noteworthy that the results of the study will strengthen evidence-based practice in the context of research aimed at promoting health in the school context.

18
  • EMELYNNE GABRIELLY DE OLIVEIRA SANTOS
  • FACTORS ASSOCIATED WITH SUICID BEHAVIOR AMONG FARMERS IN CAICÓ MUNICIPALITY

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • VERÔNICA DE MEDEIROS ALVES
  • DULCIAN MEDEIROS DE AZEVEDO
  • GIRLIANI SILVA DE SOUSA
  • KELLY GRAZIANI GIACCHERO VEDANA
  • TIAGO ROCHA PINTO
  • Data: 14 déc. 2021


  • Afficher le Résumé
  • Introduction: Suicidal behavior is configured as a self-deliberate conduct with the purpose of causing harm or death, and can be understood as an interim between suicidal ideation, suicide attempts and that may culminate in the act of committing suicide. Farmers are at risk of suicidal ideation due to vulnerability and exposure to different factors associated with living conditions and work in the field. Objective: To analyze factors associated with ideation and suicide attempts in farmers. Method: This is a study of different methods. 1) a systematic review of observational studies on factors associated with suicidal behavior in farmers was developed, with searches in PubMed, LILACS, Web of Science, Scopus, PsycInfo and CINAHL databases; 2) cross-sectional study, carried out from August 2019 to March 2020, with 450 farmers in Rio Grande do Norte, where the prevalence of suicidal ideation was assessed through the Beck Suicidal Ideation Inventory, and sociodemographic variables were analyzed, of health, income, work; 3) case-control study, in order to assess suicidal behavior considering suicidal ideation and suicide attempt, in which the sample corresponded to four controls per case and, to compensate for possible losses, 15% was increased, with the final size defined in 62 cases and 288 controls. Results: 14 studies were included in the systematic review, and factors associated with suicidal behavior in farmers were identified in mental health (depression), seasonal impacts (drought) and occupational exposures (herbicides and insecticides). In the cross-sectional stage, the prevalence of suicidal ideation was 12.4% (95%CI 9.69-15.84). In the final multivariate model, the variables associated with the highest prevalence of IS were: female gender (PR=3.28), having a diagnosis of mental disorder in the family (PR=2.37), presence of common mental disorder (PR=2. 50), alcohol abuse (RP=2.22) and being salaried or temporary (R=1.91). In the case-control study, a positive and significant association was observed between suicidal behavior and having a diagnosis of mental disorder in the family (OR=2.30), having a common mental disorder (OR=3.16), having previously undergone health treatment mental (OR=3.08), perform salaried or temporary work (OR=2.69) and have been poisoned by pesticides (OR=3.34). Conclusion: suicidal ideation and suicide attempt in farmers are mainly associated with health aspects, especially mental health, work and the female gender, and signals the need to strengthen public policies for suicide prevention with targeting strategies effective for the rural worker.

19
  • HELLYDA DE SOUZA BEZERRA
  • PREVALENCE AND FACTORS ASSOCIATED WITH MENTAL DISORDERS AND ACCESS TO MENTAL HEALTH SERVICES

     

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • KELLY GRAZIANI GIACCHERO VEDANA
  • JAEL MARIA DE AQUINO
  • ANA KALLINY DE SOUSA SEVERO
  • DIEGO BONFADA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • Data: 14 déc. 2021


  • Afficher le Résumé
  • Introduction: mental disorders are a serious public health problem, with high prevalence in Brazil and worldwide. Common mental disorders are the most prevalent mental illnesses and involve depression and anxiety disorders, affecting mainly women. Timely access to mental health services is the main form of early diagnosis and effective treatment, minimizing complications and reducing the number of mental illnesses. Objective: To identify factors associated with mental disorders and access to mental health services in Brazil and worldwide. Method: This is a study of different methods. 1) systematic review of cross-sectional studies on the prevalence and factors associated with common mental disorders in women, with searches in PubMed, Web of Science, Science Direct, Scopus, Cinahl databases; 2) systematic review of cross-sectional studies on the difference in the prevalence of access to mental health services between women and men, with searches in the PubMed, Web of Science, Science Direct, Scopus, Cinahl databases; 3) Cross-sectional study with data from the 2013 National Health Survey of Brazil, aged 18 years or older, which analyzed the prevalence of symptoms of mental distress in the Brazilian population and the association between individual characteristics and social context, in an analysis multilevel; 4) Cross-sectional study with data from the 2019 National Health Survey, including 15 years or more to analyze factors associated with poor access to health services for the treatment of depression in Brazil. Results: In the systematic review on the prevalence and factors associated with common mental disorders in women, 19 studies were included, the main associated factors were unemployment, debt, low economic income, being a housewife, smoking, lower educational level, low self-assessment in health, being single, divorced or widowed. The risk of bias of the studies was classified as low and moderate. In the second systematic review, on differences in access between men and women, 11 studies were included. The prevalence of access to mental health services among women ranged from 5.2% to 56.5%; among men it was 2.9% to 47%. Men had a higher prevalence of access only to services for the treatment of alcohol and drug use. In the first cross-sectional study, depressive thinking was associated with young and middle-aged female adults, with a low level of education, without a partner, previous or ex-persistent, and who do not have a private health plan. greater risk; belonging to classes D-E and living in states with lower expectations of years of education if disclosed as a protective factor. Results found were found for the second outcome In the cross-sectional study on poor access to depression treatment, the prevalence of poor access to health services for the treatment of depression was 14.9% (95%CI 13.6-16.2) , and was associated with owners aged 15-29 years (PR = 1.52) and 30-59 years (PR= 1.22), without education (PR = 1.43), who rate their health as regular⁄poor⁄ very bad (PR = 1.26), who have some limitation in their usual activities because of depression (PR = 2.71), who have had the last appointment of 6 months less than 2 years (PR = 2.63) and for more than 2 years (PR = 2.25) and who do not undergo psychotherapy (PR = 4.28). Conclusion: it is necessary to strengthen and redirect public mental health policies, not aiming to meet the needs of the most vulnerable people with risk factors, offering timely access to health services and reducing mental suffering, as well as the numbers of mental disorders in Brazil and worldwide.

2020
Thèses
1
  • RANYELLE CHRISTIAN DIAS RODRIGUES

  • ANALYSIS OF THE RELIABILITY OF SELF-ASSESSMENT OF PATIENT SAFETY PRACTICES IN BRAZIL

  • Leader : ZENEWTON ANDRÉ DA SILVA GAMA
  • MEMBRES DE LA BANQUE :
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • HEIKO THEREZA SANTANA
  • Data: 30 janv. 2020


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  • With the objective of reducing risks in health services, the National Health Surveillance System implemented the Integrated Plan for Health Management of Patient Safety in Health Services (2015). This plan instituted the Self-Assessment of Patient Safety Practices so that each hospital service with an intensive care bed would report its compliance with legal provisions. Although the self-assessment or self-inspection of health services is a practice applied internationally and nationally, it is necessary to analyze the reliability of the information produced with this type of regulatory intervention. Thus, this project proposes to conduct a national primary study to analyze the reliability of the Self-Assessments of Patient Safety Practices in Brazil. This is a cross-sectional study to analyze the reliability in which they will be calculated: a) general agreement index; b) specific agreement index; c) point and interval estimation (95%) of Kappa; d) correlation coefficient for the difference indicator of percentage of adhesion. The sample will be random stratified composed of 66 health services in the country that participated in the Self-assessment in 2018. Upon official request from Anvisa, the Sanitary Surveillance teams of the respective municipalities / States where these services are located, will interview those in charge of the Safety Nuclei of the Patient following a questionnaire specifically designed for this purpose. This tool is based on the Self-Assessment Form to check the compliance of information provided by self-inspection. The results are expected to provide evidence on the validity and usefulness of this national intervention for patient safety and a better knowledge about the use of self-inspection as a method for monitoring and controlling risks in health services.

2
  • SAVIO MARCELINO GOMES
  • Health training for the care of the Lesbian, Gay, Bisexual and Transgender population in SUS

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • DANIEL CANAVESE DE OLIVEIRA
  • LUIZ ROBERTO AUGUSTO NORO
  • MERCES DE FATIMA DOS SANTOS SILVA
  • Data: 25 mai 2020


  • Afficher le Résumé
  • The regulatory practices of the body, gender, and desire produce historical inequalities experienced by the Lesbian, Gay, Bisexual, Transvestite, and Transsexual (LGBT) population. These inequalities materialize in various forms of violence in institutional spaces within the scope of health, education, and social assistance services. The inclusion of the demands of LGBT people in health services depends on the knowledge of their workers on this topic, which highlights the need to include this approach in professional training. In this sense, the present study aimed to analyze the insertion of the themes of gender identity and sexuality in health education. It was performed in two stages: 1) construction and validation of the research instrument and 2) cross-sectional study with the application of the questionnaire. In the first stage, the logical theoretical model was created, followed by the previous elaboration of an inquiry, to be evaluated by 25 specialists. The consensus was obtained by measures of central tendency and by the Content Validity Index. The questionnaire was validated by 19 specialists, consisting of 39 items and 92 of 92.9% CVI. In the second stage, a cross-sectional study was executed, with a quantitative approach, in the setting of public higher education institutions in the province of Rio Grande do Norte. We studied five campi: at the federal university, we investigated the campus in Natal and Santa Cruz, and at the province university, we included the campus in Mossoró, Caicó, and Pau dos Ferros.  The instrument validated in the first stage was applied, composed of three modalities: 1) sociodemographic characterization, 2) training on LGBT health, and 3) conceptions on LGBT health. All 517 students who completed Nursing, Physiotherapy, Speech Therapy, Medicine, Nutrition, Dentistry, and Public Health courses in 2019 were invited to participate in the research. In the end, 438 students answered the questionnaire. Descriptive, cluster analysis were performed, bivariate through the Chi-square and Fischer Exact tests, and multivariate through Poisson Regression and Multiple Correspondence Analysis, using SPSS 25.0 software. Higher frequencies were presented for items present in training related to transsexuals and transvestites and the lowest concerning the National LGBT Comprehensive Health Policy. The groupings showed an association between the average number of items that students had access to and participation in social movements and political training strategies. The final adjusted model revealed that the educational institution and self-declaration as LGBT are associated with greater access to LGBT care issues. Most of the students agreed with health policies to the LGBT population, and we observed groups between those who agree with all proposed policies, others that disagree, and those who did not express an opinion. The training is crossed, therefore, by individual and institutional experiences, which must be considered in the PNSI-LGBT guidelines, to enhance and democratize access to essential items for the care of bodies in SUS.

3
  • FERNANDA FORMIGA FLAVIO
  • INDIVIDUAL AND CONTEXTUAL DETERMINANTS OF RISK FACTORS FOR CHRONIC NON-TRANSMISSIBLE DISEASES IN ADOLESCENTS IN BRAZIL: NATIONAL SCHOOL HEALTH SURVEY (PeNSE 2015)
  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • ARTHUR DE ALMEIDA MEDEIROS
  • ROSIMERY CRUZ DE OLIVEIRA DANTAS
  • Data: 17 juin 2020


  • Afficher le Résumé
  • Introduction: Adolescence is an important phase of transition of human life. Lifestyle represents conscious actions that reflect personal attitudes and values, the individual's perception is associated with their quality of life. Its influence can provide the maintenance of well-being, favoring longevity or generating problems and health problems still in adolescence or adulthood. Objectives: To produce an indicator of health risk behavior and an inherent to the school structure, and tonalyze the influence of individual and contextual factors on the behavior of risk to the health of adolescents. Method: The data originated from PeNSE (2015), a sample of 102,072 questionnaires. The analysis focused on the association of the frequency of consumption of healthy and unhealthy foods, physical activity practice, alcohol and tobacco use in relation to the socioeconomic dimension of the school and the influence of the school environment. For the risk profile, a factor analysis was performed. The was fit using the polycoric matrix. Then, the variables related to the school were submitted to analysis from the item response theory (TRI) technique. To verify the factors associated with risk profiles, the final modeling for observing the effect on outcomes was obtained from Poisson's multilevel regression. Results: It was observed that the healthy eating behavior positively associated with females, Brancthe, aged 12-14 years whose mothers had at least complete elementary school, living in Capital, in the most developed regions, in socioeconomic situation in the upper or upper tercil. Regarding low healthy eating and physical activity, a positive association was observed with females, age group 15-18 years, whose mothers have not studied, live in less developed regions, and are in socioeconomic situations of poverty. The high use of smoking and alcohol consumption presented a positive association with males, aged between 15-18 years. In multilevel analysis, for the and high unhealthy eating score, being female (PR=1.10) is a risk factor, with an association of 10%. About contextual factors private schools (RP=1.12) and with a regular structure (RP=1.12) or good (RP=1.14), establish a risk association of 12-14% the structure of the school. The healthy eating score and low physical activity, convergence was not achieved. For high smoking use and alcohol consumption, being female (RP=0.87) is a 14% protection factor. Age between 15 and 18 years (PR=1.36) establishes a risk association at 36%. Attending private school assumes protection association in 12% (RP=0.88). Conclusion: The school becomes a privileged place for health promotion, because it is a social space where schoolchildren spend much of their time. However, it is necessary to promote actions in intersectoral partnerships, mobilize resources, integrated and coordinated efforts and actions, as well as to advance communication and health education, by appropriate means that new times require when considering, in particular, the connection with the interests and possibilities presented by youth.

4
  • DANDARA RAYSSA SILVA DE SOUZA
  • MATERNAL HEALTH IN BRAZIL: ECOLOGICAL STUDY TO EVALUATE THE IMPLEMENTATION OF THE STORK NETWORK

     

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • CINTIA BEZERRA ALMEIDA COSTA
  • FABIA BARBOSA DE ANDRADE
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • Data: 19 juin 2020


  • Afficher le Résumé
  • Maternal health is an area of high interest for public health, its main indicator is the maternal mortality coefficient, with high rates being characteristic of underdeveloped countries like Brazil, but which can be avoided most of the time through actions such as quality prenatal care and adequate delivery and postpartum care. In this perspective, several policies were instituted to promote improvements for maternal health, the most recent being the stork network, established in 2011. Thus, the general objective of this work is to assess maternal health before and after the implementation of the Stork Network in Brazil. To achieve this objective, it was proposed to carry out a quantitative study of the mixed ecological type, with an analytical character, on maternal health before and after the implementation of the stork network in Brazil, using the municipalities, the intermediate regions of urban coordination, federation units and regions; considering as variables the coefficient of maternal mortality, adherence to the stork network, nine socioeconomic and demographic indicators, three indicators of the quality of maternal health and the coverage of primary care; all data that composed the variables were obtained from secondary sources of public access. For data treatment and analysis, the software Microsoft Office Excel, Statistical Package for the Social Science (SPSS) and Geoda were used, where tables, graphs, maps and statistical tests were carried out for analysis under the perspective of descriptive statistical and statistics inferential, including spatial analysis. The results demonstrate that there was an increase in the average of the maternal mortality coefficient from 5.99 to 6.28 per 10,000 live births, from the period before to the period after the implementation of the stork network, with the highest coefficients occurring in the northern and southern regions. Northeast, as well as the worst socioeconomic and demographic indicators. 61.15% of the municipalities in Brazil joined the stork network until the last year studied, with the highest percentages recorded in the northern region. The correlation between maternal mortality and the variables human development index, households with running water, life expectancy at birth, aging rate and schooling increased from the first to the second period. The distribution of maternal mortality averages in relation to adherence to the stork network demonstrates that in recent years, the average maternal mortality has become lower among the municipalities that have joined the stork network than among those that have not joined. The spatial correlation of adherence to the stork network with maternal mortality reveals significant high-high and low-high clusters located in the north, northeast and midwest regions, and low-low and high-low clusters located in the southeast regions and south. Maternal health indicators reveal that after joining the stork network, there was a constant increase in the breastfeeding coefficient, the number of prenatal consultations and the percentage of pregnant women who started prenatal care in the first trimester of pregnancy. The dispersion of the percentage of adherence to the stork network with the percentage of coverage of primary care reveals that both increased concomitantly in the second period analyzed. It can be concluded that the stork network has been gradually implemented in the municipalities of Brazil from 2012 to 2017, reaching 61% in the last year, considering it important to pay attention to the constant incentive to this adherence, aiming at uniformity in health care processes maternal and child. The increase in maternal mortality after the implementation of the stork network, can be attributed to greater exposure to risk factors and changes in the lifestyle of women today, as well as to the improvement in the notification process of maternal deaths in recent years. In addition, there was a potential long-term effect of lower maternal mortality in the municipalities that joined the stork network.

5
  • LAVINIA MABEL VIANA LOPES

  • NASF professionals' perception of the work process, advances and challenges

  • Leader : KARLA PATRICIA CARDOSO AMORIM
  • MEMBRES DE LA BANQUE :
  • JANETE LIMA DE CASTRO
  • KARLA PATRICIA CARDOSO AMORIM
  • VLADIMIR ANDREI RODRIGUES ARCE
  • Data: 25 juin 2020


  • Afficher le Résumé
  • The NASF were created with the objective of strengthening, integrating and expanding the activities developed by the Health Familly , being a specialized support of performance guided by Matrix Support. In the work routine, there are some obstacles for the NASF to be effective in the face of the health situations of the territories it supports. Thus, the objective of this study is to understand the work process of the NASF in a capital city in northeastern Brazil, based on the perception of its professionals. This is a case study with a qualitative approach, carried out with 11 professionals. For data collection, the semi-structured interview and empirical field observation were used. The data were processed through Content Analysis, categorizing the findings using the Thematic Analysis modality. All participants were publicly contested in the municipality, distributed in three NASF teams, the majority being female (n = 9), with an average age of 56 years. The professional categories that were interviewed include Physiotherapists, Physical Education Professionals, Nutritionists, Psychologists and Social Workers. From the analysis of the empirical material, five thematic categories emerged: The NASF work agent; labor relations and their implications for health practices; an incorporation of NASF's means of work; presentation of the work scenario of NASF professionals; and the paths taken, the future and uncertainties. According to the data obtained, there was no training in health that would instrumentalize professionals for SUS, the work with the supported teams develops in a distant way, with isolated actions, and the work relations with the management are marked by a lack of dialogue between peers and pressure for productivism. Regarding Matrix Support, professionals recognize their conceptual aspects, but there is still the reproduction of the logic of referral and a defense by activities of assistance nature. Work tools are also recognized, but underutilized in conducting cases. In the groups conducted by the NASF, although they did not present a defined methodology, efforts were noticed to incorporate practices based on Popular Education in Health. The work scenario has some limitations, such as the precariousness of the Health Care Networks and lack of inputs and materials for the development of activities. Even so, it is evident that the provision of NASF services has broadened the scope of the ESF's actions and the professionals note that it is not possible to discuss resolvability of the service without mentioning points that interfere with the work developed. Faced with the new PNAB, some professionals feel comfortable prioritizing individual care and others recognize the threat of losing the matrix function of the Centers. NASF still faces many difficulties in establishing itself as decisive and essential for PHC in Brazil. It is necessary to review the guiding documents of the work so that its performance is enhanced, redirecting the practices for the defense of Matrix Support as guiding this work, in order to strengthen the permanence of the NASF with the Family Health of Brazil.

6
  • JÉSSICA KELLY RAMOS CORDEIRO
  • KNOWLEDGE, BEHAVIOUR AND PRACTICES OF ADOLESCENTS CONCERNING HIV/AIDS AND OTHER STI: STUDY ON COUNTRYSIDE OF BRAZILIAN NORTHEAST.

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARQUIONY MARQUES DOS SANTOS
  • RICHARDSON AUGUSTO ROSENDO DA SILVA
  • Data: 8 juil. 2020


  • Afficher le Résumé
  • In adolescence, basic patterns of behavior are established that reverberate throughout life and, among these, there is sexuality. In this moment of great biopsychosocial transformations, sexual initiation usually occurs, often without the prior guidance of an adult and surrounded by many doubts and curiosities. Thus, it is imperative to know the knowledge and practices of school adolescents about HIV / AIDS and other STIs, in order to subsidize public health policies that work with the sexual health of this population. Thus, the objective of this work is to evaluate the knowledge and practices of adolescents in relation to HIV / AIDS and other STIs in the Northeast of Brazil. For this, a transversal study of the type CAP survey (Knowledge, Attitude and Practice) was carried out, which included twelve public schools in seven cities in the North of Rio Grande do Sul, totaling 623 individuals. Two electronic questionnaires were used, one about socioeconomic / demographic data, and the other entitled “Questionnaire for the evaluation of STD / AIDS prevention programs”, used by the Ministry of Health. The reliability of the items was verified through the Alpha Cronbach, where the mean of each value ranged from 0.198 to 0.379. Factor analysis was also performed to analyze the structure of the correlations between the variables. The study found that the remaining 10 items presented the requirements required for the development of AFE, presenting the value of 0.639 for the Kaiser-Meyer-Olkin statistic. Bartlett's sphericity test showed significance (Chi2: 762,479; GL: 45; p <0.001). The total accumulated variance was 0.763. The domains resulting from the factor analysis were: Lifestyle / habits, preventive attitudes, endogenous forms of transmission and exogenous forms of transmission. Regarding the level of general knowledge about HIV / AIDS, it was observed that female participants (6.16), with a partner (6.24), attending the 3rd year of high school (6.19), whites ( 6.20), not adepts (6.15) and not attending religious ceremonies (6.20), living alone (7.49), with unmarried parents (6.17) and children of parents with complete higher education ( 6.26 / 6.34) obtained higher average scores. Half of the adolescents said they had already had their first sexual intercourse, however, only 31.3% reported having used condoms in the last six months. Although they have a considerable level of knowledge about HIV / AIDS prevention, adolescents' sexual practices do not go against preventive measures, essentially regarding the use of condoms. Regarding the reliability of the questionnaire through the analyzes carried out, the quality of the instrument was ensured. Through the study, it was possible to evaluate the knowledge, attitudes and practices of the students, with a view to subsidizing the creation of policies and programs of sexual orientation in schools with attention to the integral health of adolescents.

7
  • LETÍCIA GABRIELLA SOUZA DA SILVA
  • PURCHASE OF FAMILY FARMING FOOD FOR PNAE IN RIO GRANDE DO NORTE MUNICIPALITIES MONITORED BY CECANE IN 2017 AND 2018

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • MARIA ANGELA FERNANDES FERREIRA
  • RICHARD MEDEIROS DE ARAÚJO
  • Data: 27 juil. 2020


  • Afficher le Résumé
  • Introduction: The National School Feeding Program (PNAE) is one of the oldest and most comprehensive programs related to Food and Nutrition Security (FNS) of schoolchildren. Through Law 11. 947/2009 30%, of foodstuffs must coming directly from family farming. Objective: To characterize the scenario of the acquisition of food from family farming under the PNAE in the municipalities of the state of Rio Grande do Norte accompanied by the Collaborating Center for School Food and Nutrition (CECANE / UFRN) in 2017 and 2018. Method: This is an evaluative research with ecological design, whose information was analyzed according to data from (CECANE) linked to the Federal University of Rio Grande do Norte (UFRN) from 2017 and 2018. The sample consisted of 31 municipalities where It was analyzed the percentage of food acquisition from family farming to PNAE in 2017 and 2018, as well as the possible difficulties in relation to this process, being variables related to the management model, bureaucratic demands, internal demands and forms of acquisition. Results: It was found that the municipalities that received monitoring and advice from CECANE in 2017 and 2018, more than 50% reported having purchased food from family farming in the previous year and said they are buying it in the current year. All municipalities reported using the centralized management model, 29% reported acquisition below 30%, 9.7% reported acquisition above 30% and 61.3% were unable to report the percentage in 2017 and 2018. Related to bureaucratic demands, It was observed that the intersectoral articulation and the public call notice were considered difficult in the process of buying and selling these foods. Concerning the internal demands the hygienic-sanitary conditions necessary for the farmer's regularization as fit to supply proved to be a point that may impact the percentage of purchase, and as regards the forms of acquisition, acquisition of organic foods and / or agroecological to be a major difficulty, listed by 80.6% of the municipalities.

     

8
  • AMANDA DE CONCEICAO LEAO MENDES
  • HOSPITALIZATION FROM PNEUMONIA IN CHILDREN UNDER FIVE YEARS OF AGE: AN SPACE-TEMPORAL AND NUTRITIONAL CONDITION ANALYSIS

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • KENYA DE LIMA SILVA
  • WILTON RODRIGUES MEDEIROS
  • Data: 22 sept. 2020


  • Afficher le Résumé
  • Introduction: Pneumonia is associated with a high rate of hospitalization. Among the risk factors for this disease are those of socioeconomic, environmental and nutritional origin. Objectives: To analyze hospital morbidity due to pneumonia in children under five years of age, from the perspective of space and time and nutritional conditions. Methods: Two analyzes were carried out, the first addressing an ecological study of hospitalizations for pneumonia in children under five years old in Brazil and the second, an integrative review on the prevalence of vitamin A deficiency in children hospitalized for pneumonia. In the ecological study, data from the SUS Hospitalization Information System from 2000 to 2019 were used. The temporal trend was analyzed by the Joinpoint Regression and the spatial analysis by the techniques of Moran, SatScan and Skater scanning. For the Integrative Review, publications were searched in PubMed, LILACS, Web of Science, Scopus and CINAHL, and in the gray literature - OpenGrey, Proquest and Google Scholar. The studies were screened in the eligibility phase and read in full and those who did not answer the research question were excluded. Methodological quality was assessed using the Downs & Black (1998) and JBI checklists. Results: a SUS hospitalization rate for pneumonia of 25.08 / 1000 children in 2000 and 13.83 / 1000 children in 2019 was identified. A significant downward trend was identified in the period from 2000 to 2019 for Brazil (APC = -3.4% CI95% -3.8; -3.0). The spatial analysis showed weak spatial autocorrelation (I <0.3), although clusters with high rates in the southern region and low rates in the northeast and southeast regions have been identified. The Scan scan map showed Relative Risk <1 for these regions. The Skater map showed clusters of areas with high rates in areas of better socioeconomic conditions and greater offer of health services in southern Brazil. The integrative review included 7 studies, which indicated subclinical and clinical vitamin A deficiency in children hospitalized for pneumonia, with the highest frequency of subclinical and clinical deficiency being 93.2% and 68.9%, respectively. Conclusion: There is a tendency to reduce hospitalization for pneumonia in the SUS associated with contextual factors and there is a high frequency of vitamin A deficiency in children hospitalized for pneumonia.

9
  • PEDRO HENRIQUE ALCÂNTARA DA SILVA
  • RACIAL INIQUITY IN PRENATAL ACCESS IN THE FIRST QUARTER OF PREGNANCY: A SYSTEMATIC REVIEW AND METANALYSIS

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • ARTHUR DE ALMEIDA MEDEIROS
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • ROSANGELA DINIZ CAVALCANTE
  • Data: 30 sept. 2020


  • Afficher le Résumé
  • Access to prenatal care is the main promoter of healthy birth and the main preventive measure of maternal mortality from preventable causes in primary care. Early entry to this service makes it possible to reach the appropriate number of consultations, as well as the performance of the recommended procedures and suitability definers. Race / skin color is an important predictor of the population's health status, as well as a marker of social inequalities. The objective was, then, to carry out a systematic review of the literature and meta-analysis of cross-sectional studies, to identify the prevalence of access to prenatal care in the first trimester of pregnancy according to race or ethnicity and its magnitude of association. The protocol for this review is registered on the PROSPERO platform under number CRD42020159968. Searches were conducted at PUBMED, LILACS, Web of Science, Scopus, CINAHL and in the gray literature (Google Scholar and Opengray), using the descriptors "pregnancy", "prenatal" and "Accessibility to health services". The quality of studies and the risk of bias were analyzed using the Joanna Briggs Critical Assessment Checklist for Cross-Sectional Analytical Studies. After the analysis steps, 17 studies were included in this review. The extracted data were tabulated and distributed qualitatively and quantitatively through meta-analysis. It was observed that, in most of the included studies, black women were those who had less access to prenatal services in the first trimester, with a prevalence of access ranging from 53% to 56.4%; white women between 74% and 76.5%; and those of other ethnicities from 64.2% to 68.8%. In the quantitative analysis of the data, it was found that black women, when compared to white women, had a 43% less chance (OR = 0.57 95% CI 0.51-0.64) of obtaining obstetric care in the first trimester, and of 22% less chances when compared with women of other ethnicities (OR = 0.78 CI 95% 0.65-0.95). Thus, it is concluded that black women, even when contrasted with white and other minorities of similar sociodemographic characteristics, still received a difficulty in accessing maternal health services, and it can be inferred that the issue of race / skin color is itself an important determinant in obtaining obstetric care, requiring the development of public policies aimed at this population and expanding their access to health services.

10
  • GERONIMO JOSE BOUZAS SANCHIS
  • Prevalence and associated factors of patellofemoral pain syndrome in schoolcrildren of Natal-RN
  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • THIAGO RIBEIRO TELES DOS SANTOS
  • ALBERT ESPELT HERNÁNDEZ
  • ANDRESSA DA SILVA DE MELLO
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • Data: 27 oct. 2020


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  • Objective: To estimate the prevalence and analysis the factors related to patellofemoral pain syndrome (PFPS) in schoolchildren of both genders, between 10 and 18 years old, enrolled in public elementary and high school in the city of Natal / RN. Methods: The research had an exploratory, descriptive, transversal, and quantitative character carried out in the city of Natal-RN. The presence of PFPS was evaluated, as well as the level of physical activity through IPAQ, the quality of movement, body mass index, navicular drop test, pain level and Kujala questionnaire. The prevalence was calculated from the complex sampling design with the inclusion of weights and cluster effects. For an association analysis, adjusted Prevalence Ratios (PR) and the confidence intervals (95%) of the outcome in relation to the independent variables were calculated and a significance level of 5% was adopted. Results: 144 students participated in the research, 51.4% (CI: 41.6 - 61.1) of the sample is male. A prevalence of 29.7% (CI: 21.5 - 39.4) of PFPS was observed. In the adapted model, the PFPS was more prevalent in females (p = 0.02) (PR: 1.82 CI: 1.0 - 3.0), in physical active (p = 0.02) (PR: 2, 3 CI: 1.13 - 4.9), in underweight youth (p = 0.03) (PR: 1.9 CI: 1.0 - 3.6). When obtained by sex, men associated a positive association between poor quality of movement of the right limb (p: 0.01) (PR: 6.0 CI: 1.3 - 26) and the outcome and the female sex obtained an association with the presence of the dynamic valgus of the left knee (p: 0.03) (PR: 2.4 CI: 1.0 - 5.8). Conclusions: The prevalence of PFPS was higher in females, in active young people, and with low weight, at the same time, the poor quality of movement associated with young male people with the syndrome and the presence of dynamic knee valgus in young women.

Thèses
1
  • KELIENNY DE MENESES SOUSA FREITAS
  • QUALITY OF OBSTETRIC AND NEONATAL CARE: GOOD PRACTICES, ADVERSE EVENTS AND EFFECTS OF THE WHO SAFE CHILDBIERTH CHECKLIST

  • Leader : ZENEWTON ANDRÉ DA SILVA GAMA
  • MEMBRES DE LA BANQUE :
  • GILBERTO MARTINS SANTOS
  • MARIA ANGELA FERNANDES FERREIRA
  • MÔNICA SILVA MARTINS
  • RODRIGO ASSIS NEVES DANTAS
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 28 févr. 2020


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  • Introduction: Although it is a physiological event, institutionalized birth is a complex process that often results in unnecessary interventions and harm. To reduce maternal and neonatal morbidity and mortality, which is intrinsically related to quality of care, the World Health Organization (WHO) developed the Safe Birth Checklist. Studies demonstrate their potential effect on improving good practice, but new studies need to assess their impact on adverse events and health outcomes. Objectives: (1) to evaluate and compare adherence to Good Practice (GP) and incidence of Obstetric Adverse Events (AE) in maternity wards in Brazil and Mexico; (2) develop a platform for monitoring childbirth care indicators; (3) analyze the effect of the intervention with the checklist on the quality of care. Method: This is a multicenter research carried out in hospitals in Brazil and Mexico, part of the WHO Safe Childbirth Checklist Collaboration initiative. An uncontrolled quasi-experimental time series design was performed with retrospective analysis of birth records from 2015 to 2016 for 24 successive biweekly measurements and cross-sectional analysis before-after longitudinal measurements. 1,440 deliveries were reviewed in two hospitals in northeastern Brazil and 2,707 in five Mexican hospitals. Chi-square statistics and control graphs were performed to evaluate the performance of the transverse and longitudinal estimates, respectively. The software for collecting, monitoring and analyzing indicators was developed with Information Technology professionals to issue evaluation reports containing descriptive tables and longitudinal and cross-sectional graphs of estimates. Results: Before the implementation of the checklist, a low adherence to BP and a high incidence of AE was identified in institutions in both countries, especially in Brazilian hospitals (26.8% of BP and 16.0% of AE) and those specialized in pregnancy high risk (24.5% BP and 27.2% EA). After the implementation of the checklist in Brazilian services, even with a relatively low level of completion (20.7%), a significant increase (p <0.001) was found in the general compliance with 9 BP recommended by the checklist for the management of hypertensive disorders and of immediate care for mother and baby was 45.4% in the reference period and rose to 49.2% after the intervention (relative improvement of 7.0%; p <0.001). There was also a significant reduction in the rate of deliveries complicated by severe hypertensive disorders, hemorrhage and AS and in the incidence of uterine rupture, obstetric hemorrhage and severe hypertension. The development of the Plataforma QualiParto (in Portuguese) (qualiparto.ccs.ufrn.br) allowed participating services to use a system to monitor and evaluate outcome indicators and care processes of childbirth. Conclusions: The main results of this study (knowledge of the obstetrics GP and AE profile, intervention with checklist and development of technology for quality monitoring allowed the contextual identification and prioritization of interventions for quality improvement and benefited the care of mothers and newborns and the organizational management of services, making obstetric practices safer and more effective.

2
  • LANNUZYA VERÍSSIMO E OLIVEIRA
  • EVALUATION OF MENTAL HEALTH CARE PROVIDED TO PERSONS WITH MENTAL DISORDERS IN CONFLICT WITH THE LAW

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • SEVERINA ALICE DA COSTA UCHOA
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • GABRIELA MARIA CAVALCANTI COSTA
  • ROBSON DA FONSECA NEVES
  • Data: 12 mai 2020


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  • The objective was to evaluate the assistance to people with mental disorders in conflict with the law. It is an evaluation study carried out in two stages: Methodological Study and Case Study. The methodological study, developed in February 2019, outlines a construction and validation of the logical model and the matrix of criteria for assessing assistance to the studied group, based on the three procedures suggested by Pasquali's psychometric framework: 1) theorists- composed of theoretical essay, scope review and availability study, in order to identify the contents that make up the logical model and the criteria matrix; 2) empirical - understand the construction of a collection instrument using Google Forms and the selection of 44 specialists for the validation process of the analyzed evaluation instrument; and 3) analytical - carried out using two Delphi steps, in which the item evaluated as adequate is considered valid, which recovered 70% of agreement between the specialists. The case study took place at the Hospital of Custody and Psychiatric Treatment of the State of Rio Grande do Norte. In January 2020, three managers and seven health professionals who worked in the surveyed scenario were interviewed. The textual content resulting from the interviews was subjected to lexicographic textual analysis, with the aid of the software Interface de R pour Analyzes Multidimensionnelles de Textes et de Questionneires and the data analysis was performed from the relevant literature. The theoretical essay reflected on the existence of (in) visible walls that surround people with mental disorders in conflict with the law. The scoping review identified that research on mental health care offered to interns at the Institutes of Forensic Psychiatry in Brazil was predominantly dissertations, with a qualitative approach, in the area of Psychology and Law, published in 2014, carried out in the southeastern region of Brazil, with emphasis on the speeches of health professionals and without specifying the methodology of data analysis. In addition, he indicated that the assistance offered to the interns of these institutions has a punitive character, is based on excessive medicalization and diverges from the current legislation, which hinders the social reintegration of these subjects. The evaluability study resulted in: the elaboration and agreement of the logical model; in the analysis and comparison between the reality of politics and the logical model; and in the elaboration of the criteria matrix. The logical model was validated by the Nominal Group Technique. The content adequacy of the criteria matrix was assessed by 16 experts in the Delphi 1 stage and by 12 in the Delphi 2 stage. The content matrix had its content validated by 0.93 Content Validity Coefficient. For managers and health professionals interviewed in the field stage, assistance in the scenario studied is permeated by structural deficiencies, but changes in the scope of institutional management have allowed advances in the process of deinstitutionalization of inmates. It is recommended to establish achievable goals, as well as the criteria matrix proposed in this study to direct continuous and systematic assessment, capable of focusing on improvements in the assistance provided to this cliente.

3
  • ALEXANDRE POLICARPO DA SILVA
  • A UTILIZAÇÃO DO ÍNDICE DE NECESSIDADE FUNCIONAL DE TRATAMENTO ORTOGNÁTICO (IOFTN) COMO FERRAMENTA DE TRIAGEM POPULACIONAL PARA TRATAMENTO DAS DEFORMIDADES DENTOFACIAIS

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • FERNANDO JOSE DE OLIVEIRA NOBREGA
  • FRANKLIN DELANO SOARES FORTE
  • JOSE SANDRO PEREIRA DA SILVA
  • LUIZ ROBERTO AUGUSTO NORO
  • Data: 21 mai 2020


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  • Dentofacial deformity (DDF) can be understood as a distortion in the process of skeletal and dental development, leading to a geometric discrepancy between maxilla and mandible, affecting the functions of the stomatognathic system and facial aesthetics, with psychological and social consequences. Its treatment is carried out in an interdisciplinary way, mainly involving surgery, and orthodontics. The aim of this study is to determine the accuracy of IOFTN in screening the need for surgical treatment in patients with DDF in the Brazilian population, validating it through an integrative review on its use, and verifying its validity by comparing its results with clinical indications between those who need and not undergo a surgical procedure to correct Dentofacial Deformity. In the integrative review we obtained 13 studies that used IOFTN in its methodology. All studies used secondary data, obtaining 90.7% of individuals classified in the categories “Great need for treatment” (class 4) and “very great need for treatment” (class 5). All patients in the study who had an indication for surgery were classified in classes 3, 4 and 5. 85.5% of them in classes 4 and 5. Among those who had no indication for surgery, 79.2% were class 1 and 2 (who do not need to perform a surgical procedure). The accuracy values were considered good, with an ideal cutoff point between classes 2 and 3, where the highest diagnostic precision (90.91%) was obtained, with 100% sensitivity and 79.17% specificity. From that point on, sensitivity tends to decrease and specificity increases. Therefore, classes 3, 4 and 5 are effective in determining the need for surgical treatment of DDF. With that, we can say that the IOFTN is an effective and reliable index to predict, in a clear and objective way, the need for orthognathic surgery. 

4
  • YONARA MONIQUE DA COSTA OLIVEIRA
  • ANALYSIS OF JUDICIAL DEMANDS FOR MEDICINAL PRODUCTS IN RIO GRANDE DO NORTE STATE
  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • GRASIELA PIUVEZAM
  • MARIA ANGELA FERNANDES FERREIRA
  • MARILIA LOUVISON
  • SILVANA NAIR LEITE
  • THEO DUARTE DA COSTA
  • Data: 24 juil. 2020


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  • The judicialization of health, especially in access to medicines, is a complex and multifactorial phenomenon that involves technical-scientific, legal, economic and social aspects, and may have different implications for public health. With the constitutional recognition of health as a right and the implementation of the Unified Health System (Sistema único de Saúde -SUS), an increasing number of citizens have sought the Judiciary to guarantee the constitutional promise, and the number of lawsuits has grown over the years. As a relevante issue, the theme of judicialization has been debated in several spaces: in society, in academia, by legal institutions and by health managers. However, it has not yet been possible to draw a national panorama of the judicialization of medicines in Brazil, with a marked concentration of research in the Southeast and South regions of the country. In this context, the aim of this study was to identify and analyze the lawsuits for medicines in the State of Rio Grande do Norte, describing the sociodemographic, medical-sanitary and judicial characteristics of the actions, making an analysis in the light of current drug policies and evaluating its possible interfaces with the process of incorporating technologies into SUS. It was conducted a descriptive, exploratory and retrospective, whose unit of analysis was the individual processes requesting medicines from the State of Rio Grande do Norte, between the years 2013 to 2017. The data were collected from the State Department of Public Health (SESAP/RN), and the information on the cases was collected through consultation with the website of the Court of Justice of RN. Nine hundred eighty-seven (987) processes were analyzed, in which 1517 medicines were requested. Most of the claimants were female (58.8%), residing in the interior of the State, with an average age of 48.3 years, represented predominantly by public legal assistance (52.8%) and with prescription from private medical services (38.1%). Most of the requested drugs (61.7%) were not incorporated into SUS, however, in 75% of the cases, there was a therapeutic alternative. In 13.6% of the actions, at least 1 medicine was prescribed for off-label use. Even the judicialized drugs that were part of the National List of Essential Medicines (RENAME), were constantly requested for indications not recommended in official protocols. In 68% of the cases, access to the drug was available, with the author responsible for the purchase in 56.1% of them, through blocking public funds. The most requested medicine was insulin glargine (74 lawsuits). Drugs not available in SUS and frequently requested in court demands tend to be incorporated later, becoming part of health policy. Of the 10 drugs with the highest number of lawsuits, 4 were subsequently incorporated into SUS, mainly insulin analogues. Regarding the process of incorporating these drugs, it was observed that internal demands predominated (60%), and the minority had economic assessments (40%), the main justification used to support decisions being the presence of scientific evidence. However, a change of position was observed after the expressive participation in public consultations and the judicialization of medicines is mentioned in some reports. The results showed that the judicial system has been consolidated as a way of accessing medicines in Rio Grande do Norte, including by citizens residing in the interior of the State, who obtain free legal assistance. The most of drugs requested that were not yet incorporated into SUS, and these requests frequently violated health and Pharmaceutical Assistance management rules. The blocking of public funds for the fulfillment of these decisions is another worrying factor for the SUS manager, as it compromises the execution of the programmed medicines policies, which impair their execution. In the process of incorporating drugs targeted by lawsuits, it was observed that despite the preponderance of the technical-scientific basis in decisions to incorporate drugs into SUS, there was an indirect influence of judicialization in the decision-making process.

5
  • GENYKLEA SILVA DE OLIVEIRA
  • FAMILY AGRICULTURE IN FOOD SCHOOL AND THE PROMOTION OF SAFETY FOOD AND NUTRITION IN BRAZIL.

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • MARIA ANGELA FERNANDES FERREIRA
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • FABIO RESENDE DE ARAUJO
  • ISLANDIA BEZERRA DA COSTA
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • Data: 31 juil. 2020


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  • Introduction: The National School Feeding Programme (PNAE) is one of the oldest programmes in Brazil in the area of Food and Nutrition Security in Brazil (SAN) and with a significant number of students attended, which makes it important to evaluate the implementation and impacts of this programme. Objective: to evaluate the contributions of direct food purchases from family agriculture to the PNAE on SAN in Brazil. Method: This is an evaluative research, using secondary data, in which different methods are used: an integrative review of the literature; a spatial correlation analysis to know the spatial distribution of the purchase of food from family agriculture and analysis of purchase trends in the years studied; and a third descriptive analysis of the deficit of stature and the percentage of resources used in the purchase of food from family agriculture with analysis through the t-test for independent samples, and multivariate analysis performed through multiple linear regression with significance of 0.05%. Results: the main contributions of the purchase of food from family agriculture for school feeding on the FNS reported were the access to diversified, mostly in natura, minimally processed and organic food; the formation of local food production and distribution markets bringing the consumer and the small producer closer together; the access to food with better nutritional and hygienic sanitary quality; and the incentive to promote healthy eating habits. Regarding the panorama of the use of PNAE resources for the acquisition of food from family agriculture, the percentage of municipalities that comply with the legal requirement rose from 34.3% in 2013 to 43.7% in 2016, with the largest number of municipalities in the southern region of the country with 72.5%, while only 26.1% in the Midwest, 27.4% in the North and 31.6% in the Northeast. The South region stands out when compared to the others (p = < 0.001). The trend analysis of the union's annual budget resources showed an average growth of 30.8% (CI = 13.2-51.1). When assessing the difference in averages between the purchases and the deficit of stature in under five years there was a statistically significant difference in the deficit of stature in the municipalities that used < 30% and ≥30%, with a difference of 1.47%. As well, in the multiple analysis it was found that the variables with independent effect on the stature deficit in children under five years, besides the purchase of food from family agriculture, were the HDI, Gini Index, illiteracy rate and proportion of extremely poor children. The linear regression model showed that for each percentage point of increase in the use of resources for the purchase of food from family agriculture to the PNAE by the municipality there will be, on average, a decrease of 0.55% in stature deficit, independent of the other variables. Conclusion: from the results it can be concluded that the purchase of food from family agriculture for the PNAE in Brazil promoted the improvement of the SAN in its different dimensions and reduced the deficit of stature in children under five years. 

6
  • GIDYENNE CHRISTINE BANDEIRA SILVA DE MEDEIROS
  • CHOICES FOR HEALTHY LIFE: NUTRITIONAL INTERVENTION IN SCHOOL TEENAGERS

  • Leader : GRASIELA PIUVEZAM
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • GILBERTO MARTINS SANTOS
  • GRASIELA PIUVEZAM
  • LUCIA LEITE LAIS
  • VALTER CORDEIRO BARBOSA FILHO
  • Data: 4 août 2020


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  • The increase in the prevalence of early obesity, especially in the first decades of the 21st century, has become an important public health problem of worldwide proportions. This is due to the fact that obesity among children and adolescents tends to persist in adulthood and is strongly associated with the development of chronic diseases and increased risk of death. Actions become relevant and necessary to contain this progression, in this sense, the school environment is suitable for educational interventions to prevent and combat obesity. The AME Program “Attitude, Movement and Choices for a Healthy Life” was developed in the Postgraduate Program in the Collective Health at the Federal University of Rio Grande do Norte and is a multicomponent, including school-based food and nutrition education, reduction of sedentary behavior, and the practice of physical activity. The objective of the doctoral thesis is to develop strategies in Food and Nutrition Education (FNE) in a school-based multicomponent intervention program to promote an active lifestyle and adequate and healthy nutrition among adolescents. This is a developmental research in which the current scientific literature was used and available in order to elaborate the protocol of the FNE axis of the AME Program. The method section is organized in two stages; the first described the method of studies of systematic reviews (SR) that contributed with the technical-scientific basis for the development of the protocol; and the second described the protocol of the randomized clinical trial (RCT) study. In stage 1, two SRs were developed following the recommendations of the Preferred Report Items for Systematic Reviews and Meta-analyzes (PRISMA) and were registered in the International prospective register of systematic reviews (PROSPERO - CRD42019116520 and CRD42019100914). Stage 2 presents the methods of the ECR, which underlie the construction of the rationale and methodological characteristics of the FNE axis of the AME Program. The ECR was approved by the Research Ethics Committee (CEP-HUOL UFRN) and registered in the Brazilian Registry of Clinical Trials (RBR-86xv46). The doctoral thesis is organized in the collection of articles. The first SR addresses educational strategies and the effect on food consumption of school adolescents and 24 RCTs were included. In 16 studies, the intervention managed to improve the consumption of at least one food or group of foods recommended as healthy foods. The results indicate that school-based interventions are generating favorable changes in adolescent food consumption. The second SR addresses the association of red meat consumption and cardiovascular diseases and 22 prospective cohort studies were included. The results indicate a possible association between the consumption of red meat, especially processed meat, and the incidence and mortality from coronary heart disease, stroke and / or heart failure. The trend of linear dose response indicates that the greater the consumption of red meat, the greater the risk of incidence and mortality from cardiovascular diseases. Stage 2 contemplates the intervention proposal of the EAN axis of the AME Program which, for its construction, considered the results found in RS, combined with the recommendations of official documents of the World Health Organization, Ministry of Health of Brazil and international institutions. The study presents the rationale for the development of the axis; the guiding theories of the AME program; goals and objectives; and characteristics of the EAN axis of the AME program. Developing FNE strategies in a school-based multicomponent intervention program to promote an active lifestyle and adequate and healthy nutrition among adolescents may provide adolescents with the construction of critical and reflective thoughts that can transform their lives, that of their families, community and even their territory.

7
  • NILA PATRÍCIA FREIRE PEQUENO
  • Quality of Life and Food Insecurity in adults and older adults: Brazuca Natal Study

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • MARIA CECILIA ROCHA
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • VILANI MEDEIROS DE ARAUJO NUNES
  • Data: 21 août 2020


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  • Quality of life (QOL) studies have been increasingly valued, given the growing aging population and increased survival of individuals with Chronic Noncommunicable Diseases (NCD). The identification of conditions that may be related to the QOL of people can help explain the heterogeneous distribution of adverse health issues. Besides, it provides decision-making support to those responsible for the management, and it can expand government actions to ensure better social, economic, and health conditions for the population. This study aimed to identify socioeconomic, demographic, lifestyle, health, and food security characteristics that may be associated with the QoL of adults and older adults in the city of Natal, Brazil. Cross-sectional research performed using data from the BRAZUCA Natal study. A group of 295 adults and older adults of both sexes aged over 20 years, residents in Natal-Brazil participated in home interviews, using a digital questionnaire (Epicollect5). The WHOQOL-bref questionnaire used to the measured quality of life and the food insecurity by the Brazilian Food Insecurity Scale (EBIA in Portuguese). Also, socioeconomic, demographic, lifestyle, and health data were collected. Data analysis was performed from the absolute and percentage frequencies, and Poisson multivariate regression was used to verify the association between quality of life domains (physical, psychological, social relations and environment) and two general questions “Perception of QOL” and “Satisfaction with health”  with the independent variables. Stratified analysis carried out to determine the association between the food security situation and QOL among people with food safety - SA (n = 152) and Food Insecurity - IA (n = 143). For the general population, being non-white people (PR = 1.56; 95% CI 1.10-2.19) and being mildly insecure (PR = 2.53; 95% CI 1.62-3.96) moderate (PR = 3.19; 95% CI 2.03-5.00) and severe (PR = 2.86; 95% CI 1.65-4.95) were associated with a higher probability of Perception of regular quality of life , bad or very bad. Satisfaction with regular, unsatisfactory, or very unsatisfactory health was associated with mild food insecurity (PR = 1.73; 95% CI 1.26-2.37), emotional disorders (1.88; 95% CI 1.43-2,49) and having hypertension (1.39; 95% CI 1.05-1.84). In the stratified analysis, being sedentary, sleeping less than 7 hours a day, having diabetes, hypertension, overweight and emotional disturbances were associated with a low perception of QOL (in different domains) in both groups (SA and AI). In group IA, in addition to the factors mentioned, being elderly, not having a partner, not having daily availability of water, and drinking untreated water was associated with a low perception of QOL, highlighting the social vulnerability of this group. In addition to conditions related to social and health inequities, QOL was shown to be associated with conditions related to physical and mental health, NCD, and their risk factors, regardless of being in a situation of AI. However, in the AI group, the condition was worsened due to the lack of adequate access to water, doubly violating the right to adequate food.

8
  • DIOGO VALE
  • PENSE - BEHAVIORS, PSYCHOSOCIAL FACTORS AND SUSTAINABILITY IN THE FEEDING OF BRAZILIAN ADOLESCENTS: FROM SURVEILLANCE TO CARE

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANA CLAUDIA CAVALCANTI PEIXOTO DE VASCONCELOS
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • GRASIELA PIUVEZAM
  • ISLANDIA BEZERRA DA COSTA
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • URSULA VIANA BAGNI
  • Data: 31 août 2020


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  • Adolescence is a period of bodily changes, the formation of behaviors, and social interactions, which impact the eating patterns and nutritional status of individuals, with possible repercussions throughout life. Aiming to contribute to the process of surveillance and food and nutritional care of this public, the objective of this doctoral thesis was to investigate the prevalence of nutritional deviations, patterns, and eating behaviors of Brazilian adolescents and their associations with psychosocial, behavioral and sustainability factors. Ten studies were developed, one methodological and eight association, using a quantitative approach with data from sample 2 of the National School Health Survey (PeNSE) 2015, and one trial. (1) The methodological study highlights the potential of PeNSE databases in studies of food and nutrition surveillance (VAN). The association studies explore the following food and nutrition issues for adolescents: (2) adherence to school feeding, (3) food and nutritional profiles, (4) obesity and height deficit, (5) indicators of food sustainability; (6) risk behaviors for eating disorders, (7) distortion of body image, (8) experience of food insecurity and (9) dissatisfaction with body image. Finally, the essay discusses (10) food and nutritional care in adolescence. The dependent/main and independent/secondary variables of the association studies were representatives of individual, home, and school contexts. The identification of the explanatory models for each problem occurred with the application of descriptive statistics, Person's Chi-square test, Poisson Regression Analysis (classic or multilevel), or Correspondence Analysis. The main results were: (1) the PeNSE databases allow several association analyzes to explore food, nutritional and behavioral issues relevant to the Brazilian adolescents' VAN process; (2) the prevalence of low adherence to school meals (64.2%) was associated with individual behaviors, the family's socioeconomic position and the school context; (3) the most prevalent food and nutritional profile among adolescents was characterized by a dietary pattern with lower nutritional risk with eutrophy (42.6%) and the six profiles formed by combinations between categories of dietary pattern and nutritional status were associated with distinct sociodemographic characteristics, behaviors and sustainability indicators; (4) the height deficit (2.3%) was explained by biological variables and the worse socioeconomic position of the adolescents; the prevalence of obesity (10.0%) was associated with individual behaviors, psychosocial risk factors for health and better socioeconomic status; (5) the average carbon (1206 gCO2e / kg), water (2760 liters / kg) and ecological (8.07 g-m2 / kg) footprints were higher among adolescents in the South and Southeast, with a higher risk food pattern nutritional; (6) the prevalence of risk behaviors for eating disorders (16.5%) was associated with worse socioeconomic status, with individual behaviors and with psychosocial factors of greater vulnerability, with differences between the behaviors for weight loss (11.3% ) and those for weight gain or muscle mass (8.8%); (7) overestimation (6.6%) and underestimation (37.1%) of body image were associated with individual behaviors (sex, body satisfaction and risk behaviors for eating disorders); (8) the experience of household food insecurity (22.8%) was explained by the worse socioeconomic position, behaviors of greater food and nutritional risk and by psychosocial factors of greater vulnerability; and (9) body dissatisfaction coexists with nutritional deviations, food consumption with greater nutritional risk, food insecurity, inattentive eating, risky behaviors for eating disorders and better socioeconomic status. Based on the recognition of this entire context, (10) a model of management and production of food and nutritional care for Brazilian adolescents should be considered based on (a) incorporating new indicators into VAN, (b) qualifying educational actions for resilience and autonomy and (c) and in the development of public health, food and nutrition policies aimed at this population in Brazil.

9
  • NAYARA PRISCILA DANTAS DE OLIVEIRA
  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ARN MIGOWSKI ROCHA DOS SANTOS
  • CLELIA DE OLIVEIRA LYRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • GUSTAVO PINA GODOY
  • TATYANA MARIA SILVA DE SOUZA ROSENDO
  • Data: 25 sept. 2020


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  • Breast and cervical cancers stand out among female cancer types with high incidence and mortality rates, which have considerable regional differences. The discussion on inequalities in the diagnosis and death due to breast and cervical cancer enables the understanding of the understanding of these diseases at the individual and population levels. The objective of this thesis was to analyze the staging and mortality from breast and cervical cancer and its connection with socioeconomic context and the distribution of health services in Brazil. Five observational studies were developed, one of the classic ecological type, two cross-sectional studies and two of the ecological type of spatial analysis. The mortality data were collected from the Mortality Information System (SIM). Individual data related to the diagnosis of cancer were obtained from the Integrator of Hospital Cancer Registries (RHC). The contextual socioeconomic variables were collected in the Atlas of Human Development in Brazil and the data on offer of health services from the National Registry of Health Institutions (NRHI), the Outpatient Health Information System (SIA-SUS) and the Agency National Supplementary Health (ANS). The mortality analysis was performed using the Poisson regression with robust variance. For the analysis of advanced staging, the Multilevel Poisson Regression model was chosen, with a random intercept. In the spatial analysis, the Moran Global Index and the Local Spatial Association Indicator (LISA) and the models with global spatial effects were used. The main results were: (1) The average age-standardized mortality rates for cervical and breast cancers were, respectively, 5.95 (±3.97) and 10.65 (±3.12) per 100,000 women. The high mortality rate from breast cancer was associated with a higher density of general practitioners and a greater offer of health services in oncology. The high mortality rate due to cervical cancer was associated with higher rates of local social inequality and lower levels of human development in the regions evaluated. (2) The proportion of late breast cancer diagnosis in Brazil was of 40.0%. Advanced staging was associated with individual and contextual factors related to public access to health services and the low density of mammography equipment. (3) In 32.4% of cervical cancer cases, staging was absent, significantly associated with individual and contextual factors in the provision of health services. The proportion of advanced staging was 48.4%, with association with individual and contextual factors of public access to health services and the low proportion of cytopathological exams. (4) Advanced staging of breast cancer presented positive spatial correlation with the Gini Index and a negative one with the density of gynecologists. Mortality rates presented a positive spatial correlation with the HDI and the density of gynecologists. (5) Advanced staging of cervical cancer presented a positive spatial correlation with the Gini Index and a negative correlation with the proportion of beneficiaries of private health plans. Mortality rates presented a positive spatial correlation with the Gini Index and a negative one with the density of gynecologists. The study highlights the social inequalities involved in advanced staging and mortality from breast and cervical cancer in Brazil. The importance of structuring equality in the access to health services and technologies in the Brazilian territory is highlighted. In addition, the reorientation of public health policies would make it possible to optimize the control, prevention and timely treatment of breast and cervical cancer.

2019
Thèses
1
  • MARIANNY NAYARA PAIVA DANTAS
  • INIQUITY IN BRAZILIAN HEALTH SERVICES: AN ANALYSIS OF RACIAL DISCRIMINATION AND ACCESS FROM THE NATIONAL HEALTH RESEARCH, 2013.
  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • ANA CLAUDIA R. DA SILVA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • MERCES DE FATIMA DOS SANTOS SILVA
  • Data: 12 avr. 2019


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  • The black population is identified in several studies as vulnerable because it is disadvantaged in socioeconomic aspects, morbidity and mortality profile and access to health services. The incapacity of the institutions, structures and organizations of society to attend this population in an equitable way can be evidenced both in the difficulty of access to health services and through the practice of racial discrimination perpetrated by health care providers. This study aims to analyze the difficulty of access and discrimination by race/color in Brazilian health services, considering the data from the “Pesquisa Nacional de Saúde” (PNS), 2013. It is a cross-sectional study based on the PNS data, 2013, with 60.202 people over 18 years. Questionnaires were used in the survey on obtaining care, not seeking health services and on discrimination by health care providers. We analyze the prevalence of difficulty of access and discrimination by race/color practiced by health care providers in relation to the socioeconomic characteristics and health conditions of the studied population; bivariate analysis with attainment of Prevalence Ratios (PR), Confidence Intervals of 95% (95% CI) and p values (p <0,05); and multivariate model using the Poisson regression, with Wald test for robust estimation, for significant variables in the bivariate analysis (p value <0,2). The difficulty of access was found for 18,11% (CI 95% 16,88-19,41) of the individuals and associated with black skin color, residing in the central-west region, in the rural area, being smoker, self-evaluation bad/very bad health and have no private health insurance. The prevalence of race/color discrimination practiced health care providers was 1,45% (95% CI 1,29-1,62) and was associated with being black, being between 25-39 years old, being a smoker, possessing four morbidities, having poor/very poor health self-evaluation, being a public health service user and residing in the urban area of the country. We found that racial discrimination and the difficulty of access to Brazilian health services reach the majority of the black population. We observe the legitimacy of institutional racism through the Brazilian health services, highlighting SUS, which proposes universal, inclusive and integral. We reinforce the need to strengthen health policies with a view to transforming this panorama.

2
  • CARLA RODRIGUES DE LIMA SILVA
  • VOCAL TRACT DISCOMFORT RELATED TO THE LABOR ACTIVITY OF SOPROINSTRUMENTIST MUSICIANS IN THE CITY OF NATAL- RN

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • LEANDRO DE ARAUJO PERNAMBUCO
  • LEONARDO WANDERLEY LOPES
  • Data: 14 mai 2019


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  •  

    Introduction: Wins instrumentalist musicians belong to a specific group of individuals who use the vocal tract intensely in the exercise of their professional activities, which can lead to the development of work-related voice disorders. These disturbances can be triggered or aggravated by individual, organizational and environmental factors of the work. Objective: This study aims to verify the perception of vocal tract discomfort associated with the working characteristics of instrumental musicians in the city of Natal-RN and to identify the presence of vocal and laryngeal symptoms and associated factors in these professionals. Methodology: The sample consisted of 117 professional and training musicians, who answered a questionnaire of socioeconomic characterization, demographic and health conditions and habits, as well as filling the Vocal Tract Discomfort Scale (EDTV). A Systematic Review was also performed on the electronic databases Science Direct, Scopus, Web of Science, PubMed and LILACS, gray literature as well as manual search, without limitation of date and language, as directed by PRISMA. A title and summary analysis was carried out, followed by the analysis of the full text, risk assessment of bias (Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies) and synthesis of the results. The research was conducted independently by two researchers. Results: The most frequent DTV symptoms reported by the musicians were dryness (53%), irritated throat (35.9%) and sensitive throat (30.8%). Similarly, these symptoms presented higher averages in EDTV before and after the practice of the instrument, the dryness symptom being more frequent the more intense. Musicians who report muscle pain, gastroesophageal reflux, and respiratory allergies have a greater number of DTV symptoms. According to the six studies selected for systematic review, the main vocal symptoms in musicians of blowing are: dysphonia, altered vocal quality, hoarseness and voice failures - laryngeal symptoms - dryness, sore throat, throat irritation, throat clearing, discomfort and tension. The associated factors identified to these symptoms were the shorter time of profession, intense use of the instrument and individual vocal issues. However, the methodological discrepancies between the studies, especially in relation to the heterogeneity and size of the sample and the instruments used, signalize great variability and compromise the reliability of the results. Conclusion: The symptoms of vocal tract discomfort are present in high frequency in wind instrumentalists musicians, being more frequent in musicians with less instrument study time. In addition, the various vocal and laryngeal symptoms found in wind instrumentalists musicians in the selected studies were associated with individual factors (prior vocal alteration, inadequate vocal habits) and organizational factors of the work (time of profession, intense use, type and instrument technique). We also reinforce the need for health education actions for these professionals taking into account physiological aspects as well as working conditions.

3
  • ANA PAULA DO REGO
  • The history of the Januário Cicco Maternity School and care provided to the mental health of women: Is there a link?

  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • JACILEIDE GUIMARAES
  • JOÃO BOSCO FILHO
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 17 juin 2019


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  • The Januário Cicco Maternity School (MEJC) was founded in the first half of the 20th century in the city of Natal-RN, known at the time as the Natal Maternity, and was used as a headquarters and hospital during World War II. With the vision to improve the health and public education of Natal, a doctor named Januário Cicco restored the building with federal funds and inaugurated the MEJC in 1928. The present study has the objective to investigate the approach about the mental health of women hospitalized in the MEJC after its creation, referring us to the developed knowledge of know-how and practices as comprehensive health, although not always having this denomination, composes an indisputable fact of the human condition. Faced with this, the question is asked about which mental health care strategies were offered to women hospitalized at the MEJC at the time of its creation? This is a study of the historical approach of the know-how in health and mental health, with the purpose of contributing to the current comprehensive care in the perspective of the care network and its devices. Documentary research favored the approach to official reports and thematic oral history enabled investigating and filling in the remaining gaps, as well as to understand situations of official foundation of a certain time or context. In doing so, we intend to reflect on the studied phenomenon and how it influences the present. The thematic oral history was based on a semi-structured interview in order to capture the discourses of key informants. The inclusion criteria for the subjects in the research were to have been a worker at the MEJC at the time of its creation and to be in a position to participate in the research, and to accept to do so freely. The participants were informed and signed the Free and Informed Consent Form recommended by Resolution 466/12 which provides for research involving human beings. The documentary data collection used were: digitized newspapers of the National Digital Library and the Zila Mamede Central Library. The analysis of the present research implemented the content analysis technique as reference according to the steps described by Minayo, which consist of preanalysis (floating reading of the material), exploration of the material or codification (search for categories and significant words) and treating the obtained results/interpretation (proposes inferences and performs interpretations). The results showed that the knowledge of Mental Health practices developed in the maternity run through the knowledge and assimilation of mental health as a psychiatry model, focused on the figures of the psychiatrist, psychologist and social worker; and is also associated with the conducts and norms related to the humanization process, such as: patient listening, 24-hour availability/visitation for companions, sufficient professionals trained in mental health, privacy and therapeutic projects which work with the mothers of children admitted to the neonatal unit. Another point considered as an approach in mental health is the way the social context is inserted in maternity, as well as the context of unemployment, safety, social determinants in health and expanded concept in health.

4
  • REGINA CÉLIA CARDOSO DE MELO BARROS
  • Public Ministry and health defense: study on the extensive heads of family health and primay health care

  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • JACILEIDE GUIMARAES
  • LENINA LOPES SOARES SILVA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 19 juin 2019


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  • The study analyzes the performance of the Public Prosecutor's Office in the defense of health for the strengthening of NASF's through the Health Defense Offices of Natal and the assistance of the Operational Support Center to the Health Protection Justice Prosecutors (CAOP) in order to identify as this work contributes to the strengthening of the Expanded Nuclei of Family Health and Basic Care (NASF-AB). It is a qualitative research of descriptive exploratory type that used as a collection instrument semi-structured interviews applied to key informants, having as subjects of the research the professionals who are part of the team of the Office of Justice of Defense of Health of Natal, including the promoters and their holders; professional member of the team of the Operational Support Center of the Justice Ministry of Health Defense; the professionals that integrate the Family Health Strategy teams of the municipality of Natal with the support of NASF-AB; and professionals who are part of the teams of the Expanded Nuclei of Family Health and Basic Care in Natal; with a total of 23 participants. In addition to the semi-structured interviews, a documentary analysis was carried out at the Office of Justice of Defense of Health of Natal, including Civil Inquiries, Recommendations and complaints received, all referring to NASF-AB in Natal; and also the analysis of the queries answered (doubts of the prosecution) and the reports of visits, all carried out by the CAOP Saúde team; and also of the strategic project of the Public Prosecution Service that included NASF-AB as one of its axes. Regarding the results, it can be seen that the performance of the Office of Justice of the Health of Natal is aimed at expanding the number of NASF-AB teams and structuring the working conditions of the teams already implemented, it is a focused work however, NASF-AB professionals revealed a dissatisfaction about the direction of this action due to the few advances made. And as for CAOP Saúde, this directs its action focused on the NASF from a Strategic Project, but focuses only on the municipalities of the interior of the state, not being requested to support the prosecution of Natal on this issue, failing to contribute with a more specialized look at this problem.

5
  • ANA MAYARA GOMES DE SOUZA
  • EVALUATION OF MORTALITY OF WOMEN IN THE FERTILITY VICTIMS OF VIOLENCE

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • CINTIA BEZERRA ALMEIDA COSTA
  • FABIA BARBOSA DE ANDRADE
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • Data: 25 juin 2019


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  • Violence against women is not a new phenomenon, although, facing consequence it brings for health and well-being, this aggression has received a growing recognition in Brazil as well as other countries regarding public health concerning. Childbearing-age women correspond to 10 to 49 age range, and they are the majority part of Brazilian female population. Therefore, this study aims to evaluate mortality data of childbearing-age women by acts of violence from 2007 to 2016, in Brazil. This is an ecological study which dependent variable was the Women Mortality Coefficient for women who were victims of violence between 10 to 49 years old range. For an analysis of space self correlation among 161 Urban Articulation Intermediary Regions (RIAU – Regiões Intermediárias de Articulação Urbana, in Portuguese) in Brazil, we applied Moran Global tests and we performed a bivariate analysis between closuring variable and independent variables (general coefficient of mortality, coefficient of mortality by chapters in 10thInternational Classification of Diseases and Related Health Problems, coefficient of mortality by socioeconomic, social inequality, health services access and age group). We also performed a classical descriptive data analysis, in which we evaluate average and medium standard deviation and test t Student for average rates comparison, concerning a confidence interval (CI) of 95% and value of p<0,05. From 2007 to 2016 it was possible to identify a mortality raise by external causes and aggression to childbearing-age women, with a higher concentration of deaths in North, Southeast and Southern regions, specially in 2016, when death numbers reach 45,24% in this population. Regarding to age groups, we noticed that 40 to 49 years-old women number of deaths is higher, and we must remark that this number increased according age raising. About schooling, the highest percentage was found between 4 and 7 years of school attendance, followed by the ones between 8 and 11 years of schooling. Lastly, regarding marital status, the proportion of deaths was higher in single women group. So, we concluded that mortality by violence amongst women express high coefficients in the most of Brazilian regions and they are still related to contextual characteristics such as breed, social layer factors, socioeconomic factors and health service access. Thus, these findings remark how important is to face violence not only by individual factors and there must be a sensibilization in services of hosting women services. 

6
  • BRUNA LORENA ALVES COELHO
  • ANALYSIS OF THE JUDICIALIZATION OF ANTINEOPLASTIC MEDICINES IN THE STATE OF RIO GRANDE DO NORTE

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • KARINA CARDOSO MEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • MARILIA LOUVISON
  • Data: 26 juin 2019


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  • The advances of health policies from the Federal Constitution of 1988 are unquestionable. However, deficiencies in the physical structure, financing and management have meant that the Unified Health System was not able to meet the health needs of the population in its fullness. Changes in the epidemiological profile of the population and technological advances have caused the population to turn to the judiciary to satisfy their health demands. This practice has become increasingly recurrent and has become what is now called the Judicialization of Health, a multifaceted phenomenon with controversial views among the authors. Among the demands in the field of health, the processes that call for drugs stand out, and in this segment one of the biggest financial impacts is linked to antineoplastic drugs, since cancer is a group of chronic non-communicable diseases, which occupies a leading role among the largest causes of death in the world, and whose technological contribution to its treatment is constantly being renewed. This is a descriptive study of lawsuits claiming antineoplastic drugs that have the state of Rio Grande do Norte as sole defendant or in solidarity with other entities, between the five-year period from 2013 to 2017, analyzed by indicators withdrawn of the manual "Evaluation indicators and monitoring of drug lawsuits". A total of 145 procedures were collected, which were analyzed according to the socio-demographic characteristics of the author; Procedural characteristics of lawsuits; Medical-sanitary characteristics of actions and Political-administrative characteristics of actions. The findings so far show that the global expenditure of the defined temporal scope was R $ 17,745,602.70, with a greater number of cases coming from the capital of the State and of the Municipality of Mossoró, composed mostly by female individuals 60 and 69, represented by public defenders. 68% of the individuals had access to the medication, which had a purchase made mostly by the author of the action (62%).

7
  • MARIA HELENA RODRIGUES GALVÃO
  • ACESSO AOS SERVIÇOS DE SAÚDE BUCAL NO BRASIL: EVOLUÇÃO DA DESIGUALDADE E FATORES RELACIONADOS À ATENÇÃO SECUNDÁRIA

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • FRANKLIN DELANO SOARES FORTE
  • ROGER KELLER CELESTE
  • Data: 27 juin 2019


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  • O objetivo do presente estudo foi avaliar a influência dos determinantes socioeconômicos no acesso aos serviços odontológicos no Brasil, sob a perspectiva da utilização e disponibilidade, considerando duas estratégias analíticas: (a) a desigualdade na utilização dos serviços odontológicos relacionada à renda na população brasileira a partir dos dados da Pesquisa Nacional por Amostragem de Domicílios (PNAD) dos anos 1998, 2003 e 2008, e a Pesquisa Nacional de Saúde (PNS) no ano de 2013 (b) a associação entre os indicadores sociais e de organização dos serviços de saúde dos municípios e a disponibilidade de serviços nos Centros de Especialidades Odontológicas, a partir dos dados do Programa Nacional de Melhoria do Acesso e da Qualidade (PMAQ-CEO). A primeira abordagem consiste em um estudo de painéis repetidos, com análise de dados secundários provenientes de estudos seccionais de base domiciliar. Foram selecionados os dados das PNAD 1998, 2003 e 2008, e os dados da PNS 2013. As variáveis dependentes foram “Já teve acesso à consulta odontológica alguma vez na vida” e “Última consulta odontológica realizada a 3 anos ou mais”. A variável independente selecionada foi “Rendimento per capita domiciliar em salários mínimos”. Com a finalidade de avaliar a desigualdade em saúde para os desfechos avaliados, foram utilizados índices complexos de avaliação de desigualdade em saúde baseados em regressão, o Coeficiente Angular de Desigualdade (CAD) e o Coeficiente Relativo de Desigualdade (CRD). A segunda abordagem trata-se de um estudo ecológico, com amostra de 776 municípios brasileiros que participaram do 1° ciclo do PMAQ-CEO realizado no ano de 2014. As variáveis dependentes do estudo consistiram no número de profissionais e carga horária semanal de cirurgiões-dentistas atuando nas especialidades mínimas por 10.000 habitantes. Realizou-se uma análise de componentes principais para a criação de um escore para mensurar o desempenho dos municípios quanto à disponibilidade de serviços odontológicos especializados. A fim de avaliar os fatores associados ao desempenho dos municípios, utilizou-se o teste do Qui-quadrado de Person, tendo como variáveis independentes os seguintes indicadores municipais categorizados em tercis: renda per capita, Índice de Desenvolvimento Humano, Índice de Gini, População residente, Despesa total de saúde por habitante, Equipes de Saúde Bucal por 10.000 habitantes, e Cadeiras de CEO por 10.000 habitantes. Observa-se uma redução na diferença absoluta no percentual de ausência de acesso entre os indivíduos com maior e menor renda. A diferença absoluta para a ausência de acesso dentre os grupos passou de 10,92% em 1998 para 7,61% em 2013. Para a ausência de acesso nos últimos 3 anos, os valores reduziram de 48,19% em 1998 para 26,98% em 2013. Também se observou uma redução da desigualdade relativa quanto à renda para ambos os desfechos. O desempenho ótimo quanto à disponibilidade de serviços especializados em saúde bucal foi observado em municípios com menor porte populacional (67,3%), com menor IDHM (41,9%) e com menor renda per capita (41,2), maior média de equipes de saúde bucal por 10.000 habitantes (50,6%), maior média de cadeiras do CEO por 10.000 habitantes (66,3%). Conclui-se que houve uma redução das desigualdades no acesso a consulta odontológica com o passar dos anos analisados, embora se mantenha em níveis preocupantes. Os municípios com piores indicadores socioeconômicos e com melhor organização dos serviços de saúde bucal obtiveram melhor desempenho quanto à disponibilidade de serviços odontológicos especializados. Os resultados demonstram o avanço obtido a partir da Política Nacional de Saúde Bucal, entretanto existem desafios a serem superados da efetivação dos pressupostos desta política.

8
  • TALITA ARAUJO DE SOUZA
  • EVALUATION OF CHILD MORTALITY TO REACH GOAL OF LIFE GOALS IN BRAZIL

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • FABIA BARBOSA DE ANDRADE
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • IRIS DO CEU CLARA COSTA
  • KENYA DE LIMA SILVA
  • Data: 27 juin 2019


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  • Infant mortality is the term used to designate all deaths that occur in children under 1 year old of age. It is the most effective indicator in the evaluation of the health situation of the population. Over the last twenty-five years, it has been possible to observe a reduction in infant mortality in Brazil. It has been shown that the country has achieved four of all objectives of the Millennium Development Goals before 2015. In 2006, the Pact for Life was released highlighting infant mortality in one of its indicators, being divided into three pacts: reduction of neonatal mortality, infant mortality due to diarrhea and reduction of infant mortality due to pneumonia. This study aims to evaluate whether the goals of the Pact for Life established by Ordinance N º 399 has been reached in relation to neonatal mortality rate for diarrheal diseases and pneumonia before and after its release in 1996 decades to 2005 and 2007 to 2016. It appears as an epidemiological ecological study of time series and spatial correlation, conducted through the Mortality Information System, considering the years 1996 to 2016, excluding 2006 due the fact it is the year of implementation of the Pacto Pela Vida. For the development and analysis of the data the 161 Intermediate Regions of Urban Articulation were considered. The coefficient of infant mortality in the years studied was determined as a dependent variable and secondary dependent variables: coefficient of neonatal mortality, coefficient of infant mortality due to diarrhea and coefficient of infant mortality due to pneumonia.  As independent variables were selected: Human Development Index, Gini Index, percentage of poor, Bolsa Famíliacoverage, Primary Care coverage, nurses rate of family health strategies per thousand inhabitants, physicians rate of health strategies family per thousand inhabitants and coverage of childcare consultations. The descriptive data were analyzed in the software Statistical Package for the Social Sciences, then the mortality data were specialized in TerraViewto determine the spatial autocorrelation and bivariate analysis was used GeoDa software, and correlated the coefficient of infant mortality with the independent variables of the study. It was found that neonatal mortality only reached the target goal of 5% decrease in 2007 and 2016, while mortality from diarrhea and pneumonia did not reach the goal proposed by the indicator in any year (decrease of 50% and 20% % respectively). In addition, infant mortality decreased in the two decades analyzed, with a mean coefficient of 22.67 in the first decade and 14.30 in the second decade. When spatially evaluated, high coefficients of infant mortality were found with positive association when compared to neighboring regions. In addition, the spatial distribution presented statistical significance in all the independent variables of the study. Based on the results, it was possible to identify that the goals of the Pact for Life were not met, making it necessary to review health actions, suggesting that there is a fragility even if there are public health policies for children that aim at reducing those diseases that must corroborate with the improvement of child health indicators.

9
  • TAINARA LÔRENA DOS SANTOS FERREIRA
  • HOSPITAL MORBIDITY AND MORTALITY IN CHILDREN UNDER FIVE YEARS IN BRAZIL IN THE PERIOD 2007 TO 2016

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • FABIA BARBOSA DE ANDRADE
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • IRIS DO CEU CLARA COSTA
  • KENYA DE LIMA SILVA
  • Data: 28 juin 2019


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  • In the last decades, we have noticed a reduction of mortality rates amongst under 5 years-old children, although a high number of deaths could be avoided. So, this age group received a new perspective by United Nations in 2015, aiming to finish avoidable deaths of newborn and under 5 years-old children. Therefore, this study aims to evaluate hospital morbidity and mortality in Brazil among under 5 years-old children between 2007 and 2016, and relate those numbers to social indicators and inequality of health and access to public services of health in Brazil. It is an transversal epidemiologic study, ecological and time series to be performed with usage of secondary data from Sistema de Informações Hospitalares do Sistema Único de Saúde (System of Hospital Information of Unique Health System, in free translation) and Informação sobre Mortalidade (Mortality Information System, in free translation) in last ten years (2007 to 2016) in a national range, available and extracted from national base of public domain by the Information Department of SUS. We used the following dependent variants: Children Mortality Estimation and Mortality Estimation of Children Among One and Under Five Years Old, percentual distribution of children hospital intakes and percentage of children among one and under five years old hospital intakes. As independent variants, we selected: Atenção Básica (Basic Attention Service, in free translation) coverage, childcare appointments coverage, immunization coverage, Bolsa Família Program coverage, Índice de Desenvolvimento Humano (Index of Human Deveolpment, in free translation), Gini Index and poverty proportion. For a statistical data analysis, we used Statistical Package for the Social Sciences (SPSS) program, 22.0 version, 10101141047 serial number, and we calculated the measures of central tendencies and dispersion. We also applied test t Student among Regiões Intermediárias de Articulação Urbana (Urban Articulation Intermediary Regions, in free translation). For spatial analysis and map construction, we used TerraView program, 4.2.2 version, and Geoda, 1.2 version. We noticed that, among under one-year old children, during the analyzed period, there was a variation in cause of deaths averages: as first cause, 33,56 (respiratory system); followed by 32,13 (diseases that come from perinatal period); and, at last, 17,07 (infectious and parasitic diseases). There was a reduction in children mortality estimation when compared 16,43 average in 2007 and 13,41 in 2016. Regarding age group between one and four years old, first cause of illness was respiratory system (42,69); the second cause was infectious and parasitic diseases (25,84). Concerning mortality coefficient of 1 to 5-year-old children, we had these numbers: 2,84 in 2007 and 2,34 in 2016. We verified clusters formation to hospital morbidity and mortality, presenting spatial dependence for events, independent age group, correlated to social, health inequality and health public services access indicators. Thus, it shows the necessity of lowering social and regional inequality, besides raising access to health public services for children and quality of low and medium complexity health assistance, aiming to reduce grievance and children morbidity and mortality indicators.

10
  • ANA CLARA DANTAS DE SOUZA
  • Prevalence of multimorbidity and associated factors in the workers Brazilian population
  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • JANUSE NOGUEIRA DE CARVALHO
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 12 juil. 2019


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  • The fast transition in the demographic and epidemiological profile has recorded the increasein longevity, chronic illness and the prococity of disability, making the health system lessprepared to meet the growinf demando f people with non communicable chronic diseases,especially those with two or more, known as multimorbidity. This study aims to estimate theprevalence of multimorbidity in the brazilian population (≥18 years old) and to know itsassociated factors considering he data from the National Health Survey (PNS), 2013. Inprinciple, a systematic literature review was conducted based on the PRISMA protocol, inorder to identify the impacto f multimorbidity on workers' health. After the review, a crosssectional study was developed based on the data from the PNS, 2013, with 60,202 people over18 years old. Survey questions were used to answer wheter the individual had alread receivedthe   diagnosis   of   some   of   the   chronic   diseases   included   in   the   study.   We   analyze   theprevalences of multimorbidity in relation to socioeconomic characteristics, lifestyle and work;bivariate analysis with obtaining the prevalence ration (RP),  confidence intervals at a leve of95% (CI 95%); and multivariate model through Poisson regression, with Wald test robustestimation, for significant variables in the analysis.. The prevalence of multimorbidity was19.98 (95%CI: 19.29% - 20.70%) and was associated with the female gender. To the agerange of 60+, to live with the spouse, to ingest alcoholic beverage moderately, to be formersmoker, to be illiterate, to live the urban área, have health insurance, perform night work andhave already suffered some work accident. A low prevalence of multimorbidity was estimatedin the economically active brazilian population and was associated with labor, socioeconomicand lifestyle characteristics.   

11
  • ANA CLARA DE FRANÇA NUNES
  • Vitamin A and Symptoms of Multiple Sclerosis: A Systematic Review of Epidemiologic and Clinical Trial Studies”.


  • Leader : GRASIELA PIUVEZAM
  • MEMBRES DE LA BANQUE :
  • GRASIELA PIUVEZAM
  • LUCIA LEITE LAIS
  • SANDRA MARIA NUNES MONTEIRO
  • Data: 7 août 2019


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  • Introduction: Multiple sclerosis (MS) is the most prevalent autoimmune disorder today and is associated with demyelination of neurons in the central nervous system (CNS) through activation of the immune system. Studies using vitamin A have been promising to improve the disease. Thus, the present dissertation aims to provide the best available evidence on the clinical impact of vitamin A on the outcomes related to symptoms of patients with MS. Methods: The article collection format was used for the production of two articles, the first one being a protocol article, used as the basis for the production of the second article, a systematic review. We searched the pubmed, embase, scopus, cinahl, scielo, web of science, cochrane library, and science direct for studies published until May 2019 to assess the relationship of vitamin A supplementation and / or serum level analysis and symptoms in patients with MS. For the design of the systematic review, PRISMA was used. To assess the methodological quality of the studies, the JADAD scale was used for randomized controlled trials and Newcastle – Ottawa for observational studies. To extract all the data found, a database was created in the Microsoft Excel program. Results: In the initial search we found 2053 studies, and at the end of the searches, 6 articles eligible for the research were selected, being 2 RCTs and 4 observational (cohort). Of the six studies included, two used vitamin A supplementation and obtained results that vitamin A is capable of containing upper limb progression and cognitive impairments, significant improvement in depression scores, total fatigue and the three fatigue subscales (physical, cognitive and psychosocial). The other four studies performed serum vitamin A dosing and found that serum retinol levels were not associated with risk and number of relapses and worsening of EDSS, but increasing retinol levels are associated with decreased results of disease activity. and retinol predict results of new lesions in subsequent months by magnetic resonance imaging. Conclusion: These findings are not yet sufficient to recommend vitamin A supplementation for MS patients. New well-controlled controlled trials are needed.


12
  • ALESSANDRA LUCCHESI DE MENEZES XAVIER FRANCO
  • Cancer care for children nd young people quality assessment tool: elaboration and validation
  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • MIRIAN CARVALHO DE SOUZA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 26 août 2019


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  • This study aimed to elaborate and validate an instrument to evaluate the quality of care for childhood cancer. This is a cross-sectional quantitative diagnostic study, developed in 2018 and 2019 in the city of Natal/RN, in two stages comprised in the elaboration of the instrument and the validation of the instrument content by experts. The sample was selected by intentionality, following the inclusion criteria, so that the invitation to the judges was through an electronic form, obeying all ethical aspects for the research. The elaboration phase of the instrument was understood through the meeting with the experts, which directed the literature review that culminated in the elaboration of the first version of the instrument. Starting the second stage of the study, the instrument was subjected to expert evaluation, according to the Delphi technique, and should be evaluated by them, judging each item using the established Likert scale, until agreement was measured using the of the Content Validity Index by Item (IVC-I) and the Content Validity Index (IVC) of the instrument, adopting as a minimum reference value 0.78, and an acceptable agreement rate of 80%. Given the meeting of experts, it was possible to determine that the instrument would be organized by four domains: prior to diagnosis; for the diagnosis; treatment; after treatment. Thus, the evaluation criteria were defined, which were translated in the first version of the instrument with ninety-five items. After the first round of evaluation by the experts, of the 17 invited judges, 12 proceeded with the evaluation. It was observed that only 14 items presented CVI-I lower than recommended, CVI corresponded to 0.89, however CVI based on the criteria of the assessment used was equivalent to 0.75 which indicated the need for adjustments. Thus, 50 items were revised, 14 were deleted, 3 were added and 13 were kept according to the original wording. Therefore, the second version of the instrument was elaborated and submitted again to the judges, presenting IVC-I for all items with values above 0,78, in addition to IVC equivalent to 0.98, and according to the evaluation criteria. obtained an IVC of 0,99, compared to the participation of only ten judges. Thus, in view of obtaining agreement between the judges, the instrument was validated according to its content, tense in its final version the existence of eighty-four items. For this instrument the score was proposed based on the percentage of positive responses by domain, and overall, according to three evaluation categories: presence of weaknesses to obtain quality; presence of improvement opportunities to achieve quality; presence of strongholds to obtain quality. The use of such an instrument will contribute to the assessment of the quality of care attention for children and juvenile cancer, thus allowing the diagnosis of this, in order to guide the interventions to optimize the results obtained, consequently directing the organization and formatting of the care attention pursuing the destination of higher quality care attettion for children and young adults.
13
  • EWERTON HANDERSON FIGUEIREDO DE MEDEIROS
  • ANÁLISE DO PROCESSO DE REGULAMENTAÇÃO E FISCALIZAÇÃO SANITÁRIAS DAS COMUNIDADES TERAPÊUTICAS DO ESTADO DO RIO GRANDE DO NORTE

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • JOAO MARIO PESSOA JUNIOR
  • KENIO COSTA DE LIMA
  • ROSIRES MAGALI BEZERRA DE BARROS
  • Data: 14 nov. 2019


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  • Therapeutic Communities (TC) are presented as an alternative to the treatment of addiction to alcohol and other drugs. With the insertion of these institutions into the Psychosocial Care Network (RAPS) and their multiplication in various regions of the country, the State has been left with the role of accompanying this dizzying growth and, especially, regulating and overseeing these services. Thus, this study aims to analyze the process of sanitary regulation and inspection related to therapeutic communities located in the state of Rio Grande do Norte (RN). This is a descriptive and exploratory research using a mixed method involving a quantitative and qualitative approach. The target audience were eleven TC and sixteen Health Surveillance (Visa) professionals from various regions of RN. For data analysis, the Statistical Package for Social Sciences (SPSS) was used in the quantitative approach, whose description was based on absolute and percentage frequency and measurements of the distribution center. In the qualitative approach, the technique used for content analysis was the ―thematic analysis‖, which seeks to discover meaning cores present in the communication and that demonstrate some meaning for the research object. Regarding the organizational characteristics of the TC, the results show that most of them are located in rural areas (63.6%), religious in nature (81.8%) and associated with evangelical denominations (63.6%). The family is responsible for a significant part of the institutionalization (90.9%), as well as being the main source of TC funding (63.6%). Regarding the sanitary characteristics of the TC, (63.6%) had an updated sanitary license and only (36.4%) had solid waste shelter. Residents' access to health services in their territories is still one of the problems observed in this study, because despite advances in the approach to primary care services, they are still far from the CAPS and other services offered by the organization. RAPS. The sanitary organs present weaknesses regarding the sanitary regulation and inspection process of these institutions, which, consequently, corroborates the perceived distance between them and the TC, weakening the construction of a permanent interinstitutional dialogue.

14
  • TASSIANA ALICE FIGUEIREDO ROCHA
  • PUBLIC DEATH POLICIES: UNDERSTANDING THE LIFE CARE OF HEALTH CARE SERVICES

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • MARIA ELIANE MOREIRA FREIRE
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: 25 nov. 2019


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  • The present work deals with a qualitative research, using as methodological instruments: indepth interview and documentary research, focusing on the thematic content analysis based on Bardin. The objective was to understand the articulation of Primary Care in the Health Care Network for end-of-life care, through the analysis of how actions are developed and articulated health care services to assist people in end of life in the understanding of professionals and health managers. The study was developed in the state of Rio Grande do Norte and had as collaborators the managers and health workers who work in cities with more than 100,000 inhabitants: Natal, Mossoró, Parnamirim and São Gonçalo do Amarante. The collaborators were the Health Secretaries of the cities, the heads of the Primary Care Departments, as well as primary health care doctors, nurses and nursing technicians. The sample size of doctors, nurses and nursing technicians was defined by theoretical saturation. . The narratives were analyzed and categorized following the steps proposed by Bardin: Pre-analysis, Material Exploration, Coding and category selection. The thematic categories were related to the objectives of the work and later grouped into sections for discussion of the results. The complexity of living with the phenomenon of death, described by the research participants, points to an ambivalence: Death that is seen naturally, while there is great difficulty in dealing with it. The structure of the health system and lack of training were pointed out as elements that hinder end-of-life care, in addition to the absence of specific guidelines and provisions that offer subsidies, and the doctrinal principles of SUS were pointed as guidelines. It is considered that this study is an invitation to rethink practices, but also to problematize the very structure of the system. It is an appeal that adds to the struggle for the right to comprehensive care, which considers not only health-related needs but also those related to death.

15
  • EMILY KATHIENE SILVA DE MESQUITA
  • OS DESAFIOS DA ESTRUTURAÇÃO DOS CUIDADOS PALIATIVOS NA CIDADE DO NATAL RN

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • MARIA ELIANE MOREIRA FREIRE
  • KARLA PATRICIA CARDOSO AMORIM
  • KENIO COSTA DE LIMA
  • Data: 25 nov. 2019


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  • The purpose was to evaluate how the end of life care is structured in the city of Natal RN. It is about a sectional study, with a convergent parallel combination method type, involving quantitative and qualitative approaches of treatment and data analysis. It was developed at institutions enrolled on the National Academy of Palliative Care Website on Natal RN, that offers the basic needed services regarding palliative care. The included institutions were: Hospital Monsenhor Walfredo Gurgel, University hospital Onofre Lopes and Liga Contra o Câncer. The target population of this study were medical professionals specialized on palliative care or that nominate palliative care and patients under palliative care, accompanied by enrolled institutions at the National Academy of Palliative Care (ANCP), which are able to provide this type of care, during the period of data gathering that occurred between June and September of 2019. Initially, one made an identification of the units who were providing palliative care. After this, one raised the epidemiological profile of patients under palliative care: mostly women, with an age group of 60 to 79 years old, that never smoked and most of them (40.2%) had advanced mammary neoplasia. Afterwards, deep interviews were made with medical professionals with the purpose of identifying the knowledge about palliative care, and finally, it aimed to evaluate the quality of life of the patients under palliative care through the Palliative Care Outcome Scale (POS). We obtained as results that the quality of life is unfavorable, because the scores are always at a moderate level. It is concluded that palliative care in Natal RN is still under construction. For it arose as challenges: The advanced state of illness in which the patient arrives. Professionals feel uncomfortable to indicate palliation, because throughout their training is taught to cure and not care. The unfavorable quality of life results from the entire unfavorable process to palliative care, even with staff and medication support, as it encompasses major factors ranging from culture change to the absence of guidelines that regulate palliative care more effectively.

     

     

16
  • AMANDA ALMEIDA BATISTA
  • HEARING HEALTH PROGRAMS: CONTRIBUTIONS TO DEVELOPING CHILD IMPLANTS
     


     
  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • MARIA ANGELA FERNANDES FERREIRA
  • JOSELI SOARES BRAZOROTTO
  • HANNALICE GOTTSCHALCK CAVALCANTI
  • Data: 5 déc. 2019


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  • Cochlear Implant (CI) is an electronic device capable of partially replacing a sensory organ in individuals with severe to profound hearing loss. Brazil currently has 26 referral centers that assist the deaf population at all ages, both in the private network and in the Unified Health Service. The objective of this study is to know the sociodemographic profile and the etiology of deaf children submitted to cochlear implantation by the Unified Health System in Rio Grande do Norte. This is a cross-sectional study, based on information from medical records of children using cochlear implants throughout the state, at the cochlear implant referral service, Otomed Clinic. The study population consisted of children from 0 to 12 years old, of both sexes, users of cochlear implants, who underwent surgery and activation between January 2008 and December 2017, residents of the state of Rio Grande do Norte. For the analysis of qualitative variables, it was used the description of absolute and relative frequencies and for the quantitative variables were extracted the measures of central tendency and dispersion. The qualitative analysis also considered the descriptions of the cases with the dissertation of the particular findings of the relevant cases. The partial results show that the service has been working positively regarding the equitable access of low-income families and early diagnosis, however, it was also observed the negative aspects such as the lack of etiological diagnosis of deafness, the cochlear implant after the critical period for oral language development and the failure of medical records.

17
  • LUCIANA MARIA PEREIRA DE SOUSA
  •  

    HUMAN RIGHT TO FEEDING OF WOMEN IN THE PRISONAL SYSTEM OF PARAÍBA

     

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • ANA CLAUDIA CAVALCANTI PEIXOTO DE VASCONCELOS
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • GABRIELA MARIA CAVALCANTI COSTA
  • SEVERINA ALICE DA COSTA UCHOA
  • Data: 16 déc. 2019


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  • The right to food is part of the fundamental rights of humanity and refers to a set of necessary and essential conditions for all human beings, equally and without discrimination, to exist, to develop their capacities and to participate fully and with dignity. of life in society. A challenging context for the realization of the right to food is the scenario of the Brazilian prison system. In 2016, with 42 thousand women deprived of liberty, the occupation rate in the Brazilian prison system, compared to women, is 156.7%, which means that in a space for 10 women, they are in custody 16 women in the prison system. In Paraíba, this rate is over 168% and currently there are 620 women in the state prison system. Overcrowding increases the chance of exposure to precarious conditions and hinders the access of this population to quality food, effective and equitable, thus representing a relevant problem of public health. The aim of this study is to analyze the realization of the human right to adequate food for women in the Paraíba prison system. This is a case study with a qualitative approach, developed in the four prisons that receive women in conflict with the law in the state of Paraíba: The Maria Júlia Maranhão Reeducation Center in João Pessoa, the female prison of Campina Grande, the Penitentiary Ducks and the Cajazeiras Women's Penitentiary. The subjects of the research are representatives of the Paraíba Penitentiary Administration Secretariat, nutritionist of the general storeroom of the state penitentiary administration, female prison officers for the state, women in prison (closed for at least one year) and women in prison that develop labor activity in the kitchens of the penitentiaries studied. Data collection was through semi-structured interview. For data analysis we used the Content Analysis method, by Bardin, 2011. The results are presented through the categories: 1- Scenario of Female Incarceration in Paraíba; 2- Access to adequate food for women in prison in Paraíba; and 3- Perception of women deprived of liberty regarding the right to adequate food. We note that the context of incarceration makes it impossible to realize the right to food with regard to food availability, adequacy, accessibility and stability of supply. As a conclusion, it is evident that with regard to women in the Paraíba prison system, the dimensions of the right to food that refer to being free from hunger and the right to adequate food are not effectively realized. Food for human beings must be understood as a process of transforming nature into healthy and citizenship people. For this, it is essential that practices that promote the right to food consider the principles that relate to it and thus overcome discriminatory and authoritarian practices.

     

18
  • ISABELLE NASCIMENTO DE OLIVEIRA BEZERRA
  • Planning, self-assessment and institutional support in primary health care: a study with data from the 3rd cycle of the Access and Quality Improvement Program

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • ARDIGLEUSA ALVES COELHO
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • FABIA BARBOSA DE ANDRADE
  • Data: 17 déc. 2019


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  • The aim of this study was to analyze an association of socioeconomic factors with the quality and practices of municipal management in primary health care in Brazil, from a perspective of Planning, Self-Assessment and Institutional Support (AI). An ecological cross-sectional study with aggregation at the municipal level, conducted in 5324 Brazilian municipalities participating in the third cycle external evaluation phase, and statistical data on the final EAB certification of the Access and Quality Improvement Program - PMAQ-AB (2015- 2018). The dependent variables to the management were the activities of Planning, Self-Assessment and Institutional Support by EAB, after grouping by municipality and organization by participation were classified as: 1- “No team perform (2) - what is the quality of AB, how was the EAB grouped into: 1-Good Teams ”; 2- “Bad Teams”, and the answers were categorized as: 1- “No good (bad) teams”; 2- “Partially good (bad)”; 3- "All teams are good (bad)". The contextual independent variables were: Municipal Human Development Index - MHDI; Gini Index; Proportion of 15-24 year olds who do not study, do not exercise and are vulnerable in the vulnerable population in this range; Proportion of extreme poverty; adopted the categorization from the median.  In order to evaluate the associated factors, Pearson's chi-square test (Qui²)  was used. As the main results were observed on the Planning, Self-Assessment and Institutional Support activity, there is a significant association (p <0.001) for the population size, small size municipalities (up to 20,000hab), the best percentages and greater homogeneity within the population. of the territory; In general, the municipalities of the interior perform more as activities than the Brazilian capitals. In regional terms (p <0.001), the municipalities in which all teams develop better management are concentrated in the Northeast (Planning-89.9%; Self-assessment-72.9%; AI-85.1%) and less in the Northeast. North region (Planning-80.4%, Self-Assessment-48.3%; AI-69.1%). When it comes to socioeconomic aspects, or the percentage of management activities is detected in all as EAB in smaller municipalities (Gini up to 0.4900), (Planning-85.3%; Self-assessment- 76.3%; AI-80, 9%); low HDI (up to 0.6630) (Planning-89.1%; AI-83.6%), highest extremely weak proportion (> 6.880) (Planning-89.2%; AI-83.3%). The best teams (good teams) are concentrated in inland municipalities (24.1%), small, up to 20,000hab (29.1%); in the Northeast (26.3%) and lower in the North (10.6%), with lower inequality (Gini up to 0.4900) (28.6%) and highest mean extreme poverty (24.6%). the teams are in municipalities with the best HDI (33.8%); The results show the advancement in shared management, especially in the interior and small municipalities, induced by the equity policies, and expansion of the ESF, strengthening the National Policy of Primary Care, despite the challenges to be overcome, to achieve a management that impacts the work process of the Primary Care Teams and the reduction of regional inequalities.

     

Thèses
1
  • MARIA DE FÁTIMA TRINDADE PINTO CAMPOS
  • MASTICATORY PERFORMANCE AND  ORAL HEALTH IMPACT OF LIFE ON IMMEDIATE LOAD IMPLANT SUPPORTED DENTURES

  • Leader : ADRIANA DA FONTE PORTO CARREIRO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • ANTONIO RICARDO CALAZANS DUARTE
  • CARMEM SILVA LAUREANO DALLE PIAGGE
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • SANDRA LÚCIA DANTAS DE MORAES
  • Data: 14 févr. 2019


  • Afficher le Résumé
  • Introduction: The impact of oral health on the quality of life (OHRQoL) of patients through the replacement of conventional total dentures (PTC) with implanted implanted prostheses (PFIS) still lacks evidence. Objective: The objective of this non-randomized controlled clinical trial was to compare masticatory performance (PM) and OHRQoL in patients who were rehabilitated with PFIS with immediate loading and PTC. Methodology: The sample included 43 individuals, 4 males and 39 males, mean age 58.56 (± 7.15). All patients were rehabilitated with PTC initially. The PFIS group (20 patients), after 3 months of rehabilitation, had their PTC converted into PFIS and were installed with immediate loading, after the placement of 3 or 4 implants. The OHRQoL was measured using the OHIP - edent questionnaire (Brazilian version) and the PM, using the sieve method. Data were collected before (T0), and after 3 months of installation of PTC and PFIS (T1), remaining in this last group 10 collections to be performed. The statistical analysis was developed from the Generalized Estimates and Poisson distribution, adopting α≤0.05. Results: It was evidenced that the PFIS group had better PM when compared to the PTC group (1.71 mm, p <0.001) and in the initial condition (CI) (1.41 mm, p <0.001). PTC group did not improve their PM (0.30 mm, p = 0.02). Regarding OHRQoL, it was identified that the PFIS group obtained better results in all domains of OHIP-edent in relation to IC (p <0.01). When compared to the PTC group, the PFIS group was only higher in domain 3 (0.42 mm, p = 0.08). The OHIP-edent values were also different among the groups, with the lowest scores in the PFIS group followed by the PTC group and the CI group, with a significant difference between them (p <0.01). There was also a positive and moderate correlation between PM and OHIP-edent (r = 0.51; p = 0.03) in the PFIS group alone.

2
  • LAERCIO ALMEIDA DE MELO
  • PREVALENCE AND FACTORS ASSOCIATED WITH MULTIMORBIDITIES IN BRAZILIAN OLDER ADULTS

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • VILANI MEDEIROS DE ARAUJO NUNES
  • LEANDRO DE ARAUJO PERNAMBUCO
  • MANUEL ANTONIO GORDON NUNEZ
  • Data: 18 févr. 2019


  • Afficher le Résumé
  • The objective of this study was to identify the prevalence of multimorbidity in the elderly in Brazil and its factors associated with socioeconomic and lifestyle variables. This is a cross-sectional, population-based study. The database was used for the National Health Survey. The elderly were considered multimorbital when they had a diagnosis of two or more chronic diseases. In the analysis of the data, the chi-square test was used and then the prevalence ratios were estimated by means of Poisson multiple regression, both with 95% confidence level. A total of 11,697 elderly people with a mean age of 70.1 years participated in the study. The prevalence of multimorbidity was 53.1%. As a result of the multivariate analysis, the elderly (p<0.001), the older (p=0.002), those who are not single, more strongly associated with widowers (p=0.001) and those with health insurance in the (p<0.001) are associated with multimorbidity. Compared with the elderly with two chronic diseases, women are associated with three (p=0.003) and four or more chronic diseases (p<0,001). In addition, hypertension and high cholesterol (31.3%), hypertension and stroke (30.9%) and hypertension and diabetes (23.3%) were found to be the most prevalent conditions for those with multimorbidity. There was association of the first condition with the female sex (p<0.001), younger elderly people (p<0.001) and the fact of not smoking (p = 0.005). On the other hand, the second condition was associated with female gender (p = 0.001) and low level of education (p<0,001). The third group was associated with low educational level (p=0.020), those who did not exercise (p<0.001) and did not smoke (p<0.001). It is concluded that multimorbidity in Brazilian elderly is a very common condition and that it has been influenced by socioeconomic factors and little related to lifestyle. However, for the main multimorbities, in addition to socioeconomic conditions, lifestyle also influenced their prevalence.

3
  • MATHEUS DE SOUSA MATA
  • INEQUALITY IN MORTALITY AND THE COMPOSITION OF THE INEQUITY IN HEALTH INDEX IN A BRAZILIAN CAPITAL

  • Leader : IRIS DO CEU CLARA COSTA
  • MEMBRES DE LA BANQUE :
  • FABIA BARBOSA DE ANDRADE
  • IRIS DO CEU CLARA COSTA
  • SAIONARA MARIA AIRES DA CAMARA
  • ALEXSANDRO SILVA COURA
  • ARDIGLEUSA ALVES COELHO
  • Data: 25 févr. 2019


  • Afficher le Résumé
  • Differences in health outcomes among different population groups are revealed by several academic studies and government reports, and are not new. Nevertheless, the theme of social inequalities is the object of a recurrent study in the different areas of knowledge, perhaps due to the expansion of these inequalities over the years. In Brazil, despite the reduction in inequalities in the last decades, there is an immense inequality and there is a clear distinction between health indicators between north-south of the country, mortality among blacks and whites, and sickness among the poorest and the most affluent. In view of this, this study proposes to describe the inequality in health in a Brazilian capital and, also, to propose an index that is composed of health and socioeconomic indicators. Descriptive analyzes consisted of comparing the average of years lived between the districts of the city of Natal-NR, as well as the means of the potential years of life lost. The creation of the Index of Inequality and Vulnerability in Health (IDVS), in turn, sought to contemplate the data of the census tracts, whose area is smaller than a neighborhood, allowing to discriminate even better the inequality within the territories. The results show that the difference in the average of the years lived between the neighborhoods of Natal-RN reaches 25 years, with the worst neighborhood showing comparable mortality conditions to poor countries in Africa, whereas the neighborhood with the highest average of years lived is similar to the Brazilian average. The results point to a relationship between health outcomes and socioeconomic indicators. For index creation, factorial analysis and cluster analysis were consistent methodological possibilities, and it is not conclusive which is the best option to describe territorial inequalities in smaller units, such as the census tracts.
4
  • MARCOS FELIPE SILVA DE LIMA
  • Assessment of nutritional status, development and validation of equations for the estimation of weight and height among elderly people living in nursing homes.

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • KENIO COSTA DE LIMA
  • LEANDRO DE ARAUJO PERNAMBUCO
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • URSULA VIANA BAGNI
  • Data: 22 juil. 2019


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  • Malnutrition in elderly people is related to the fragility, multimorbidity and mortality. In order to identify the risk of deficits early, anthropometric methods based on weight, height, perimeters and skinfolds can be used, which allow for the evaluation of anthropometric indicators. When it is not possible to measure weight and height, estimative equations can be used from these measures. The objective of this study was to evaluate the anthropometric nutritional status, to develop and validate equations for estimating weight and height in elderly living in nursing homes. The study was conducted with elderly people living of nursing homes in Brazil. Anthropometric data (weight, height, body perimeters and skinfolds) were collected for each participant. For analyze the anthropometric nutritional status Principal Component Analysis stratified by sex was performed and the factorial scores of the chosen model were evaluated in relation to the age group, type of nursing home, racial/ethnic identity, schooling, burden of disease and functional capacity. Methods of weight and height estimation were elaborated by linear multiple regression. The regression models developed considered statistical reliability criteria, such as the coefficient of determination (R²), the standard error of the estimate and the Akaike Information Criterion (AIC). The prediction equations were validated by concordance tests such as the Intraclass Correlation Coefficient (ICC) and its respective confidence interval (95% CI). For all analyzes, p values <0.05 were considered statistically significant. Regarding the analysis of main components, the extracted components were denominated "Anthropometric Nutritional State (ANS)" and "Stature (S)". It was verified that the elderly people living in non-profit nursing home (male ANS = -0.855, female ANS = -0.952, male S = -0.919, female S = -0.711), non-white color (male ANS = -0.866, female ANS = -0,816, male S = -0,783; female S = -0,700), low level of schooling (male ANS = -0.973, female ANS = -0.931, male E = -0.846, female E = -0.692), and with a restriction of mobility (male ANS = -0,855; female ANS = -1,076) were the ones that presented the lowest score in the evaluation by the joint indicators. In relation to the development of weight equations, we developed models of predictive equations broken down by the perimeter of the arm, another model adjusted to the statistical criteria, and a third model of equations with measures that are easy to obtain in bedridden or wheelchair-bound elderly. The most appropriate model is calf circumference, knee height, waist circumference, subscapular skinfold, age and sex (ICC = 0.876). Regarding the development of equations of height estimation, models were developed with measurements of knee height, hemi-span, demi-span or ulna length. The most adjusted model uses knee height, age and sex (ICC = 0.863). The components "Nutritional Status" and "Stature" were extracted, which had relation with, especially, the restriction of mobility. The development of weight and height estimation methods followed statistical criteria and the convenience of collecting the component variables of the models.

5
  • IRISMAR KARLA SARMENTO DE PAIVA
  • Psychosocial Care Network IN the interface with homeless persons: BETWEEN THE INSTITUTED AND THE instituting

  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • ANDERSON DA SILVA ROSA
  • ANA KARENINA DE MELO ARRAES AMORIM
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • JACILEIDE GUIMARAES
  • JOÃO BOSCO FILHO
  • SEVERINA ALICE DA COSTA UCHOA
  • Data: 29 juil. 2019


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  • This research brings up the interface Psychosocial Care Network (PCN) and Homeless Persons (HPs). These people have historically been relegated to the commonplace of crime and madness, constituting a challenge for health services, which requires us to break with the institutionalizing and bureaucratized ways of producing health towards a true integration among actors/services/social movements in line with the principles of the Brazilian Sanitary Reform (BSR) and of the Brazilian Psychiatric Reform (BPR). The core objective of this paper is to analyze how the articulation among the services of the Psychosocial Care Network in Natal/RN is performed in the perspective of the comprehensive care for the homeless persons. This is a qualitative research with descriptive-exploratory approach, guided by the light of dialectical historical thought. Data collection took place by means of the circulation of ten services representing the five Health Districts that integrate the components of the Psychosocial Care Network in Natal/RN, establishment of a focus group with professionals of this Network and semi-structured interviews with 13 homeless citizens who were users of these services. It received the approval from the Research Ethics Committee of the Onofre Lopes University Hospital of the Federal University of Rio Grande do Norte (HUOL-UFRN) on August 9th, 2018 – CAAE 92971818.1.0000.5292 and opinion nº 2.809.420. The construction of the results entailed movements from concrete to abstract, from singular to plural, seeking new references that illuminate the research object. The results were systematized on the basis of the Minayo’s operational proposal, drawing up the following analytical categories: Homeless Persons in the Psychosocial Care Network: from white blindness to black numbers, where we discuss how PCN sees the Homeless Persons. These people, when not invisible, are associated with stigmas and labels that refer them to places of discredit, street of exception, i.e., deathly life. Regarding the access of the Homeless Persons to the mental health services, we can identify numerous barriers that separate the places of care from the empty place of the (de) territorialized individuals. Faced with this model of lack of care, we should place our bet on the processes of singularization as a challenge to introduce care to these people. Psychosocial Care Network: on the tightrope of the care structure, which consists of a Network balance performed through the challenges for deinstitutionalization of madness. Although we have been identified in this category obstacles that walk against the Brazilian Psychiatric Reform, we recognize potentialities that favor its effectiveness in the instituting forces that are arranged in a micro-politics of the desire. In summary, the interface Psychosocial Care Network and Homeless Persons has vulnerabilities, being this public relegated to a kind of exile landscape that hampers the achievement of the right to health. Moreover, the living condition of the public in question requires us to consider the different ways of inhabiting and circulating in the city, the inclusion of diversity and the production of new sociabilities. We hope that the results may serve as a way of contributing to the feasibility of a national policy for homeless persons in the loco-regional context; and, in the molar dimension, we intend to activate instituting ways of fostering the Brazilian Psychiatric Reform and the defense of the right to health as a matter of citizenship.

6
  • JANMILLE VALDIVINO DA SILVA
  • Perspectives of the sexual violence in Brazil

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • EDMILSON LOPES JUNIOR
  • JOSÉ MARIA PEREIRA DA NÓBREGA JÚNIOR
  • MARIA ANGELA FERNANDES FERREIRA
  • THADEU DE SOUSA BRANDAO
  • Data: 2 août 2019


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  • Sexual violence has a major impact on individuals, families and society in general. In addition to being a violation of human rights, it causes profound damage to physical, sexual, reproductive, emotional, mental and social well-being. However, due to their nature, their occurrence and impacts are often veiled, resulting in a significant underestimation of the actual level of damage caused. This type of injury has been registered in all countries, but the issue is still little investigated in developing countries. In this perspective, this paper aimed to know, from a conceptual and epidemiological point of view, the situation of sexual violence in Brazil, analyze its evolution over the years and its association with contextual characteristics and social inequities. To do so, this study was developed from six different designs in order to contemplate as much as possible the strands that involve such a complex phenomenon. In the first study a conceptual essay on sexual violence was carried out. In the other studies, an epidemiological approach was adopted using ecological designs with different statistical models. As for the units of analysis, individual data were used, from the municipalities and Brazilian federal units. The results analyzed in all the studies were the occurrence of sexual violence, in different calculations, with data collected by the Violence and Accident Surveillance System (VIVA) and / or National System of Public Security and Criminal Justice Statistics (SINESPJC). The independent variables used were individual characteristics collected by VIVA; contextual characteristics related to education, economic, social and employment conditions extracted from the Brazilian Census; and contextual variables related to health services, social services and public safety, obtained respectively from the National Registry of Health Establishments (CNES), the Public Health Information System (SIOPS), the Census of the Single Social Assistance System SUAS) and the Brazilian Yearbooks of Public Security. Descriptive analyzes, mean comparisons, multilevel Poisson analysis, multiple linear regression analysis for panel data, inequality analysis and multiple linear regression were performed. The results point to an unequal gender structure in Brazilian society, with a male hegemonic pattern that establishes behaviors and social positions, which has favored sexual violence. As for the associated factors, both individual and contextual characteristics are related to sexual violence, observing a strong contextual effect, at the level of federative units. The records of sexual violence were more prevalent in Brazilian municipalities and federative units with better socioeconomic conditions. These records varied over the years 2010 to 2014 between the Brazilian federal units, with an overall increase over the years. In the same period there was an improvement in the indicators of economic and social conditions in the Brazilian states and municipalities, with the highest records of sexual violence associated with the best living conditions in all years. There was an increase in the inequality of the rate of notifications of sexual violence as a function of household income and HDI. There was a reversal in the reports of sexual violence structured by social inequality in Brazil. There was an increase in the reporting rate of sexual violence, which was accompanied by a simultaneous increase in reporting inequality. Rates of records of sexual violence vary according to the registration system. In general, the police system recorded more sexual violence than the health services system. There is considerable underreporting of sexual violence in the VIVA system, especially in the southern region of the country and in small towns. However, in some federative units, the VIVA registry is more efficient in capturing sexual violence than the police system. Contextual factors are also associated with sub-registration of sexual violence in different information systems on the subject. It is concluded that more incisive gender equality policies backed by the reduction of structural violence are still necessary in Brazil to confront sexual violence. In addition, guarantees of basic rights, such as education and income, are also needed, both to reduce the statistics of the problem and to improve the registration of this grievance in the national information systems. More equitable income distribution and increased social development are also relevant factors in combating sexual violence in the country. Finally, it is understood that for the construction of more assertive health policies in the fight against sexual violence, it is necessary to compile information from different sources, considering that there is currently a considerable underreporting of the VIVA system, the main governmental tool of situational analysis of violence in the country.

7
  • INGRID FREITAS DA SILVA PEREIRA
  • Life expectancy free of lifestyle-related risk factors in the Brazilian population

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • CLELIA DE OLIVEIRA LYRA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • MIRELA CASTRO SANTOS CAMARGOS
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • Data: 19 août 2019


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  • The substantial increase in life expectancy in Brazil in the last decades makes it essential to know the health situation and the quality of the years lived by the country’s longest-lived population. In this context, Chronic Non-communicable Diseases (NCD) point out as the main causes of limitations, disabilities and morbimortality. Measuring the occurrence and magnitude of lifestyle-related modifiable risk factors for NCD is an indispensable premise for meeting this emerging demand through effective public policy. In this sense, the aims were: (1) to identify multidimensional profiles of lifestyle-related risk factors, describing the prevalence of the sociodemographic and self-perceived health profiles and their characteristics; (2) to estimate life expectancy free from lifestyle-related risk factors in the Brazilian population. This is an ecological study, based on data from the National Health Survey (Pesquisa Nacional de Saude, PNS) published in 2013. Grade of Membership (GoM) method was used to identify lifestyle profiles, with data from 45,881 individuals over 30 years by applying the inclusion of 12 lifestyle-related variables. The analysis of the characteristics associated with these profiles was done through Pearson's chi-square test and unconditional logistic regression. The prevalence of the healthy profile identified in the first stage of the study - alongside the Brazilian population's life table for 2013 - were used in the Sullivan's method to calculate life expectancy free of lifestyle-related risk factors. In this stage, individuals aged between 30 and 69 years were selected, totalling 40,942. Two lifestyle profiles were identified in the first stage of the study: a profile called “healthy profile” (61.6%; 95% CI 61.1 - 62.2), characterized by adequate consumption of fruits and vegetables, fish, and non-regular consumption of soda, meat with fat and beans. The profile was also characterized by overweight and for meeting the recommendations for physical activity at leisure time. The second profile was entitled “risk profile” (38.4%; 95% CI 37.8 - 38.9), characterized by non-consumption of healthy markers, except bean consumption, by the consumption of all unhealthy markers of eating, replacing meals with snacks, alcohol consumption and tobacco use. The second profile was also characterized for not being physically active at leisure and for being eutrophic when it comes to the Body Mass Index (BMI) classification. The healthy profile was associated with females, elderlies, white populations, residents of the North and Northeast regions of Brazil, widowed, married, high-educated populations and individuals who evaluate their health habits positively. The risk profile was associated with males, young adults, residents of the Midwest and South regions of Brazil, singles, less educated populations and individuals who evaluate their health habits negatively. The estimated lifetime for Brazilians free of lifestyle-related risk factors at age 30 was 29.5 years for both sexes: 33.5 years for women and 25.5 years for men. Females had a higher life expectancy free of risk factors at all ages in relation to males, although the gender disparities reduced with increasing age. The findings of the present study show the association of lifestyle-related risk factors with sociodemographic characteristics and contribute to the discussion of gender inequalities when it comes to morbimortality. Brazilian men live less time free of lifestyle-related risk factors, which may contribute to the high rates of premature mortality among them.

8
  • DENISE GUERRA WINGERTER
  •  

    ACURACY OF THE PROBABILISTIC RELATIONSHIP OF RECORDS IN THE IDENTIFICATION OF OBJECTS BY FALLS OF ELDERLY PERSONS IN THE STATE OF RIO GRANDE DO NORTE

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • GRASIELA PIUVEZAM
  • KENIO COSTA DE LIMA
  • MARTA ROVERY DE SOUZA
  • NEIR ANTUNES PAES
  • Data: 29 août 2019


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  • The underreporting of deaths due to falls in the elderly has been commonly observed. In this regard, the probabilistic relationship of records has been increasingly used in the identification of subregistrations and for the improvement of information quality. The objective of this study was to evaluate the accuracy of the probabilistic relationship in the identification of deaths by falls individuals aged 60 and over in the State of Rio Grande do Norte, in the years 2010 and 2015. This is a Diagnostic study based on in the probabilistic relationship (linkage) of death records by falls reported to the Mortality Information System (SIM) and hospitalizations with falls information in the Hospital Intervention System (SIH) using RecLink software. In 2010 and 2015, a total of 23631 deaths were reported to the elderly, and 106 (0.45%) of them were caused by falls. In the same period, the SIH reported 3107 hospitalization procedures for the elderly with primary or secondary diagnosis of falls, of which, 163 died, a difference of 57 deaths. The method presented sensitivity of 99.9% in 2010, specificity of 74.7%, positive predictive value of 65.4%, negative predictive value of 99.9% and accuracy of 82.8%, in 2015 these values were, respectively, 99.8%, 83.8%, 62.6%, 99.9% and 87.2%. After linkage the specific mortality coefficient for fall was adjusted in 2010 from 15.9 to 65.2 / 1000.000hab, and in 2015 from 14.7 to 64.3, an increase of 308% and 333% respectively. These results suggest that the probabilistic relationship of registers is a valuable tool in the identification of under-registration in the systems. It is observed the need to qualify the morbidity and mortality data by falling in the elderly in the NB, so that the epidemiological picture can be closer to reality and that this data can serve as a basis for the design of strategies for health promotion and prevention of this aggravation.

9
  • NATERCIA JANINE DANTAS DA SILVEIRA
  • PROGRAMA MAIS MÉDICOS: ANÁLISE DA PRODUÇÃO DE CUIDADOS NA ATENÇÃO PRIMÁRIA A SAÚDE

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • PAULO DE MEDEIROS ROCHA
  • FABIO CESAR BRAGA DE ABREU E LIMA
  • JULIANA SAMPAIO
  • Data: 10 sept. 2019


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  • Brazil has been currently experiencing a struggle for the survival of the Unified Health System (SUS) as a political and democratic project in a scenario where there is the strong feeling of a collapse of the public sector and profound difficulty in the continuation of social policies. A scenario with the prevalence of distributive inequality with respect to human resources persists, which translates into cracks in the production of integral care. The purpose of the “More Doctors” Program (PMM), launched in 2013, is to educate/train human resources in the medical area of the SUS, it is the main public policy in terms of the emergency provision of care in the country. The research intends to analyze the production of care conducted by the professionals of the More Doctors Program in Brazil in 2015. For that purpose, quantitative and observational research was conducted, relying on the use of secondary data derived from the report of the first supervision visit, held in 2015, related to the working process and the health actions. For the data analysis, it was used the multiple model approach through Poisson regression with robust variance and the multiple correspondence analysis for the identification of the latent variable. It was also used qualitative research in small and extremely vulnerable municipalities, namely: Venha Ver, Riacho de Santana, Vera Cruz and Jardim do Seridó, where techniques such as Observation and Focus Group were performed. Data analysis was conducted through Minayo’s operative proposal. An analysis of data from 3,816 municipalities, encompassing 16,000 professionals, was conducted. The production of care pervaded the working process, with emphasis on the principle of fairness, taking into account that the most vulnerable municipalities and which count on a larger coverage conduct a larger number of activities in their working process. With respect to the professional profile, the production of care permeated the health actions, obtaining three professional profiles: “Bright White: the community physician”; “White Coat: the clinical-traditional physician”; “Promotion, Prevention and Education: construction of the medical professional”, which have their practices associated with the professional background, consolidating itself as a determining factor for the carrying out of actions compatible with the population’s real needs. Such findings were associated with the socioeconomic variables, with special focus on funding, health centers’ infrastructure and coverage. The production of care was consolidated and embodied through narratives experienced by the social players in the municipalities in Rio Grande do Norte’s countryside which associated the More Doctors Program (PMM) to an “enzyme”, a catalyzing element for the strengthening of Primary Health Care, being capable of causing changes in the care models, as well as in the working process. It is concluded that, with the implementation of the More Doctors Program (PMM), it took place the consolidation of the tripod working process in health, basic care and fairness, making it possible the carrying out of a working process focused on the Primary Health Care (APS). This implies in the performance of a larger number of activities inherent to the Primary Health Care, which were not conducted as a result of the absence. It’s also suggested strategies to expand the scope of the practices carried out in the Primary Health Care, from the perspective of permanent education and training of health professionals, being of paramount importance the emphasis on the routine of the service.

10
  • ANDERSON NICOLLY FERNANDES DA COSTA
  • Avaliação longitudinal da condição periodontal em idosos institucionalizados e não institucionalizados 

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • GRASIELA PIUVEZAM
  • GUSTAVO PINA GODOY
  • KENIO COSTA DE LIMA
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • YURI WANDERLEY CAVALCANTI
  • Data: 11 oct. 2019


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  • Since changes in the oral cavity that cause aging lead to physiological changes that predispose the elderly to develop periodontal diseases, which is the most common condition, causing changes in periodontal tissues that most often culminate without edentulism. Before that, this research aimed to investigate a periodontal condition in institutionalized and non-institutionalized elderly from philanthropic and private institutions. This research is characterized by being a qualified prospective cohort for 128 elderly, 94 non-institutionalized and 34 institutionalized elderly. Most of the elderly were diagnosed with periodontics in stages I/II and grade A. The periodontal condition of the elderly is applied by individuals suffering from institutional damage or not seen by those suffering gingival bleeding, dental calculus, shallow and deep periodontal pocket. As latent variables created from the periodontal condition were Periodontal disease, Periodontal disease sequel and Deep periodontal pocket. There was a significant relationship (p <0.05) between functional capacity and periodontal impact factors and Deep periodontal pocket. The worsening of the Deep periodontal pocket factor was associated with variables institutionalization, diabetes and cognitive ability. It was concluded that in relation to periodontal diagnosis, the majority of the elderly have a higher prevalence of periodontics in recent groups and granules, as well as the elderly who were not institutionalized, non-diabetic and oriented are related to the worst Deep periodontal pocket. 

11
  • JONIA CYBELE SANTOS LIMA
  • PROFESSIONAL TRAINING FOR THE UNIFIED HEALTH SYSTEM AND PERCEPTIONS ON PUBLIC HEALTH CONTENTS

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • DANIELA LEMOS CARCERERI
  • ELIANA COSTA GUERRA
  • JANETE LIMA DE CASTRO
  • LUIZ ROBERTO AUGUSTO NORO
  • TALITHA RODRIGUES RIBEIRO FERNANDES PESSOA
  • Data: 18 nov. 2019


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  • Most health courses, guided by the National Curriculum Guidelines (DCN), have sought to privilege the Unified Health System (SUS) as the preferred setting for academic education. This perspective has been emphasized in the pedagogical projects of these courses and in the incorporation of teachers with collective health education seeking to approach this logic. The objectives of the present study were to define essential elements to be addressed for SUS-oriented education, to identify students' views on the impact of these elements on their academic education and their possible insertion in the SUS, and to analyze the perception of teachers of Brazilian dentistry courses on the possible advances already achieved in the academic education for SUS. It is a research composed of three phases. In the first phase, an evaluability study was conducted to validate the matrix of criteria with an approach to the fundamental elements to the academic education processes, enabling health professionals to work in the SUS. The matrix was characterized as a tool for knowledge integration, starting from the premise that by taking the essential competences to the formation in SUS, the formative process can be problematized by all actors involved. In the second phase, the validated matrix was applied to graduating students of health courses at UFRN, characterized as a case study with quantitative, cross-sectional and exploratory approach. Among the findings of the study, there was a significant number of students who reported wishing to work in the SUS, which is a positive point when considering the constant disputes between the public and private sector to attract professionals. With the participation of 119 teachers of dentistry courses from various Brazilian Higher Education Institutions, the third phase of the study was conducted. Participants responded to the validated criteria matrix, and exploratory factor analysis was performed for data analysis, which defined five factors responsible for the formation of SUS: Primary Care; Social Responsibility and Teamwork; Health Management; Information Systems and Continuing Education / Humanization. The clear signaling of the main advances indicated by the professors of dentistry courses, participants of this study, is configured as an essential aspect for understanding the education focused on the SUS. The following stand out as progress: the planning of activities and the development of actions in Primary Care; the learning scenarios that run through diverse knowledge which encompass the contents of teamwork; knowledge of SUS principles and guidelines; the Primary Care information system that brings mastery and knowledge based on valuing health analysis; the perception of social groups, knowledge of language and the reality of the community; the process of territorialization of the area of action of the team, considering the social, economic, demographic and epidemiological characteristics of the territory and turning to the applicability of the provisions of the National Humanization Policy. However, there are challenges posed by teachers that require a deepening in order to face the barriers still posed by traditional health education.

12
  • ADALA NAYANA DE SOUSA MATA
  • TECHNOLOGIES FOR IMPROVING QUALITY OF COMMUNICATION SKILLS IN PRIMARY HEALTH CARE

  • Leader : GRASIELA PIUVEZAM
  • MEMBRES DE LA BANQUE :
  • SUELY GROSSEMAN
  • GILBERTO MARTINS SANTOS
  • GRASIELA PIUVEZAM
  • SIMONE DA NOBREGA TOMAZ MOREIRA
  • TATYANA MARIA SILVA DE SOUZA ROSENDO
  • Data: 6 déc. 2019


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  • Communication skills used as an important tool for patient-centered health systems and services. An effective professional-patient relationship should consider the patient's needs, placing them as an active subject in the decision-making process of their healthcare. Improved care can be stimulated through assessment and training in communication skills that enable behavioral changes in clinical practice. This study aims to develop technologies to improve communication skills of primary health care professionals. It is structured in a two-phase methodological model. Phase 1 includes the Systematic Review study and the process of cross-cultural adaptation and validation, and phase 2, the construction of the training protocol. The implementation of the Systematic Review was designed to provide scientific information on effective communication skills training to improve the self-efficacy of health professionals. We included 5 clinical studies investigating the effectiveness of communication skills training by searching 8 databases, extracting information on time, content and assessment methods employed. The quality of the studies was assessed by Risk of Bias by RevMan software. The review pointed out that the programs include content related to the basic concepts of communication, contextualized to the context in which professionals are inserted, and patient-centered. They use student-centered learning strategies such as videos and role play, pointing to improved communication skills after the intervention. the process of cross-cultural adaptation and validation of the Self-Efficacy Questionnaire (SE-12) was performed using standard methodology, through the following steps: conceptual and item equivalence, semantic equivalence (translations, retranslations, formal appraisal, discussion and synthesis, and pretest), operational and idiomatic equivalence, and measurement equivalence through Cronbach's Alpha (α) internal consistency analysis and exploratory factor analysis. A viable instrument was produced for the Brazilian context, which after some adjustments was considered valid, presenting high internal consistency (α = 0.946), and factor analysis indicating a single dominant factor in SE-12, with high correlation between items. Phase 2 is the construction of a communication skills training program for health professionals, consisting of 2 content modules, which should address basic concepts and specific themes of communication through active learning methodologies. The program should be implemented through 3 meetings in each module, with follow-up at 12 months. The evaluation of the participants should take place in six moments, through the Self-efficacy Questionnaire (SEbr-12) and the Jefferson Empathy Scale. The systematization of scientific evidence, the construction of an accurate and useful measure to assess the self-efficacy of communication of health professionals, and the proposal of a communication skills intervention program can instrument the improvement processes that focus on focused care. to the patient.

2018
Thèses
1
  • ARETHA HEITOR VERISSIMO
  • EFFECT OF DIFFERENT REPAIR STRATEGIES ON THE BOND STRENGTH TO COMPOSITE RESIN AND CELL VIABILITY OF NEW CAD/CAM BLOCKS: IN SITU STUDY


  • Leader : RODRIGO OTHAVIO DE ASSUNCAO E SOUZA
  • MEMBRES DE LA BANQUE :
  • PATRICIA DOS SANTOS CALDERON
  • RENATA MARQUES DE MELO
  • RODRIGO OTHAVIO DE ASSUNCAO E SOUZA
  • Data: 20 mars 2018


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  • Introduction: New CAD/CAM blocks of resin, hybrid and ceramic restorative materials have been recently developed. However, the literature does not yet have a repair protocol for these materials against a cohesive fracture of the restorative material. Purpose: To determine the influence of surface treatment (diamond burs, abrasive jet Al2O3, COJET, and hydrofluoric acid) and in situ aging on CAD/CAM shear bond strength (Lava Ultimate / 3M, Vita Enamic / VITA and VITA Suprinity / VITA) to the composite resin. Methodology: 300 blocks (6 x 5 x 2.5mm) were made, with 100 of each restorative material. Fifty samples of each restorative material were embedded in total dentures in use, and after a period of 60 days (aging in situ), the 150 aged and 150 no aged samples were randomly divided (N = 30 / n = 10) according to treatment done: Diamond burs + Single Bond Universal (SUB), Diamond burs + silane + conventional adhesive; Hydrofluoric acid 10% + silane + conventional adhesive; COJET + silane + conventional adhesive; abrasive jet aluminum oxide Al2O2 + silane + conventional adhesive. Then, Z350 (3M ESPE) composite resin cylinders (Æ: 2.37mm, height: 2mm) were built on the cementation surface of the blocks. Subsequently, the 300 specimens were then thermocycled (10,000 cycles, 50 / 550C) and then the shear test (50KgF, 0.5mm/min). After fracture, the failure analysis was performed in stereomicroscope (20X). Additional samples were made from each restorative material for further analysis: Vickers microhardness (10 units each); analysis of cell viability (10 units each); scanning electron microscopy (SEM) analysis of surface treatments (10 units each). And in two samples of each block by surface treatment were carried out the analyzes of EDS and XRD for characterization of the materials. The data of shear strength (MPa), cell viability (UFC/mL) and microhardness (HV) were analyzed statistically by ANOVA (2 factors) for the first two (1 factor) for the latter and Tukey's test (5%). Results: For the LU, the highest bond strength was observed in the group Diamond burs + Universal Single Bond (SUB) aged (14.67Mpa), for the VE the aged HF group (17.10Mpa) had higher union strength, for VS the HF group without aging (14.27Mpa) presented higher bond strength. Adhesive failure presented a higher prevalence in all types of CAD / CAM block. The Vita Suprinity (734.31HV) exhibited the highest hardness of Vikers and the Lava Ultimate (137.34HV) the lowest statistically relevant. Cell viability demonstrated no difference between fungal adhesion between the three materials. Regarding the analysis of the treated surfaces (SEM), it was observed that the blasting showed a greater change in the surfaces of the materials; the EDS analysis showed that surface sandblasting with Al2O3 and COJET showed the deposition of aluminum in the composition of all materials. Conclusion: The bond strength of the materials was altered by in situ aging. The zirconium-reinforced glass ceramic has a higher hardness, surface treatments promote surface changes of topography as composition in the materials tested.

2
  • ANA EDIMILDA AMADOR
  • The youth lost in Brazil: socioeconomic and spatial inequalities in youth mortality due to violence.

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • GRASIELA PIUVEZAM
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • MARTA ROVERY DE SOUZA
  • Data: 3 mai 2018


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  • The objective of this study was to analyze the inequalities in spatial distribution of mortality among young people aged 15 to 29 years due to violent causes in Brazil. This is an ecological study in the 482 in the Immediate Regions of Urban Articulation (RIAU) of Brazil. The spatial distribution of violent deaths, intensity and significance were assessed using the Global and Local Moran index, their correlation with socioeconomic variables, and the Years of Life Lost (YLL) indicator for the period from 2001 to 2015 for five years. There were 425,180 deaths of young people due to violence in Brazil. Deaths were obtained in a secondary way from the Mortality Information System and the socioeconomic indicators of UNDP. The RIAUs that presented the highest Standardized Mortality Rates from 2001 to 2005 were: Foz do Iguaçu (48.45 deaths/ 100 thousand young people), Recife (42.26 deaths/ 100 thousand young people) and Vitória (37.18 deaths / 100 thousand young people); from 2006 to 2010: Foz do Iguaçu (48.12 deaths/ 100 thousand young people), Maceió (43.95 deaths/ 100 thousand young people) and Porto Seguro (40.40 deaths/ 100 thousand young people). From 2011 to 2015: São Miguel dos Campos - AL (53.29 deaths/ 100 thousand young people), Porto Seguro - BA (48.74 deaths/ 100 thousand young people) and Maceió - AL (45.13 deaths/ 100 thousand young people). The Moran Global test pointed to a pattern of spatial dependence in the distribution of rates for the North, Northeast and Southeast regions. These deaths resulted in a loss of YLL of 6,435,042.5 years in the first period, 6,494,960 years in the second and 7,216,005 in the third. The mean age of death is at 22 years of age, resulting in a mean PWL / death of 47 years. The ratio of YLL to sex ratio was 15.09 from 2001 to 2005 and from 15.22 from 2011 to 2015. Male overmortality is observed for all quinquennia, as well as for the black population, compared to the white population. The bivariate analysis showed that, among the 9 selected socioeconomic indicators, all correlated significantly with the RIAU Standardized Mortality Rate (p<0.05). It is concluded that violence mortality is unevenly distributed in the immediate regions, forming clusters in the north, northeast and southeast of the country. Although with a weak correlation with the socioeconomic factors, there was an unequal distribution in the territory, as well as differentials of YLL by sex and race / color.

3
  • DANYLLO DO NASCIMENTO SILVA JUNIOR
  • QUALITY OF HOSPITAL CARE IN RIO GRANDE DO NORTE: EVALUATION OF USERS AND COMPANIONS

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • ELLANY GURGEL COSME DO NASCIMENTO
  • LUIZ ROBERTO AUGUSTO NORO
  • SEVERINA ALICE DA COSTA UCHOA
  • Data: 12 juin 2018


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  • The evaluation in the health area has gained more and more space in the national and international scenario, quality being one of the strategic elements on which the transformation and improvement of modern health systems is based. This research had the general objective of analyzing the perceptions of users and companions about the quality of hospital care in Rio Grande do Norte. To that end, the methodological course was guided by the following steps: (a) an integrative review was carried out, aiming to identify national and international perspectives related to the quality evaluation of hospital care; (b) a sectional study with the objective of identifying relationships among socio-demographic variables of users who answered the SUS Charter with characteristics of the hospital and outpatient services of the Unified Health System (SUS); (c) an analytical cross-sectional study to evaluate the SUS users' satisfaction regarding hospital and outpatient care, with reference to the physical structure, the health team's attendance and the quality of the treatment received; and (d) a qualitative study aimed at capturing and evaluating the perception of users and caregivers of public hospitals and contracted to SUS in Rio Grande do Norte. The results evidenced that most of the studies produced in Brazil and in the world about the subject had the user as a public, as well as American origin and quantitative approach. Of the total SUS SUS respondents, 62.3% were women, 62.4% were over 40 years old, 56.8% were in services in the interior, 70.3% in public services, the majority of the visits (68.7%) characterized as of medium complexity. The overall level of user satisfaction with services was above 80% in almost all regions of the state. The results also showed that there was no difference in the evaluation of services when compared to men and women; people over 60 tend to better evaluate health services; in all aspects the high complexity and services of the capital had better results (p≤0.001) and users evaluated more positively the service rendered by the private units agreed to the SUS than the public establishments. Regarding the qualitative findings, it was noticed that users and companions presented variations when comparing the types of hospitals, with fewer complaints to a university hospital before a state hospital of reference. It was also noticed that issues involving structural and material resources tend to have a greater negative impact on the perception of users. In general, this research revealed that the users were satisfied with the health services, however, peculiar aspects as indicated in the results of this study collaborate for the change in satisfaction level and reveal deficiencies in fundamental aspects for the guarantee of the organizational arrangements and the integrality of the care, essential to the process of realizing SUS.

4
  • RODOLFO XAVIER DE SOUSA LIMA

  • Physical and biological properties of experimental self-etching adhesive systems

  • Leader : BONIEK CASTILLO DUTRA BORGES
  • MEMBRES DE LA BANQUE :
  • BONIEK CASTILLO DUTRA BORGES
  • ISAUREMI VIEIRA DE ASSUNCAO
  • PEDRO HENRIQUE SETTE DE SOUZA
  • Data: 25 juin 2018


  • Afficher le Résumé
  • Objective: To evaluate the Residual Monomer Release (RMR), Flexural Strength (FS), 
    elastic modulus (EM) and cytotoxicity of GDMA-P-based experimental adhesives (EA). Methodology: EA 
    were divided into 9 groups according to the following parameters: a) monomeric %mass 
    of GDMA-P/HEMA/UDMA (10/30/30, 20/30/20 and 30/30/10); mol% of photoinitiators 
    CQ/BAPO/EDMAB/DH (1.0/0.0/1.0/0.2, 0.0/1.0/0.0/0.2; 0.5/0.5/1.0/0.2). For cytotoxicity, NIH-3T3 
    cells and the MTT Assay and Alamar Blue (n = 8) assays were used. For FS and EM, the method described 
    in ISO 4049 (n = 7) was followed. To assess RMR, 54 third molars were used to obtain a flat area of dentin 
    (n = 6), which received the adhesive systems and the MRL was read in a high performance liquid chromatography 
    apparatus after 24 hours. Statistical analysis was performed with two-way ANOVA and Tukey post-hoc test 
    (p<0.05). Results: for Alamar Blue, there was no difference among the 10%, 20% and 30% concentrations. 
    Among the photoinitiators, CQ and BAPO alone presented better values for 30% and CQ + BAPO for the 20% 
    concentration. For MTT Assay, there was no difference among photoinitiators and % of GDMA-P. For RMR, for 
    the same photoinitiators and different concentrations of GDMA-P, the 10% concentration released more HEMA. 
    For the different concentrations of GDMA-P and the same photoinitiators, the groups containing CQ released more 
    HEMA. For UDMA, among the groups of photoinitiators, only CQ presented differences, being the percentage of 
    10% of GDMA-P that most released UDMA monomers. For the three concentrations of GDMA-P, CQ released more 
    UDMA monomers. For the release of GDMA-P, among the same photoinitiators, the concentration of 10% provided 
    greater release of monomers to the groups containing CQ. Among the same concentrations and different 
    photoinitiators, CQ provided greater release of GDMA-P to 10% and 30%. For the 20% concentration, BAPO 
    allowed the highest release. For FS, 10% of GDMA-P presented differences between the photoinitiators, being the 
    BAPO group the highest FS. The BAPO + CQ mixture allowed a higher FS value for the 20% and 30% 
    concentrations. For EM, 30% GDMA-P was the only one to present significant difference, being the BAPO + CQ 
    group the highest value. Conclusions: 20% and 30% concentrations of GDMA-P associated with the BAPO + CQ 
    photoinitiator group may provide better results for the properties tested.
5
  • ANA MARGARIDA DOS SANTOS MELO
  • Use of dual-cured adhesive systems and its impact on degree of conversion in situ, marginal adaptation, bond strength and nanoleakage of composites in dentin cavities

  • Leader : ISAUREMI VIEIRA DE ASSUNCAO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • EMANUELLE DAYANA VIEIRA DANTAS
  • ISAUREMI VIEIRA DE ASSUNCAO
  • Data: 27 juin 2018


  • Afficher le Résumé
  • The proper polymerization of adhesive system influences the mechanical properties and longevity of restoration. The effect of irradiance on the adhesive layer in deep cavities is still unknown, in which dual-cure adhesives may be a viable alternative. Objective: To evaluate the influence of the use of dual-cured adhesive systems cured in different ways on the degree of conversion on hybrid layer (GC), marginal adaptation (AM), bond strength (RU), failure pattern (PF) and nanoleakage (NN) of adhesive interfaces of restorations with composite resin in dentin cavities. Methods: High C-factor dentin cavities were prepared on 120 bovine incisors with maxicut burs in custom-made preparation, creating cavities with 4 mm of depth, which were then restored with the composites Filtek Z250 XT [XT], Filtek Bulk Fill [FB] and Filtek Bulk Fill Flow [FF] with the adhesives Single Bond Universal [SB], Adper Scotchbond Multiuso Plus cured [MPa] and the last one without photo-activation [MPd]. The GC analysis was performed in micro Raman, the AM with Caries Detector product and software Image J, the RU in a universal testing machine, the PF by eteroscopic magnifying glass and the NN in Scanning Electron Microscopy (MEV). GC, AM and RU data were analyzed by two-way analysis of variance and Tukey tests (p<0.05).  The other tests were qualitatively analyzed through descriptive statistics. Results: GC, unlike AM, did not change due to the region analyzed. In addition, MPf obtained the best performance for the GC and the worst for the AM and intermediate for the RU, while the MPd had balanced results for GC and AM and excellent performance in the RU. The predominant PF was adhesive failure. All the adhesive strategies used presented nanoinfiltration. Conclusions: The strategy without immediate photoactivation had balanced results, evidencing the value of this adhesive strategy to establish good physical properties to the final restoration.

6
  • ANA PATRICIA DE QUEIROZ MEDEIROS DANTAS
  • Prevalence of antipsychotics in the Nursing homes in the city of Natal / RN.
  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • GRASIELA PIUVEZAM
  • LUCIANA BRANCO DA MOTTA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 29 juin 2018


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  • Aim: To identify the prevalence of the use of antipsychotics in elderly in Nursing Homes in the city of Natal-RN. Methodology: A cross-sectional study based on data from the project "Human Aging and Health: the reality of the institutionalized elderly in the city of Natal / RN", which occurred between October to December 2013 in 10 Nursing Homes of the city of Natal. The sample consisted of 320 residents of Nursing Homes who were 60 years or older who consented to participate in the study. For the identification of factors associated with antipsychotic prescription, bivariate analysis was used using the chi-square test and Poisson regression in which the dependent variable was the number of prescribed antipsychotics. Independent variables included age, gender, type of Nursing Homes (for-profit and non-profit), mental disorder, depressive symptoms, polypharmacy, cognitive impairment, functional capacity and morbidities. A multivariate analysis was performed from the Poisson Regression model with robust variance. Results: The prevalence of antipsychotic use among the elderly was 50% (n = 160). In the for-profit institutions, 65.5% (n = 76) of the elderly used at least 1 antipsychotic, whereas in non-profit Nursing Homes, the prevalence was 40.9% (n = 83). Multiple analysis showed that the age of 60 to 79 years (PR = 1.39), had moderate to severe cognitive impairment (PR = 1.78), had a mental disorder (PR = 2.07), had polypharmacy PR = 1.30), being in For-Profit Institutions (PR = 1.51), presented statistical association (p <0.05), to the greater use of antipsychotics in the elderly in the Natal’s Nursing Homes. Conclusion: A high prevalence of antipsychotic use was observed in Nursing Homes in the city of Natal and due to the possible negative outcomes that this may generate, other measures that result in decrease of the prescription of these medications should be evaluated.

7
  • AMANDA FELIX GONÇALVES TOMAZ
  •  

    Confiabilidade da análise morfológica da telerradiografia em norma lateral na determinação da tendência de crescimento craniofacial de pacientes na dentadura mista

  • Leader : PATRICIA TEIXEIRA DE OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • PATRICIA TEIXEIRA DE OLIVEIRA
  • SERGEI GODEIRO FERNANDES RABELO CALDAS
  • PATRICIA BITTENCOURT DUTRA DOS SANTOS
  • Data: 4 juil. 2018


  • Afficher le Résumé
  • Introduction: The determination of the craniofacial growth tendency has a fundamental importance in Orthodontics, since it is directly related to the prognosis of the case and guides the orthodontist in the selection of an individualized orthodonticTo mechanic. Purpouse: To evaluate the level of orthodontists concordance in morphological analysis of the lateral radiographs to determinate the craniofacial growth tendency in mixed dentition patients. Materials: A researcher selected 3 digital lateral radiographs of children between age of 7-11 years in the mixed denture phase, diagnosed with Class I Angle dental and skeletal function. Each radiographs represented a craniofacial gowth tendency (vertical, balanced and horizontal) which was confirmed cephalometrically through manual tracing of the cephalogram on ultraphan paper measurements of SN.GoGn and FMA angles and the Vert index. A form was developed on the Google Forms® platform, which was aswered by orthodontists randomly divided in 3 study groups, according to the time of orthodontic training: Group 1 (G1) consisting of orthodontists trained for up 1 year, Group 2 (G2) composed of orthodontists graduated for more than 1 and up to 5 years, and Group 3 (G3) composed of orthodontists trained for more than 5 years ago. The cephalograms were cut in the regions of mandibular head, mandibular ramus, gonial angle, mandibular plane, mandibular bevel, mandibular symphysis, occlusal plane and interincisal angle using the Adobe Photoshop CS6® software. The images obtained from the clippings, as well as the complete cephalometric radiographs, were ramdomly distributed throughout the questionnaire so the orthodontists did not know which cut belonged to each cephalometric radiograph. The orthodontists should define the craniofacial growth tendency that the images suggested. Results: Orthodontists demonstrated a low level of concordance for the mandibular head in the horizontal growth tendency and a almost perfect concordance for the gonial angle e the mandibular plane in the vertical growth tendency, for the mandibular bevel and for the mandibular plane in the horizontal growth tendency, and when all the anatomical structures were analysed concomitantly in the complete cephalograms. There were no significant differences in the morphologival analysis performed by the studied groups. Orhodontists demonstrated similar levels of difficulty or ease to morphologically analyse the interincisal angle, mandibular ramus and the complete radiographs in the 3 growth tendencys. Conclusion: Orthodontists demonstrated different levels of concordance in the morphological analysis of lateral cephalometric radiography, depending on the anatomical structure and the craniofacial growth tendency analyzed. Additionally, the time of graduation as a specialist did not influence the ability to determine the craniofacial growth tendency from the observation of lateral radiographs.

8
  • ARYELLY DAYANE DA SILVA NUNES ARAÚJO
  • PREVALENCE OF HEARING DISABILITY AND ASSOCIATED FACTORS IN SCHOOLS IN NATAL/RN.

  • Leader : ISABELLE RIBEIRO BARBOSA MIRABAL
  • MEMBRES DE LA BANQUE :
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • ADRIANA BENDER MOREIRA DE LACERDA
  • Data: 4 juil. 2018


  • Afficher le Résumé
  • Introduction: Hearing is fundamental for the development of language and learning, social interaction, acquisition of knowledge and makes it possible for the individual to transmit thoughts and feelings. Early prevention, identification and intervention of auditory changes are essential because of their relevance to language and learning aspects and to reduce costs with the consequences of hearing impairment. Objective: to analyze the prevalence of hearing impairment in schoolchildren in the city of Natal / RN and its associated factors. Methodology: This is a cross-sectional study that analyzed 238 primary school children and adolescents, enrolled in public schools in the city of Natal-RN, evaluated by meatoscopy, audiometric screening with a Telehealth Audiometer and self-rated hearing loss and earache evaluation. The bivariate analysis was used to identify factors associated with hearing loss using the Chi-square, Fisher's Exact and Prevalence Ratio tests, considering a significance of 5%. Data were analyzed in SPSS 23. Results: the prevalence of hearing loss was 16% (11.7% -21.4%); 20% reported ear pain and 26.1% presented altered meatoscopy. About 90% of the participants belonged to the economic class C-D-E; the mean age of participants was 10.76 years. The prevalence of hearing loss was higher among schoolchildren who reported hearing difficulties and earache, among children aged 6 to 12 years and type of airway infections (p <0.05). Airway infection (PR = 3.37 CI 95% 1.48-7.68) was found as a risk factor associated with hearing loss. Conclusions: the prevalence of hearing loss in schoolchildren in the city of Natal is above that reported in other studies conducted in Brazil for this age group, which shows the need for fonoaudiologic care, in order to systematize actions of hearing health promotion for this population in the city of Natal-RN.

9
  • DAYANE CAROLINY PEREIRA JUSTINO
  • EVALUATION OF MORBIDITY AND CHILD MORTALITY FROM 2000 TO 2015 IN BRAZIL

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • FABIA BARBOSA DE ANDRADE
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • Data: 5 juil. 2018


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  • The year was to have a higher health care in the age of children, have been found in the age of behavior the age of behavior in the Primary Health Care. Among the factors that contribute to the reduction of values and, consequently, the improvement of health and health, fertility level, mothers' schooling and environmental conditions, and the quality of health care can be evaluated by mortality preventable causes. Thus, an idea for the situation of Brazil arose. The present study aimed to analyze the distribution of infant morbidity and mortality in the period from 2000 to 2015 in Brazil. It is an ecological study of temporal trend with spatial relationship, using the DATASUS data, through the Hospital Information System and the Mortality Information System, from 2000 to 2015. admissions and deaths in minors of one year, and as independent, causes of illness, Human Development Index, income, schooling and coverage of basic care. Statistical Parameters for the Statistical Study of the Social Sciences by means of the standard test, standard deviation, Student's ttest and chi-square, using the 95% Confidence Interval and Spatial Analysis of TerraView and GeoDa. When evaluated, the Mortality rate was seen decreasing on average between the first (100.87), the second five years (82.42) and the third of 83.25. It was observed a high rate of infant mortality in the North and Northeast regions. When correlated with cluster systems, in the Northeast, Central-West, Southeast and South regions. When evaluated, the hospital admission rate is that between the first (66.89) and the second (53.38) is less than that the average (56.79) quinquennium. The major causes of infant mortality were: some conditions originating in the perinatal period (57.3%), congenital malformations, deformities and chromosomal abnormalities, some infectious and parasitic diseases (6.1%), symptoms, signs and findings, abnormal examinations (5.9%) and Diseases of the respiratory system (5.8%). The main causes of hospitalization were respiratory diseases (33.7%), Some conditions originating in the perinatal period (31.9%), Some infectious and parasitic diseases (17.1%), Diseases of the digestive system (3.5%) and Endocrine, nutritional and metabolic diseases (2.1%). The correlations with the support of the Basic Consultation and Child Care Consultations were clusters in the Midwest, South and Southeast regions. Independent of the health-disease process in common areas. More attention and specific planning to modify the reality of the data presented here is advisable.

10
  • MONIQUE DA SILVA LOPES
  • EVALUATION OF MORBIDITY AND MORTALITY FROM CHRONIC DISEASES: A STUDY FOCUSED ON PMAQ-AB

     

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • ARDIGLEUSA ALVES COELHO
  • FABIA BARBOSA DE ANDRADE
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • Data: 5 juil. 2018


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  • Chronic diseases represent a problem of great magnitude and are the main cause of death today. It is pertinent to highlight that Systemic Arterial Hypertension and Diabetes Mellitus are among the main causes of morbidity and mortality due to these diseases. The objective of this study is to evaluate the indicators of morbidity and mortality in the Northeast of Brazil from Chronic Non-communicable Diseases - specifically Systemic Hypertension and Diabetes Mellitus, considering actions recommended by the Ministry of Health based on the External Evaluation of Program for Improving Access and Quality of Primary Care. This is a retrospective study, whose data were obtained in secondary banks, on actions developed by the Primary Care teams for chronic diseases and obtained in the Portal of the Department of Basic Attention of the Ministry of Health regarding the External Evaluation in cycles 1 and 2 of that program. The data for calculations referring to mortality and morbidity rates were obtained from the Health Information Systems on Mortality and Hospitals, respectively, through the Information System of the Unified Health System. The results showed that 5,549 teams of Basic Care, of the Northeast Region, participated in the improvement program in cycle 1 and, in cycle 2, this number was 10,678. The nurse was the professional who most answered the interview. Most of the teams said to program actions for hypertension, being 90% in cycle 1 and 96.6% in cycle 2. For diabetes were 90.1% and 96.1%. It is expressive the number of teams that referred to request specific tests, to have registered users and to schedule the actions from the stratification of cases for Hypertension and diabetes. The correlation between the morbimortality rates for both diseases presented a heterogeneous distribution and the concentration of these rates even in places with high coverage of Primary Care. The spatial analysis presented a poor autocorrelation for the rates but presented statistical significance (p<0.05) in the majority. On the spatial correlation with the coverage of Basic Attention in some analyzed places, it was possible to observe a significance of  95%. The study concludes that a significant number of Primary Care teams participated in the Basic Attention Improvement program in the Northeast Region. These presented positive answers for most of the questions about the management of hypertension and diabetes. Despite a high coverage of Basic Care and a poor correlation presented, morbidity and mortality indicators were unevenly distributed in the territory of the delimited Region, which reveals a need for state analysis.

11
  • JONATAS PEREIRA DE LIMA
  • EFFECTIVENESS OF A HEALTH EDUCATION PROGRAM IN STUDENTS 
  • Leader : GRASIELA PIUVEZAM
  • MEMBRES DE LA BANQUE :
  • GRASIELA PIUVEZAM
  • MARIA ANGELA FERNANDES FERREIRA
  • MARIA DE FÁTIMA CAMAROTTI
  • Data: 16 juil. 2018


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  • The helminthiases are diseases that have as main targets the children of school age, especially in the age group between 3 and 12 years. This fact is justified by the lack of information related to personal hygiene measures and the greater contact of these subjects with risk environments. The process of health education is considered an important tool to control and prevent these. The objective of this study was to evaluate the effectiveness of a school health education program aimed at the prevention of helminth diseases at two moments, one month and one year after the implemented health education practices. This is a research with epidemiological design of intervention of the type prophylactic clinical trial. The study was carried out at the Sesquicentennial Teaching-Learning Experimental State Center (CEEEA Sesqui.), And included in the data collection children aged 10 to 14 years, enrolled in the 6th and 7th year of Elementary School II. The methodological procedures developed in the project include the following steps: Baseline, Educational intervention for teaching and sensitization of helminthiases, Post-test T1 performed one month after the intervention and Post-test T2 performed one year after project completion and Test application with Group control. Preliminary results indicate that after the application of the intervention the number of hits related to the transmission of the diseases were: Ascaridiasis (86.7%), Enterobiosis (86.7%), Schistosomiasis (89.6%), Ancylostomiasis ) and teniasis (84.4%). One year after the educational intervention, the results remained positive Ascaridiasis (77.8%), Enterobiosis (72.7%), Schistosomiasis (80.7%), Ancylostomiasis (74.1%) and Teniasis (83%). Thus, the results indicate that the proposed intervention model was effective one month later and remained one year after the intervention, so that the methodology used can be recommended for interventions in health education for schoolchildren in this age group.

12
  • TACIANA EMÍLIA LEITE VILA- NOVA
  • Effect of low temperature degradation, finishing and polishing regimes on the flexural strength, surface topography and phase transformation of monolithic zirconias.

  • Leader : RODRIGO OTHAVIO DE ASSUNCAO E SOUZA
  • MEMBRES DE LA BANQUE :
  • LILIANA GRESSLER MAY
  • PATRICIA DOS SANTOS CALDERON
  • RODRIGO OTHAVIO DE ASSUNCAO E SOUZA
  • Data: 17 juil. 2018


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  • Monolithic zirconia restorations may require adjustments to their structure prior to cementation. Several methods of finishing and polishing are suggested in the literature, however they may promote changes in the surface characteristics of the zirconia, which may affect the mechanical strength of the material in the long term. The aim of this study was to investigate in vitro the effect of degradation at low temperatures and different finishing and polishing regimes on the flexural strength and surface topography of two types of zirconia. Methods: 300 zirconia bars (zirkon ice translucent / Conventional and Prettau Anterior / Ultratranluzent, Zirkonzahn, Gais, Italy) were made in sizes 1,9-1,3x 2,5x10mm, sanded and sintered, presenting final dimensions of 1,5 -1 x 2 x 8mm. The bars were divided into 20 groups (n = 15) according to three factors "type of ceramic - 2 levels", "Degradation" - (with: autoclave at 127 ° C, 1,7 bar / 24h; "Polishing" - (C- Control, B- Polishing, P- grinding with burs, PB- grinding with burs + polishing, PG- burs + glaze). The bars were submitted to the miniflexural test (3 points). Two samples from each group were prepared for the topographic analyzes in SEM. Data were analyzed statistically by means of ANOVA (3 factors) and Tukey (5%). Results: ANOVA revealed that the factors "Degradation" (p=0.01, 1007.4 MPaA> 919.1MPaB), "Polishing" (p=0.0000, 1183.4MPaA >1066.4MPaB > 1012.4MPaBC> 933.2MPaC > 620.9MPaD) and "Zirconia" (p = 0.0000; 1398.4 MPaA> 528.1 MPaB) were statistically significant. The ZPBD (1670.2 ± 252.7)A, ZBD (1663.5 ± 216.8)A and ZB (1654.7 ± 367.7A) groups had the highest mean flexural strength. The groups of the ultratranslucent zirconia had lower averages of flexural strength, standing out the group UTPG (372.1 ± 56.2) G, which obtained the lowest one among the others (Tukey).

13
  • MICAELLA POLLYANA SILVA DO NASCIMENTO DA COSTA
  • INFLUENCE OF THE THERAPIES PLATE, ADVICE AND MANUAL THERAPY ON SLEEP, PAIN AND DEPRESSION IN PATIENTS WITH DTM. RANDOMIZED CLINICAL TEST.

  • Leader : ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • MEMBRES DE LA BANQUE :
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • EDUARDO JOSÉ GUERRA SEABRA
  • RENATA SILVA MELO FERNANDES
  • Data: 17 juil. 2018


  • Afficher le Résumé
  • TMDs are a major public health problem, they are the most commonly reported causes of chronic pain that interfere with daily activities. Biological and behavioral characteristics such as depression and sleep quality may play an important role in adapting to pain and patients recuperation. Aim: Analysis of  therapies,  splint, counseling and therapy manual on pain, depression and sleep in patients with temporomandibular disorders. Methods: 85 patients diagnosed with TMD through RDC / TMD (Diagnostic Criteria for Research in Temporomandibular Disorders) were included in this randomized clinical trial. They were randomly assigned to 4 different treatment groups: PO (n = 24), PAC (n = 24) TM (n = 19) and AC (n = 18). The patients were analyzed for the Visual Analogue Scale (VAS) to evaluate pain, Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADSd) to evaluate depression and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. The data were used in the Split Plot ANOVA test, in order to observe the difference between time and groups, with a confidence level of 95%. Results: all therapies were optimized, with reduction of pain (p = 0.000), decrease in depression scores BDI (p = 0.001) and also sleep by PSQI (p = 0.001) 0.005). Except for depression assessed by HADSd, it was not found over time (p = 0.106) and between groups (p = 0.890). Significant difference was not found between treatment groups in any of the variables during the study period. Conclusion: splint oclusal, splint oclusal with counseling, therapy manual, and therapeutic counseling, positive results regarding pain, depression and sleep in patients with TMD, without presenting differences of superiority between them.

14
  • ANA LOUISE OLIVEIRA DE CARVALHO
  •  EFFECT OF DIFFERENT CONSERVATIVE THERAPIES IN PAIN, QUALITY OF LIFE AND ANXIETY OF PATIENTS WITH TMD. RANDOMIZED CLINICAL TRIAL.

  • Leader : ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • MEMBRES DE LA BANQUE :
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • EDUARDO JOSÉ GUERRA SEABRA
  • RENATA SILVA MELO FERNANDES
  • Data: 18 juil. 2018


  • Afficher le Résumé
  • Introduction: Temporomandibular dysfunction (TMD) is a condition that affects the chewing muscles, temporomandibular joint (TMJ), and associated structures. Such condition has high prevalence and implies in the biopsychosocial behavior of the individual, reflecting in damages the quality of life. Of multifactorial character, numerous options of therapy are available for the TMD, but without clear evidence of isolated effectiveness. Objective: The present study aims to evaluate the effectiveness of conservative therapies isolated for TMD, as well as their interference on quality of life, pain and anxiety in patients with dysfunction. Methods: A double-blind randomized clinical trial with TMD patients diagnosed by the Diagnostic Criteria for Temporomandibular Dysfunction (RDC / TMD) was performed. 85 patients were randomly assigned to four different groups: counseling (CA), manual therapy (TM), occlusal plaque (PO) and plaque associated with counseling (PO + AC) and evaluated without therapy and at 1 month and 3 months after therapy. The statistical test Slip Plot ANOVA with a confidence level of 95% was used. Results: all therapies were effective over time for the variables: pain (p = 0.000), oral health impact on quality of life (p = 0.000), general quality of life (p = 0.029) and physical p = 0.000), psychological (p = 0.006) and social p = 0.017) and anxiety through BAI, HADS and IDATE trait (p = 0.000, p = 0.000 and p = 0.002, respectively). Conclusions: conservative therapies (counseling, physical therapy, and plaque in association with counseling) were effective in improving pain symptomatology, anxiety and quality of life over time, but no therapy was superior to another.

15
  • DAVI NETO DE ARAÚJO SILVA
  • Effects of antimicrobial photodynamic therapy with chloro-aluminum phthalocyanine on clinical parameters and salivary levels of GSH and MDA in patients with chronic periodontitis
  • Leader : ANA RAFAELA LUZ DE AQUINO MARTINS
  • MEMBRES DE LA BANQUE :
  • ANA RAFAELA LUZ DE AQUINO MARTINS
  • EULER MACIEL DANTAS
  • LUCIANA BASTOS ALVES
  • Data: 19 juil. 2018


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  • Antimicrobial photodynamic therapy (ADT) has been suggested as adjunctive therapy to basic periodontal scaling and coronal root straightening (RACR) therapy. In vitro and in vivo studies have demonstrated superior efficacy when PDA is performed with the photosensitizer chloro-aluminum phthalocyanine (AlClFc) in association with nanocarriers. Objective: To evaluate the efficacy of TFF with AlClFc in oral hygiene indexes, periodontal clinical parameters and salivary levels of oxidative stress markers (GHT) and malondialdehyde (MDA) in patients with chronic periodontitis. Methods: This randomized, double-blind, parallel, longitudinal, and prospective trial evaluated 22 patients in two groups: 14 in the test group (RACR + TFDA) and 8 in the control group (RACR only). Each patient had at least 2 diseased periodontal sites (PS≥5mm), totaling 63 periodontal sites, 40 sites belonging to patients in the test group, and 23 sites belonging to patients in the control group. The TFDA was applied once only after the completion of the RACR sessions. The oral hygiene indexes - visible plaque index [IPV], gingival bleeding index [ISG], and periodontal clinical parameters - probing bleeding [SS], probing depth [PS] and clinical insertion level [NIC] - were evaluated before treatment at T0, and after 3 months (T3) and 6 months (T6) times. Saliva samples were collected at each study time for GSH and MDA dosing. Data were statistically analyzed using non-parametric Wilcoxon and Mann-Whitney tests, with a significance level of 5% being pre-established. Results: The intragroup analysis showed that there was a statistically significant difference between the T0, T3 and T6 times with p <0.05 for the ISG, NIC and GSH variables only in the control group, but without detecting between the time pairs the difference. For PS, there was a significant decrease in the median in the test group between T0 (5.49) and T6 (4.33), with p1 = 0.008. In the control group there was also a significant difference between the three times, but it was not possible to identify among which there was this difference. For the other IPV, SS and MDA variables, there was no significant difference between the two groups. In the intergroup analysis, it was observed that there was a statistically significant reduction in the control group for the ISG in the T6 (p2 = 0.041) and the GSH in the test group in T3 (p2 = 0,031). For the other variables, there were no statistically significant differences between the two groups. Conclusion: TFAP with the adjuvant AlClFc photosensitizer to RACR did not bring additional benefits over periodontal clinical parameters after 6 months of treatment, but showed additional benefits over GSH after 03 months of treatment.

16
  • HELOÍSA HELENA GOMES LIMA

  • Inequality in spatial distribution of breast cancer mortality in Brazil.

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • ANA CRISTINA PINHEIRO FERNANDES DE ARAUJO
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 19 juil. 2018


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  • Introduction: breast cancer is the type of neoplasia that has the highest incidence and the highest mortality rate in the female population worldwide. Affecting both developing and developed countries. Purpose: To evaluate the spatial distribution of mortality from breast cancer in the Intermediate Regions of Urban Articulation of Brazil from 1998 to 2015. Methodology: This is an ecological study carried out in Brazil through the 161 Regions of Urban Articulation that analyzed the deaths of women caused by breast cancer between the age of 50-69 years and its association with the ratio of screening mammography exams, population coverage estimated by the Primary Care teams, coverage of women with private health plans and the index of municipal human development (IDHM). It was calculated in terraView the global and Local Moran index for the mortality standardized rate (TMP) for breast cancer. In Geoda, the bivariate analyzes were performed between the mortality rate and the socioeconomic and service indicators; The local bivariate Index of Moran and representations by means of the Dispersion Diagram of Moran Bivariate and Lisa Cluster Map were calculated. Results: Breast cancer mortality rates in the period 1998-2006 ranged from 0.23 to 7.67 deaths per 100,000 inhabitants. (Moran index: 0.733, p-value: 0.01) with higher rates found in the South and Southeast regions; in the 2007/2015 period ranged from 0.23 to 8.73 / 100,000 inhabitants. (Moran index: 0.594, p-value: 0.01), the high rates were observed in the South, Southeast, Midwest and Northeast regions. In the bivariate analyzes, positive correlations were obtained between TMP for breast cancer and the ratio of mammographic examinations (I = 0.352), private health plan (I = 0.436) and IDHM (I = 0.733) and a negative correlation with the primary care (I = -0.116). Conclusions: Mortality from breast cancer has increased in the country over the years and the services and socio-economic indicators do not seem to contribute to a reduction of mortality, requiring reassessment and reformulation strategies that contribute to the reduction in mortality from breast cancer.

17
  • HAROLDO GURGEL MOTA FILHO
  • Effect of low level laser therapy on cell viability and oxidative stress of periodontal ligament stem cells

  • Leader : RUTHINEIA DIOGENES ALVES UCHOA LINS
  • MEMBRES DE LA BANQUE :
  • ANA RAFAELA LUZ DE AQUINO MARTINS
  • FERNANDO JOSE DE OLIVEIRA NOBREGA
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • Data: 23 juil. 2018


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  • Low level laser therapy (LLLT) is widely used in different areas of the regenerative medicine, especially for its beneficial effects on cellular metabolism. This study aims to evaluate the effects of LLLT on cell viability and oxidative stress of periodontal ligament stem cells (PDLSCs). PDLSCs will be isolated from the periodontal ligament extracted from human teeth. The cells will be characterized, through the differentiation in adipogenic and osteogenic culture media and also analysis of surface markers of stem cells in flow cytometry. After their isolation and characterization, the PDLSCs will be maintained under cell culture conditions, and divided into three groups: Group I (control); Group II (Laser 7.5 J / cm 2) and Group III (Laser 22.5 J / cm 2). The experiments were performed in quadruplicate and occurred in three time intervals (T0h, T24h and T48h). After the intervals, the experimental tests were done to evaluate the cellular parameters. For the cellular viability analysis, the Alamar Blue tests, the MTT assay, and the evaluation in flow cytometry of Annexin V and PI will be used. To evaluate the release of reactive oxygen species, the dosage of malonaldehyde will be used. Preliminary results showed that the cells scored positively for markers of mesenchymal stem cells. The MTT result showed that Group III had a lower absorbance in the range of T48h with statistical difference in relation to both Group I and in relation to Group II.

18
  • LIDYA NARA MARQUES DE ARAÚJO
  • EFFECT OF PERI-IMPLANT TISSUE CONDITIONING DURING SINGLE REHABILITATION WITH IMPLANT-RETAINED TEMPORARY CROWN IN ESTHETIC AREA.

  • Leader : BRUNO CESAR DE VASCONCELOS GURGEL
  • MEMBRES DE LA BANQUE :
  • BRUNO BRAGA BENATTI
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • FERNANDO JOSE DE OLIVEIRA NOBREGA
  • Data: 26 juil. 2018


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  • Aim: To analyze the behavior of peri-implant tissues during rehabilitation with   provisional crowns in superior esthetic region. Methods: This longitudinal observational study evaluated the periodontal condition of 16 patients rehabilitated with implant-supported provisional crowns in esthetic area using the parameters of Visible Plaque Index (VPI), Bleeding on probing (BoP) and Gingival Thickness (GT) of the adjacent teeth and the prosthetic space (PS) in T0 (before implant placement surgery), T1 (installation of provisional crown), and T2 (during soft tissue conditioning). The parameters: Probing Depth (PD), Transparency in Probe (TP), Height/Width of the interdental papilla (HP/WP), Height/Width of the provisional crown (HC / WC), and keratinized mucosa (KM) were performed on T1 and T2. The parameters of the implant-supported prosthesis were compared to the same aspects of adjacent teeth. Friedman and Wilcoxon tests were applied to analyze data from the follow-ups. The comparison between the rehabilitated region and the adjacent teeth were achieved using Wilcoxon test for paired sample. Both analyses showed significance level of 5%.  Results: The mean time of soft tissue conditioning was 40 days (mean of 2.6 sessions). There was an increase on the VPI between T0 (31.1%) and T2 (40.5%), but without statistically significant difference (p> 0.05). Regarding the BoP, it was not observed statistically significant differences over time (T0 - 21%, T2 = 20.8%). For GT, there was statistically significant difference between follow up periods (T0 - 1.66mm, T1 - 1.22mm, T2 - 1.16mm). The PD increased from T1 (1.76 mm) to T2 (1.86 mm) without statistically significant difference. The same was observed with an HC / WC (from 1.06 to 1.19) and HP / WP (0.62 to 0.84). The Wilcoxon test showed a not significant result between T1 and T2 for HP / WP (p <0.05) and HC / WC (p <0.05). When comparing the implant and the adjacent teeth area, the parameters that showed statistically difference (p<0,05) of means were: HP/WP in T1, with a lower mean (0,62) than the adjacent teeth (0.79); and GT at T0, when the implant area had a higher mean (1,66) than the adjacent teeth (1,18). Conclusion: For this study, the provisional implant-supported crown promoted alterations on the adjacent peri-implant soft tissue on GT, HP/WP, and HC/WC.

19
  • SAMUEL BATISTA BORGES
  • IMPACT OF TREATMENTS FOR ROOT COVERAGE USING CONJUNCTIVE TISSUE AND A COLLAGEN MATRIX IN PATIENTS CENTRATED FACTORS.

  • Leader : BRUNO CESAR DE VASCONCELOS GURGEL
  • MEMBRES DE LA BANQUE :
  • ANA RAFAELA LUZ DE AQUINO MARTINS
  • BRUNO BRAGA BENATTI
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • Data: 27 juil. 2018


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  • Gingival recessions can cause cervical dentin hypersensitivity and have a negative effect on the oral health related quality of life and a strong social, psychological and emotional impacts on the daily life of each patient. Root coverage techniques by subepithelial connective tissue graft (CTG) and collagen matrix being a great treatment options for gingival recessions. OBJECTIVE: To evaluate the impact of root coverage techniques by subepithelial connective tissue graft and collagen matrix in the groups of patients with Miller's class-I and II gingival recession with 6-month follow-up. METHODS: This randomized, double-blind, split-mouth, controlled clinical trial evaluated 27 subjects with bilateral Miller's class-I and II gingival recession treated with root coverage techniques by subepithelial connective tissue graft (control) and collagen matrix (test). Data evaluation of hipersensibilty, aesthetics, patient satisfaction and quality of life was realized at post-operative at baseline, three months and six months after surgery. Data were analyzed using the split-plot analysis of variance (SPANOVA) and One-way ANOVA with a significance level of 5%. RESULTS: The patients had a mean age of 29,53 years (22-53, ± 7,12) and were equally distributed according to sex. Statistical analysis showed that was an improvement in quality of life after 03 and 06 months of the surgical procedure (p<0,001) with physical pain and psychological discomfort being the ones that presented the best results. Statistically significant reductions were observed in the parameters postoperative pain, dentin hypersensitivity, aesthetics and patient satisfaction within each treatment group in the evaluated periods (p<0,001). CONCLUSION: Both treatment procedures resulted in significant reduction of negative impacts on quality of life and patients centrated fator at 06 months. No statistically significant differences were found between the two techniques for root coverage with regard to any parameter evaluated. The collagen matrix represents a possible alternative to CTG.

20
  • BÁRBARA SUELLEN FONSECA BRAGA
  •  
    PUBLIC EXPENDITURE WITH JUDICIALIZED MEDICINES IN RIO GRANDE DO NORTE IN THE YEARS OF 2016 AND 2017
  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • GRASIELA PIUVEZAM
  • MARIA ANGELA FERNANDES FERREIRA
  • MARILIA LOUVISON
  • Data: 30 juil. 2018


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  • The judicialization of health is a phenomenon that began in Brazil after the Federal Constitution of 1988. This type of lawsuit has been growing in quantity every year, which directly affects health financing. The objective of this article is to characterize the legal claims for drugs in the State of Rio Grande do Norte in relation to the financial aspect in the years 2016 and 2017. This is a descriptive exploratory study, in which 370 individual 2016 and 2017, requesting medicines, moved in the State of Rio Grande do Norte. The amounts spent on the judicialization of medicines in these years were R$ 10.687.951,09. 572 drugs were required, 61.36% of which were outside the official list of drugs and the most demanded type of drug were antineoplastic agents and immunomodulators (24.13%). The purchase was made by the patient in 75.81% of the cases from the release of a court order. Thus, the judicialization of medicines in a small state causes iniquities in the access of users of the Brazilian health system to medicines and in the financing of Pharmaceutical Assistance.

     

21
  • MYLA MARILANA FREIRE DA CUNHA
  • EFFECTS OF THERAPIES FOR TEMPOROMANDIBULAR DYSFUNCTION ON CRANIOCERVICAL POSTURE

  • Leader : GUSTAVO AUGUSTO SEABRA BARBOSA
  • MEMBRES DE LA BANQUE :
  • ANDRE ULISSES DANTAS BATISTA
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • Data: 7 août 2018


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  • The objective of the present study was to evaluate whether the occlusal plaque, physiotherapy and counseling therapies used in the treatment of temporomandibular disorders (TMD) alter the craniocervical posture and the pain picture. This is a controlled, randomized, blinded study that included individuals previously diagnosed with TMD through the RDC / TMD (Research criteria criteria for temporomandibular disorders). The patients were randomly selected from four treatment groups: occlusal (OP, n = 17), physiotherapy (F, n = 19), counseling (AC, n = 15) and counseling, totaling 65 individuals. For the postural analysis, a teleradiography was performed at the baseline and 1 month after the application of the therapy, in order to observe the occipito-atlas distance (DOA), the craniocervical relationship (ACR) and the positioning of the hyoid bone. Traits were performed on the images using CorelDraw X6 software (2012 Corel Corporation, Canada). To analyze the pain variable, the visual analogue scale was applied before and 1 month after the therapies. The data obtained were submitted to several paired T tests (α = 5%) and for the pain variable the SPANOVA test was applied. With the exception of the PAC group in the ACr variable (p = 0.003), the results showed that there was no statistically significant difference for the analyzed variables regarding the different therapies over time. However, it can be observed that all the treatment groups allowed a reduction of the patients' pain picture (p = 0.013) over time. It is concluded that the therapies applied have little influence on craniocervical posture, but are effective for the relief of painful symptoms.

22
  • MARCELO LEITE MACHADO DA SILVEIRA
  • BIOMECHANICAL ANALYSIS OF DIFFERENT TYPES OF FIXATION IN THE SAGITTAL SPLIT RAMUS OSTEOTOMY AFTER DIFFERENT TYPES OF MANDIBULAR MOVEMENTS: A FINITE ELEMENT STUDY.

  • Leader : ADRIANO ROCHA GERMANO
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • EDUARDO COSTA STUDART SOARES
  • JOSÉ WILSON NOLETO JÚNIOR
  • Data: 10 août 2018


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  • The present study aimed to evaluate the best osteosynthesis arrangement in patients that underwent orthognathic surgery with mandibular advancement and mandibular angle clockwise and counter-clockwise rotation through a finite element analysis. A virtual model of a mandible was obtained via CT scan and then subjected to different kinds of surgical planning in the Dolphin® software. A total of 6 surgical plans were made and 6mm and 12mm advances were associated with linear, clockwise and counter-clockwise rotation of the mandibular angle. The virtually operated mandibles were then transformed in a solid framework in the NX 10® software. In this stage, the mandibular solids were meshed with the solids of the osteosynthesis plates and screws in a one or two plate fashion using 4 or 8 mini screws respectively. After the 12 solids were built, the Nastran software® was utilized to evaluate the superficial tensions after loading in the incisors region.

23
  • DANIELLE CLARISSE BARBOSA COSTA
  • STUDY OF OCCURRENCE OF RECURRENCE AFTER ENUCLEARATION, FOLLOWED BY PERIPHERAL OSTECTOMY AND CARNOY SOLUTION IN THE TREATMENT OF AGGRESSIVE BENIGN ODONTOGENIC LESIONS: PRELIMINARY RESULTS

  • Leader : ADRIANO ROCHA GERMANO
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • PATRICIA TEIXEIRA DE OLIVEIRA
  • EDUARDO COSTA STUDART SOARES
  • Data: 7 nov. 2018


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  • The purpose of this study was to verify the relapse rate and associated clinical, radiographic and surgical factors after the protocol of enucleation followed by peripheral ostectomy and Carnoy's solution as treatment of aggressive odontogenic lesions. The retrospective cross - sectional study was composed of thirty patients submitted to the protocol from 2008 to 2018 who were contacted and submitted to clinical and radiographic exams in order to verify the presence of relapses. The study consisted of two phases, represented by the data collection of the medical records (phase I) and return of the patient for clinical and radiographic evaluation (phase II). Descriptive and statistical analyzes were performed using the Stata / IC version 14.0 program (StataCorp, College Station, TX). The Mann-Whitney test, the Fisher's exact test and the Chi-square test, as well as the Kaplan Meier method and the Log-rank test were used to verify the possible prognostic factors for relapses, adopting p <0,05. The sample was composed of 22 patients with odontogenic keratocysts (73.3%), 3 odontogenic myxomas (10%) and 5 ameloblastomas (16.7%). Recurrence affected 7 patients (23.3%), all of which were in odontogenic keratocysts, with a minimum recurrence time of 12 months and a maximum of 34 months and a maximum follow-up of 9 years and 5 months. There was no statistical difference between the factors evaluated and the development of relapses, but patients who remained with adjacent teeth after the surgical procedure presented earlier recurrence. Kaplan-Meier curves showed a cumulative risk of more than 80% for recurrence after 29 months postoperatively and after 36 months of follow-up, only 37.50% of these patients would be free of relapses (p = 0.023), in addition this group were 5.5 times more likely to develop recurrences than patients who had their teeth extracted. The results showed that the protocol presented lower recurrences than what in the scientific literature when comparing marsupialization and enucleation/curettage alone, considering the same lesions, however, it presented inferior results when compared to similar therapies.


24
  • JOÃO PAULO TEIXEIRA DA SILVA
  • The regional health planning in Brazil: evaluation from the hospital network

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • CLELIA DE OLIVEIRA LYRA
  • MARILIA LOUVISON
  • Data: 19 nov. 2018


  • Afficher le Résumé
  • The Brazilian health regions correspond to 437 clusters of Brazilian municipalities and 1 that corresponds to the federal district, totaling 438 clusters. The distribution and composition of these regions is the responsibility of the states in partnership with the regional inter-agency commissions, with a great diversity in this distribution due to the peculiar dimensions and multiculturality of the Brazilian territory. This study aims to evaluate the regionalization of health in Brazil, the performance of the regions and associated factors, in light of the information provided by the health indicators, focusing on the hospital network. This is an ecological, multi-group, quantitative approach that incorporates descriptive and analytical statistical analysis using SPSS v. 24. Pearson's association and linear regression analyzes were performed, with the dependent variable being the proportion of hospitalizations within the health region and independent socioeconomic, structural, and health care variables. The period of analysis is from 2012 to 2016 and includes data from the Ministry of Health (DATASUS) linked to data from the Annual Report on Social Information and Atlas of Human Development in Brazil. The socioeconomic profile of the health regions presents better indexes in the South and Southeast regions of the country, with better HDI indicators, higher life expectancy, higher per capita income, lower percentage of those vulnerable to poverty and inadequate sanitary conditions. The health structure of the regions reveals that coverage and resources invested in primary health care are better in the Northeast, while the percentage of municipalities' own resources is higher in the Southeast. The number of beneficiaries of health insurance is higher in the Southeast. While the Central-West region has the highest number of hospitals per 100,000 inhabitants, the Southeast region has the largest number of beds and the Northeast region has the most basic care units. The Southeast region is the one that most invests in beds in detriment of the primary care units. The participation of SUS beds is greater in the Northeast and North regions. The South and Southeast regions have more doctors, nurses and intensive care beds. The health regions present in the South and Southeast of the country still stand out by interning patients within their regions of residence, maintaining the best indicators for the hospitalizations of urgency, medium and high complexity in their own health regions. However, the North region is the highlight for the number of hospitalizations in the own network, while the South region is the one that resorts the most to the private sector. The Central-West region is the one that presented the best indicators for medical consultation and outpatient production per inhabitant. The analysis of association with the hospitalization variable in the same region showed a significant correlation with the mean number of beds in SUS, life expectancy at birth and ambulatory procedures.

25
  • PEDRO PAULO MAIA DE SENA
  • TOMOGRAPHIC EVALUATION OF PALATAL MUCOSA THICKNESS IN INDIVIDUALS WITH THIN AND THICK  BIOTYPES
  • Leader : EULER MACIEL DANTAS
  • MEMBRES DE LA BANQUE :
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • EULER MACIEL DANTAS
  • FERNANDO JOSE DE OLIVEIRA NOBREGA
  • Data: 4 déc. 2018


  • Afficher le Résumé
  • INTRODUCTION: The identification of the periodontal biotype is an important tool in the diagnosis and prognosis of periodontal treatments. In the treatment of gingival recession, the palatal region has been described as the main graft donor area. PURPOSE: This study aimed to investigate the difference in thickness of the palatal mucosa in individuals with thin and thick biotypes, evaluated in different regions. METHODS: This study included 30 periodontally healthy patients submitted to computed tomography (CT) scans. The images were acquired on the CS8100 3D tomograph and all parameters were analyzed tomographically in the CS 3D Imaging software. The gingival thickness was measured in the maxillary central incisors and categorized into thin or thick biotype. Then, the thickness of the palatal mucosa was measured in the canine, 1st premolar, 2nd premolar and 1st molar at 3mm, 6mm, 9mm and 12mm from the gingival margin. The Mann-Whitney, Wilcoxon and Friedman tests were used to evaluate differences in palatal mucosa thickness between groups, between teeth and in different regions, respectively. RESULTS: There was no statistical difference in mucosal thickness between the groups and between the different teeth analyzed (p> 0.05). In all analyzed teeth, the furthest from the gingival margin, the thickness of the palatal mucosa was higher (p <0.0001). CONCLUSION: In the analyzed sample, the palatal mucosa thickness was not correlated to the type of patient biotype and there was no statistical difference between the different teeth evaluated. However, it was observed that, independently of the tooth, areas more distant from the gingival margin may be better suited to grafting procedures because they have a higher tissue thickness.

26
  • THIAGO CLÍSTINES DE MEDEIROS
  • EVALUATION OF BOND STRENGTH OF REPAIRS IN BULK FILL RESINS AFTER DIFFERENT PROTOCOLS OF ADHESION


  • Leader : MARILIA REGALADO GALVAO RABELO CALDAS
  • MEMBRES DE LA BANQUE :
  • ANA KARINA MACIEL DE ANDRADE
  • DIANA FERREIRA GADELHA DE ARAUJO
  • MARILIA REGALADO GALVAO RABELO CALDAS
  • Data: 6 déc. 2018


  • Afficher le Résumé
  • Objective: To evaluate the microtensile bond strength of repairs performed on bulk fill and conventional composite resins subjected to aging, after different adhesion protocols.Materials and methods: 42 specimens (8x8x4 mm3) of each of the following materials were prepared in shade A1: a microhybrid composite (Filtek Z250 XT-3M ESPE, St. Paul, MN, USA) and a regular consistency bulk fill (Filtek Bulk Fill - 3M ESPE, St. Paul, MN, USA). These specimens were aged by storage in artificial saliva at 37 ° C for 30 days. After, they received a mechanical surface treatment by means of abrasion with a diamond bur 4138F, followed by the division in six groups, according to the adhesion protocol employed: FSA - etching with 37% phosphoric acid + silane + conventional adhesive (Single Bond 2 - 3M ESPE, St. Paul, MN, USA); SA - silane + conventional adhesive; FA - etching with 37% phosphoric acid + conventional adhesive; A - conventional adhesive; FU - 37% phosphoric acid + universal adhesive (Universal Bond Single - 3M ESPE, St. Paul, MN, USA); U - universal adhesive. All specimens were repaired with Z250 XT composite, in shade A3, to differentiate them from the base materials. The repaired resin blocks were cut into sticks (8x1x1 mm3) and submitted to microtensile test. Fractured specimens were evaluated by macrophotography to determine the type of fracture (adhesive or cohesive). In order to analyze the differences among the adhesion protocols and among the composite types, two-way ANOVA statistical test was used, with a significance level of 5%. Results: No statistically significant differences were found in bond strength values among the adhesion protocols (p=0.38) and among the composite resins repaired (p=0.13), as well as no interaction between these variables (p=0.16). Conclusion: For the aging pattern adopted in this study, repair bond strength of bulk fill composites was similar to that found in conventional microhybrid composites, with no distinction between several adhesion protocols.

     

27
  • JÉSSIKA RAÍSSA MEDEIROS DE ALMEIDA
  • EVALUATION OF SUPERFICIAL ROUGHNESS AND SURFACE TOPOGRAPHY OF BULK FILL, CONVENTIONAL AND FLOW COMPOSITES BEFORE AND AFTER SIMULATED TOOTHBRUSHING

  • Leader : MARILIA REGALADO GALVAO RABELO CALDAS
  • MEMBRES DE LA BANQUE :
  • ANA KARINA MACIEL DE ANDRADE
  • DIANA FERREIRA GADELHA DE ARAUJO
  • MARILIA REGALADO GALVAO RABELO CALDAS
  • Data: 6 déc. 2018


  • Afficher le Résumé
  • Introduction: The increasing of the aesthetic exigency by the patients and the continual development of materials – such as bulk fill and flow composites, demands a crescent need of studies on this area to evaluate the properties of the materials when submitted to the wear occasioned by toothbrushing abrasion over time. Objective: To evaluate the surface characteristics of restorations performed before and after the process of simulated toothbrushing and to compare the results between the composites. Materials and methods: In total, 80 samples were made (7x4mm), being 20 to each type of resin utilized, color A1: Bulk Fill One (3M/ESPE, St. Paul, MN, USA), Bulk Fill Flow (3M/ESPE, St. Paul, MN, USA), Z350XT 3M/ESPE St. Paul, MN, USA) and Z350XT Flow (3M/ESPE, St. Paul, MN, USA). After the confection of the specimens, the samples were immersed in distilled water for 24 hours and stored at 37°C in stove, moment that was performed the finishing and polishing with the sequence of sandpaper discs (TDV, Brasil). Half of the specimens was submitted to 60,000 cycles of simulated toothbrushing, meanwhile the other half was the control group (n=10). The surface of the restorations was evaluated through Scanning Electronic Microscopy (SEM), surface roughness (Ra), and weight loss (through measurements), in two moments: before and after the process of simulated toothbrushing. To the statistical analysis, it was used the variance analysis ANOVA two factors and Tukey’s post test. Results: In the analysis performed by SEM, in amplification of 500x, it was observed the presence of medium and small protruding particles in all resins tested after simulated toothbrushing, with exception of the resin Z350 flow. All materials presented increasing on Ra after simulated toothbrushing. Regarding to mass variation, all materials presented mass loss after simulated toothbrushing, suggesting that wear of the restoration structure. Conclusion: To sum up, there is still a concern about whether the wear is most influenced by the type of dentifrice or by the proprieties of the material itself. 

28
  • CAMILA DAYZE PEREIRA SANTOS
  • Temporal distribution of Infant Mortality in a capital of Northeastern Brazil, 2006-2013: reflections on the quality of Primary Health Care.

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • DIRCE MARIA LOBO MARCHIONI
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 7 déc. 2018


  • Afficher le Résumé
  • The objective of this study was to analyze the temporal distribution of infant deaths, bio sociodemographic factors related to infant mortality, the main causes, type of avoidance of death and factors related to the quality of maternal and child health care in Primary Health Care in Natal / RN, between 2003 and 2016, before and after the Pact for the Reduction of Infant Mortality in the Northeast and Legal Amazon (PRMI) (2003-2009 and 2010-2016 respectively). Ecological study, of a time series, carried out with data from the Mortality Information System. Infant mortality rates (IMR), neonatal (TMN) and post-neonatal (MTP), and IMR due to death and type of avoidance of death were calculated for each year evaluated. The join point method was used to calculate the Annual Percentage Change (APC). The bio sociodemographic variables were analyzed: sex, race, type of gestation, type of delivery, gestational age, and birth weight, comparing the periods of 2003-2009 and 2010-2016. To assess the association of these variables and the occurrence of infant death in the neonatal and post-neonatal period, the prevalence ratio (PR) and the 95% confidence interval were calculated. To evaluate the quality of care in Primary Care (AB), data from the Program for Improving Access and Quality of Primary Care (PMAQ-AB) 2014 were used. IMR significantly reduced -12.74% (95% CI -23.9 (-7.01% / year) and in endocrine and nutritional diseases (16.21% / year), between 2007 and 2011. From the causes of death, there was a significant reduction only in deaths due to respiratory diseases. The probability of avoidable death was higher in neonatal mortality for both 2003-2009 and 2010-2016 periods. From the bio sociodemographic variables analyzed, the type of gestation, gestational age at birth and birth weight were associated with neonatal mortality, with a higher probability of dying in the neonatal period; of twin gestation; premature and that presented very low birth weight in the two periods analyzed. Regarding maternal and child care, there was a significant increase in the number of pregnant women who performed more than 7 prenatal consultations (4.1% / year between 2003 and 2009) and the number of neonatal ICU beds (8.5% / year between 2005-2016). Of the total number of infant deaths, 1836 (71.7%) occurred due to preventable causes, the highest proportion being reduced by adequate attention to women during pregnancy (38%), which showed a tendency to increase between 2010 and 2016 (APC 6.59%). Regarding the quality of prenatal care, some indicators were found that may have a negative impact on the infant mortality rate: referral consultation (7.4%); existence of a system that alerts to the probable date of birth (10.2%); (34.7%) and early capture of pregnant women and complications during pregnancy (45.3%). It is concluded that PRMI's objective of reducing the IMR by 5% per year in 2009 and 2010 in Natal / RN was reached, but there was an upward trend in the succeeding years, which showed that efforts, were insufficient to keep infant mortality in decline. There is still a high occurrence of deaths due to preventable causes and failures in Primary Care assistance observed due to the low supply of some agreed maternal and child health indicators.

29
  • CRISTIANE LORENA MAIA PINHEIRO
  • DEVELOPMENT AND CHARACTERIZATION OF SODIUM HYPOCHLORITE GEL FORMULATION FOR ENDODONTIC USE

  • Leader : FABIO ROBERTO DAMETTO
  • MEMBRES DE LA BANQUE :
  • CICERO ROMAO GADE NETO
  • FABIO ROBERTO DAMETTO
  • LETICIA MARIA MENEZES NOBREGA
  • Data: 10 déc. 2018


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  • This research focused on the development and characterization of a gel formulation for NaOCl, which allows greater control during the root canals irrigation without losing the characteristics that make it such na efficient cleaning and decontamination agent. It was used a concentrated solution of NaOCl, which was titrated to determine the active chlorine content, and a surfactant, sodium lauryl ether sulfate, for which the critical micellar concentration in distilled water was calculated. From these reagents were carried out dilutions and manipulated seven formulations of 2.5% NaOCl with different surfactant concentrations, which were submitted to the following analysis: pH, surface tension, Fourier transform infrared spectroscopy (FTIR), wettability on human dentin, rheology and antibacterial potential against Enterococcus faecalis. The pH values showed that the addition of the surfactant did not alter this parameter, keeping the alkaline medium desirable for NaOCl action. The surfactant addition reduced surface tension by more than 50% relative to the NaOCl aqueous solution. The FTIR showed that the reagents only solubilize and interact, not implying the occurrence of chemical reaction between them. The wettability on human dentin was lower than that measured for the NaOCl solution. The viscosity study revealed micellar solution behavior for the formulations with lower concentrations of surfactant, and gel behavior for the more concentrated ones. All formulations showed viscosity and appearance that allow clinical use satisfactorily. The microbiological disk-diffusion test on agar showed a satisfactory action similar to the 2.5% aqueous NaOCl solution.

30
  • RAFAELA MONTEIRO DE ARAÚJO
  • EVALUATION OF TENSILE STRENGTH WITH DIFFERENT TYPES OF SURGICAL FIXATION HOOK PREFABRICATED ON ORTHODONTICS WIRES

  • Leader : HALLISSA SIMPLICIO GOMES PEREIRA
  • MEMBRES DE LA BANQUE :
  • HALLISSA SIMPLICIO GOMES PEREIRA
  • SERGEI GODEIRO FERNANDES RABELO CALDAS
  • LEONARDO EULER ANDRADE GOMES DO NASCIMENTO
  • Data: 10 déc. 2018


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  • OBJECTIVES: This research was realized in vitro assay to evaluate the traction resistance of prefabricated surgical hook, threaded prefabricated hooks, hooks made of stainless-steel wire and surgical hook made of brass wire comparing different ways of fixing them and different commercial brands. MATERIAL AND METHODS: The sample consisted of 340 segments of orthodontic wire associated to surgical hooks divided into 34 groups. One of them was the control group with 10 hooks made of brass wire fixated with silver weld and the others 33 experimental groups were composed of 10 surgical hooks in each group. In 25 groups, the hooks were prefabricated, fixed to the orthodontic wires by means of manual pressure made with appropriate pliers associated to different quantities of electric welding points. In one group, the pressure was performed with heavy-cut pliers and in another group the base of the hook was distempered and then the pressure was made with appropriate orthodontic pliers. The brands compared were Morelli, TP orthodontics, American Orthodontics and MAO MidAtlantic Ortho and the types of fixation were manual pressure made with appropriate pliers and manual pressure associated with 2,3,4 and 5 point of electric solder. In 5 groups, the hooks were made of stainless-steel wire, one group being fixed with silver solder or with 1, 2, 3, and 4 electric soldering points respectively. The last group consisted of 10 threaded surgical hooks. Topography of the sample was evaluated by scanning electron microscopy before and after the experiment. The Kruskal-Wallis and Mann-Whitney analyzes were used to compare the groups at a significance level of 0.05 to identify the differences between the measures of each group. RESULTS: The control group was better than all the other groups (p <0.0001 / Kruskal-Wallis). The group of steel hooks was independent of the control group (p <0.0001 / Kruskal-Wallis). American Orthodontics hooks were also found in relation to the other brands, regardless of the form of fixation (p <0.05 / Mann-Whitney). The rosquetics were those that improved with the difference between them (p <0.05 / Mann-Whitney). CONCLUSIONS: There was no increase in the resistance of the pressable hooks when different solder exposure points were saved. The best mark was an American Orthodontics. Welding wire hooks with soldering points have the same efficacy to welding with silver soldering, and can replace them. The threaded hooks are successful results with the clips.

31
  • ANDERSON DE SOUZA FERNANDES
  • HEALTH PLANNING IN THE ORAL HEALTH TEAMS: ANALYSIS OF THE LABOR PROCESS AND ASSOCIATED FACTORS

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • LUIZ ROBERTO AUGUSTO NORO
  • NILCEMA FIGUEIREDO
  • Data: 13 déc. 2018


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  • The dentist has in the family health strategy a broad field of action, but must maintain its practices oriented by the principles of basic care and SUS. In this context, among the responsibilities of the oral health team, health planning and the organization of the work process are mandatory and elementary management technologies to achieve greater reorientation and quality of actions and oral health services. Thus, the objective of this study is to analyze the knowledge and practices about health planning as part of the work process of the oral health teams. This is an exploratory study developed in two phases: 1) Quantitative analysis of secondary data from the external evaluation of the 2nd cycle of the Program for Improving Access and Quality of Primary Care (PMAQ-AB) with oral health teams in Brazil; 2) Qualitative research with dental surgeons of the family health strategy and health managers of Rio Grande do Norte (RN). Phase 1 consisted of a multivariate analysis with data from the Health Information Systems aggregated with socioeconomic variables of the Atlas of Human Development in Brazil. In phase 2 a case study was carried out with four municipalities of the RN, being used triangulation of methods for data collection, followed by content analysis by the Bardin method. As results, in the factorial analysis were generated three components: Poverty and edentulism; Oral health care; Coverage of oral health team. There was a significant difference (p <0.001) in the distribution of these components among the Brazilian regions, being associated (p <0.001), for the most part, with questions related to the oral health planning practice evaluated by PMAQ-AB, that also present locoregional differences (p <0.001). In the case study in the RN, it is verified that the practice of planning oral health actions is generally incipient and amateur, as well as the epidemiological surveys and the reorientation of the oral health care model. Despite the commitments made with PMAQ-AB, the improvements are punctual and evidently manipulated for the moment of external evaluation of the program. In addition, there was little institutional support for management and little mobilization and leadership of professionals for the qualification of care and for the strengthening of SUS.

32
  • EDER SAMUEL OLIVEIRA DANTAS
  • PSYCHOSOCIAL CONTEXT OF SUICIDE OF WOMEN INSIDE RIO GRANDE DO NORTE

  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • JACILEIDE GUIMARAES
  • NADJA CRISTIANE LAPPANN BOTTI
  • SORAYA MARIA DE MEDEIROS
  • Data: 13 déc. 2018


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  • Suicide is an intentional and deliberate act of putting an end to one's life. There are several factors related to this
    type of self-inflicted death, which may be related to the biological, psychological and social. In this scenario, the 
    gender relations are predicted as predictors of suicide, and all individual and non-individual factors that are based 
    on social relations.  Thus, the objective of this study was to analyze the psychosocial context of women who 
    committed suicide in the city of Caicó / RN. It is a qualitative research that uses the psychosocial autopsy method 
    as a means to approach this phenomenon in a socially wide way and to seek singularities of the human dimensions. 
    First-degree relatives of women who committed suicide between the years 2011 and 2016 were interviewed. 
    The analysis of the collected material will be carried out through the thematic content analysis, using a theoretical 
    reference on gender relations and suicide. Finally, it is expected that this study may reveal particularities about the 
    suicide of women from the interior of Rio Grande do Norte, and may even subsidize preventive measures for suicide.
33
  • MARCELA EMÍLIO DE ARAÚJO
  • Effect of a high potency light emitting diode (led) on the retina of rats

  • Leader : SERGEI GODEIRO FERNANDES RABELO CALDAS
  • MEMBRES DE LA BANQUE :
  • HALLISSA SIMPLICIO GOMES PEREIRA
  • MATHEUS MELO PITHON
  • SERGEI GODEIRO FERNANDES RABELO CALDAS
  • Data: 13 déc. 2018


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  • Introduction: The evolution of light curing units (LCU) in terms of potency and consequent reduction of clinical time have been shown to be of great value to orthodontists, regarding the routine of brackets bonding. However, there is a lack in the literature regarding the effect of these devices on the operator and/or patient retina, as both may receive indirect reflected light during procedures. Aims: Evaluate the effect of the use of a high potency light emitting diode-based device (LED) in the retina of Wistar rats. Material and Methods: Six Wistar rats were used and their ocular structures considered objects of the study. During the photostimulation of each animal, the right eye, established as the control sample, was covered with a removable PVC tampon, as the contralateral eye - experimental sample - was exposed to high potency LED light, 3200mW/cm2 (Valo Ortho - Ultradent) for 144 seconds, at the distance of 30cm. Animals were exposed to LED light three times per day, aiming to induce possible acute inflammatory alterations in retina. Seven days after the first photostimulation, all rats were anesthetized and then euthanized for posterior eye removal and histological processing. The histological slides were scanned using a camera connected to an optical microscope and their images analyzed for the measurement of histomorphological and stereological parameters of the retina. Results: A statistically significant raise was found in the total volume of retina and in the following layers: ganglion cells layer (GCL), outer nuclear layer (ONL), inner nuclear layer (INL) and extension of cone and rods (ECR) in the experimental group. Regarding density, no statistically significant difference was observed. However, the nuclear area of the cells raised significantly in all layers analyzed after high potency LED exposure. Besides that, hyperchromic cells suggestive of pyknosis were found. Conclusions: Despite the short and acute protocol of eye exposure to high potency LED, a significant alteration was found, especially in the metabolic activity of photosensitive and neuronal cells. These results emphasize the importance of using eye protection during the use of these devices.

34
  • ULICÉLIA NASCIMENTO DE AZEVEDO
  • SUICIDE IN THE ELDERLY POPULATION: ANALYSIS OF GENDER MORTALITY IN THE BRAZILIAN STATES

  • Leader : MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MEMBRES DE LA BANQUE :
  • KARLA PATRICIA CARDOSO AMORIM
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • NADJA CRISTIANE LAPPANN BOTTI
  • Data: 14 déc. 2018


  • Afficher le Résumé
  • OBJECTIVE: To analyze the standardized mortality rate for suicide in the elderly in the Brazilian states and the differences between the genders. METHODS: An ecological study was carried out to analyze suicide deaths in the elderly in the Brazilian states, based on data from the Mortality Information System (SIM) in the period from 2011 to 2015. Deaths from suicides (self-induced injuries: X60 -X84), according to the age group of 60 years and over, and the gender of the individual, categorized from the International Statistical Classification of Diseases and Related Health Problems - 10th Revision. Information on deaths was collected from the Mortality Information System (SIM) of the Department of Informatics of the National Health System (Datasus). Population data by State and Federal District, by sex and by age group, were obtained from the Demographic Censuses and Intercensity Projections, on the website of the Brazilian Institute of Geography and Statistics (IBGE). RESULTS: 8,483 deaths from suicide among the elderly in Brazil were recorded between 2011 and 2015. The proportion of deaths was 80% (6,799) for males, and 20% (1,683) for females. The spatial distribution of the standardized Mortality Rate (TMP) for suicide according to sex in Brazil indicated an average rate of 0.84 deaths (105 inhabitants) for both sexes, 1.32 deaths (105 inhabitants) for males and 0.33 deaths (105 inhabitants) to the female. The highest TMP per suicide expressed per 100,000 inhabitants went to Rio Grande do Sul (both sexes with 1.99, male with 3.30 and female with 0.76), Santa Catarina (both sexes with 1.78, male with 2.80 and female with 0.74) and Piauí (both sexes with 1.52, male with 2.42 and female with 0.64). The TMP ratio between the male and female sexes in Brazil was 4.15 / 105 inhabitants. The states with the highest ratios were: Acre (10.20 / 105 inhabitants), Amapá (8.62 / 105 inhabitants), Bahia (5.39 / 105 inhabitants), Maranhão (5.25 / 105 inhabitants), Paraná (4.90 / 105 inhabitants), Mato Grosso 4.87 / 105 inhabitants) and Paraíba (4.84 / 105 inhabitants). CONCLUSIONS: Mortality due to suicide among the elderly presents a tendency to increase and its greatest distribution is between the states of the Northeast, Center-West and South of Brazil. There are differences between the proportion of deaths by suicide considering the male and female sexes among the elderly population, being the highest rates found in the male population

35
  • CARINA TAÍSE DE MEDEIROS MACÊDO
  • EVALUATION OF HUMOR (AFFECTIVE) DISORDERS AND OTHER MENTAL AND BEHAVIORAL DISORDERS IN NORTHEAST OF BRAZIL

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • FABIA BARBOSA DE ANDRADE
  • JULLIANE TAMARA ARAUJO DE MELO CAMPOS
  • MARIA DJAIR DIAS
  • Data: 14 déc. 2018


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  • This study consists of the evaluation of morbidity and mortality indicators in the Northeast region of Brazil in relation to hospitalization for mood disorders (THA and other mental and behavioral disorders), which seeks to compare indicators of morbidity and mortality related to these diseases, in the period from 2007 to 2016, with the objectives and goals of the Prevention of Mental Retardation Policies in Brazil. This is an ecological, retrospective, exploratory study, using health information from the northeast region of Brazil, produced by DATASUS, through the Hospital Information System and Mortality Information System. The dependent variables are the hospitalization rate and mortality rate of the diseases studied and as independent the age group, sex, schooling and marital status. The Statistical Package for the Social Sciences (SPSS) was used to analyze the data, by means of the study of mean, median, standard deviation and Student's t test, considering a 95% confidence interval. Thus, when the hospitalizations for mood disorders (affective) and other mental and behavioral disorders were evaluated, both had a reduction in the average throughout the decade, and mood disorders (affective) have higher values when compared to other mental disorders and behavioral. These data are statistically significant when submitted to the t student test. It was found that the average hospitalizations and mortality rate of both diseases showed a general tendency to reduce, however, with some points of increase, such as in the period between 2007 and 2008 for other mental and behavioral disorders and between 2009 and 2010 for mood (affective) disorders. The mortality rate from hospitalization has behaved the same in both of them during the decade. Still on the mortality rate, a greater number of elderly people are identified in the age groups of 80 years or more, followed by the age group of 70 to 79 years and the tendency presented is an increase in the number of deaths, according to the increase in the life years of the population. Regarding gender, a higher percentage of women were observed when dealing with mood disorders (affective), the opposite observed in other mental and behavioral disorders, whose male population has the highest numbers. Regarding marital status, most deaths were concentrated among single people. When the chapter on mental disorders was evaluated, it was found that, in general, 50% of deaths were related to mental and behavioral disorders due to alcohol use. When spatially evaluated, similar areas are observed over the years studied. Overall, the data indicate that the most vulnerable populations, such as children and the elderly, are more likely to suffer from mood (affective) disorders.

36
  • KÉZIA RAPHAELA DE LUCENA ALVES
  • LONG-TERM EFFICACY OF A 4% SODIUM FLUORIDE SOLUTION AND AsgAaL LASER FOR THE TREATMENT OF CERVICAL DENTIN HYPERSENSITIVITY

  • Leader : EULER MACIEL DANTAS
  • MEMBRES DE LA BANQUE :
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • EULER MACIEL DANTAS
  • FERNANDO JOSE DE OLIVEIRA NOBREGA
  • Data: 18 déc. 2018


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  • INTRODUCTION AND BACKGROUND: Although there are several forms of treatment for Dentin Hypersensitivity (DH), the main challenge is to find a substance or form of treatment that effectively eliminates pain and does not recur in the short or long term. OBJECTIVE: This randomized controlled clinical trial evaluated the efficacy of 4% sodium fluoride solution for the treatment of DH, comparing it to low power laser therapy with visible infrared LASER emitter, and the active AsGaAl medium. METHODOLOGY: The sample was composed of 92 dental elements selected after being submitted to two stimuli, a tactile one, and a second thermal-evaporative stimulus. The sensitivity was measured through a visual numerical scale. The teeth were alternately divided into two groups (Group 1 and Group 2) to receive the treatment according to the group for which it was selected. For Group 1, 4% sodium fluoride solution was applied in three sessions, with intervals of 1 week between them. The dental elements of Group 2 received low-power laser irradiation of AsGaAl diode in a punctual way, in the cervical region of the vestibular face in three sessions with intervals of 1 week between them. At each application of the 4% sodium fluoride solution or the low-power LASER, patient responses to tactile and thermal-evaporative stimuli were recorded on the visual numerical scale. At the end of the treatment and with one, three and six months, new evaluations were carried out to verify the effectiveness of the substances in the long term. Statistical analysis of the data was done using non-parametric Wilcoxon and Mann-Whitney tests, complemented with a descriptive analysis composed of tables and graphs. PARTIAL RESULTS: The results showed that after six months of treatment, there was a reduction in pain sensitivity in relation to both stimuli, both in dental elements treated with fluoride solution and those treated with LASER. The average pain of the dental elements treated with the 4% sodium fluoride solution increased from 5.93 to 1.73 in response to the evaporative stimulus and from 3.63 to 0.804 to the tactile stimulus. For dental elements treated with LASER, the average pain increased from 6.020 to 1.854 with the evaporative stimulus and from 3.50 to 0.937 with the tactile stimulus. All of these pain reductions were statistically significant (p <0.00). However, when comparing the two therapies, there were no statistically significant differences between them (P> 0.05). CONCLUSION: Both therapies were effective in reducing DH after six months of control. There is no statistically significant difference between the two therapies proposed in this study.

    INTRODUÇÃO E JUSTIFICATIVA: Embora existam diversas formas de tratamento para a HSDC, o principal desafio é encontrar uma substância ou forma de tratamento que efetivamente elimine a dor e não tenha recidiva em curto e longo prazo. OBJETIVO: Este ensaio clínico controlado randomizado avaliou a eficácia do uso da solução de fluoreto de sódio a 4% para o tratamento da Hipersensibilidade Dentinária Cervical (HSDC) comparando- a laserterapia de baixa potência com emissor invisível de LASER infravermelho, e o meio ativo AsGaAl. METODOLOGIA: A amostra foi composta por 92 elementos dentários selecionados após serem submetidos a dois estímulos, um táctil, e um segundo estímulo, térmico-evaporativo,  A sensibilidade foi mensurada através de uma escala visual numérica. Os dentes foram distribuídos aleatoriamente e alternadamente em dois grupos (Grupo 1 e Grupo 2) para receber o tratamento de acordo com o grupo para o qual foi selecionado. Para o Grupo 1 foi realizado aplicação de solução de fluoreto de sódio a 4%, em três sessões, com intervalos de 1 semana entre elas, Os elementos dentários do grupo 2 receberam irradiação do LASER de baixa potência de diodo AsGaAl de forma pontual, na região cervical da face vestibular em três sessões com intervalos de 1 semana entre as mesmas. A cada aplicação da solução de fluoreto de sódio a 4% ou do LASER de baixa potência, foram registradas as respostas dos pacientes aos estímulos tácteis e térmicos-evaporativo, na escala visual numérica. Ao término do tratamento e com um, três e seis meses foram realizadas novas avaliações para a verificação da efetividade das substâncias em longo prazo. A análise estatística dos dados foi feita através dos testes não paramétricos Wilcoxon, Friedman e Mann-Whitney, complementada com uma análise descritiva composta de tabelas e gráficos. RESULTADOS PARCIAIS: Os resultados demostraram que após seis meses de encerrado o tratamento, houve redução da sensibilidade dolorosa frente aos dois estímulos, tanto nos elementos dentários tratados com a solução de fluoreto quanto aqueles tratados com o LASER.  A média de dor do elementos dentários tratados com  a solução de fluoreto de sódio a 4% passou de 5,93 para 1,73 em resposta ao estímulo evaporativo e de 3,63 para 0,804 ao estimulo táctil. Para os elementos dentários tratados com  LASER a media da dor passou de 6,020 para 1,854 ao estímulo evaporativo e de 3,50 para 0,937 ao estímulo táctil. Todas essas reduções da dor foram estatisticamente significativas (p <,0,00).  No entanto quando comparadas as duas terapias, não se observaram diferenças estatisticamente significantes entre as mesmas (P>0,05). CONCLUSÃO: As duas terapias foram eficazes na redução da HSDC após seis meses de controle. Não há diferença estaticamente significativa entre as duas terapias propostas nesse estudo.  

37
  • VICTOR ARTHUR OLIVEIRA DE FARIAS
  • Soft Tissue Conditioning in Provisional Crowns in Esthetic Zone: a Clinical Trial.

  • Leader : PATRICIA DOS SANTOS CALDERON
  • MEMBRES DE LA BANQUE :
  • ANA CLARA SOARES PAIVA TORRES
  • ANA RAFAELA LUZ DE AQUINO MARTINS
  • PATRICIA DOS SANTOS CALDERON
  • Data: 21 déc. 2018


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  • BACKGROUND: The esthetic outcome is one of the criteria used to build a definition of success in implant-supported restorations. Besides performing a masticatory function, dental implants have to bring back satisfactorily the smile esthetic, which is composed not only by the restoration but also by the adjacent peri-implant soft tissue. The aim of this study is to measure the influence of soft tissue conditioning on esthetic outcome of provisional crowns on single implants in the smile zone. METHODS: This study had sixteen patients with indication for rehabilitation with single implant in esthetic region. All patients underwent an implant placement surgery to install a morse tapered implant and whenever possible, immediate loading was applied. All patients received an acrylic resin implant-supported provisional crown. The soft tissue conditioning was performed with a non-surgical technique of gradual pressure. Photographs of the rehabilitated region were taken at the first provisional crown installation and at the last section of soft tissue management. A blind examiner applied the Pink Esthetic Score (PES) based on criteria observed at the photographs. RESULTS: The sample consisted of 10 females and 6 males with a mean age of 40.8 (21—57) years with indication to receive single implants. The missing teeth occurred mostly in anterior region (9) and the most frequent tooth to be rehabilitated was the central incisor (5). Two patients had implant placement with immediate loading, receiving a provisional crown after the surgery procedure. The mean soft tissue conditioning session number was 2,6 (2—4).

     

38
  • ANTONIO PEDRO DA SILVA NETO
  • ELDERLIES HEALTH: A CROSS-SECTIONAL STUDY ON THE LIVING AND HEALTH CONDITIONS OF A PLACE IN THE NORTHEAST OF BRAZIL
  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • ELIANA BARRETO FIXINA
  • Data: 26 déc. 2018


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  • The current society is in constant process of aging, thus triggering a significant increase in the number of elderly people. In this sense, the present study aimed to analyze the prevalence and associated factors to multimorbidities and negative self-evaluation of health in elderlies in a municipality in the interior of the Brazilian Northeast. This is a transversal study with a quantitative, descriptive and inferential approach. The target group was 181 elderly people from the city of Pau dos Ferros, registered in the Family Health Strategies (ESF) of the municipality and that were randomly selected and proportional to the number of elderly registered in each ESF team in the municipality. Of the 181 elderly people, belonging to the first stage of the research, there was a loss of 33 elderly (18.2%). The interviewer in charge was a resident of each elderly woman, drawn with the Free and Informed Consent Form (TCLE) for the application of a questionnaire from the "Health, well-being and aging" survey (SABE). Data collection was performed from January to September, 2018. The Statistical Package for the Social Science (SPSS) was used to analyze the data, whose description was based on absolute and percentage frequency values. The inferential analysis was based on the Chi-square test for a significance level of 5% and, later, a logistic regression analysis, whose odds ratio was converted to the prevalence ratio. In the sample, female superiority was found (64.2%). It was observed that the age group between 70 and 79 years presented a frequency of 40.5% of the elderly, influencing the characterization of a municipality with an already marked aging process. Regarding the dependent variables, one has to consider two forms of conceptualization for the multimorbidities. The first one is the one that considers the presence of two chronic diseases, and the second one is based on three chronic diseases. For the first condition, a prevalence of 66.2% (95% CI 58.6 - 73.8%) was found, with a significant association with hypertension, polypharmacy, difficulty in accessing health services, and self-evaluation of memory. For multimorbidity characterized by three or more pathologies, a percentage of 40.5% (95% CI 32.6 - 48.4%) was obtained, with significant associations for polypharmacy, memory self-evaluation and hypertension. In addition, dependent self - rated health had a negative self - assessment prevalence of 73% (CI 95% 66 - 80%) with associations with the following variables: multimorbidities with 3 more pathologies, polypharmacy, oral health and number of caregivers. It is evident, therefore, how much the disease health process is influenced by the most varied factors, whether biological or not, evidencing the need for a strategy that discusses the social determinants as an important aspect to be taken into account in the care. Not unlike the other studies, SABE Pau dos Ferros has produced results that will support the execution of a strategic planning aimed at the elderly public.
Thèses
1
  • LIGIA REJANE SIQUEIRA GARCIA
  • CHILD STUNTING IN BENEFICIARIES OF BOLSA FAMILIA PROGRAM: DETERMINANTS AND INEQUALITIES IN BRAZIL

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • RAFAEL DA SILVEIRA MOREIRA
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • URSULA VIANA BAGNI
  • Data: 2 mars 2018


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  • This study aimed to identify social inequalities and the associations between life conditions and child stunting on beneficiaries of a Brazilian cash transfer program. It was developed from three different designs, using secondary data from the Department of Informatics of the Brazilian National Health System (DATASUS, from the Portuguese acronym) and from the Brazilian division of the United Nations Development Program (UNDP). The dependent variable was child stunting in beneficiaries of the Brazilian cash transfer program called “Programa Bolsa Família (PBF)” and the independent variables were those related to life conditions in the 5570 Brazilian municipalities, especially indicators for educational and socioeconomic status, sanitation, income inequality and human development, from 2009 to 2012. Regarding the analysis of determinants, it was initially performed a bivariate analysis using Chi-square test, followed by the estimation of adjusted Prevalence Ratios through the Poisson Regression modelling. The spatial dependence of child stunting prevalence was assessed by the Global Moran Index and the spatial correlation was verified by the Bivariate Moran Index. In order to assess the modifications in social inequalities between 2009 and 2012, the Slope Index of Inequality and the Relative Index of Inequality were calculated. For all tests, the significance threshold adopted was 5%. Results showed that the probability of having a high prevalence of child stunting was higher in those municipalities with low socioeconomic indicators (PR 1.43; 95% CI 1.25–1.64) and higher prioritization of Primary Health Care (0.78; 0.70–0.87). It was observed spatial dependence in the distribution of child stunting (I=0.52; p=0.010), with higher prevalence in North and Northeast regions. It was observed reduction in the prevalence of child stunting and an improvement in socioeconomic indicators, followed by a decrease in the absolute inequalities over the studied period (2009 to 2012). In conclusion, the child stunting in Brazil showed a significant reduction in the inequalities, a strong evidence of the social determination and a spatial dependence, when analysed in children beneficiaries of the “Bolsa Família” program.

2
  • TAMIRES CARNEIRO DE OLIVEIRA MENDES
  • PROFILES OF MORTALITY OF ELDERLY IN THE NORTHEAST: STUDY
    COMPARATIVE BETWEEN THREE AGE GROUP AND ITS FACTORS
    RELATED CONTEXT

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • DALIA ELENA ROMERO MONTILLA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • KENIO COSTA DE LIMA
  • MARIA DO CARMO EULÁLIO
  • VILANI MEDEIROS DE ARAUJO NUNES
  • Data: 27 mars 2018


  • Afficher le Résumé
  • The elderly population grows rapidly and reveals a variability of characteristics that results
    in different levels of health. In order to make public policies adequate to the new demands, it
    is essential to comprehend the real health pattern and the mortality statistics are an important
    instrument to produce objective bases for this. In this sense, this ecological study proposes to
    analyze the mortality profile of the elderly in the northeastern municipalities from 2001 to
    2015, as well as to identify the contextual socioeconomic factors related. The elderly
    population was analyzed from the perspective of their heterogeneity, dividing it into three
    groups: 60 to 69 years old (younger or sexagenarians), 70 to 79 years (septuagenarians) and
    80 years old or older (longevity). Based on data from the Mortality Information System (SIM)
    and the Brazilian Institute of Geography and Statistics (IGBE), the causes of death, according
    to ICD-10 chapters, were measured using Proportional Mortality (MP) for the descriptive
    analysis of the Northeast region as a whole and through the Age - specific Mortality
    Coefficient (CMId) for the delineation of the mortality profiles in municipalities level. Data
    from IBGE, United Nations Program (PNUD) and the Institute of Applied Economic
    Research (IPEA) were summarized by Principal Component Analysis for the Brazil and then
    in the Northeastern municipalities specifically. The clusters of municipalities with similar
    mortality profiles were defined by means of K-means Clustering Analysis and compared with
    each other and with the socioeconomic indices by Student's T test, Mann-Whitiney, ANOVA
    or Kruskal-Wallis, according to the number of groups and the distribution of the data, at a 5%
    significance level. In addition, the results were analyzed spatially. In the studied period,
    2,461,383 deaths were recorded in the elderly in Northeast. 44.2% of the deaths corresponded
    to the octogenarians, 31.4% to the septuagenarians and 24.4% to the sexagenarians. Most of
    the deaths occurred in the hospital (55.5%), among males (50.8%), brown race (49.0%),
    married (37.1%) and without any study (34.5%). Regarding the causes of death,
    cardiovascular diseases have the highest number of deaths (35.8%), followed by ill-defined
    causes (15.4%) and neoplasms (13.1%). The clustering analysis formed five clusters for the
    sexagenarians group (High burden of neoplasms, High burden of ill-defined causes, Low
    coverage, Intermediate profile and High mortality and good registration), three for the
    septuagenarians (Highest quality of information, Low coverage and Ill-defined causes and
    low coverage profile) and two clusters for octogenarian’s individuals (Cardiovascular
    diseases and ill-defined causes and low coverage and ill-defined causes). The indices of
    Deprivation and Rurality were constructed for the Brazilian municipalities and, in the
    application of the analysis specifically in Northeast, the first one was divided in two
    components (Favorable socioeconomic context and Low education and dependence of the
    State) and the second was adapted as Urbanization and its reflexes. The last one was the most
    important factor for the discrimination of the northeastern municipalities. The bivariate
    analysis showed that satisfactory levels of contextual socioeconomic determinants are related
    to mortality patterns that are closer to the modern characteristics of epidemiological
    transition, as well as a higher quality of the SIM, and this influence is greater in the younger
    individuals. The municipalities identified in the clusters with the most unfavorable health
    profiles should be prioritized in health planning, considering the socioeconomic context for
    reducing health inequities.

3
  • YAN NOGUEIRA LEITE DE FREITAS
  • ORAL HEALTH CONDITIONS AND FUNCTIONAL CAPACITY IN ELDERLY: A POPULATION-BASED LONGITUDINAL STUDY
  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • EDJA MARIA MELO DE BRITO COSTA
  • EUDES EULER DE SOUZA LUCENA
  • GUSTAVO PINA GODOY
  • KENIO COSTA DE LIMA
  • Data: 8 mai 2018


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  • The study proposes a longitudinal analysis between oral health conditions and the functional capacity of the elderly population from the municipality of Macaíba-RN. For that, two waves of observations were performed in a elderly population representative cohort from this municipality. The oral health conditions examination sought to evaluate the degree of caries attack (DMFT), the periodontal condition (CPI/PAL), pairs of teeth in occlusion, the use and necessity of dental prostheses and the presence of changes in soft tissue. The functional capacity evaluation, which determines their degree of dependence, was obtained through the application of the Katz index and the Lawton-Brody index. Furthermore, a questionnaire was used to characterize the socioeconomic and demographic profile of the sample. Data from the 209 individuals investigated in the second wave revealed a predominantly female sample (66.5%). The mean age was 75.2 (± 8.14) years, with an average family income of 1.99 (± 1.49) minimum wages. The number of self-reported diseases by the elderly was 1.7 (± 1.1) on average, and regular consumption of medications was reported by 182 subjects (87.1%). As to the oral health longitudinal evaluation, measured from the proposed multidimensional indicator, it was observed that for 22.2% of the subjects there was a worsening in the oral health condition, while 115 individuals (63.9%) maintained the same oral health conditions and, therefore, to 13.9% was observed an improvement in these conditions. Functional capacity was not associated with these changes. Although the functional capacity was not associated with the oral health condition, it was observed that the oral health situation of the elderly from Macaíba-RN is precarious and stable over time, which makes it difficult to investigate associations that may indicate factors related to this context. It is understood that the findings presented are extremely useful to foster reflections on the living conditions of these individuals regarding health policies, especially the policies of oral health, which clearly does not prioritize this age group.

4
  • HIPOLITO VIRGILIO MAGALHAES JUNIOR
  • EVIDENCES OF VALIDATION OF AN OROPHARYNGEAL DYSPHAGIA SCREENING INSTRUMENT

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • ANA CALINE NÓBREGA DA COSTA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • LUCIA FIGUEIREDO MOURÃO
  • MARIA ANGELA FERNANDES FERREIRA
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 21 mai 2018


  • Afficher le Résumé
  • In the elderly, feeding may be compromised as a result of a swallowing disorder during the passage of food through the oral and pharyngeal region called oropharyngeal dysphagia (DO), a health condition that interferes with the maintenance of the nutritional status and hydration of the with the possibility of significant respiratory complications. Recognized as a geriatric syndrome by two important European communities, OD affects the autonomy and independence of the elderly in carrying out their daily life activities and contributes to functional decline and fragility. The objective of this study was to develop and validate a self-referenced questionnaire for the diagnosis of oropharyngeal dysphagia in the elderly (RaDI). The research methodology of this non-randomized, cross-sectional validation study followed the assumptions of the Standards for Educational and Psychological Testing, which describe the process of obtaining evidence based on: test content, response processes, internal structure, with other variables (convergent validity, discriminant, criterion and generalization). The collection, carried out from March 2013 to October 2017, in the city of Natal, state of Rio Grande do Norte, included the elderly, aged 60 and older, of both sexes, attended in the services of care for the elderly, Institution de Longa permanence, University Hospital and two Coexistence Centers, and excluded those with functional difficulties to understand, without any oral feeding, laryngectomized and tracheostomized patients. In the first two stages of validation, four researchers involved in the issues of swallowing and aging, three speech therapists and a sanitary dentist participated in a panel of experts to evaluate the analyzes of 32 judges on the first version of RaDI with 17 items. After its reformulation, the questionnaire was applied to the target population in 40 elderly people, and adjusted to 14 questions that were applied in 211 elderly people to perform the confirmatory factor analysis within a previously hypothesized theoretical model. The RaDI was reduced in 9 questions and was administered along with the associated factors questionnaire in 393 participants, within the same sociodemographic profile, to evaluate the concurrent validity, and in 110 along with the Rosenberg Self-esteem Scale to analyze its divergent validity , performed using the Spearman coefficient (r). The reliability examined by the test-retest in 75 elderly, used intraclass correlation (ICC), weighted Kappa, instrument measurement error (SEM) and the smallest real difference (SRD), and the internal consistency considered Cronbach's alpha, in of the 95% confidence interval. Results: RaDI was adjusted in its internal structure in the nine questions model, with good reliability (ICC = 0.83, CI 0.74-0.89, p <0.001, SEM = 2.13, SRD = 5.90 ) and high internal consistency (a = 0.90). Conclusions: RaDI has produced valid and reliable answers to identify the symptoms of oropharyngeal dysphagia in the elderly and is still in the process of obtaining the most adjusted psychometric parameters in its confidence interval.
     
     
5
  • JOSE ADAILTON DA SILVA
  • STRATEGIC GROUP ON HEALTH PROMOTION: A PARTICIPATORY RESEARCH ON THE AUTONOMY OF PEOPLE LIVING WITH DIABETES

  • Leader : ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ANA KARENINA DE MELO ARRAES AMORIM
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • JOÃO BOSCO FILHO
  • MARCELO VIANA DA COSTA
  • MARIA DE FÁTIMA ANTERO SOUSA MACHADO
  • Data: 26 juin 2018


  • Afficher le Résumé
  • Diabetes requires changes in the lives of those who become diagnosed with it, requiring healthy living habits, regular physical activity and even self-administration of medications. Sometimes, it requires a certain self-control that involves the ability to recognize options and make decisions: in this sense, the exercise of personal autonomy is necessary. Discussion on autonomy pays attention to the respect for people's choices, even in the face of restraining situations. Certainly, working with practices of autonomy in chronic diseases are still quite challenging. The purpose of this study was to compose health promotion strategies, based on a Strategic Health Promotion Group (GEPS), to help create the conditions for the exercise of people's autonomy regarding health care dealing with a disease chronic condition. The research is participatory, with a qualitative approach based on reflexivity. A previous consent was necessary to form a sixteen people group diagnosed with diabetes. Different topics were discussed, and the analysis of narratives produced in the meetings resulted in three thematic axes: a) Recognizing diabetes; b) Living with diabetes, and c) Exercising autonomy and protagonism. These axes formed three respective textual summaries, which were evaluated and validated by the participants in other three meetings. An interpretative exercise unfolded these summaries. Results demonstrate how participant´s experiences are related to the impact of diabetes diagnosis, provoking a moment of instability in the recognition of their ways of taking care of their own health, implying in the adoption of new meanings for their life habits. The recognition of this chronic condition transforms the way they come to live with diabetes, deriving in diverse personal strategies of self-control, self-care and adaptation. Sharing experiences facilitates the recognition of choices to the subject, stimulating their autonomy and protagonism. Shared care in a co-management process is critical to the longitudinality of diabetes care. In conclusion, the study emphasizes that the Strategic Group for Health Promotion extends the possibilities of self-care management and provokes reflections on health workers and health promotion practices, becoming an important tool for the health collective management. Group strategies, when directed towards the subject´s autonomy, tend to strengthen Primary Health Care and to achieve its essential attributes. 

6
  • MÁRCIA CAVALCANTE VINHAS LUCAS
  • WHERE DOES SIDA COME FROM, WHERE DOES IT GO TO? POSSIBLE PATHWAYS FOR THE ERADICATION OF THE HIV EPIDEMIC FROM THE PRESENT TIME

  • Leader : ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • JACILEIDE GUIMARAES
  • ROSANA LUCIA ALVES DE VILLAR
  • ANGELA APARECIDA CAPOZZOLO
  • JOÃO BOSCO FILHO
  • Data: 2 juil. 2018


  • Afficher le Résumé
  • As the fourth decade of HIV/AIDS epidemic in Brazil approaches, the epidemic context in the country has extremely complex new characteristics. In 2016, what we find in Brazil is a picture of resurgence of the epidemic with a new profile centered in MSM, chemical dependents, young gays and sex workers; reduction on international investments; and the upsurge of conservative sectors against public policies, restraining the epidemic approach based on human rights. At the same time, the United Nations affirm that it is possible to eradicate the epidemic of HIV/AIDS until 2030. The general purpose of this research is to understand and to assess experiences of people who live the epidemic of HIV/AIDS in the present context of adoption of therapeutic strategies in order to achieve national and international goals of eradication of the epidemic until 2030. Two central research strategies have been adopted: interviews focused on life stories and ocumentary research. The later assessed documents produced by the UN System that address the global policy of confrontation of the epidemic in the period from 2000 to 2016, in a total of 27 documents.The researcher has also explored official documents about the Brazilian Policy of Control and Eradication of the epidemic, from 1999 to 2016, and the Epidemiologic Bulletins of HIV/AIDS, from 2001 to 2016, in a total of 24 documents. Five health professionals and four users have been interviewed. The interpretive exercise of the interviews, with emphasis on life stories, was referenced in Sociology of Emergencies, Translation Work and in the Ecology of Knowledge, inspired by Boaventura de Souza Santos, who sought on local speech what, from the experience and expectation of the subjects who experience the care to the people living with HIV routinely, affirmed or denied knowledge and practices, new and old, and identified possibilities of future that are being built in the present through care practices concerned with the future of individuals and collectivities. The Translation work between narratives of subjects that produce local knowledge and practices and the official narrative that produces global knowledge from the argumentative work of the researcher was based on the analysis of the empirical material produced on the research and from the theoretical framework that has been adopted. From this work of translation between global, national and local knowledge and practices, prevention emerged as the most neglected stage of HIV/aids care and, thus, the most prone to setbacks, at the same time that we notice a pluralism of practical knowledge associated to it. Setting the epistemological path oriented by the ecology of knowledge, we identified the insufficiency of the image associated to combination prevention proposed by the Health Ministry in the representation of practices announced by different actors as being the ones with the capability of conciliation, provoking the need for its expansion. For this reason, based on the results of the study, we propose an alternative representation of the combination prevention mandala that embodies other aspects of the care applicable to the combination prevention. The interpretive exercise of approximation between different knowledge highlighted the need to put people, community and specially the right to prevention in the center of the responses to the confrontation of the epidemic of HIV/aids, if we want to understand the reinvention of the present more than projecting a future.

7
  • SAMARA CAROLLYNE MAFRA SOARES
  • PREVALENCE AND FACTORS ASSOCIATED WITH SCREENING FOR PROSTATE CANCER AND BREAST CANCER IN THE BRAZILIAN POPULATION

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • GUSTAVO PINA GODOY
  • ISABELA PINHEIRO CAVALCANTI LIMA
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 26 juil. 2018


  • Afficher le Résumé
  • Screening for the early detection of cancer has advantages and disadvantages in its realization, and its practices. Both in the public service and in the private health sector, should be guided by scientific evidence in order to ensure benefits and to avoid potencial damages and harms. Prostate cancer is one of the most frequent among men in Brazil and worldwide, and recommendations for its screening have been undergoing constant changes in the face of recent scientific evidence about the gains and potential harms of diagnostic tests, the PSA and digital rectal examination (DRE). The present study aims to identify the prevalence and factors associated with the performance of DRE in Brazilian men over 40 years of age. The Stata® 14 software was used to tabulate and statistically analyze the Prevalence Ratios with the respective 95% Confidence Intervals and p values, using the National Health Survey (NHS), Brazil, 2013. Multivariate analysis with Poisson regression. The men with private health plans (63.3%, CI = 60.5-66.0) had a higher prevalence in the implementation of DRE than in the public health system (41.6%, CI = 39.8% 43.4). The results showed a positive association for DRE in men with private plans aged 60-69 who married, and never smoked and domiciled in urban areas. For men who use the public health service, this positive association with DRE occurred in the age group of 70-79 years, living with consort, have poor / very poor self-perception, who do not drink, former smokers, with university level, who have 4 or more comorbidities, and domiciled in urban areas. Also for this group there was a negative association of the DRE for men living in the northern region of the country. The findings point to a difference in the medical practice in force in these two types of health service in the country, and also differences in access to this diagnostic test.
8
  • ANGELA MARIA DE MEDEIROS SOARES
  • INTERNAÇÕES EM IDOSOS E FATORES CONTEXTUAIS ASSOCIADOS NO NORDESTE BRASILEIRO

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ALBERT ESPELT HERNÁNDEZ
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • KENIO COSTA DE LIMA
  • LEANDRO DE ARAUJO PERNAMBUCO
  • VILANI MEDEIROS DE ARAUJO NUNES
  • Data: 2 août 2018


  • Afficher le Résumé
  • The present study aimed to investigate the elderly hospitalizations by cause group and by sensitive conditions to basic health (HSCBH), identifying their relationship with contextual factors in the Northeast of Brazil. A cross-sectional ecological study was performed using secondary data from the Hospital Information System of Brazil (SIH-SUS) to describe hospitalization rates by cause group and by HSCBH of the elderly between 2010 and 2015. The dependent variables were the elderly hospitalizations by cause group and by HSCBH. Therefore, the non-hierarchical cluster analysis (K-means) was performed by grouping of municipalities based on the cause group chapters in general admissions and those sensitive to basic care, with 3 Clusters. For the general hospitalization rate, Cluster 1 was characterized by the prevalence of low hospitalization rates, Cluster 2 with a high prevalence of hospitalization rates and Cluster 3 with predominance of intermediate hospitalization rates. In the HSCBH rates, Cluster 1 was classified as intermediate rates, 2 as low rates and 3 high rates. For the association with the dependent variables, were selected 11 independent socioeconomic contextual variables. The variables selected were summarized through the Factor Analysis starting Principal Components Analysis (PCA). Thus, we obtained component 1 that was called "urbanization and its reflexes", the second component being nominated as "favorable socioeconomic context" and the third component titled "little education and dependence of the state". In addition to these variables, we used the GINI Index, HDI, Firjan Index, the average coverage of basic care in municipalities between 2010 and 2015, and the rate of the physician visits among the elderly in basic care during the same period. The total hospitalization rate in the period was 1,212.60, with the greatest number being to circulatory system diseases, followed by respiratory system diseases and infectious/parasitic diseases. The clusters of hospitalization rates differed significantly between contextual factors, so that the municipalities with the highest hospitalization rates presented the highest values for the favorable socioeconomic context, the highest values being related to the few schooling and state dependence of municipalities with lower hospitalization rates. In relation to HSCBH, the total hospitalization rate was 527,524 (43.5% of all hospitalizations), with a higher number of heart failure diseases, followed by cerebrovascular and infectious gastroenteritis. In the association between the rates with the contextual factors, there was a significant difference between all the clusters and the factors. The cluster with the highest admission rates was the one that presented the highest averages for the “favorable socioeconomic contexto” and for “little education and dependence of the state”. The cluster with the lowest hospitalization rates had the highest averages for the "urbanization and its reflexes” factor. In the analysis of the coverage and the rate of physician visits among elderly people in basic care, it was observed that the clusters did not differ significantly, although in the cluster with the highest hospitalization rates, there were the highest number of physician visits among the elderly. About this context, was concluded that in this elderly population there is a predominance of hospitalizations due to diseases of the circulatory system. In the HSCBH, the largest number of hospitalizations is due to heart failure. Regarding the contextual factors, we can conclude that these fators interfere in a significant way in the hospitalizations of the elderly population, being relevant the point of these factors in the construction of the health public policies, taking into account the vulnerabilities of this population and contributing to the improvement of the elderly health  and the reduction of hospitalizations in this population.

9
  • CLECIO GABRIEL DE SOUZA
  • EFFECTS OF TRANSCRANIAL STIMULATION BY CONTINUOUS CURRENT ON CHRONIC PAIN IN INDIVIDUALS SUFFERED BY CHIKUNGUNYA.

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ALEXANDRE HIDEKI OKANO
  • ALEXSANDRO SILVA COURA
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARCELO CARDOSO DE SOUZA
  • WOUBER HÉRICKSON DE BRITO VIEIRA
  • Data: 9 août 2018


  • Afficher le Résumé
  • Chikungunya is a condition that has reached thousands of Brazilians, with alarming numbers of serious and incapacitating cases throughout the country. It is transmitted by the Aedes Aegypti mosquito and causes acute onset fever, joint and muscle pain. The persistence of symptoms of continuous and disabling joint pain has been a characteristic of relevant concern for collective health. There is still no specific treatment for cases of chronic pain caused by Chikungunya and the mechanisms responsible for chronic pain can be involved with the phenomenon of central pain sensitization. Neuromodulation techniques could act on these effects and among them there is Transcranial Current Stimulation (ETCC), which is a technique of applying currents of low intensity on the scalp in order to modulate cerebral areas and has been shown to be efficient in the treatment of cases involving chronic pain. The objective of this study was to analyze the effect of CTEF on chronic pain in patients treated by Chikungunya. A randomized clinical trial of women with Chikungunya, aged between 28 and 70 years, was divided into two experimental groups (CTEF) and placebo (SHAM). The sociodemographic and clinical characteristics of the participants were evaluated, as well as the level of functional capacity and pain symptomatology before and after being submitted to six sessions of ECTS on alternate days. A total of 59 women participated in the study, with a mean age of 52.85 ± 10.76 years and the time of disease involvement presented a mean of 21.54 ± 3.53 months. Regarding the presence of Chikungunya-associated diseases, 39% reported having a previous rheumatic disease. For the variables of functional capacity and pain, an improvement was observed in the two groups of the research, but this difference was greater in the experimental group, especially when compared to pain at different moments, with a follow-up of fifteen days after the last session. ETCC was able to improve the level of pain reported by individuals affected by Chikungunya.

10
  • HUGO DE ALMEIDA VARELA
  • Platelet rich fibrin in injectable form (i-PRF): celular, morphological and protein characterization

  • Leader : AURIGENA ANTUNES DE ARAUJO
  • MEMBRES DE LA BANQUE :
  • AURIGENA ANTUNES DE ARAUJO
  • ANA RAFAELA LUZ DE AQUINO MARTINS
  • JOSE SANDRO PEREIRA DA SILVA
  • HECIO HENRIQUE ARAUJO DE MORAIS
  • RENATA CIMÕES JOVINO SILVEIRA
  • Data: 9 août 2018


  • Afficher le Résumé
  • One of the great challenges of clinical research is the development of new biomaterials that aid in tissue regeneration and accelerate the healing process. Experimental studies demonstrate the effect of platelet rich fibrin (PRF) on tissue regeneration techniques, optimizing the repair process; and can be used in injectable form (i-PRF). The objective of this research was to determine the cellular, morphology and protein characterizations  involved in the repair process and to evaluate its interaction with a bioceramic material from an in vitro model. Blood samples were collected from 15 human volunteers for comparison of the cellular constituents between i-PRF and peripheral blood. Samples of i-PRF and blood clots were cultured in vitro for 10 days. The supernatant of the samples was collected at intervals 1h, 8h, 24h, 3 days and 10 days for quantification of PDGF-AB and VEGF growth factors by ELISA immunoassay. Samples were histologically treated for morphological characterization and submitted to the immunohistochemical methodology for the labeling of IL-10, Osteocalcin  and TGF-β proteins. The gene expression of collagen transcription factor type 1 was investigated. Samples of i-PRF mixed with granular bioactive ceramics (HA / β-TCP) were prepared to evaluate the interaction between these compounds through SEM. A higher concentration of leukocytes (8,124 ± 1,419) and platelets (3.96x105 ± 0.72) in i-PRF compared to peripheral blood (p <0.001) was observed, with a higher proportion of lymphocytes (60%) in i- PRF. Higher levels of VEGF were released from the blood clot (1933± 704) compared to i-PRF (852 ± 376; p <0.001); no differences were observed between PDGF-AB levels (p>0.05). Immunohistochemical assay demonstrated staining  for TGF-β, IL-10 and Osteocalcin in the i-PRF group. RT-PCR analysis showed increased gene expression of collagen type 1 in the i-PRF group (p>0.05) . Microscopically, the formation of large platelets and fibrin clusters and a fibrin network in a three-dimensional spatial and homogeneous distribution were observed. SEM images showed good integration between the ceramic granules and the fibrin mesh formed by i-PRF. In describing and analyzing the morphological and biological properties of i-PRF in vitro, we can better understand its clinical effects and develop guidelines for future therapeutic applications.

     

11
  • LYANE RAMALHO CORTEZ
  • FIXATION OF THE PHYSICIAN IN PRIMARY HEALTH CARE – A PERSPECTIVE FROM THE PROGRAM TO VALUE PRIMARY HEALTHCARE PROFESSIONALS


  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • LUIZ ROBERTO AUGUSTO NORO
  • PAULO DE MEDEIROS ROCHA
  • CLAUDIA SANTOS MARTINIANO SOUSA
  • WASHINGTON LUIZ ABREU DE JESUS
  • Data: 16 août 2018


  • Afficher le Résumé
  • The present study not only analyzed factors that led physicians to migrate from the Program to Value Primary Healthcare Professionals (PROVAB) to the More Physicians for Brazil Project (PMM), opting to continue as Primary Health Care (APS), but also aimed to identify the perception of users, managers and supervisors regarding the profile and work of physicians, gathering which factors were important for individual and collective care. It used a mixed methodology when contemplating qualitative and quantitative aspects in order to potentialize the diagnosis and to approach the researched phenomenon. Secondary data from the First Impressions Report (RPI) were used by physicians when they arrived at PROVAB. The Iramuteq software was used to analyze these data. To analyze the qualitative data collected from six focus groups, the content analysis technique was used, identifying the respective categories of thematic analyzes. Upon arriving at PROVAB, the doctor identified that the access of the user was hampered by an agenda organization that prioritized free demand and care by type of illness and life cycles, with a loss in the identification, listening and reception of the users' health needs. There were difficulties related to lack of material, inadequate infrastructure conditions and a routine of overloading health workers. In the training of these doctors there was a gap in the graduation course related to the APS, and the year of formation at PROVAB was configured as an aggregator of these competences, providing professional experience with autonomy, ability to work as a team and to work in permanent education in their territories qualifying care in APS. The physicians identified a differentiated posture regarding the listening and follow-up of users with a strong bond and commitment to care in the territory. It was verified that the access to health services and actions is influenced by the presence of the physician and the model of attention with emphasis on the health needs of the users and in the health promotion and education from the reception and humanized access, increasing the resolving capacity and the completeness of care. The management was a facilitator of this qualification process triggered by the program, and aspects such as sensitivity, flexibility and search for permanent qualification were observed, which allowed the promotion of a live work in an act, produced by the knowledge and know-how social workers involved in the Primary Health Care workforce. Finally, despite all the challenges faced by PROVAB throughout its course, it has had a unique contribution to the qualification of APS, contributing to the birth of a new logic of medical education in Brazil. Its effective contribution to the consolidation of the PMM, which is still under construction, is a major movement of resistance to the disarticulation and deconstruction of the SUS that happens daily in our country.

12
  • DÉBORAH KAROLLYNE RIBEIRO RAMOS LIMA
  • BETWEEN WIRES AND KNOTS: AN ANALYSIS OF THE PSYCHOSOCIAL CARE NETWORK IN NATAL/RN

  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • JACILEIDE GUIMARAES
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • ANA KARENINA DE MELO ARRAES AMORIM
  • JOÃO BOSCO FILHO
  • NADJA CRISTIANE LAPPANN BOTTI
  • Data: 29 août 2018


  • Afficher le Résumé
  • This thesis is at the interface between collective health and mental health. Its research object is the Psychosocial Care Network (RAPS, as per its Portuguese acronym), analyzed from the viewpoint of its organizational logic and having as a guiding axis the articulation between the services comprising it. It is broadly aimed: to analyze the RAPS Natal/RN, considering the care in the territory and its modes of articulation; and specifically: to draw up a network design, relating the municipal installed capacity, the current care flows and the intersectoral partnerships directly related to the line of care in psychosocial care; to understand the modes of articulation between the services comprising it, considering the continuity of care in the territory; to propose strategies to enhance this network of care, based on loco-regional specificities. This is a qualitative research guided by the Complex Thought, with Morin’s orientation, as an understandable lens of reality and of the phenomenon in question. In order to collect data, we moved through the health services comprising the various points of care in the RAPS Natal/RN, and also performed focus group sessions with directors, workers and users of the visited health services, totaling 22 subjects. It was approved by the Research Ethics Committee of the Onofre Lopes University Hospital of the Federal University of Rio Grande do Norte (HUOL-UFRN), on April 3rd, 2017 – CAAE 65226817.5.0000.5292 and opinion 1.997. The results were built from the corpus originating from the transcripts of the focus groups, and divided into two categories of analysis, namely: 1) From the tangled wires to the basting of a network –  which consists of the presentation of the RAPS Natal/RN from the graphic viewpoint and regarding the characteristics of community-based mental health care developed in the municipality; 2) Concerning the articulation of the RAPS: relinking wires and knots, basting the network – where we will discuss the strategies adopted by actors, services and sectors to promote interconnections that foster the continuity of mental health care in the territory. Still in the second category, problems are debated evidenced in the local scenario and that have direct or indirect implications for the articulation of the RAPS and for the continuity of the care in territory and that are denominated like the "nodes of the network". In short, we recognize in the local scenario more the existence of a continuum between services than of an RAS proper. We call attention to the relationship of recursion that we judge to be established between care in the territory and the articulation of RAPS. So, care based on specialty, medicalization and fragmentation - as evidenced by the research - is the product and producer of a network that articulates in a timely manner, in a fodder triggered by labels and intersubjectivities. We are betting on the trinity of "integrality-sharing of care-intersectoriality" to extrapolate flows of labyrinth assistance towards the realization in RAPS territory

13
  • ISABELLE MARIA MENDES DE ARAÚJO
  • Vulnerability in Enviromental Health: the case of impementation of automobile complex in the Goiana territory, Pernambuco, Brazil.

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • CRISTINA LARREA KILLINGER
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • IDE GOMES DANTAS GURGEL
  • LUIZ ROBERTO AUGUSTO NORO
  • Data: 12 sept. 2018


  • Afficher le Résumé
  • This research was based on the reflection on the integrated approach of Collective Health and the environmental issue, considering the scenario of the coming of global industrial enterprises in the brazilian local context, related to the productive restructuring of capital, with evidence for the automotive sector. The general objective of the study was to analyze the environmental health vulnerability resulting from the installation of the FCA / Jeep automotive complex in the city of Goiana, Pernambuco, especially on the Acaú-Goiana extractive reserve, with emphasis on the health, economic, political-social, cultural and environmental aspects of the territory, for the construction of a predictive matrix of vulnerabilities. Specifically, we involve discussing the environmental issue in the field of collective health in a theoretical-conceptual articulation with the field of political ecology; to understand the socio-sanitary profile of Goiana/PE in the pre and post installation of the automotive pole, as well as the impacts on the water resources of the territory and the consequences for human health; to construct an explanatory matrix based on the FPSEEA (Force-Pressure-Situation-Exposure-Effect-Action) framework, with systematization of indicators for the monitoring of impacts / effects on the health of the local population and the environment; in addition to analyzing the perception of the traditional extractive communities (Resex Goiana) on the dimensions of the processes of vulnerability caused by the pole, using the categories of social reproduction (ecological, biocommunal, communal-cultural, societal-economic and political reproduction). We conclude that the study on environmental health vulnerability makes it possible to understand the aggravations in local contexts, nature, social relations and singular and communitarian life, resulting from the inequities and injustices caused by the power of Capital and the State to the detriment of social groups historically destitute and socioecological systems.

14
  • ANA CLARA SOARES PAIVA TORRES
  • MANDIBULAR COMPLETE DENTURE SUPPORTED BY IMPLANTS: FACTORS INFLUENCING THE SUCCESS OF REHABILITATION

  • Leader : ADRIANA DA FONTE PORTO CARREIRO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • ANDRE ULISSES DANTAS BATISTA
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • JULIANA APARECIDA DELBEN
  • PATRICIA DOS SANTOS CALDERON
  • Data: 14 sept. 2018


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  • The long-term success of implant-supported dentures is one of the supports to indicate these treatments. The aim of this study was to evaluate a set of variables that may interfere in the success of rehabilitation. The masticatory performance (PM) (granulometric method - X50 identification), oral health impact on quality of life (OHIP-EDENT), occurrence of complications and the health of the peri-implant tissues of patients with overdentures supported by 2 implants with a bar  clip retention system (G1) or with fixed complete dentures on 4 or 5 implants (G2), opposed to conventional complete denture. The peri-implant tissues were evaluated for mini-pillar biofilm (BMP), probing depth (PS), bleeding, inflammation, keratinized mucosa (MC), mucosal margin level (NMM) and bone loss (PO). Follow-up times were 3 (T1), 12 (T2), 24 (T3), 36 (T4) and 48 months (T5) after rehabilitation. To analyze the statistical differences in each group and over time the main tests used were Mann-Whitney, Wilcoxon and Friedman, with a significance level of 5%. The sample consisted of 45 patients. Among them, 32 have HE-type implants. The others (n = 13) had Cone Morse implants (CM). The mean age of the total sample, including patients with HE and CM, is 63.02 years (± 8.27). Rehabilitation groups were as follows: G1 with n = 25 (55.6%) and G2 with n = 20 (44.4%). Of these, 34 (75.6%) were women and 11 (24.4%) were men. The results showed that mean values of total OHIP increased from 5 to 6.60 and 6.71 in 2 (n = 33), 3 (n = 30) and 4 years (n = 28). In those times the same thing happened with the X50 that increased from 5.68 mm to 6.25 mm and 6.33 mm. In T4, G1 had a greater negative impact of oral health on quality of life in terms of physical dysfunction (p = 0.019). Overdenture patients experienced worsening of PM over time (p = 0.001). Regarding the complications, it is highlighted that in G1 there are 2.28 times more chances of complications occurring. Among the HE patients BMP increased over time in G2 (p = 0.042) and was higher in G2 than in G1 from T2 through T5 (p <0.05). PS values increased in G1 over time (p <0.001) and NMM was lower in G2 than in G1 at all times (p <0.05) and PO over time increased in G2 (p <0.001) and was greater than in G1 at 2, 3 and 4 years (p <0.05). When evaluating patients with HE and CM, it was possible to notice that bleeding was greater in G2 than in G1 in T3 and T4 (p <0.05) and NMM remained lower in G2 at all times (p <0 , 05). Thus, it was concluded that both treatments resemble the impact on quality of life and masticatory performance, however, patients rehabilitated with overdentures are more prone to prosthetic failure. While patients who are rehabilitated with fixed prosthesis have less favorable peri-implant tissue conditions.

15
  • LORENA MARQUES FERREIRA DE SENA
  • Effect of different bonding protocols on degree of monomer conversion and bond strength between orthodontic brackets and enamel

  • Leader : RODRIGO OTHAVIO DE ASSUNCAO E SOUZA
  • MEMBRES DE LA BANQUE :
  • ANA CLÁUDIA MOREIRA MELO TOYOFUKU
  • CARMEM SILVA LAUREANO DALLE PIAGGE
  • HALLISSA SIMPLICIO GOMES PEREIRA
  • PATRICIA DOS SANTOS CALDERON
  • RODRIGO OTHAVIO DE ASSUNCAO E SOUZA
  • Data: 13 nov. 2018


  • Afficher le Résumé
  • Objective: To evaluate the effect of different surface treatments and polymerization protocols on the bond strength of brackets to enamel, and the degree of conversion of the bonding agents. Methods: 120 bovine crowns were embedded in acrylic resin blocks and sanded. Next, the blocks were randomly assigned into 12 groups. Metal brackets were bonded to enamel according to the "surface treatment" factor (A: Phosphoric Acid; ATxt: Phosphoric Acid + Transbond XT Primer®; Tse: Transbond Plus Self Etching Primer®; and SBU: Scotchbond Universal®) and "polymerization" factor (R20: Radii-Cal®/20 seconds; V20: Valo Cordless®/20 seconds; and V3: Valo Cordless®/3 seconds). All samples were stored for 6 months (water, 37ºC) and then subjected to a shear bond strength test (SBS). Bond failures were classified according to the Adhesive Remnant Index (ARI) and analyzed with the Kruskal-Wallis and Mann-Whitney tests (5%). Using the same factors, 120 resin discs were made to assess the degree of conversion (DC) of the monomer. Data from the SBS (MPa) and DC (%) were analyzed by analysis of variance (2 factors) and Tukey's test (5%). Results: For the SBS, the factors "polymerization" (R20=8.1B; V20=13.2A; V3=5.2C, p=0.0001) and “surface treatment” (A=3.1C; ATxt=13.6A; Tse=12.3A; SBU=6.3B, p=0.0001) were statistically significant among groups. The highest adhesion value were found for the ATxt/V20 group (22.2A) and the lowest value for the A/R20 group (1.2E). Regarding ARI, score 2 was the most prevalent in groups A, ATxt, V20 and V3, while score 4 was the most prevalent in the Tse, SBU and R20 groups, with no significant difference between them (p=1.0).  Regarding DC, the factors "polymerization" (R20=66.6A; V20=58.4B; V3=45.1C, p=0.0001) and "surface treatment" (A=52B, ATxt=59.7A, Tse=51.4B, SBU=63.8A, p=0.0001) were statistically significant. Conclusions: Tse was more sensitive to the variations in polymerization protocols than the other surface treatments. Treatment A did not present suitable bond strength or degree of conversion.

16
  • GIOVANNA DE FATIMA ALVES DA COSTA BORGES
  • IMPACT OF AN ADDITIONAL POLISHING METHOD ON PHYSICAL, MICROMORPHOLOGIC AND MICROTOPOGRAPHIC PROPERTIES OF BULK FILL COMPOSITES

  • Leader : BONIEK CASTILLO DUTRA BORGES
  • MEMBRES DE LA BANQUE :
  • ALEX JOSE SOUZA DOS SANTOS
  • BONIEK CASTILLO DUTRA BORGES
  • CLAUDIA TAVARES MACHADO CUNHA
  • ISABELA PINHEIRO CAVALCANTI LIMA
  • JOSE RENATO CAVALCANTI DE QUEIROZ
  • Data: 12 déc. 2018


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  • The aim of this study was to evaluate the surface roughness, wettability, compactness, mapping of chemical elements, 3D microtopography and micromorphology of bulk fill composites after additional polishing. The specimens were prepared from bulk fill (Filtek Bulk Fill Tetric N-Ceram Bulk Fill Opus Bulk Fill X-tra Fil) and conventional composites (Filtek Z250 XT, Grandioso, Tetric N-Ceram, Vittra APS), and randomly distributed in 3 groups (n = 10): without finishing and polishing, finishing and polishing with Astropol, additional polishing with Astrobrush (Astropol + Astrobrush). The surface roughness (Ra) and contact angles were measured using a profilometer and adapted goniometer, respectively. The 3D microtopography was evaluated using atomic force microscopy (AFM), while the micromorphology and the compactness, through scanning electron microscopy (SEM). The mapping of chemical elements was evaluated using (SEM / EDS - X-ray Dispersive Energy Detector). The roughness and the contact angle were analyzed by 2-way ANOVA and Tukey's test (p <0.05); other variables were descriptively analyzed. All the composites involved in this study had a superficial layer rich in dilute organic matrix, a subsurface layer rich in particles of smaller dimensions. Additional polishing step reduced surface roughness of Filtek Bulk Fill resins, Vittra APS, Tetric N-ceram Bulk Fill and X-trafil resins, increased the contact angle value of the X-tra Fil and decreased the Filtek Z250 XT. In the analyzes for 3D microtopography and micromorphology, smoother and uniform surfaces were observed in all a composites. The elements: Carbon (C), Oxygen (O), Silicon (Si) were present in all composite resins. Fluorine (F) was detected only in the Tetric N-ceram, Tetric N-ceram Bulk Fill. Only X-tra Fil did not present zirconia (Zr). Barium (Ba) was detected in Filtek Bulk Fill, TetricN-ceram Tetric N-ceram Bulk Fill, X-tra Fil, but absent in Vittra APS, Opus Bulk Fill and Grandiose. Titanium was found only in Opus Bulk Fill and tungsten only in Filtek Bulk Fill. Additional polishing step improved the surface properties of the composites studied.

17
  • FRANCISCA SUELI MONTE MOREIRA
  •  

    Use of drugs for elderly people in the elderly in long-term care institutions
     
     
     
  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • DJANILSON BARBOSA DOS SANTOS
  • JULIANA MARIA GAZZOLA
  • MARIA ANGELA FERNANDES FERREIRA
  • MARIANA MARTINS GONZAGA DO NASCIMENTO
  • RAND RANDALL MARTINS
  • Data: 17 déc. 2018


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  • The rapid growth of the Brazilian elderly population has been accompanied by a greater burden of diseases, an increase in the use of health services and an increase in the demand for Nursing Home (NH). The elderly are more susceptible to the occurrence of adverse events due to physiological changes related to aging that may influence the pharmacokinetics and pharmacodynamics of the drugs. The present study has as main objectives to verify the prevalence of potentially inappropriate drug use (PIM) for the elderly and the associated factors, as well as to evaluate the changes in the occurrence of PIM over time. The first stage of the study (study 1) follows a cross-sectional design and used baseline data from the study "Human Aging and Health: the reality of the institutionalized elderly in the city of Natal / RN", which aims to assess health / institutionalized elderly in the city of Natal / RN. The collection was performed based on the data collected in 10 Institutions of NH. Inappropriate medications were classified according to the 2015 American Geriatric Scoiety (AGS) Beers Criteria. Sociodemographic variables, related to NH and health conditions, were analyzed. Univariate and multivariate analyzes were performed between the main variable (PIM use) and the other variables. The study population consisted of 321 elderly people, and the prevalence of 54.6% of PIP was identified. Multivariate analysis revealed that PIM use was associated with polypharmacy and dementia. The second part of the study (Study 2) followed a 24-month longitudinal with 6-month follow-up intervals. The variables and 2015 AGS Beers Criteria adopted in study 1 were maintained. The prevalence of PIM use was high in the 4 waves, with 63.4% in wave 1, 62.9% in wave 2, 69.2% % in wave 3 and 65.9% in wave 4. The classes of drugs most frequently used as PIM in all waves were antipsychotics, bezodiazepines and proton pump inhibitors. The study revealed that the use of PIP is high among NH residents, remaining high over time. The prevalence of MPI in this magnitude reveals the need to improve the quality of the pharmacotherapy of the elderly and requires actions of professionals and managers.

2017
Thèses
1
  • ARIANE SALGADO GONZAGA
  • Mechanical, thermodynamical and chemical characterization of commercial CuNiTi wires

  • Leader : SERGEI GODEIRO FERNANDES RABELO CALDAS
  • MEMBRES DE LA BANQUE :
  • SERGEI GODEIRO FERNANDES RABELO CALDAS
  • PATRICIA BITTENCOURT DUTRA DOS SANTOS
  • RENATO PARSEKIAN MARTINS
  • Data: 30 janv. 2017


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  • Introduction: CuNiTi (copper Ni-Ti) wires have indications of specific clinical use and should therefore express the mechanical and thermodynamic characteristics reported by manufacturers. With the fall of the production patent, several companies began to manufacture these wires with great variation of price, process of manufacture and possibly of quality. Objectives: In order to verify the properties of these wires, this work aims to characterize mechanically, thermodynamically and chemically CuNiTi commercial wires. Materials and Methods: The sample consisted of 40 precontoured, thermodynamic arches with addition of copper, dimensions of 0.017 "x 0.025" with Af temperature of 35°C, from 5 manufacturers, American Orthodontics® (G1), Eurodonto® (G2), Morelli® (G3), Ormco® (G4) e Orthometric® (G5), 8 wires of each one. The wires underwent a standardization test of their dimensions, tensile tests, MEV-EDS and differential scanning calorimetry (DSC) test. Due to the small variability inherent of the mechanical tests in wires, parametric tests (ANOVA OneWay and Tukey post test) were used, considering a significance level of 5%. Results: All wires presented standardized dimensions of 0.017 "x0.025". In the tensile test, all presented superelastic behavior with SE rate higher than 8 and the following means of force plateau - G1 36,49N; G2 27,34N; G3 19,24N; G4 37,54N; e G5 17,87N. In the DSC assay, the means of Af for G1 (29.40°C), G2 (29.13°C) and G3 (31.43°C), had p>0.05 relative to each other. G4 (32.77°C) and G5 (35.17°C) presented statistically significant differences between themselves and among the other groups, with p <0.05. MEV-EDS assay for all samples presented Ni, Ti, Cu and Al in different concentrations. Conclusion: All wires have superelastic behavior. G5 wires were the only ones having an Af temperature similar to that indicated by the manufacturer. G5 and G3 showed the lowest plateau means during deactivation. Cu is fundamental to stabilize the TTRs, however in non-equiatomic alloys a higher concentration of Al seems to be fundamental to raise the transition temperature.

2
  • GLEYSSON MATIAS DE ASSIS
  • BIOMECHANICAL ANALYSIS OF RESISTANCE OF SAGITAL OSTEOTOMY OF RAMO AFTER DIFFERENT MANDIBULAR MOVEMENTS: IN VITRO STUDY

  • Leader : ADRIANO ROCHA GERMANO
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • ALESSANDRO COSTA DA SILVA
  • PETRUS PEREIRA GOMES
  • Data: 10 févr. 2017


  • Afficher le Résumé
  • The objective of this study was to evaluate the resistance of fixation in the sagittal split ramus osteotomy (SSRO) when performing great advances (12 mm), as well as the influence of the movement associated to the occlusal plane clockwise rotation, using a biomechanical test. Plates and screws of the 2.0 mm system. Two types of advancements were used (6 and 12 mm), using polyurethane hemimandibulars, with standardized SSRO, divided into 5 groups: G1 (Test 1) - linear advance of 6 mm / 1 plate and 4 screws; G2 (Test 2) - linear advance of 12 mm / 1 plate and 4 screws; G3 (Test 3) - linear advance of 12 mm / 2 plates and 8 screws; G4 (Test 4) - advance of 12 mm, associated to the clockwise rotation of the occlusal plane / 1 plate and 4 screws; G5 (Test 5) - 12 mm feed rate, associated with the plane clockwise rotation / 2 plates and 4 screws. The hemimandibules were submitted to a vertical compressive load in the first molar region and the applied force in Newtons was recorded in the displacements of 1mm, 5mm and 10mm, as well as the maximum force applied between 1 and 10mm. Using a 95% confidence interval, the means of strength were obtained and the groups were compared to each other. The statistical tests used were Kruskal-Wallis * for the analysis of all groups and Mann-Whitney ** for the comparison of two groups separately. The results showed that the G3 group presented higher strength means (p <0.001 *), being therefore the most resistant between the groups. When only 1 plate was used for the fixation of the hemimandibula, at the 12 mm advance, the clockwise rotation was more resistant than in the linear movement, at the displacements of 1, 5 and 10 mm (p <0.05 **) , Not resulting in statistical difference only in the maximum displacement (p = 0.112 **). In a large advance (12mm) there was a significant loss of resistance in the FIR, being necessary to compensate this situation with use of more fixation and the clockwise rotation in these cases also added resistance in the OSRM, only in cases where a single plate is used.

3
  • CAMILA DE OLIVEIRA PICADO NOGUEIRA
  • EFFICACY EVALUATION OF FIBERGLASS POSTS DISINFECTION METHODS AND ITS INFLUENCE ON BOND STRENGTH.

  • Leader : MARILIA REGALADO GALVAO RABELO CALDAS
  • MEMBRES DE LA BANQUE :
  • MARILIA REGALADO GALVAO RABELO CALDAS
  • ISAUREMI VIEIRA DE ASSUNCAO
  • BRUNNA MOREIRA DE FARIAS PEREIRA
  • Data: 17 févr. 2017


  • Afficher le Résumé
  • The purpose of this study was to evaluate which disinfection method is more effective on the decontamination of fiberglass posts, and to observe if these methods influence on the bond strength of the post to the root canal. Sixty-four fiberglass posts were used, being 32 serrated type, and 32 smooth type. They were submersed in solution containing 5mL of suspension of  E. faecalis. Then, were divided in 8 groups in which each one remained for 5 minutes in its respective disinfection agents (Chlorhexidine 2%, phosphoric acid 35% and alcohol 70%), with the exception of the control group. Afterwards, the number of colony forming units per milliliter (UFC/mL) of E. faecalis was determined. Then, 64 selected bovine roots were patronized and restored with fiberglass post. Passed 7 days of cementation, the roots were sectioned perpendicular to the long axis, and the specimens were submitted to the adhesive resistance test (push-out). Anova 2 factors and Tukey post test were used as statistical method to analysis of the results obtained. The analysis of UFC/mL did not present any growing/development of E. faecalis coloniesThe evaluation of bond strength, considering the type of post, presented significant statistical difference only on control and alcohol groups, in which the type smooth post showed greater results. On the evaluation of the surface treatment factor, is noted significant difference on the smooth post group which did not receive any type of treatment, the one which was cleaned with phosphoric acid or chlorhexidine, and the one which was cleaned with alcohol, obtaining so the greater values of bond strength. There was not any significant statistical difference on the serrated posts groups. Therefore, antimicrobial substances commonly used on the disinfection of fiber glass post are, in fact, efficient at the elimination of E. faecalis colonies. However, there is some influence on the bond strength between the fiber glass post groups previously disinfected with those irrigators. Alcohol 70% presented greater results of bond strength when applied to this purpose.

4
  • RENATA SUELLEN GALVÃO DA SILVA COSTA
  • DENTAL CLARIFICATION WITH 38% HYDROGEN PEROXIDE INDUCES INFLAMMATION AND EXPRESSION OF IL-1β, TNFβ, FGF2, GPX AND OSTEOCALCIN IN RATS PULP

  • Leader : BONIEK CASTILLO DUTRA BORGES
  • MEMBRES DE LA BANQUE :
  • BONIEK CASTILLO DUTRA BORGES
  • EMANUELLE DAYANA VIEIRA DANTAS
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • Data: 20 févr. 2017


  • Afficher le Résumé
  • The presence of inflammatory infiltrate in pulp after dental bleaching has been
    increasingly discussed, however, it is not known which mediators participate in this process. This study analyzed the inflammatory infiltrate and expression of interleukin (IL)-1β, tumor necrosis factor (TNF) β, cyclooxygenase (COX)-2, macrophage migration inhibitory factor (MIF), fibroblast growth factor (FGF)2, superoxide dismutase (SOD), glutathione peroxidase (GPX), inducible nitric oxide synthase (iNOS) and osteocalcin, due to bleaching procedure in teeth of rats with 38% hydrogen peroxide gel. Forty incisors of male Wistar rats were bleached, and forty unbleached incisors were used as controls. Two bleaching sessions were performed in two test groups, with an interval of 7 days between them. At each session, animals were anesthetized, and two bleaching gel applications of 15 min each were made. Half of animals were sacrificed after 24 h of last session, and the other half after 10 days. Teeth were processed for histological analysis, confocal immunofluorescence of osteocalcin and immunohistochemistry of IL-1β, TNFβ, COX-2, MIF, FGF2, SOD, GPX and iNOS. Data were statistically analyzed using Mann-Whitney test, Student&#39;s t test (p&lt;0.05) and in a descriptive way, respectively. There was a statistically significant difference between bleached groups and control groups (p&lt;0.05), when condition of pulp tissue 
    and stage of inflammation were analyzed, however, there was no significant difference between bleached groups, despite the 10-day interval for analysis. There was immunoreactivity only in bleached groups for IL-1β, TNFβ, FGF2 and GPX. There was no immunoreactivity for SOD, MIF, COX-2 and iNOS in any groups. The bleached group 10 days showed a statistically superior value of osteocalcin when compared to groups bleached 24 h and control 10 days (p &lt;0.05). In conclusion, tooth bleaching causes damage to pulp in rats, and IL-1β, TNFβ, FGF2, GPX and osteocalcin act as mediators in this process. 
5
  • RIVANALDO ADRIANO HOLANDA ALVES
  • PHYTOCHEMICAL SCREENING AND ANTIMICROBIAL ACTION IN VITRO OF Spondias mombin L. EXTRACT FRONT To Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli

  • Leader : RUTHINEIA DIOGENES ALVES UCHOA LINS
  • MEMBRES DE LA BANQUE :
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • FABIO ROBERTO DAMETTO
  • CICERO ROMAO GADE NETO
  • Data: 22 févr. 2017


  • Afficher le Résumé
  • Brazil is a country of great ethnobotanical diversity and due to the immense therapeutic potential of
    our flora, there is a notorious need for further research on new species of plants, especially ones such 
    as the Spondias mombim L that reportedly present antimicrobial, anti-inflammatory and anti-oxidant effects.
    This paper was based on various databases ( ) and gathers information from previous researches regarding 
    the Spondias Genus (with emphasis on the Spondias mombim L Species, which belongs to the Anacardiaceae 
    Family) analyzing its botanical characteristics along with its ethno-pharmaceutical and chemical properties. 
    Popularly known as ‘Hog Plum Fruit’ the Spondias mombim L species is frequently prescribed in the 
    ethnomedicine as a abortifacient, vermifuge, diuretic, snakebite venom antidote, antidepressant, 
    emetic substance as well as a treatment against throat and oral cavity inflammations, prostatitis, herpes labialis, 
    urethritis, cystitis,conjunctivitis, venereal diseases and tumors. As to its chemical properties, it is important to 
    indicate the existence of carotenoids, vitamin A, tannins, saponins, resins, sterols, triterpenes, flavonoids, 
    alkaloids, anarcadic acid, 2-O-caffeicol - (+) - alloxycytic acid, chlorogenic acid butyl ester, as well as ellagic 
    acid and quercetin. Despite its proven properties, further research is still necessary especially around the 
    plant’s antimicrobial effect on both exogenous and endogenous microorganisms that inhabit the oral cavity 
    and other parts of the human organism, allowing for future production of clinically applicable substances. 
    It was observed that the extract S. mombin L. showed activity on the tested microorganisms, 
    showed anti-adherent effect on all the bacteria tested, revealed that the crude extract was remarkable 
    already in the first two hours of contact with the samples tested .
6
  • MARIANA LINHARES ALMEIDA
  • EVALUATION OF THE INFLUENCE OF DIABETES MELLITUS TYPE II ON THE EFFECTIVENESS OF BASIC PERIODONTAL THERAPY ABOUT THE CLINICAL AND MICROBIOLOGICAL PARAMETERS OF 
    SALIVA IN PERIODONTAL DISEASE
  • Leader : BRUNO CESAR DE VASCONCELOS GURGEL
  • MEMBRES DE LA BANQUE :
  • ANA RAFAELA LUZ DE AQUINO MARTINS
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • LUCIANA MACHION SHADDOX
  • Data: 23 févr. 2017


  • Afficher le Résumé
  • The relationship between periodontal disease and diabetes mellitus is bidirectional, however, there is a need for more evidence regarding basic periodontal treatment on clinical aspects and the presence of bacteria in patients with and without diabetes. The aim of the present study was to evaluate the influence of type II diabetes mellitus (DM) on the efficacy of basic periodontal treatment in the clinical and microbiological parameters of saliva. Fifty-one patients were treated between 30 and 65 years old, who were evaluated before the periodontal treatment, at six and 12 months after its conclusion. In the periodontal examination, the Bleeding Probing Index (BOP), Visible Plaque Index (VPI), Probing Depth (PD), Gingival Recession (GR) and Clinical Attachment Level (CAL) were evaluated. The blood parameters evaluated were fasting glucose and glycated hemoglobin (HbA1C) only for the group with diabetes (GD). Saliva samples were collected before each periodontal examination. Quantification of the bacterial species Treponema denticola, Porphyromonas gingivalis, and Tannerella forsythia by real-time PCR was performed. The results showed that the clinical parameters showed a significant improvement for BOP, VPI and PD for both groups, whereas for CAL only for GD (p = 0.023). There were no differences between the group with diabetes and no diabetes in the evaluated periods, only the species Tanerella forsythia presented a statistically significant difference in the 12-month period (p = 0.004), with a higher median for the GND group. In the intragroup analysis, only GD presented statistical difference for all species evaluated (p <0.05), but Porphyromonas gingivalis increased after 12 months. Diabetes did not influence the response of periodontal treatment, both groups showed improved clinical parameters, and the diabetic group had a lower amount of bacteria over time.

7
  • PAULO RAPHAEL LEITE MAIA
  • OCCURRENCE AND FACTORS ASSOCIATED WITH CAROTID ARTERY CALCIFICATIONS DETECTED BY DIGITAL PANORAMIC RADIOGRAPHY IN CHRONIC RENAL PATIENTS ON HEMODIALYSIS.

  • Leader : HALLISSA SIMPLICIO GOMES PEREIRA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • PATRICIA TEIXEIRA DE OLIVEIRA
  • SANDRA REGINA TORRES
  • Data: 7 mars 2017


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  • Chronic Kidney Disease (CKD) leads to a progressive and irreversible loss of renal function. The final and most severe stage of the disease often requires supportive therapy through hemodialysis. Patients with CKD have a higher risk of developing cardiovascular complications, such as atherosclerosis. This condition is characterized by the accumulation of fatty plaques in intima of blood vessels, which when calcified can be observed on panoramic radiographs requested by dental surgeons. The aim of this study was to evaluate the occurrence of detectable carotid artery calcifications (CAC) in digital panoramic radiography of patients with CKD undergoing hemodialysis and, in addition, to investigate possible associated factors. The clinical data were obtained from the records of the Nephrology sector of the Onofre Lopes Hospital while the panoramic radiographs were collected from the database of the Department of Dentistry of UFRN. The exam´s analyses were done by a single radiologist, who investigated the presence of CAC in these individuals. Of the 309 patients in the study, 15.9% had calcifications. To verify the associations between the dependent variable, presence of CAC, and the independent variables of the study, Chi-square and Fisher's exact tests were used. After analysis, a statistically significant association (p≤0.05) was observed between the presence of these calcifications and the following independent variables: age, sex, hemodialysis time, diabetes mellitus and presence of styloid process elongation. The results of this research revealed a high occurrence of CAC in patients with CKD on hemodialysis when compared to the general population, and this presence was statistically associated with female sex, advanced age, longer time of hemodialysis, presence of diabetes mellitus and Presence of elongation of the styloid process.

8
  • ISABELE DOS ANJOS PAIVA DOS SANTOS
  • PATIENT SAFETY AND NURSING WORK PROCESS

  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • JACILEIDE GUIMARAES
  • EDILMA DE OLIVEIRA COSTA
  • JOÃO BOSCO FILHO
  • Data: 14 mars 2017


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  • The provision of a quality service should be associated with a commitment to patient safety and for this it is imperative to understand the complexity of the health work process. Nursing, in particular, is a profession that encompasses all aspects related to the quality of health services, since it develops care activities and management, besides taking care of the patient for a longer time and with more proximity than other professionals Involved in this work process. For this reason, it is important to reflect on the work process in order to point the way to safe and quality health care. In this sense, the present research aims to analyze the relationship between patient safety and nursing in a hospital environment based on the reflection about their work process. It is a qualitative research of the descriptive and exploratory type, using semi-structured interview techniques. Twenty nursing professionals were interviewed in a large public hospital, 5 nurses and 15 nursing technicians. The information was analyzed in light of the thematic analysis technique, included within the content analysis method. After organizing the nuclei of meanings for the semantic similarities, two categories were constructed: Category 1: Considerations about patient safety and Category 2: Relationship between nursing and its work: about the work process. It can be inferred that the quality of nursing care has a strong impact on patient safety, which points to the need to understand the relationship between nursing and its work as an important aspect for coping with problems of unsafe care Insecure.

9
  • ALINE SILVA DE OLIVEIRA
  • PERMANENT EDUCATION FROM THE PERSPECTIVE OF PROFESSIONALS OF THE MOBILE EMERGENCY CARE SERVICE

  • Leader : MAISA PAULINO RODRIGUES
  • MEMBRES DE LA BANQUE :
  • ANTONIO MEDEIROS JUNIOR
  • JOÃO BOSCO FILHO
  • MAISA PAULINO RODRIGUES
  • Data: 17 mars 2017


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  • The study aimed to analyze the perception of professionals about permanent education in the Mobile Emergency Care Service of a municipality in the State of Rio Grande do Norte. It is a qualitative study that used the thematic analysis of content for data analysis. From the interviews with 29 professionals emerged three categories: Perception on Permanent Education in Health; Effectiveness of Permanent Education and Educational Processes. The speeches of professionals, for the most part, reveal that Permanent Education is seen as synonymous with Continuing Education. In addition, the multiple employment links, associated with scarce staff meetings, among others, were identified as difficulties to implement permanent education. The reported facilities were the gratuity of the courses, good infrastructure and flexibility of days and times of educational processes. Regarding educational processes, it was observed that the professionals were satisfied and that these not only contribute, but also apply to the reality of the day to day work. However, it was identified that the choice of educational processes is carried out in a hierarchical way, without the direct participation of the workers. In addition, various educational needs were reported by practitioners. Thus, the study made it possible to identify that permanent education should be present in this scenario as a strategy for qualifying practices in emergency and emergency services. It is necessary not only to understand the concept of permanent education, as well as its implementation in daily practice, which represents a challenge in this scenario.

10
  • GISELLE FIRMINO TORRES DE SOUSA
  • OROFACIAL CLEFTS IN BRAZIL: PREVALENCE AND FACTORS ASSOCIATED WITH DELAY OF  PRIMARY SURGICAL TREATMENT UNDER THE BRAZILIAN HEALTH SYSTEM

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • CLELIA DE OLIVEIRA LYRA
  • MARIA ALICE PIMENTEL FUSCELLA
  • Data: 7 avr. 2017


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  • This study aimed to identify the prevalence of cleft lip and palate in Brazil and the effect of demographic factors and municipal socioeconomic indicators on the delay of primary surgical treatment of this morbidity in the Brazilian Health System (SUS), from 2009 to 2013. An ecological study was conducted using data from the Department of Informatics of the Brazilian National Health System (DATASUS) and the Human Development Atlas of the United Nations Development Program (UNDP). We included live births with cleft lip and palate from the 5,565 Brazilian municipalities in the years 2009 to 2013, registered in the National Live Birth System (SINASC), and patients with cleft lip and palate that performed lip and / or palate surgeries that appear in the records of the Hospital Information System of the Ministry of Health (SIH / SUS), in the same period. Prevalence rates of cleft lip and paltate for Brazil were calculated for five natural geographic regions and for the 27 federative units, with relation to each year and to the five years of the study. The delay was evaluated using the ages recommended by the American Cleft Palate-Craniofacial Association (12 months for lip surgeries and 18 months for palatal surgeries). The data regarding the delay were analyzed through descriptive statistics, bivariate analysis, prevalence ratios and multilevel Poisson regression with robust variance. For all tests, a significance level of 5% was adopted. The results showed that the average prevalence of cleft lip and palate in the period was 5.86 per 10,000 live births, with important regional differences and between federative units. The prevalence of delay for lip primary surgeries was 66.4% and for palatal surgeries was 71.2%. The North and Northeast regions had the worst percentages of delay. Non-whites had a 27% greater probability of delay in cleft palate surgeries and 40% in cleft lip surgeries. The multilevel analysis identified the influence of race and of Municipal Human Development Index on the delay of primary lip surgery, and of Municipal Human Development Index and of Gini index on the delay of the palate surgery. The importance of social determination in the delay to primary surgeries of cleft lip and palate was evident.

11
  • JUSSARA LISBOA VIANA
  • Public Health; Job Market; Graduation Public Health; Study of Graduates; Professional Practice.

  • Leader : ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • CIPRIANO MAIA DE VASCONCELOS
  • LILIANA SANTOS
  • Data: 20 avr. 2017


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  • The performance of the Public Health Professional was associated, historically, with some training graduated in another profession, initially in Medicine and, later, these professionals worked with post-graduation in Hygiene or Public Health.. After the 1960s there was a multiprofessional insertion with graduates from areas such as engineering, nursing, pharmacy and veterinary medicine, who could also act as Public Health Professional when they obtained the postgraduate degree in the area of Preventive and Social Medicine. In the late 1970s, "Collective Health" emerged as a field of knowledge and health practices articulated to the political project of Sanitary Reform. The Movement of Sanitary Reform contributes to the creation of the Unified Health System, which the need for professionals with skills in Public Health to work in this universal health system. Some Public Health debaters argue that the SUS needed a new strategic actor to drive the changes not reached during the Sanitary Reform, since only the postgraduate in the area was not enough. In this sense, the Graduate Courses in Public Health were created. At the Federal University of Rio Grande do Norte (UFRN), this degree is called Management in Health Systems and Services (GSSS). This research has the objective of analyzing how the insertion (space, time and conditioners) and professional performance of graduates of GSSS Graduation of UFRN, specifically: Identify limits, potentialities and strategies in the professional insertion of graduates; Identify the activities developed by the graduates at work; Analyze the challenges for graduates in the world of work; Analyze the conditioning factors of this Graduation in the professional insertion and performance; And to know the coordinators' vision on the creation and training of the GSSS Graduation. The study is linked to the notion of researchers involved and to reflexivity as a research concept. The data were produced using the technique of Focal Group and individual interview with a semi-structured script, both of which were completed with graduates of Graduation in the period of 2012.2, 2013.2 and 2014.2, being also interviewed coordinators of said Course. Regarding the insertion, the challenges were categorized in: remuneration; Recognition of the profession in Public Health; Professional identity and party-political interference, the potentialities were categorized in: training; Core knowledge and practice of Public Health and the scenario of the Municipal Health Department of Natal, And the strategies for insertion are actions of a collective and individual character that aim to disseminate the Graduation and its professional and advance in the process of regulation of a new profession. Regarding the professional performance, the activities developed in the work by the graduates are described, these are associated with the training line of Planning, Management and Evaluation in Health using the terms planning, monitoring, coordination, evaluation and execution of public policies. These professional activities reinforce the idea of the Graduation of GSSS in forming Health Managers to act in the health services and systems. However, we consider that the performance of a generalist in Public Health will go beyond this area. The challenges for the new professional in the world of work influence the mental health of the graduates and were categorized in: Relations of power, autonomy and clientelism; Institutional culture, the crystallized vision of the professionals, the friction between the new and the experienced and the centralized management model; Employment relationship, for not recognizing the professional qualification in Public Health and precariousness of work. Regarding the influence of the training in the professional insertion, the Curricular Internship stands out, since the student expands its knowledge and gives professional visibility to itself by the bond with the other professionals. Moreover, the graduates bring their positive and negative criticism of the training that influenced their professional performance. Due to the formation and professional performance, the Graduates of the Public Health Graduation are new actors with different identity Public Health Professionals with postgraduate degrees and coming from other graduations.

12
  • HELLYDA DE SOUZA BEZERRA
  • EVALUATION OF THE SPACE DISTRIBUTION OF THE REASON FOR ONCOT CYCLOPATHOLOGY AND MORTALITY FOR CANCER OF THE UTERINE COLUMN

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • EDNA MARIA DA SILVA
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • IRIS DO CEU CLARA COSTA
  • MARIA DJAIR DIAS
  • Data: 2 juin 2017


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  • Cervical cancer, despite being preventable, is one of the most common types of neoplasms, being considered a serious public health problem for Brazil and the world. Knowing this, it is necessary to trace the cervical cancer by increasing the coverage of the Pap test in women. The general objective of the study is to evaluate the spatial distribution of the oncotic cytopathology ratio and Cancer Mortality of the Uterine Cervical Cancer in Brazil, in the historical series from 2008 to 2014. This is an epidemiological, retrospective, observational and ecological study, c'arried out in the 161 intermediate regions of urban articulation in Brazil. The study variables were the ratio of cytopathological examinations of the cervix, cervical cancer mortality rate, schooling, Gini index and HDI. As a data source, the Cervical Cancer Information System (SISCOLO), the Mortality Information System (SIM) and the United Nations Development Program (UNDP) were used. The Statistical Package for the Social Sciences (SPSS), version 22.0, serial number 10101141047 was used for the statistical analysis of the data and cross-checking of some variables. The variable ratio of cervical cytopathological examinations and cervical cancer mortality rate were calculated in a descriptive way, through which mean, median and standard deviation were identified. The student's t test and the Chi-Square test were also performed between the intermediate regions of urban articulation. For the spatial analysis and construction of the maps, the TerraView program, version 4.2.2 was used.  For the bivariate spatial analysis, the Geoda program, version 1.2 was used. It can be observed that the averages of the ratio of Brazil, in all the years involved, were above the cutoff point of the indicator studied, corresponding to 0.33, being the year of 2009 the highest average of the ratio, falling from year 2012. The mortality rate averages, starting in 2011, began to grow, reaching the highest average in 2014 (7.6). Regarding the cross-over of the oncotic cytopathology ratio and mortality rate, in most regions, they were classified with low ratio and high mortality. Regarding spatialisation, the lowest averages of Pap smears were found in the North and Northeast regions, where they formed clusters in Bom Map, with the classification of "Low-Low" in most municipalities. As for mortality, there is a worse average also in the North and Northeast regions, forming "Alto-Alto" clusters in some municipalities of the Northeast. In the bivariate analysis, it was observed from the dispersion graphic and the spatialization graphic that the cytopathological ratio is influenced by the schooling, Gini index and HDI. It is concluded that Pap smear coverage in Brazil is influenced by the socioeconomic inequalities of the country, being smaller in the less developed regions, such as North and Northeast, and in better conditions, in the South and Southeast.

13
  • ALANNY FERREIRA MOUTINHO
  • Prevalence and Factors Associated with the non-realization of Pap smear in Brazilian women

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • MATHIAS WELLER
  • Data: 19 juin 2017


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  • Cervical cancer is curable in almost all cases and can be easily detected through the Pap smear, which is the screening method for cervical cancer and its precursor lesions. Therefore, the present study aimed to identify the prevalence and factors associated with the non-realization of Pap smear in Brazilian women.  For this purpose, the database obtained through the National Health Survey was used in Brazil in 2013. For statistical tabulation and analysis, Stata® 14 software was used to verify the Prevalence Ratios with respective Confidence Intervals of 95% and p values, using the Poisson regression in the multivariate analysis. The results were negative for Pap smear after 3 years white and non-white women with no schooling, non-white with a primary level of education, age between 60-64 years, self-perception of regular health, poor / very poor, without health insurance, who does not live with a spouse, is a smoker, does not practice any physical activity, and has multimorbidities. Papanicolaou never had a negative association with white and non-white women with no schooling, white and non-white women with a primary level of schooling, non-white with a mean level of 25-29, 30-39 and 60-64 years, without occupation, without a health insurance, who does not live with the spouse, is a former tobacco smoker, drinks moderately and was diagnosed with 3, 4 or more chronic diseases. For the Papanicolaou never performed because of difficulty of access to health services, there was a negative association between white and non-white women with no schooling, non-white with a fundamental level, ages between 25-29 and 30-39, without health insurance, who did not live with the spouse and belongs to the social strata D-E. And for personal reasons white and non-white women with no schooling, not white with basic and average levels of schooling, ages 25-29, 30-39 and 60-64, without occupation, who do not have health insurance, do not live with the spouse, is a smoker and former smoker of tobacco and does not perform enough physical activity.

14
  • EVA EMANUELA LOPES CAVALCANTE FEITOSA
  • CONCEPTIONS AND PRACTICES OF THE HEALTH SURVEILLANCE: THE VOICE OF THE MANAGERS

  • Leader : MAISA PAULINO RODRIGUES
  • MEMBRES DE LA BANQUE :
  • MAISA PAULINO RODRIGUES
  • SORAYA MARIA DE MEDEIROS
  • GISETTI CORINA GOMES BRANDÃO
  • Data: 26 juin 2017


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  • The Health Surveillance is part of the proposals framework of the Health Unique System (Sistema Único de Saúde, SUS), contemplating the actions of the Epidemiological Surveillance, Sanitary Surveillance, Environmental Surveillance, Occupational Health Surveillance, focusing in disease prevention and the health promotion. This research aims to analyze conceptions and practices of the Health Surveillance, from the conceptions of the managers. For the study, we used a qualitative approach, carried out with 11 managers, from the interviews with semi-structured script, carried out during October and December 2016. From the material collected, two corpus were constituted to analysis. The first was submitted to the program Iramuteq and was generated three categories. The second corpus was submitted the analysis of the Laurence Bardin's content and was originated two thematic categories: “Conceptions about the Health Surveillance” and “Practices of the health in Surveillance”, discussed from the theoretical framework. The results demonstrate that the managers understand Health Surveillance as an indispensable model to SUS, in addition pointing to the realization of the collective planning. However, there are contradictions when the managers mentioning that the developed actions are disarticulated between the sectors and, thus, they need the implementation of strategies capable of the impacts about the effectiveness of the articulation. There are also, reports of precarious working conditions, insufficient human resources and fragility in the worker health sector. From this reality, it’s necessary the support of the supporters, managers, professionals and social control around a broad debate, with the perspective of promoting new knowledge and actions capable of transforming the current model of care in relation to Health Surveillance.

15
  • TATIANA DE MEDEIROS CARVALHO MENDES
  • TEACHING-SERVICE-COMMUNITY INTEGRATION FROM THE PERSPECTIVE OF THE MEDICAL, NURSING AND DENTISTRY TEACHERS

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • IRIS DO CEU CLARA COSTA
  • ANTONIO MEDEIROS JUNIOR
  • EDNA MARIA DA SILVA
  • LENILMA BENTO DE ARAÚJO MENESES
  • Data: 4 juil. 2017


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  • The teaching-service-community integration proves to be an important strategy to achieve the changes outlined by the Brazilian Curriculum Guidelines (DCN, as per its acronym in Portuguese) for the training of health professionals able to meet the social demands. This study was intended to analyze the teaching-service-community integration from the perspective of the Medical, Nursing and Dentistry teachers from the Federal University of Rio Grande do Norte (UFRN). This is an exploratory and descriptive study, with a quantitative and qualitative approach. Data collection took place through an interview form with 106 teachers, of whom 21 were teachers from the nursing course, 56 were from the medical course and 29 from the dentistry course, all from UFRN, Natal Campus. The analysis of the quantitative data was performed taking into account the variables “gender”, “age”, “course”, “teaching time”, “period and place of practical/field classes”, using SPSS, version 22. With respect to the qualitative analysis, we used the Iramuteq software, and the interviews were analyzed in light of the Bardin’s Content Analysis. The results unveiled that, from the perspective of the interviewees, the nursing course is the one that has the training most compatible with DCN. The variable “place of work” was more prominent when we considered the training according to what is recommended by the current DCN, the use of active methodologies and the advances in the teaching-service-community interaction. The surveyed teachers recognize that the interaction contributes to the training of health professionals able to meet the social demands, in addition to providing multiprofessional and interdisciplinary experiences in real practice scenarios. Nevertheless, several challenges should be surpassed in order to ensure a quality education capable to insert the undergraduate students into the services in a context of poor infrastructure of SUS, predominant hospital-centered model, curricula fragmented in disciplines, emphasis on technical training, little appreciation and stimulation to practices outside the walls, refusal of some teachers in participating in the interaction, among others. Thus, we can highlight the need to institutionalize the teaching-service-community interaction, besides the appreciation of initiatives that foster and soften the teaching in multiprofessional and interdisciplinary activities, with a view to involving all actors – teachers, students, health professionals, users and managers, in addition to awakening the commitment of all institutions involved in changing the health training and in transforming the health care processes.

16
  • LIDIA MARIA COSTA ARAUJO MAGALHAES
  • WORKER HEALTH INDICATORS: A STUDY WITH FOCUS ON OFFICIAL EXPERIENCE AND PERIODIC MEDICAL EXAMINATION

  • Leader : FABIA BARBOSA DE ANDRADE
  • MEMBRES DE LA BANQUE :
  • IRIS DO CEU CLARA COSTA
  • EDNA MARIA DA SILVA
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • LENILMA BENTO DE ARAÚJO MENESES
  • Data: 4 juil. 2017


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  • The Occupational Health Indicators (OHI) are relevant parameters for planning actions aimed at the surveillance on Occupational Health. In Brazil, Occupational Health and Safety (HOS) actions for federal public servants were standardized according to the Occupational Safety and Health Care Policy (PASS in Portuguese). The objective of this study is to know the indicators of the Worker’s Health focused on the Official Health Expertise and the Periodical Medical Examination (PME) of the servants of the Federal University of Rio Grande do Norte. This is an exploratory-descriptive and cross-sectional research, with a quantitative approach and a retrospective nature, with data relating to the period from 2011 to 2015, in the city of Natal/RN. As for the absenteeism due to disease, the profile of the servants licensed for health treatment was characterized by the predominance of women aged between 51 and 60 years and working at medium and elementary-level positions. Throughout the historical series, the number of lost days of work per servant and the frequency of leaves increased, although the Absenteeism Duration Index decreased and the Frequency of Workers with Medical Leave (FWML) kept stable. Regarding the causes of absenteeism, there was a prevalence of respiratory diseases (25.6%), musculoskeletal diseases (16.2%), and infectious and parasite diseases (13.0%) among the short-time leaves. Musculoskeletal diseases (18.4%), mental disorders (17.2%) and respiratory diseases (9.2%) prevailed in relation to leaves approved by means of expert evaluation. As for the adhesion of the servers to the PME, it was decreasing, with a higher percentage in the year 2012 (35.3%). During the analyzed period, 5,166 servers performed the PME and the majority (60.6%) presented non-ideal weight, 41.1% were sedentary, 33.2% had dyslipidemia, 29.0% were alcoholic, 3.2% were smokers, 5.9% diabetics, 16.4% reported high noise in the workplace, 27.8% inadequate lighting and 35.9% inadequate work furniture. In view of the results, there is need to maintain and strengthen the PASS and, consequently, to implement positive impact strategies for OHS.

17
  • LETICIA VIRGINIA DE FREITAS CHAVES
  • FLUIDS BULK FILL COMPOSITIONS VERSUS TRADITIONAL: PHYSICAL-MECHANICAL BEHAVIOR.

  • Leader : BONIEK CASTILLO DUTRA BORGES
  • MEMBRES DE LA BANQUE :
  • BONIEK CASTILLO DUTRA BORGES
  • ISAUREMI VIEIRA DE ASSUNCAO
  • ISABELA PINHEIRO CAVALCANTI LIMA
  • Data: 7 juil. 2017


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  • Objectives: To evaluate [BB1] depth of polimerization (DP), contraction strress (SC), flexural strenght (FS), elastic modulus (EM) and bond strength (BS) of three low-viscosity Bulk Fill composites resin compare as of  high-viscosity traditional composites. Methods: Three Bulk fill composites (Filtek BKF, Surefil SDR, X-tra Base) and three traditional ( Z250 XT, Grandioso, TPH3) were used. For FS/ME, 60 (n=10) bar specimens (7 mm x 2 mm x 1 mm) were prepared and evaluated with Universal Testing Machine (UTM). For DP e BS, conical cavities (n=10) were prepared in bovine dentine and restored with materials. DP was analyzed trough the ratio base/top with microhardness of surface and BS on the push-out test in UTM. SC was measured for to increment one of Bulk Fill Resins and two increments of traditional resins in UTM attached to a extensometer (n=5). The data were statistically evaluated by ANOVA 2-way/Tukey (p<0,05). Results: For EM the conventional resins show higher values compare to all the BKF resins, however for the FS they were the same, except for only the VOCO Bulk Fill that was inferior. For the PP, conventional and BKF were statistically similar. In TC and in BS the BKF were superior to conventional, also with the exception of Xtra Base Bulk Fill (VOCO), which was statistically the same as the conventional ones in the BS. Conclusion: The Bulk Fill composites resin present most of property physical and mechanical higher or similar than traditional composites, except the elastic modulus.

18
  • SAMILA NERES DE OLIVEIRA
  • Codeine / paracetamol and ibuprofen against immediate sensitivity to tooth whitening: a clinical trial.

  • Leader : ISAUREMI VIEIRA DE ASSUNCAO
  • MEMBRES DE LA BANQUE :
  • ANA KARINA MACIEL DE ANDRADE
  • ISAUREMI VIEIRA DE ASSUNCAO
  • MARIA CRISTINA DOS SANTOS MEDEIROS
  • Data: 10 juil. 2017


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  • Dental sensitivity is the main adverse effect caused by dental office whitening. The aim of the present study was to compare the efficacy of ibuprofen and codeine associated with paracetamol in the control of the sensitivity generated by dental office whitening with 35% hydrogen peroxide. Sixty patients were randomly selected and divided into three groups G1: Placebo, G2: Ibuprofen, G3: Codeine + Paracetamol. The patients were submitted to 2 whitening sessions with 35% hydrogen peroxide in 2 applications of 20 minutes each. And they took the medications 1 hour before the bleaching procedure for 72 hours (3 days). The same procedure was repeated in the second session. Data were collected using a visual analog pain scale. Statistical analyzes were performed using Assistat® software. The results showed that when comparing the three groups, the Anova generated statistically significant differences between treatments with p <0.01. It was concluded that codeine with paracetamol has an effective action to reduce the sensitivity generated by dental bleaching with hydrogen peroxide 35%.

19
  • DÉBORA MICHELLE GONÇALVES DE AMORIM
  • IMPACT OF THE ADDITION OF CALCIUM HYDROXIDE IN EXPERIMENTAL SELF-ETCHING ADHESIVES: INFLUENCE ON DEGREE OF CONVERSION AND pH

  • Leader : MARILIA REGALADO GALVAO RABELO CALDAS
  • MEMBRES DE LA BANQUE :
  • EMANUELLE DAYANA VIEIRA DANTAS
  • MARIA CRISTINA DOS SANTOS MEDEIROS
  • MARILIA REGALADO GALVAO RABELO CALDAS
  • Data: 18 juil. 2017


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  • To evaluate the effect of the addition of calcium hydroxide - Ca (OH) 2 on the neutralization of pH and degree of conversion of experimental self - etching adhesives. Methods: Four adhesives were formulated in two flasks: Bottle A, containing UDMA, HEMA, GDMA-P, TPO, DH and solvent; Bottle B: composed of UDMA, HEMA, TPO, DH. The solvents used were ethanol and water (1: 1). The concentration of Ca (OH) 2, added to flask B, in the mass fractions of 0% (control), 1%, 2% and 4% was evaluated, and the adhesives were divided into four groups (A + B0, A + B1, A + B2, A + B4). Equal volumes of bottles A and B of each adhesive were mixed and ~ 5 μ of this mixture was inserted into silicone molds to make the disks. Before polymerization of the adhesive the pH of the adhesive was measured through a pH meter. After the photoactivation, the disks (n = 5) were immersed in distilled water, and pH readings of the eluate were performed for 72h. To evaluate the degree of conversion, five samples of each adhesive were submitted to the FTIR, with attenuated total reflectance (ATR) device, before and after the photoactivation of the samples. For the photoactivation procedures, a 3rd generation LED light source - Bluephase G2 was used. The data were statistically evaluated by ANOVA 1 (degree of conversion and pH of the adhesive) and 2 factors (pH of the eluate) and Tukey's post-test (p <0.05). Results: No statistically significant difference was found between the experimental adhesives tested in the conversion test. The pH of the experimental adhesives tested were all statistically different from each other. The pH of the eluate was neutralized in the A + B2 and A + B4 groups after the immersion period. Conclusion: the degree of conversion was not affected by the incorporation of calcium hydroxide. The pH of the adhesive and the eluate was neutralized with the addition of calcium hydroxide

20
  • EVELYNN CRHISTYANN MEDEIROS DUARTE
  • Evaluation of the coronary coloration change after the pulpal revascularization technique.

  • Leader : FABIO ROBERTO DAMETTO
  • MEMBRES DE LA BANQUE :
  • FABIO ROBERTO DAMETTO
  • ALEX JOSE SOUZA DOS SANTOS
  • CICERO ROMAO GADE NETO
  • Data: 19 juil. 2017


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  • The pulp revascularization technique allows the reactivation of the root formation, however clinically the coronary discoloration it’s noted. So, the present study aimed to analyze in which stage or stages of this treatment the color change occurs. It is an experimental in vitro study where 75 bovine incisors, with n=15, was divided into 5 groups: G1- triple antibiotic paste, G2- blood, G3- WMTA, G4- control and G5- complete protocol. The color evaluation was performed with the Easyshade® device. The color was obtained through the CIE-L*a*b* parameters. The Statistical analysis was performed using the split-plot analysis of variance test, and the average value in all groups was adjusted by Bonferroni, with a significance level of 95%. For intergroup and intragroup analysis, the statistical comparisons were made through the ANOVA test with the Tukey Post Hoc. According to the multivariate comparison, considering the total average of the degree of darkening, the blood and protocol groups presented more significant darkening (p<0.05). In the intergroup analysis of 15 days to 3 months, the groups containing antibiotic, WMTA and control did not show any difference among them (p>0.05), the group containing blood presented difference to the other groups in 15 days to 3 months (p<0.05). The protocol group presented coronary discoloration in the first and third months, in relation to the other groups (p<0.05). In the intragroup analysis, the antibiotic group presented a decrease on the darkening in 15 days compared to the baseline (p<0,05) and then remained stable. The group containing blood had an increase after 15 days (p<0,05), the WMTA group presented a reductuion on the darkening after 15 days (p<0,05), and the remained stable. The protocol group, in 15 days showed lower darkening rate, after this period, which correspond to the blood addition and WMTA on the root canal, the darkening rate raised, showing variation to the baseline on the third month (p<0,01). So, it was concluded that the blood is the main cause of dental darkening.

21
  • RAFAELA ALBUQUERQUE MELO
  • Effect of different types of Temporomandibular Dysfunction treatment on pain and depression: Randomized Clinical Trial

  • Leader : GUSTAVO AUGUSTO SEABRA BARBOSA
  • MEMBRES DE LA BANQUE :
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • FABÍOLA PESSÔA PEREIRA LEITE
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • Data: 19 juil. 2017


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  • Introduction: Temporomandibular Dysfunction (TMD) is a condition of multifactorial etiology that affects the stomatognathic system, possessing, among the factors contributing to its development, biopsychosocial aspects. Thus, their initial therapeutic management should be multidisciplinary, with conservative and reversible treatments. Objective: To evaluate the effect of occlusal plaque (OP), counseling (CS) and plaque with counseling (PCS) on pain and depression symptoms in patients with TMD. Methods: Sixty patients diagnosed with TMD through RDC / TMD (Research Diagnostic Criteria for Temporomandibular Disorders) were allocated into three treatment groups (21 in PCS, 22 in OP and 17 in CS). Participants responded to the BDI (Beck Depression Inventory) and HADS (Hospital Anxiety and Depression Scale) questionnaires regarding depression and the Visual Analogue Scale (VAS) for pain and were re-submitted to RDC / TMD after therapy, With 30 (thirty) days of treatment. The data were analyzed using SPSS (Statistical Package for the Social Science) 22.0 with the Split Plot ANOVA test, with a confidence level of 95%. Results: There was a significant reduction in the depressive parameters by BDI (p = 0.002) and HADS (p = 0.008) and also pain symptoms (p = 0.001) after 30 days of treatment in all groups analyzed. However, there was no statistically significant difference between the treatment groups in the depressive parameters, either by BDI (p = 0,315) or HADS (p = 0.843) and pain (p = 0.267), showing that no therapeutic group was superior to the reduction of the analyzed parameters. Conclusion: Within the limitations of the study, it can be concluded that occlusal plaque treatments and counseling, individually or in combination, were effective in reducing pain symptoms and depressive aspects within 30 days after treatment. However, no therapeutic group was superior to the other in reducing the observed parameters

22
  • VICTOR DINIZ BORBOREMA DOS SANTOS
  • INFLUENCE OF THE MANDIBULAR PLANE MODIFICATION, MAGNITUDE AND TYPE OF MOVEMENT IN THE MECHANICAL RESISTANCE OF FIXATION IN SAGITAL OSTEOTOMY OF THE MANDIBULAR RAMUS: AN IN VITRO STUDY

  • Leader : ADRIANO ROCHA GERMANO
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • ANTONIO DE LISBOA LOPES COSTA
  • WALTER LEAL DE MOURA
  • Data: 19 juil. 2017


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  • The aim of this study was to evaluate the resistance of fixation in the sagittal osteotomy of the mandibular ramus (OSRM) when performing great advances (12 mm), as well as the influence of the movement associated with the anticlockwise/clockwise rotation of the occlusal plane , Using plates and screws of the 2.0 mm system. Two types of advances were used (6 and 12 mm) using polyurethane hemimandibulars, with standardized OSRM, divided into 7 groups: G1 (Test 1) - linear advance of 6 mm / 1 plate and 4 screws; G2 (Test 2) - linear advance of 12 mm / 1 plate and 4 screws; G3 (Test 3) - linear advance of 12 mm / 2 plates and 8 screws; G4 (Test 4) -  12 mm advance, associated with clockwise rotation of the occlusal plane (15 °) / 1 plate and 4 screws; G5 (Teste 5) - 12 mm advance, associated with clockwise rotation of the occlusal plane (15 °) / 2 plates and 8 screws;  G6 (Test 6) - 12 mm advance, associated with anticlockwise rotation of the occlusal plane (15 °) / 1 plate and 4 screws; G7 (Test 7) - 12 mm advance, associated with the counterclockwise rotation of the plane (15 °) / 2 plates and 8 screws. The hemimandibules were submitted to a vertical compressive load in the first molar region and the applied force in Newtons was recorded in the displacements of 1mm, 5mm and 10mm, as well as the maximum force applied between 1 and 10mm. Using a 95% confidence interval, the means of strength were obtained and the groups were compared to each other. The statistical tests used were Kruskal-Wallis for the analysis of all groups and the Mann-Whitney test  for comparison of two groups separately. The results showed that, according to the Kruskall-Wallis test, there were differences between groups. When only 1 plate was used for the fixation of the hemimandibula, at the 12 mm advance, the clockwise rotation was more resistant than in the linear movement, at the displacements of 1, 5 and 10 mm (p <0.05 **), Not resulting in statistical difference only in the maximum displacement (p = 0.112 **). In a large advance (12mm) there was a significant loss of resistance in the FIR, being necessary to compensate this situation with use of more fixation and the clockwise/counterclockwise rotation in these cases also added resistance in the OSRM, only in cases where a single plate is used. The counter-clockwise turn proved to be less sturdy than the clockwise rotation when fixed with one plate and more resistant when fixed with 2 plates. Both situations presented statistical significance with p <0.05. In view of these findings, it was concluded that regardless of movement, the fixation with 2 plates considerably increases the resistance to applied force.

23
  • LORENA DE SOUZA ARAÚJO
  • Evaluation of the anti-inflammatory and antioxidant activity of Olmesartan in an experimental model of oral mucositis

  • Leader : AURIGENA ANTUNES DE ARAUJO
  • MEMBRES DE LA BANQUE :
  • AURIGENA ANTUNES DE ARAUJO
  • RENATA FERREIRA DE CARVALHO LEITÃO
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • Data: 21 juil. 2017


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  • Oral Mucositis (MO) is one of the main complications involved in the treatment of cancer, especially in the head and neck region. It is an inflammation that affects a mucosa of the oral cavity and is clinically characterized by erythematous, ulcerated and painful lesions, Which can lead, in more severe cases, to an interruption of chemotherapy treatment. The aim of this study was to evaluate the effect of Olmesartan (Olme), an angiotensin II (Ang II) receptor antagonist, on oral mucositis. A pre-clinical trial was performed, in vivo, randomized, unicego, with use of control groups. 42 Golden Siriam hamsters were divided into 6 groups: Control, Mechanical Trauma, 5-FU, Olme 1mg/kg, Olme 5mg/kg and Olme 10mg / kg. In the diseased groups MO was induced on the first two days of the experiment with a chemotherapeutic, 5-fluorouracil (5-FU, 60 mg / kg day 1 and 40 mg / kg day 2). Animals were pretreated with oral Olme (1, 5, or 10 mg/kg) or vehicle (control) 30 min before 5-FU injection and daily until day 10. Cheek pouch samples were subjected to histopathologic analysis, protein/immunology analysis, and immunoistochemistry. Reverse transcriptase polymerase chain reactions (RT-PCRs) were used to quantitate expression of NF- κBp65, PI3K, ACE2, and MKP1. Inducible nitric oxide synthase (iNOS) and extracellular regulated kinase (ERK)1/2 levels were analysed with immunoblots. Treatment with 10 mg/kg Olme reduced ulceration, myeloperoxidase (MPO) and malonaldehyde (MDA) levels, cellular inflammation, o edema, and hemorrhage, leaving granulation tissue (p<0.05). The 10 mg/kg Olme treatment also reduced tumour necrosis factor (TNF)-α, interleukin (IL)-1β, and macrophage migration inhibitory factor (MIF) levels, while increasing IL-10 levels, producing great labelling expression of FGF and TGF-α, increasing expression PI3K, and decreasing expression of NFKBp65, ACE2, MKP1, and decreasing iNOS and ERK1/2 levels. Olme at a dose of 10 mg/kg prevented the mucosal damage and inflammation associated with 5-FU– induced OM, increasing granulation tissue.

24
  • ITANIELLY DANTAS SILVEIRA CRUZ
  • SHEAR STRENGTH AND DEGREE OF CONVERSION: EFFECT OF DIFFERENT PHOTOACTIVATION PROTOCOLS ON THE BONDING OF METALLIC BRACKETS

  • Leader : HALLISSA SIMPLICIO GOMES PEREIRA
  • MEMBRES DE LA BANQUE :
  • RODRIGO OTHAVIO DE ASSUNCAO E SOUZA
  • SERGEI GODEIRO FERNANDES RABELO CALDAS
  • ANA CLÁUDIA MOREIRA MELO TOYOFUKU
  • Data: 25 juil. 2017


  • Afficher le Résumé
  • Objective: To analyze the effect of different photoactivation protocols on shear bond strength (SBS) of metallic brackets bonded to enamel and the degree of conversion (DC) of an orthodontic resin using three different photoactivating devices. Methodology: The crowns of 230 permanent bovine incisors, sectioned at the cemento-enamel junction, were included in blocks of acrylic resin and randomly distributed in 23 groups (n = 10). After the surface treatment with phosphoric acid (15 seconds) and Primer Transbond XT (3M Unitek), metal brackets were bonded to the enamel with Transbond XT resin (3M Unitek) using 23 different photoactivation protocols according to the factors "photoactivator" (FlashMax P4 – RMO, Valo Cordless – Ultradent or Radii-Cal – SDI), "photoactivated faces" (center/vestibular; mesial and distal; cervical and incisal or mesial, distal, cervical and incisal) and "photoactivation time" (2 seconds, 3 seconds, 4 seconds, 6 seconds, 20 seconds or 40 seconds). The samples were stored for 4 months (distilled water, 37°C) and then the shear test (100KgF, 1mm/min) was performed. In parallel, 230 resin discs (0,1 mm thick and 5 mm diameter, on average) were made using the same 23 photoactivation protocols for DC analysis. Considering a significance level of 5%, all SBS data (MPa) and DC (%) were evaluated descriptively and through Student's T-test, Analysis of Variance (one-way ANOVA) and the Tukey test. The union failures were classified according to the Adhesive Remnant Index (ARI) and analyzed descriptively and through the Kruskal-Wallis test. Results: Of all 23 protocols, only 5 presented clinically accepted SBS values according to the literature. Considering the result of the statistical analysis for the groups where the photoactivation was performed only in the center, SBS values were significantly affected by the "photoactivator" factor (p=0.000), and Radii-Cal was the only one of the three that did not presented clinically accepted SBS values. Regarding the factors "photoactivated faces" and "photoactivation time", the Valo Cordless protocols were the only ones that presented statistically similar SBS results (p=0,230 and p=0,093, respectively). Of the groups that presented statistically significant difference (p≤0.05) regarding the factor "time of photoactivation" according to SBS, 66.6% corresponded to the protocols where only the central face of the bracket was photoactivated. When comparing the groups where only two faces were photoactivated, those in which the pair of faces corresponded to the mesial and the distal were the ones that resulted in higher SBS values, but only 1 clinically accepted against 2 of protocols where the pair corresponded to the cervical and the incisal. Concerning the DC, the result of the statistical analysis when comparing all the protocols of the three devices where the photoactivation was performed only in the center was statistically significant (p=0,000). However, considering the "photoactivated faces" factor, only the results of the FlashMax P4 groups were statistically different (p≤0.05). The Valo Cordless was the only device in which the factor "time of photoactivation" did not affect statistically means the values of the DC (p=0,968). And, similar to what was observed for SBS, the majority (66.6%) of the higher DC values when only two faces were photoactivated also corresponded to those protocols in which such faces were mesial and distal. Regarding ARI and considering all 23 protocols, there was a statistically significant difference between the scores (p=0.000), and the score 2 was the most observed in 52.6% of the sample, followed by 4 (20.2%), 5 (14.2%), 3 (12.7%) and, finally, score 1 (0%). Conclusion: The SBS of the metal brackets bonded to the enamel and the DC of the Transbond XT resin may present statistically significant differences depending on the selected photoactivating device and the bonding protocol used by the orthodontist regarding the photoactivated faces and the time of photoactivation. In addition, it’s assumed that the adhesive force between the resin and the dental enamel is greater than that between the bracket and the Transbond XT.

25
  • KEIVERTON RONES GURGEL PAIVA
  • EFFECT OF PROVISIONAL SINGLE-TOOTH IMPLANT REHABILITATION ON THE SATISFACTION AND QUALITY OF LIFE: A PILOT STUDY

  • Leader : PATRICIA DOS SANTOS CALDERON
  • MEMBRES DE LA BANQUE :
  • PATRICIA DOS SANTOS CALDERON
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • ANDRE ULISSES DANTAS BATISTA
  • Data: 25 juil. 2017


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  • Introduction: in order to fill patient expectations in single-implant treatment in aesthetic area, the subjective aspects and patient opinion must be considered. Proposition: to determine the sample size needed to evaluate the effect of provisional single-implant rehabilitation on patient satisfaction and quality of life. Methodology: the aim of this cross-sectional study was to evaluate patients who were rehabilitated with provisional single-implant crowns in the aesthetic area regarding quality of life, using two questionnaires (OIDP and OHIP-14), and satisfaction, using a visual analog scale. The evaluation was performed before and after rehabilitation with the provisional crowns. Results: the sample size of this pilot study was 10 patients, of which seven had the absence of a superior incisor. The OIPD showed that quality of life had a positive impact on all performances after rehabilitation, however two performances remained with negative impact (eating and mouth cleaning), but slightly better than baseline values. The OHIP-14 score has shown an improvement of 21% in quality of life after rehabilitation. Considering patient satisfaction, there was an improvement after the procedure in all evaluated aspects. The sample size calculation showed, for quality of life (OHIP-14), that the ideal size ranges from 25 to 529 patients. For satisfaction the ideal sample size ranged from 13 to 138, so, a minimum difference to be detected was established, equal 1.00 for quality of life and 2.00 for satisfaction, so the sample change for 11 to 54 and 16 to 62, respectively. Conclusion: the sample size of 60 patients seems to be the ideal to establish a significant difference over time, aiming to determine the effect of the provisional prosthetic rehabilitation on quality of life and satisfaction patient.

26
  • ANGÉLICA KERCYA PEREIRA DE MENDONÇA
  • Antimicrobial action of extracts of Turnera ulmifolia L. and Passiflora edulis against endogenous and exogenous bacteria in the oral environment.

  • Leader : RUTHINEIA DIOGENES ALVES UCHOA LINS
  • MEMBRES DE LA BANQUE :
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • CICERO ROMAO GADE NETO
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • Data: 25 juil. 2017


  • Afficher le Résumé
  • The chemical control of the dental biofilm acts as a coadjuvant of the mechanical control for end of maintenance and/or restoration of oral health. In this context, the phytotherapics surface with the purpose of acting as antimicrobial agents in the oral cavity. The present study aimed to evaluate the antimicrobial action of leaf and root extracts of Turnera ulmifolia L. (chanana) and Passiflora edulis leaf (passion fruit) against bacteria constituting the dental biofilm (Streptococcus mutans, Streptococcus oralis and Streptococcus Sanguinis) and opportunistic bacteria (Pseudomonas aeruginosa and Enterococcus faecalis). The Minimum Inhibitory Concentration (MIC), a Minimum Inhibitory Adherence Concentration (MIAC) and a Bactericidal Kinetics of the extracts were investigated, using chlorhexidine digluconate at 0.12% as the control. The results have been showing that, as compared to the bacterial composition of the dental biofilm, the extracts of Turnera ulmifolia L., which are more effective in their pure concentration (1: 1 crude extract). With respect to the anti-adherent effect, the root extract of Turnera ulmifolia L. showed a superior result that one presented by the extract of the leaf of the same plant, although both were lower than the results found by the chlorhexidine digluconate at 0.12%. As regards Bactericidal Kinetics, the extracts of Turnera ulmifolia L. did not present satisfactory results.

27
  • ADRIANO DE AGUIAR FILGUEIRA
  • Use of dental services and factors associated with young people in the northeast brazil
  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • SÔNIA CRISTINA LIMA CHAVES
  • Data: 26 juil. 2017


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  • The assurance of universal access defined by the Brazilian Constitution of 1988 and the recent advances achieved with the implementation of the National Oral Health Policy have brought positive results in relation to the access and use of dental services, however this increase occurred unequally between the different population groups all over the country. Although several theoretical models have been trying to explain the influence of several factors on the use of health services, important gaps still persist and require new research with different approaches to a better understanding of the relationships between the social determinants of health and the access and use of dental services. This study aims to assess the use of oral health services and the main associated factors in young people aged 17 to 21 years in the city of Sobral, Ceará, based on different methodological designs. The first design is a cross-sectional approach relating the different outcomes related to the use of dental services with individual determinants. The second one also developed a cross-sectional study, but it addressed the contextual factors and the relationships with the use of oral health services. Thematic maps were also made for a better visualization of the spatial distribution of the contextual variables and the outcomes used. The third study consisted of a cohort study, where trajectory profiles were created regarding the use of dental services and how they are related to individual factors in two different moments of life: childhood and youth. The sample for all the designs was originated from a cohort of oral health performed in the municipality of Sobral with data collected in the years 2000, 2006 and 2012. The results indicate the influence of socioeconomic factors, especially in the first years of life, in the access and use of oral health services, as well as the type of service used. The toothache at some point in life was associated with going to the dental office at some point in life and having been denied access. The presence of dental treatment needs was related to the greater use of dental services and early access to them. A non-regular visit to the dentist seems to increase the likelihood of oral problems in youth. To implement public policies that aim at a better distribution of income and social inclusion, as well as actions of promotion and prevention in oral health, can contribute to the improvement of aspects related to the use of dental services.

28
  • CAMYLA BERNARDO MEDEIROS
  • USER EMBRACEMENT TO THE ELDERLY PERSON: THE USER'S LOOK AT  PRIMARY HEALTH CARE

  • Leader : MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MEMBRES DE LA BANQUE :
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • EDNA MARIA DA SILVA
  • ROBERTA KALINY DE SOUZA COSTA
  • Data: 31 juil. 2017


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  • The welcoming of the Elderly Person in the National Health Care, is one of the National Humanization Policy guidelines, it is made by technology for the reorganization of the services, this way allowing and guarantee the universal access and humanization of the health care. This study aims to analyze the host (welcoming) in Primary Care by the elderly person's perspective, as well as to identify the elderly person's conception about the reception and to provide reflections on the welcoming. This is an analytical descriptive study composed by 30 elderly users, with the age of 60 or over, of both sexes, linked to the Hiperdia Program, and that attend the Family Health Unit of Bom Pastor, Natal / RN.

    The Ethics Committee of HUOL, with opinion n º 1,808,237, approved this research.

    To collect the data, a semi-structured interview with identification data and sociodemographic profile was used. The data was analyzed using the Bardin Content Analysis, emerging categories: Care; Access and Resolutivity. It was observed that the elderly consider the host as care and respect to the person, this conception is a broad conception, exceeding the biological view.

    In the second category, care and access to services was reported, despite the difficulties in waiting, having an appointment time scheduled, the acquisition of records, and the lack of doctors.

    Regarding the third category, it was mentioned that there is a resolution for the problems, but the long wait and bureaucratization of the health system was emphasized again and because of this, the search for private health care services has been their choice. Although, we can see advances in the SUS, and in effect in Basic Care, the study showed that the Welcoming to the elderly person still has many frailties, standing out the contradictions in the humanization of the actions in health.

29
  • AMANDA CIBELLY BRITO GOIS
  • Prevalence and associated factors with voice disorders  in elderly residents of the community

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • CYNTHIA MARIA BARBOZA DO NASCIMENTO
  • JULIANA FERNANDES GODOY
  • KENIO COSTA DE LIMA
  • Data: 3 août 2017


  • Afficher le Résumé
  • The changes that occur along the aging process are reflected in the voice, one of the fundamental elements for human communication. Voice disorders (VD) occur when the individual is unable to transmit the verbal message satisfactorily, which generates interference in physical, emotional and social capacities, reflecting a greater risk of worsening general health. In this sense, the objective of this study was to determine the prevalence and associated factors with vocal alteration in elderly residents in the community. The instrument Screening for Voice Disorders in Older Adults (RAVI) was used, whose interpretations of the results are valid and reliable for the purpose of this study. Variables related to individual socioeconomic-demographic characteristics were collected; lifestyle and general health conditions of the elderly. Data were analyzed descriptively and variables with more than two categories, dichotomized. A bivariate analysis was performed using the Pearson's chi-square test or the Fisher's exact test, and the magnitude of the association was the prevalence ratio. Poisson regression was performed, considering only the variables with a critical value of p less than 0.20. For all calculations, the level of significance was 5%. According to a quota sampling process, 463 individuals living in the city of Natal / RN, without cognitive decline, with a predominance of females and an average of 70 (± 7.74) years of age were interviewed. The prevalence of VD was 51.4% (95% CI: 46.8-55.9). The main complaints were related to the sensation of dry throat, throat coughing and throat itching. The multivariate analysis showed a statistically significant association between VD and hyposalivation, smoking, selfreported hearing loss and seeking medical or health care professionals because of VD. This study demonstrated that in the city of Natal / RN, the prevalence of VD in elderly residents in the community is high and is associated with general health, lifestyle and self-perception factors of the elderly, which leads to a decrease in communicative capacity and demand attention of managers and professionals involved with the community. The investment in strategies that minimize the negative impact of VA and its associated factors can contribute to the maintenance of vocal and communicative quality, full social insertion and better general health conditions of the elderly population

30
  • GERLAYNE BARROS DE AGUIAR
  • Use of Impression Technique to Identify Areas of Super Compression before Installation of New Complete Dentures: A Pilot Randomized Clinical Trial

  • Leader : ADRIANA DA FONTE PORTO CARREIRO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • SANDRA LÚCIA DANTAS DE MORAES
  • Data: 29 août 2017


  • Afficher le Résumé
  • The aim of this study was to identify areas of super compression by a printing technique and adjustment prior to installation can decrease ulcer frequency. The influence of this procedure on the number of ulcers after installation, patient satisfaction and quality of life were evaluated to measure the sample size. Thirty-five complete denture wearers, who sought replacement dentures because of complaints associated with them were included in the study. The participants used their current dentures for at least one year. According to the inclusion criteria, the participants were selected and randomly divided in two groups. In 15 subjects, super compression areas were identified by printing technique with fluid silicone and in these areas denture base was adjusted before installation (Test group-TG); twenty subjects received new complete dentures without adjustments before installation (Control group-CG). The number of ulcers were registered 1, 7, 15 and 30 days after installation. patient satisfaction and oral health impact on quality of life with the Oral Health Impact Profile (OHIP) were collected before and after 1 month of installation. Statistical analysis was performed to evaluate differences between groups and within each group pre-and post-treatment using non-parametric Mann- Whitney, Wilcoxon and Friedman tests. Sample size was calculated using Open Epi software. Application of the printing technique did not decrease the number of ulcers after installation of new dentures. The results for each group for the mandible showed a reduction in the number of the ulcers over the time(p<0,001). Patient satisfaction and the quality of life related oral health was improved after installation of new dentures in both groups (p2 <0,005). No difference were observed between groups when considered analised variables. Although patient satisfaction and OHIP were improved after installation of new dentures,the printing technique with fluid silicone did not improve the adaptation to new dentures. The high sample size calculated suggests the need for adjustments in the proposed thecnique.

31
  • MARIA DE FÁTIMA LUCENA DOS SANTOS
  • Management of work in the evaluation of National Program for Access and Quality Improvement in Primary Care

  • Leader : PAULO DE MEDEIROS ROCHA
  • MEMBRES DE LA BANQUE :
  • CLAUDIA SANTOS MARTINIANO SOUSA
  • PAULO DE MEDEIROS ROCHA
  • QUENIA CAMILLE SOARES MARTINS
  • Data: 29 août 2017


  • Afficher le Résumé
  • Health professionals are fundamental to the process of strengthening the
    Unified Health System (SUS) and, especially, in Primary Health Care,
    it is necessary that the worker can guarantee a continuity of actions,
    with longitudinal care. The present study analyzes the work management in APS based on data
    from the second cycle of the National Program for Access and Quality Improvement in Primary Care and its relation to the performance of the
    participating teams. The collected data were
    subjected to descriptive exploratory and inferential analysis, with a
    significance level of 5%. Pearson's chi-square tests and an adjusted
    logistic regression model was performed. There was a greater presence of precarious employment tie in small towns and the implementation of Career and
    Salary Progression Plan is still low in all regions of Brazil. However, in the calculation of odds ratio (OR) the results were not significant, which shows that there is no relation between the type of employment tie with the performance of the teams participating in the program.

32
  • CÁSSIA RENATA DE FIGUEIRÊDO RÊGO
  • The occlusal splint, manual therapy and counseling are effective in reducing the pain and anxiety of patients with temporomandibular disorders? Randomized clinical trial.  

  • Leader : ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • MEMBRES DE LA BANQUE :
  • ALFREDO JÚLIO FERNANDES NETO
  • EDUARDO JOSÉ GUERRA SEABRA
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • Data: 29 sept. 2017


  • Afficher le Résumé
  • Introduction: Anxiety is considered a relevant psychosocial factor in the multifactorial etiology of temporomandibular dysfunction (TMD). Aim: To determine the effect of treatment with occlusal splint (PO), manual therapy (TM), counseling (AC) and the association of occlusal splint + counseling (PAC) in the measurement of pain and anxiety in patients with TMD. Methods: A randomized clinical trial was conducted with 89 patients from the Integrated Center for the Care of Patients with Stomatognathic Device Disfunction (CIADE), diagnosed with TMD through RDC / TMD (Research Diagnostic Criteria for Temporomandibular Disorders) and divided into four groups of treatment: PAC (n = 25), PO (n = 24), TM (n = 21) and AC (n = 19). Participants were assessed before and after 1 month of therapy for pain, anxiety and TMD diagnosis. Pain measurement was done according to a visual analogue scale (VAS). To assess anxiety, three questionnaires were used: the Hospital Anxiety and Depression Scale (HADS), the Beck Anxiety Inventory (BAI) and the Trait-State Anxiety Index (IDATE-T and E). The data were analyzed using SPSS (Statistical Package for Social Science) 22.0 with the Split Plot ANOVA test, with a confidence level of 95%. Results: Among the participants, there was a predominance of females (82.1%, n = 72) and the mean age was 28 years (± SD = 9.34). The four groups obtained a significant reduction (p <0.001) in the pain variable after 1 month of treatment. The evaluation of anxiety, made with three different questionnaires, showed that there was reduction of anxiety symptoms after 1 month for all groups. However, this reduction was only statistically significant when evaluated over time, HADS (p <0.001), BAI (p <0.001), IDATE-T (p = 0.006), and therefore, there was no significant decrease in symptoms among different treatment groups. Only for the evaluation of state-anxiety by the IDATE-E, no significant reduction was found between the groups (p = 0.068) nor over time (p = 0.760). Conclusion: The results of this study showed that the therapies used were effective in reducing pain and anxiety symptoms in patients diagnosed with TMD. However, no group was superior to the other in reducing the studied variables.

33
  • YRIU LOURENCO RODRIGUES
  • BIOMECHANICAL ANALYSIS IN DIFFERENT EXTENSIONS OF CUSTOM TEMPOROMANDIBULAR PROSTHESES

  • Leader : JOSE SANDRO PEREIRA DA SILVA
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • BRUNO ALEXANDRE PACHECO DE CASTRO HENRIQUES
  • JOSE SANDRO PEREIRA DA SILVA
  • JULIO CESAR MATIAS DE SOUZA
  • Data: 29 sept. 2017


  • Afficher le Résumé
  • When the surgical treatment of temporomandibular joint replacement is indicated, customized prostheses vary in design and extension in order to provide a proper rehabilitation to the patient. However, there is a great lack of information in the literature regarding the understanding of biomechanical behavior and stability when the dimensions of TMJ prostheses vary. The present study aimed to investigate the biomechanical influence of the increase of the size of custom temporomandibular prostheses, through the Finite Element Method. From a computerized tomography, a 3D computational model of the mandible was generated. This model was replicated and underwent three different progressive resections, which were rehabilitated with custom temporomandibular prostheses, based on TMJ Concepts®. The models that underwent resection were rehabilitated with a custom temporomandibular prosthesis, based on TMJ Concepts®. Thus generating three experimental models (MIM, MLO and M3M) plus the intact mandible (MC). Based on the geometries generated, four models of finite elements were created, aiming to mimic a real condition. The models were considered isotropic, homogeneous and linearly elastic. Using virtual simulation software, the actions of the main muscular forces acting on the mandible were reproduced, and an analysis of the distribution of stress and strain on the adjacent bones of the prosthesis, opposite condyle to the prosthesis, personalized prosthesis, and on fixation screws were performed. It was possible to observe that there was an increase in von Mises equivalent values in the adjacent bones and in the opposing condyles, after the installation of the prostheses. However, these values remain similar between prostheses. Stress concentrations in adjacent bones and prostheses occurred in the region around the screws, and the latter had the highest stress peaks ranging from 836 MPa to 13010 MPa. In the analysis of the strain distribution, it was possible to observe that there was no concentration of deformation in the opposing condyles. However, the MIM showed the highest deformation peaks in the adjacent bone and prosthesis, whereas the M3M presented the highest on the screws, reaching 9770 μԑ. The increase of the size of the customized prostheses led to the increase of the tension peaks at critical values in the bones adjacent to the prostheses and fixation screws, compromising the stability and function of the prostheses in all the experimental models, requiring then more than three fixing screws.

34
  • FERNANDA GONDIM LEMOS DE OLIVEIRA MEDEIROS
  • EFFECT OF DIFFERENT CONSERVATIVE THERAPIES ON PAIN, PATIENT QUALITY OF LIFE AND SLEEP WITH DTM. RANDOMIZED CLINICAL TRIAL.

  • Leader : ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • MEMBRES DE LA BANQUE :
  • ALFREDO JÚLIO FERNANDES NETO
  • EDUARDO JOSÉ GUERRA SEABRA
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • Data: 29 sept. 2017


  • Afficher le Résumé
  • Introduction: Temporamandibular dysfunction (TMD) can have a major impact on a patient's daily life, limiting their quality of life and sleep. In view of the variety of existing treatments, it is necessary to determine which ones inferred in these factors. Objective: To evaluate the effectiveness of different conservative therapies in the quality of life, sleep and pain in TMD diagnosed patients. Methods: The clinical trial consisted of 78 patients and distributed in four modalities: occlusal splints, physiotherapy, counseling and occlusal splints in association with counseling. The critters were evaluated by means of the Visual Analogue Pain Scale (EVA), Pittsburgh Sleep Quality Index (PSQI), World Health Organization Quality of Life (WHOQOL-BREF) and Oral Health Impact Profile (OHIP-14). Slip Plot ANOVA statistical test was used to observe the results, with a confidence level of 95%. Results: All therapy modalities were successful in TMD treatment over time with regard to pain (p <0.001), sleep quality (p = 0.003), oral health impact on quality of life (p <0.001) and quality of life in all domains (p<0.001), but there was no significant difference between therapies. Conclusion: The conservative therapies studied were effective in improving pain, quality of sleep and quality of life, however, no therapeutic group was superior to the other.

35
  • ANDRESSA DE SOUSA LEITE BISPO
  • EFFECTS OF THE SPLINT OCCLUSAL AND COUSELING ON PAIN, PSYCHOSOCIAL ASPECTS AND RELATED SLEEP IN PATIENTS WITH TEMPOROMANDIBULAR DYSFUNCTION: RANDOMIZED CLINICAL TRIAL.

  • Leader : GUSTAVO AUGUSTO SEABRA BARBOSA
  • MEMBRES DE LA BANQUE :
  • ALFREDO JÚLIO FERNANDES NETO
  • ANDRE ULISSES DANTAS BATISTA
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • Data: 2 oct. 2017


  • Afficher le Résumé
  • Introduction: Temporomandibular disorders (TMD) have a multifactorial etiology and encompass muscular, articular problems of the stomatognathic system. The literature reports that possible psychosocial impacts can be found, among them, the presence of sleep disturbances, negative influence on quality of life, general and oral health. Objective: To evaluate the effects of occlusal plaque therapy and counseling, alone or in combination, on pain, sleep and quality of life in patients diagnosed with TMD. Methods: A randomized blind clinical trial with 55 patients was performed, applying three therapies: Occlusal Plaque (PO); counseling (AC); occlusal plaque associated with counseling (PAC). Three-month follow-up was performed after the treatments to assess pain using the Visual Analogue Pain Scale (EVA), sleep quality through the Pittsburgh Sleep Quality Index (PSQI), quality of life in health with the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) and the impact of oral health on quality of life with the Oral Health Organization 14 (OHIP-14). The diagnosis of TMD was made through the Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD). The Split Plot ANOVA test was used to observe the difference between the groups over time and within the group, with a confidence level of 95%. Results: The three therapies applied in the three-month period showed significant improvement in pain (p = 0.000), sleep quality (p = 0.008) and the impact of oral health on quality of life (p = 0.000) and did not show any significant differences in general quality of life (0.118), however, the levels found did not show differences between different therapies (p> 0.05) for all indices evaluated. Conclusion: Within the limitations of the study, it can be concluded that occlusal plaque treatments and counseling, individually or in combination, were effective in reducing pain, improving sleep and the impact of oral health on quality of life, showed no significant improvement in overall quality of life. As well, no therapeutic group was superior to the other in reducing the observed parameters

36
  • MARIANA SILVA BEZERRA
  • Spatial distribution of the prevalence of food insecurity associated with the conditions of social vulnerability in Brazil

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • Data: 8 déc. 2017


  • Afficher le Résumé
  • The objective was to analyze the spatial distribution of food insecurity and its correlation with indicators of social vulnerability, socioeconomic conditions and infant mortality in Brazil, and to observe the prevalence of food insecurity according to the presence or absence of individuals under the age of 18 years in the household. Ecological study, with data from two national surveys, the Brazilian National Household Survey (2009) from the Brazilian Institute of Geography and Statistics, and Altas Brasil from the Institute of Applied Economic Research. For the bivariate analysis, we used the Moran Local spatial statistics. The highest prevalence of food insecurity occurred in the North and Northeast regions, where most households had individuals under the age of 18 years. The prevalence of food insecurity showed a negative and moderate spatial correlation with HDI (-0.643; p<0.05); positive and moderate with % of extremely poor (0.684; p<0.05), infant mortality (0.572; p<0.05), social vulnerability index (0.654; p<0.05), social vulnerability index - human capital (0.636; p<0.05); positive and strong with social vulnerability index – income and labor (0.716; p<0.05) and positive and weak with social vulnerability index – infrastructure (0.273; p<0.05). It was concluded that the occurrence of food insecurity was unevenly distributed in the Brazilian territory, in which the highest prevalence rates were found in the North and Northeast regions, especially in households with individuals under 18, where there is a lower Human Development Index and increased vulnerability associated to poor income and labor.

37
  • ISRAEL ALEXANDRE DE ARAUJO SENA
  • Effect of antimicrobial photodynamic therapy with Chloro-aluminum phthalocyanine on the clinical parameters of patients with chronic periodontitis

  • Leader : ANA RAFAELA LUZ DE AQUINO MARTINS
  • MEMBRES DE LA BANQUE :
  • ANA RAFAELA LUZ DE AQUINO MARTINS
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • MAIARA DE MORAES
  • Data: 19 déc. 2017


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  • Antimicrobial photodynamic therapy (PDTa) its  applied as an adjunct to scaling and root planing (SRP)  in the treatment of chronic periodontitis. Chloro-aluminum phthalocyanine (AlClPc), as a photosensitizing drug, has shown favorable results in clinical and laboratory studies, but no reports of its application in PDTa in patients with chronic periodontitis. Thus, the purpose of this study was to evaluate the effect of adjuvant PDTa with AlClFc on non-surgical periodontal treatment in periodontal clinical parameters of patients with chronic periodontitis.The study was characterized as randomized split-mouth double-blind clinical trial, longitudinal and prospective. Fifty-four periodontal sites were randomly distributed into two groups: 27 in the test group (SRP + PDTa) and 27 in the control group (SRP). The RACR was performed in a single session and the periodontal clinical parameters - plaque index [PI], bleeding on probing [BOP], probing depth [PD] and clinical attachment level [CAL] - were assessed at the baseline and after 3 months. The data collected were tabulated and submitted to statistical analysis with non-parametric Wilcoxon and Mann-Whitney tests, at a significance level of 5%. For the test group, there was an increase in PI (p = 0.554), whereas in the control group there was a reduction (p = 0.319). There was a reduction in the BOP in both treatment groups, with adjuvant PDTa (p = 0.003) and only RACR (p = 0.001) between T0 and T3. In the intergroup comparison for PI and BOP, there was no statistically significant difference between the groups at any of the evaluation times. In relation to PD and CAL, there was statistically significant reduction of PD and clinical attachment gain for both treatment groups (p <0.05) after 3 months of therapy. In the intergroup comparison, there was no statistically significant difference (p> 0.05) at baseline and at 3 months. Adjuvant PDTa to SRP did not provide additional benefits for clinical parameters assessed after three months of intervention.

38
  • LAYANNE CRISTINI MARTIN SOUSA
  •  
    THE HEALTH SURVEILLANCE FROM THE PERSPECTIVE OF ITS WORKERS
  • Leader : MAISA PAULINO RODRIGUES
  • MEMBRES DE LA BANQUE :
  • FRANKLIN DELANO SOARES FORTE
  • LUIZ ROBERTO AUGUSTO NORO
  • MAISA PAULINO RODRIGUES
  • Data: 20 déc. 2017


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  • Health Surveillance is characterized as an articulated set of actions focused on health promotion and disease prevention, from the point of view of integral care. The objective of this study is to analyze the Health Surveillance from the perspective of its workers using a qualitative approach. A total of 28 central-level Health Surveillance professionals were interviewed in  Natal and Rio Grande do Norte. The semi-structured interviews were carried out between November and December 2016. The material produced was analyzed using the Content Analysis technique in light of the theoretical reference of Bardin. Four thematic categories emerged: conception of Surveillance in Health; intrinsic and extrinsic articulation of Health Surveillance; Health Surveillance’s potential; and, conversely, it’s challenges. The results showed that the workers have an expanded concept of Health Surveillance, although the technician’s view is still present. Consequently, their actions developed a fragmented result, both between surveillance and health services. The workers, who have shown commitment in its functions and satisfaction, pointed out some challenges to be overcome to improve health surveillance such as: investing in diverse resources, professional evaluation and greater support on the part of management. In this process of transformation points out the necessity of reorganization of the work processes and training in health.

Thèses
1
  • JULIANA TEIXEIRA JALES MENESCAL PINTO
  • ACCESS TO HEALTH SERVICES FOR CHILDREN AND ADOLESCENTS WITH TUBERCULOSIS

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • SEVERINA ALICE DA COSTA UCHOA
  • ELISANGELA FRANCO DE OLIVEIRA CAVALCANTE
  • ARDIGLEUSA ALVES COELHO
  • RAFAEL NICOLAU CARVALHO
  • Data: 14 févr. 2017


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  • Tuberculosis is a public health problem, and in children, it is related to the bacilliferous adult, and the access to the care network is essential for the diagnosis and treatment of the disease. The objective of this study was to analyze the access to health services for people with tuberculosis under fifteen years old. This is a case study, with a qualitative approach, performed in two cities in a Brazilian state especially for tuberculosis control. Initially, the number of cases of tuberculosis in children under fifteen years old in 2014 was surveyed. Subsequently, semi-structured interviews were carried out with 11 parents of children and adolescents with tuberculosis, 11 nurses of the basic health units and 3 coordinators of the program of tuberculosis, selected in an intentional way. The interviews were recorded, transcribed and organized in Atlas Software ti. The methodological assumptions of Bardin (2011) were used to analyze the speeches. As a result, four categories emerged: the gateway to the health system; Paths traveled: the search for the diagnosis and treatment of tuberculosis; The experience of tuberculosis: factors that hindered and facilitated access to health services; The stigma and prejudice of tuberculosis in the family and the society. It is possible to identify that parents used emergency services as a gateway to the health system, showing the fragility of the family bond with primary care and the difficulty of the professionals of these services to diagnose tuberculosis in the children. The diagnosis was made in children´s hospitals, confirmed by imaging tests. This shows the lack of knowledge about tuberculosis in children during the approach of professionals and difficulty in carrying out examinations in this age group. The treatment was done in the basic health units and the monitoring by two services at the same time. The closure of the cases was hampered by the lack of information from the parents and the absence of home visits by the professionals. The access was evaluated in a positive way, in the distance from the residence to the health unit, the time spent, the availability of collective transportation, the spontaneous demand service, the assistance incentive, in the food stamps and free supply of medicines. Factors such as violence in the territory, difficulty in physical access, lack of knowledge about the organization and the hours of operation of the units were cited as barriers to diagnosis and treatment. The expenses in this process were related to transportation, food, hygiene materials, absences from parents to work, contracts of care for the child, loss of employment, routine or imaging examinations and acquisition of financial loans. The stigma and prejudice were observed in the family by professionals and the community. Being difficult to diagnose tuberculosis in children, it is necessary to investigate adults with tuberculosis, to train professionals at different levels of care about infant tuberculosis and to increase the dissemination of the disease in the most accessible media to the population. Thus, political, financial and personnel investment and an integrated and resolute health care network are necessary.

2
  • ANDRÉ IGOR FONTELES
  • Effect of transcranial direct current stimulation associated with acute physical exercise on cognitive performance, cerebral oxygenation and cardiac autonomic regulation in healthy adults: randomized intervention study

  • Leader : ALEXANDRE HIDEKI OKANO
  • MEMBRES DE LA BANQUE :
  • ALEXANDRE HIDEKI OKANO
  • EDUARDO BODNARIUC FONTES
  • HASSAN MOHAMED ELSANGEDY
  • EDGARD MORYA
  • WAGNER LUIZ DO PRADO
  • Data: 20 févr. 2017


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  • Cognitive impairment, even in the absence of dementia, is also associated with mortality, with cognitive impairment being one of the greatest challenges to public health. There is a growing interest in the effects of non-pharmacological interventions on cognitive functions. Physical exercise and transcranial direct current stimulation (TDCS) have been shown to influence brain function in improving cognitive performance by promoting an increase in blood flow and cerebral oxygenation. Therefore, the objective of the study was to analyze the effect of TDCS associated with acute physical exercise on cognitive performance, cerebral oxygenation and cardiac autonomic regulation in adults. Twenty physically active adult males were recruited for convenience. To verify the cognitive performance, the Stroop Color Test was used. The volunteers performed, on different days and random order, four encounters, being: three rectangular exercises for 30 minutes, in a mild, moderate or severe intensity and a control condition. After that moment, we had two more meetings, with the participation of all the volunteers submitted to the TDCS real session and Sham in a randomized and counterbalanced way every other day. The TDCS was applied for 20 minutes with current intensity of 2 mA, the cathode electrode was positioned in the T4 region, and the anode in the F3 region on Pre Frontal Frontal Cortex (CPDL). Brain activity was assessed from the monitoring of cerebral hemodynamics through absolute concentrations of oxyhemoglobin (HbO), deoxyhemoglobin (Hb) and total hemoglobin (Hbtot) using near infrared spectroscopy (NIRS). The two-way ANOVA (2 conditions X 3 moments) with repeated measures was used to compare the responses of cognitive performance, brain activity and HRV between conditions. The significance of the analyzes was assumed when P <0.05. Comparing the intensities of exercise vs. control, moderate and severe intensity showed a higher oxygenation indicating an increase in activity in the prefrontal cortex, concomitantly with improvement in cognitive performance. Exercise-associated TDCS increased brain activity through increased post-exercise oxygenation. However, these brain changes did not impact on better cognitive performance. On the other hand, physical exercise increased cognitive performance by decreasing reaction time and making mistakes when compared to the control condition. In addition, the exercise-related TDCS did not modulate the Heart Rate Variability (HRV). These results suggest that non-pharmacological practices of low cost, easy applicability and noninvasive can be a useful tool in public health for prevention and improvement of cognitive behavior.

3
  • ANGELICA TERESA NASCIMENTO DE MEDEIROS
  • EVALUATION OF PERTUSSIS REEMERGENCE IN BRAZIL

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • CLEONICE ANDREA ALVES CAVALCANTE
  • DIEGO BONFADA
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • MARIA ANGELA FERNANDES FERREIRA
  • MARISE REIS DE FREITAS
  • Data: 17 mars 2017


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  • Pertussis is an infectious disease, currently regarded as a reemerging infection. Factors such as decreased immunity, year following immunisation, changes in the genotype of a bacterium and increased susceptibility among young and adults are considered to have contributed to increase the disease incidence rate. Thus, this study aimed to verify the spatial distribution of confirmed pertussis cases between 2007 and 2015; to identify the patterns in the time-series of pertussis incidence rates during the period 2001 to 2015 in Brazil and to evaluate the effectiveness of pertussis vaccine in Rio Grande do Norte state. Therefore, the methodological research was divided into three parts. The analysis of the spatial distribution considered the 482 Regions Immediate Urban Articulation as unit of analysis and used the Terraview software to construct the thematic maps. In order to verify the trend in the series we chose to use the adjustment of a polynomial function in time, using polynomial regression models. To analyze the effectiveness of the vaccine, a control case study was carried out. For the case-control study, data source was available through the State's Secretariat of Health in Rio Grande do Norte, consisting of confirmed cases of pertussis from 2011 to 2014 in the whole state. The controls were the cases discarded from the same database. The results suggests that the disease has a democratic spatial distribution throughout the country, forming small clusters with high incidence rates in the urban articulation from the South and Southeast regions. It was also identified in the time-series an increasing tendency of the disease over a period of 15 years. Finally, the results indicate that regardless of vaccination status, individuals are getting sick with pertussis, which did not generate enough scientific evidence to measure the effectiveness of the vaccine. The findings suggest that aspects of vaccination need to be further investigated to ensure disease control. It is also necessary to improve the surveillance strategies to assure a reliable epidemiological representation of the disease.

4
  • IRAMARA LIMA RIBEIRO
  • Evaluation and Development of a Serious Game about Food Education for Schoolchildren

  • Leader : IRIS DO CEU CLARA COSTA
  • MEMBRES DE LA BANQUE :
  • ANDRE LUIS SANTOS DE PINHO
  • ANTONIO MEDEIROS JUNIOR
  • IRIS DO CEU CLARA COSTA
  • MICHELLE FERRET BADIALI
  • RITA DE CÁSSIA RIBEIRO DA SILVA
  • Data: 2 mai 2017


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  • Current society has been preoccupied about childhood eating habits because of the rising prevalence of overweight / obesity in this stage of life. However, in so far as children increasingly take ownership of technologies, Serious Games in the perspective of Food and Nutrition Education can contribute to the improvement of this scenario. This study aims to evaluate the perception of healthy eating by schoolchildren between 7 and 10 years of age from an electronic game developed for this purpose. This is an action research of qualitative approach and developed by the technique of participatory design and under the light of the perception of Merleau-Ponty in three steps: I. Understanding of the participants about food and interests to the game, besides testing of a paper prototype; II. Construction of the game; III. Evaluation of satisfaction and perception of the game by schoolchildren. Results of step one showed that the students' understanding of healthy foods was influenced by parents, teachers, socioeconomic factors and the media. As for the electronic game, the interviewees proposed the inclusion of the themes of physical activity and hygiene habits. The prototype test pointed to the need for improving menus and characters, as well as adapting the game script. This was materialized by the creation of the Ran-gO® game under a structure of role-playing game in which the player assumes the role of a character. In step three, the user satisfaction test demonstrated children's satisfaction as to knowledge about feeding, motivation and user experience. The need for adjustments was identified in order to reduce information overload to increase confidence. The older the child the higher was the satisfaction. However, there were difficulties of those with seven years in relation to the ability / competence to play. The perception assessed by means of interviews in the last step was associated to the nutritional quality of the food and the amount consumed by the character in the game environment, and there was contextualization of the child to its real life. The perceptive experience was related to the past and the present of the child, which can lead to habit, in a relationship with the future. Ran-gO® shows itself as a Food Education tool fruitful as what concerns informing the child about food habits to make its choices consistent with its needs.

5
  • JANUSE NOGUEIRA DE CARVALHO
  • EPIDEMIOLOGY OF MULTIMORBIDITY IN BRAZILIAN ADULT POPULATION

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • CLELIA DE OLIVEIRA LYRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • GILMARA CELLI MAIA DE ALMEIDA
  • GISETTI CORINA GOMES BRANDÃO
  • Data: 15 mai 2017


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  • The simultaneous occurrence of two or more chronic diseases in a person is called multimorbidity. Knowing the occurrence of this condition in the population has been the subject of study in recent years, since it impacts on the quality of life of the population, in addition to expanding the use and spending of health services. This study was based on data from the National Health Survey, a household survey conducted in Brazil in the year 2013 and the objective was to evaluate the multimorbidity profile of the Brazilian adult population (≥18 years) and its relations with socioeconomic, demographic, behavioral variables and health services utilization. Data from 60,202 participants were included. A descriptive analysis was performed to estimate the prevalence (%) of multimorbidity considering a 95% confidence level. In order to observe the relationship between the presence of multimorbidity and the independent variables, the multivariate analysis was performed using Poisson regression with robust variance. To observe the combinations between chronic conditions, a cluster analysis was performed. The results show a considerable number of people with two or more chronic diseases in Brazil. The prevalence of multimorbidity was 23.6% and was higher among women, in ≥60 years old (57.1%), people with low schooling (46.4%), living with partners (28.6%), living in urban areas (28.9%) and had no occupation (34.7%). The most frequent combination of diseases was hypertension with hypercholesterolemia (7.2%). The states of the southern region were more prevalent. There was a higher prevalence among ex-smokers, those who did not practice physical activities and those with obesity. The use of health services was significantly higher for individuals with multimorbidity for consultations, hospitalizations and urgent and emergency at home. Socioeconomic, demographic and behavioral aspects should be considered in the planning of health services and development of strategies for the prevention and treatment of multiple chronic diseases.

6
  • LEONIDAS DE OLIVEIRA NETO
  • nursing homes; Health of Institucionalized Elderly; Chronic inflammation; Muscular Diseases; cytokines.

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ANDRE LUIZ SILVA DAVIM
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • HASSAN MOHAMED ELSANGEDY
  • IGOR CONTERATO GOMES
  • KENIO COSTA DE LIMA
  • Data: 5 juin 2017


  • Afficher le Résumé
  • Clinical diagnosis for sarcopenia is not adapted to the conditions of the institutionalized elderly. More over, although the loss of muscle mass is determinant for the diagnosis of sarcopenia and the inflammatory state is considered a trigger for the loss of muscle mass, associated loss of fat and lean mass has been observed in sarcopenic elderly, concurring in the development of a Inflammatory state in the elderly and in the development of the theoretical construct of sarcopenia. Objective: To discuss the calculation for the diagnosis of sarcopenia in institutionalized elderly patients and to verify the association between inflammation and sarcopenia, as well as to analyze their associated factors. Methodology: Three studies were conducted in elderly people of both sexes, living in institutions of long stay in the city of Natal / RN. In study 1 (n = 219) an adaptation of the European Consensus for Diagnosis of Sarcopenia (2010) was carried out, adding elderly people with low physical and cognitive capacity. Study 2 (n = 75) found which factors are associated with sarcopenia. In study 3 (n = 187), the analysis of the conglomerates of the elderly according to their inflammatory state was performed and the factors associated with this condition were verified. Results: Inclusion of elderly individuals with low physical and cognitive status (study 1) increased the prevalence of sarcopenia by 32.2%. In study 2, the factors associated with sarcopenia were knee height, eutrophy and excess weight (according to BMI) and the ability to ambulate, developing 2.71%, 37.71%, 91.81% and 30.08% chance protection for sarcopenia. In study 3, it was possible to verify that increase of 1 unit μg / dL in LDL, HDL and triglycerides presented increase of 1.5%, 4.1% and 0.9% of the chance of inflamm-aging and elderly people aged ≥80 years ) Had an 84.9% chance of inflammation. Conclusion: Inclusion of elderly with good physical and cognitive capacity to calculate sarcopenia is valid and representative to the institutionalized elderly, presenting the nutritional, anthropometric and physical aspects as their main associated factors. In addition, no association of Inflamm-aging with sarcopenia was observed, corroborating with the construct that in sarcopenia there is no selective loss of muscle mass.

7
  • JOHNNATAS MIKAEL LOPES
  • SLEEP DISORDERS IN THE BRAZILIAN POPULATION: ANALYSIS OF FACTORS ASSOCIATED WITH THE COMPLAINTS OF INSONMIA AND SLEPPINESS, AND IMPLICATIONS IN DEATH AND CARDIO-CEREBROVASCULAR EVENTS

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ALVARO CAMPOS CAVALCANTI MACIEL
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • FÁBIO GALVÃO DANTAS
  • GRASIELA PIUVEZAM
  • LUIZ ATAÍDE JUNIOR
  • Data: 27 juil. 2017


  • Afficher le Résumé
  • The aim this study was to identify biological, behavioral and social factors associated with the presence of dyssomnias in the Brazilian population as well as their effects on the occurrence of death and cardio-cerebrovascular events. The study was developed based on three designs. The first was an analysis of cross-sectional data from the National Health Survey of 2013 that aimed to estimate association with insomnia, excessive daytime sleepiness and sleep repair function. The second design is a prospective cohort of elderly community-based adults in 2009, divided into dyssomnic exposed and non-exposed groups, to estimate their effects on mortality and cardiovascular events in eight-year follow-up. The third design consisted of a historical cohort exposed to the diagnosis of Obstructive Sleep Apnea Syndrome and non-exposed after a polysomnographic diagnosis in general population. The study was submitted to the Research Ethics Committee of Hospital Onofre Lopes, register with number 2.048.708. The results of the first study indicate approximately 28.2% (95%CI: 27.4%-29.0%) of adults and 34.1% (95%CI: 32.6%-35.7%) in the elderly had insomnia/SED. The sleep-repair function was reduced by 34.1% (95% CI: 32.6%-35.7%) in adults and 29.2% (95% CI: 27.2%-30.6%) in the elderly. There’s association between depressive symptoms (PR = 3,10, 95% CI: 2.70-3.56), emotional oscillation (PR = 2.14, 95% CI: 1.89-2.42), poor perception Of general health (PR = 2.44, 95% CI: 2.05-2.90), chronic health condition (PR = 1.57, 95% CI: 1.40-1.77) and live in urban areas (RP = 1.32, 95% CI: 1.14-1.52) with the occurrence of dyssomnias. The studies suggest that dyssomnias are very common health conditions in Brazil, related to other morbidities, aggravating them and predisposing to death.

8
  • ROSIMERY CRUZ DE OLIVEIRA DANTAS
  • Construction and validation of protocol for consultation and follow-up of hypertensive users in Primary Health Care

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • CIPRIANO MAIA DE VASCONCELOS
  • MARCELO COSTA FERNANDES
  • THEREZA MARIA MAGALHÃES MOREIRA
  • Data: 16 août 2017


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  • Primary Health Care (PHC) is the first contact with the health system, highlighting three essential functions: resolution, communication and accountability. Despite its strengthening, hospitalizations for diseases that could be controlled under its action continue to occur, such as systemic arterial hypertension (SAH), whose control is based on continuous monitoring and recording, with an evaluation of the effective of the treatment. It is justified the construction of a protocol for multiprofessional care to hypertensive patients in PHC. The purpose of this study was to construct and validate a care protocol for consultation and follow-up of hypertensive patients in PHC. It was a methodological research, using the Delphi method for validation of the construct, developed in 4 phases: 1. Preliminary reading of the theoretical references, 2. Construction of the instrument and presentation to the bench of judges, 3. Validation by Experts, 4. Reproducibility. The research involved 20 experts distributed in nine physicians and 11 nurses and 160 hypertension patients allocated for convenience. The collection took place from July / 2015 to August / 2016. The analysis was made by the Likert Scale, Index of agreement (CI) among the experts, Content Validity Index (IVC), Pearson Correlation, Kappa Coefficients (Ϗ) and Intraclass Correlation Coefficient (ICC). The study followed the recommendations of Resolution 466/2012 that deals with research with human beings and was submitted and approved by the Ethics Committee of the Federal University of Rio Grande do Norte under n°. 1.144.406. The protocol have 50 items.  The Likert Scale was> 4, the CI among the experts was 98.1%, the IVC> 0.90, Pearson's correlation was moderate to strong (p <0.001). Kappa was > 75 and ICC > 0.80. The instrument showed robust evidence of validity and reliability, as well as reproducibility, making it propitious for its use in PHC, besides being a guide for conducting and follow-up of the hypertensive client, allowing a greater dialogue between the professional and the patient. As well as a space for the registrations to happen more effectively, guaranteeing a more personalized service, focusing on the individual needs of each one.

9
  • MARIA CECILIA AZEVEDO DE AGUIAR
  • Longitudinal study of oral health conditions in nursing home residents

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ANA KARINE MACEDO TEIXEIRA
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • EUDES EULER DE SOUZA LUCENA
  • KENIO COSTA DE LIMA
  • LUIZ ROBERTO AUGUSTO NORO
  • Data: 30 oct. 2017


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  • The aim of this research was to evaluate the oral health of institutionalized elderly over
    time and the associated risk factors. Therefore, it was carried out a prospective cohort
    study in 11 Long-term Institutions for the Elderly (LTIEs) in the city of Natal (Brazilian
    Northeast), in the years of 2013 and 2017, resulting in a final sample of 124 elderly. The
    data collection included oral examination of the elderly, application of a questionnaire
    to them, consultation to the medical records and interview to the institutional leaders. A
    descriptive analysis of the variables was performed, followed by evaluation of the
    influence of the independent variables (sociodemographic, institutional, general health
    conditions and access to dental services) on the difference in the situation over time of
    the oral conditions (grouped in dimensions and, after qualitative comparison, labeled as
    &quot;worsening&quot; or &quot;stability / improvement&quot;). The bivariate analysis had significance level
    of 5%, using chi-square or Fisher&#39;s exact tests, assessing the magnitude of the effect
    through measures of relative risk (RR) with 95% confidence interval. As a result, in
    2013 the mean age of the elderly was 79.1 years (± 8.44), with an average
    institutionalization time of 4.9 years (± 5.37), the majority being female, race / white
    color, residents of ILPI non-profit. Between the two observation waves, there was
    stability in most of the parameters evaluated, but the root caries occurrence (from
    13,56% to 35,59%, p &lt;0.001) and upper and lower central sextants absence (from
    55,37% to 69,40%, p &lt;0.001) had increased, and the number of valid sextants for
    periodontal assessment (from 99 to 86, p &lt;0.05) , p &lt;0.001) and &quot;oriented&quot; cognitive
    status (from 73.77% to 51.6%, p &lt;0.001) and had decreased. The bivariate analysis
    showed that, during the cohort, there was an increased risk of worsening in the dental
    and functional dimension (35.6%) and in the periodontal dimension (66.3%) in people
    aged 60 to 79 years, in relation to those with 80 or more years. The probability of
    worsening in the periodontal dimension was 75% lower in the elderly with moderate to
    severe cognitive decline, compared to those with intact cognition or mild decline. Signs
    and symptoms of xerostomia and hyposalivation over time showed a risk of worsening
    in 82.4% of diabetics, in 58.3% in the aged with multimorbidities and in 73.1% in those
    who had last visit to the dentist for less than one year. There were no statistically
    significant associations regarding the influence of the independent variables on the
    dimensions of oral rehabilitation and on temporomandibular dysfunction. It can be
    concluded that, although there are considerable differences in the sociodemographic,
    institutional and general health conditions among the institutionalized elderly, oral
    health conditions have remained largely stable over time and are influenced only by age
    and some health conditions. The results of this research indicate the need for collective
    interventions with a view to modifying this epidemiological picture.
10
  • MARCELLO BARBOSA OTONI GONCALVES GUEDES
  • CONSTRUCTION AND VALIDATION OF A QUESTIONNAIRE FOR EVALUATION OF SOCIAL INFORMAL SUPPORT FOR ELDERLY

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • KENIO COSTA DE LIMA
  • LEANDRO DE ARAUJO PERNAMBUCO
  • LUCIANA BRANCO DA MOTTA
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 28 nov. 2017


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  • Population aging is a reality in Brazil and in the world, evidencing, besides a demographic transition, an epidemiological transition. New demands for the integral care of the elderly are made present and to be considered, the multidimensionality of health, its social aspects should also be considered in health assessment. Among social factors important for the evaluation of the elderly, Social Support, especially the informal, deserves special mention. Thus, the objectives of this study were to construct and validate a questionnaire to evaluate informal social support for the elderly. It is a descriptive, observational, quantitative type research. The project was approved by the research ethics committee of the Onofre Lopes University Hospital, and was performed between January and December 2016 in the city of Natal-RN and other locations in Brazil through face-to-face interviews with the elderly and a questionnaire with virtually the specialists. Inclusion criteria were: proven experience in the social support area (for specialists) or 60 years of age or older and have preserved cognitive ability (for the elderly). In the VC stage, was evaluated by relevance of the items according to the General Content Validity Index (IVC) and per item and panel assembly were evaluated with the observations made by the specialists. In the VPR stage, the understanding of the items by the target audience was evaluated. For factorial validity we proceeded with Exploratory Factor Analysis (AFE). For the realization of the AFE the statistical program M PLUS Version 7® was used. Variable grouping (type R) and factor extraction were performed with analysis of common factors, using oblique rotation Geomin. As criterion of exclusion of the items was adopted a reference value greater than or equal to 0.35 of factorial load and greater or equal to 0.5 of commonality per item. To determine the amount of retained factors, the criteria of own values> 1, minimum cumulative explained variance of 60% and parallel Horn analysis were observed. In the VC stage with specialists, a total of 40 interviewees were obtained, 90% were Doctors, 7.5% Masters and 2.5% Specialists. The general IVC was 0.88 and only one item had considered poor. After panel evaluation, two items were included and the others modified. In the VPR stage with the elderly, a total of 41 interviewees were obtained. After analyzing the panel of observations made by the elderly, the issues went through modifications for their improvement. A sample of 259 elderly people from the five regions of Brazil answered the questionnaire. After AFE, 4 items were excluded due to the poverty of their factorial loads and 4 factors were identified: "composition and extension of the social network", "instrumental and availability", "reciprocity and longitudinality" and "emotional support and social participation". The questionnaire showed a good relevance of the proposed items and the observations made by the interviewees allowed an approximation of the language used in the instrument, to the language used by the elderly. The instrument with 20 items and 4 retained factors presented good psychometric properties, such as: acceptable factor loads and excellent commonalities. We suggest 42 as the overall optimal cut score.

     

11
  • WILMA MARIA DA COSTA MEDEIROS
  • Analysis of the impact of traffic accidents on the self-reported health of the victim and on social security costs

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • MARIA ANGELA FERNANDES FERREIRA
  • ROSA LÍVIA FREITAS DE ALMEIDA
  • Data: 22 déc. 2017


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  • This study aimed to estimate the prevalence of traffic accidents in self-reported health (SAR) of the Brazilian population and Social Security costs. A cross-sectional, descriptive and exploratory, population-based study with data collected in 2013 by the National Health Survey (PNS) and secondary database of the Department of Information Technology of the National Health System (SIH-DATASUS) and the Ministry of Social Security (SUB-MPS); In addition, the population-based data from the Brazilian Institute of Geography and Statistics (IBGE) and the Statistical Yearbook of Social Security (AEPS), from 2007 to 2016. The relationships between TA and SAR were analyzed for reasons of prevalence and 95% confidence intervals. Traffic accidents occurred in 3.2% (~ 4.5 million individuals) of the Brazilian adult population, being more frequent among men, young adults, up to 40 years old. Among the injured young adults who suffered sequelae and / or disabilities, compared to non-injured, they reported a worse health condition, with men having a probability 1.35 (95% CI: 1.05-1.65) and women 1.60 (95% CI: 1.15-2.05). Those injured over 40 years of age, who suffered sequelae and / or disabilities compared with non-injured, reported a precarious state of health, with men being 1.40 (95% CI: 1.09-1.72 ) and women 1.41 (95% CI: 1.10-1.72). Thus, men and women who were victims of TA, especially over 40 years of age, had a precarious health self-assessment when they had sequelae and / or disabilities. The part of the research related to the analysis of the impact of TA on Social Security costs is in the execution phase.

2016
Thèses
1
  • LUCIANA MARGARIDA DE SANTANA MADRUGA
  • A integração ensino serviço no processo de formação dos graduandos em fisioterapia da UFPB

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • FRANKLIN DELANO SOARES FORTE
  • MARIZE BARROS DE SOUZA
  • Data: 4 févr. 2016


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  • O paradigma de saúde, consolidado no século passado, direcionou a formação dos profissionais de saúde, educados sob a égide do modelo de formação flexneriano, fragmentário e hospitalocêntrico. Contudo, este provou ser insuficiente para atender as demandas do Sistema Único de Saúde (SUS) e da população. Nesse sentido, as Diretrizes Curriculares Nacionais (DCN) para os Cursos de Graduação em Saúde despontam como marco normativo na proposição de um novo perfil profissional, como também na recomendação de estratégias para a reestruturação dos currículos e das práticas pedagógicas, e uma delas é a integração ensino-serviço. Portanto, o objetivo do presente estudo foi investigar o processo de formação dos acadêmicos do Curso de Fisioterapia da Universidade Federal da Paraíba (UFPB), tendo como eixo orientador a integração ensino-serviço, considerando as DCN. Para tanto, o método escolhido foi o estudo de caso, com abordagem qualitativa. A amostra foi do tipo intencional, incluindo todos os docentes do quadro permanente do Departamento de Fisioterapia da UFPB, vinculados a componentes curriculares cujos cenários de prática ocorrem na rede de serviços do SUS e com tempo de atividade superior a um ano naquele componente. A técnica de coleta de dados foi a entrevista semi-estruturada. A análise dos dados foi realizada por meio da técnica de análise de conteúdo. Foram consideradas as seguintes categorias: Formação Profissional para o SUS, A integração dos estudantes aos serviços Rede SUS, A relação teoria e prática na formação do fisioterapeuta, Parceria docente-profissional de saúde no processo de ensino-aprendizagem e Os Programas de Reorientação da Formação e sua integração com o Curso. Os resultados permitiram identificar como potencialidades no processo de integração ensino-serviço: reconhecimento da importância das atividades de integração entre a universidade e os serviços de saúde a partir da valorização da inserção do estudante na rede, da atuação conjunta com os profissionais de saúde do serviço e da oportunidade de trabalhar em equipe interprofissional; existência da Rede Escola estruturada e organizada; participação de estudantes e docentes em programas governamentais que oferecem a experiência de inserção no universo do trabalho. Como fragilidades da integração se sobressaíram: dificuldades nos processos de pactuação, planejamento e avaliação das atividades junto ao serviço; descompasso entre atividades teóricas e práticas; indefinição dos papeis do docente e do profissional de saúde do serviço no processo de formação e frágil relação dos programas de reorientação da formação profissional com as atividades curriculares do Curso. A integração ensino-serviço, como eixo orientador da análise da formação do profissional fisioterapeuta revela limites e possibilidades para uma  formação que atenda as necessidades de saúde da população. Assim, o posicionamento e as escolhas das instituições de ensino frente ao modelo assistencial exercem influência nas práticas em saúde, bem como o compromisso firmado pela gestão e serviços e a permeabilidade às instâncias de controle social contribuem decisivamente para a orientação da formação dos futuros profissionais de saúde. Logo, é indispensável o comprometimento de todos os atores envolvidos para a efetiva mudança do processo de formação e do paradigma de saúde.

2
  • ERICO GURGEL AMORIM
  • Saúde mental de sujeitos com deficiência visual sob a ótica dos determinantes sociais de saúde

  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • JACILEIDE GUIMARAES
  • ANA KARENINA DE MELO ARRAES AMORIM
  • LENINA LOPES SOARES SILVA
  • Data: 17 févr. 2016


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  • Saúde mental de sujeitos com deficiência visual sob a ótica dos determinantes sociais de saúde

3
  • ANA LUÍSA DE BARROS PASCOAL
  • EFICIÊNCIA MASTIGATÓRIA E QUALIDADE DAS PRÓTESES TOTAIS CONFECCIONADAS PELAS TÉCNICAS TRADICIONAL E SIMPLIFICADA.

  • Leader : PATRICIA DOS SANTOS CALDERON
  • MEMBRES DE LA BANQUE :
  • ANDRE ULISSES DANTAS BATISTA
  • PATRICIA DOS SANTOS CALDERON
  • RODRIGO OTHAVIO DE ASSUNCAO E SOUZA
  • Data: 7 mars 2016


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  • Os métodos tradicionais de confecção de próteses totais exigem uma ampla sequência de procedimentos clínicos e laboratoriais, entretanto, não há evidência científica de que eles produzam resultados superiores aos métodos simplificados. Objetivo: Avaliar a efetividade de uma técnica simplificada (S) para confecção de prótese total, comparando-a a tradicional (T), através da eficiência mastigatória e da avaliação da qualidade das próteses. Método: Realizou-se um ensaio clínico controlado randomizado com 50 pacientes, 25 reabilitados com próteses totais duplas produzidas pela técnica tradicional e 25 reabilitados por uma técnica simplificada. Avaliou-se a eficiência mastigatória pelo método colorimétrico com o auxílio de uma cápsula mastigatória. A qualidade das próteses foi obtida por meio do instrumento desenvolvido por Sato et al. em 1998. Resultados: 39 pacientes concluíram o estudo, sendo 18 do grupo tradicional e 21 do grupo simplificado. Não houve diferença entre os grupos para a eficiência mastigatória (p=0.835). Um paciente apresentou prótese com qualidade ruim (grupo S), nove com qualidade regular (T= 3; S=6) e 29 pacientes apresentaram próteses com qualidade boa (T= 15; S= 14), sem diferenças entre os grupos. A qualidade das próteses obteve diferença significativa para a atura do rebordo inferior (p=0.05). Conclusão: as próteses totais duplas confeccionadas pelo método simplificado foram consideradas eficazes do ponto de vista da eficiência mastigatória e da qualidade das próteses, apresentando resultados semelhantes às confeccionadas pelo método tradicional.

4
  • MONIQUE RAMOS PASCHOAL DUTRA
  • ANÁLISE ESPACIAL E TEMPORAL DA COBERTURA DA TRIAGEM AUDITIVA NEONATAL NO BRASIL (2008-2015)

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • HANNALICE GOTTSCHALCK CAVALCANTI
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 1 avr. 2016


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  • A triagem auditiva neonatal (TAN) é a primeira etapa de um programa para detecção de perda auditiva em recém-nascido, pois quando identificada e tratada precocemente minimizam as consequências da patologia. Na literatura existe um consenso quanto a universalidade da triagem, ou seja, o índice de triagens realizadas nos programas deve ser superior a 95% dos nascidos vivos. Nesse sentido, o objetivo deste estudo é realizar a análise espacial e temporal da cobertura de triagem auditiva neonatal no Brasil no período de janeiro de 2008 a junho de 2015. Trata-se de um estudo ecológico e utiliza como base o território Nacional e como unidade de análise as 161 Regiões Intermediárias de Articulação Urbana. A população de referência foram os nascidos vivos no país usuários do SUS no período de janeiro de 2008 a junho de 2015. Para o cálculo da porcentagem da cobertura da triagem auditiva neonatal foi utilizado como fonte de dados o Sistema de Informação de Nascidos Vivos (SINASC), o Sistema de Informações Ambulatoriais (SIA/SUS) e o Sistema de Informações de Beneficiários (SIB) da Agência Nacional de Saúde Suplementar (ANS). Os dados foram divididos em quatro períodos, na qual foi realizada a análise exploratória dos quatro mapas, através do programa TerraView 4.2.2. Em seguida, para o mapa mais recente, foi realizada a análise espacial estatística, por meio do Índice de Moran Global e do Moran local. A cobertura da triagem auditiva neonatal apresentou uma evolução de 9,3 para 37,2 % no período estudado.  Em 2008-2009 observa-se que a porcentagem da cobertura variou de 0,00 a 79,92%, porém a maioria das regiões obteve cobertura entre 0,0 e 20%, já em 2014-2015 a cobertura variou entre 0,0 a 171,77%, observou-se um visível aumento da porcentagem da cobertura no país e doze regiões apresentam cobertura maior que 95 %. O Índice de Moran Global teve valor de 0,397 (p=0,01), caracterizando um padrão de cluster disperso. Na análise espacial estatística observamos que a maioria das regiões são não significantes e que o estado do Rio Grande do Sul predominou o cluster Alto-Alto e algumas regiões dos estados do Paraná e São Paulo. Conclui-se que, a cobertura da triagem tem crescido ao longo do tempo, mas ainda é baixa e apresenta uma distribuição desigual no território podendo ser explicada pelas leis e políticas locais e pela disposição das diferentes modalidades de serviço de saúde auditiva no país.

5
  • AILA MAROPO ARAUJO
  • DESIGUALDADE NA MORTALIDADE POR VIOLÊNCIA EM IDOSOS NO TERRITÓRIO BRASILEIRO

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • MARIA ANGELA FERNANDES FERREIRA
  • WILTON RODRIGUES MEDEIROS
  • Data: 18 avr. 2016


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  • Este estudo objetivou investigar a distribuição espacial da mortalidade por agressão em idosos e a correlação com os determinantes sociais da saúde. Trata-se de um estudo ecológico realizado nas Regiões de Articulação Urbana do Brasil entre 2009 e 2013. Os dados foram provenientes do Sistema de Informação sobre Mortalidade, Sistema de Indicadores de Saúde e Acompanhamento de Políticas do Idoso, Instituto Brasileiro de Geografia e Estatística e Atlas de Desenvolvimento Humano, coletados entre janeiro e agosto de 2015. Os óbitos para o cálculo da taxa de mortalidade por agressão em idosos foram definidos segundo a Classificação Internacional das Doenças – 10ª Revisão (CID-10). Foi utilizado o programa Tabwin 3.2 para a coleta de dados. Em seguida, realizou-se a análise estatística com a correlação de Pearson, com um nível de significância estatística de 95%. Foram encontrados 12.600 óbitos por agressão em idosos, a maioria (85,53%) do sexo masculino, faixa etária de 60 a 69 anos (49,61%), raça/cor parda (46,39%), escolaridade de 1 a 3 anos de estudo (17,34%). O local de ocorrência foi no hospital (28%) e a principal fonte de informação foi o boletim de ocorrência (57,37%). Os tipos de causas mais frequentes foram agressão por meio de disparo de arma de fogo ou de arma não especificada (X95) (37,25%) e agressão por meio de objeto cortante ou penetrante (X99) (22,95%). A taxa de mortalidade por agressão em idosos nacional foi de 9,97 por 100.000, as regiões sul e sudeste foram as maiores: 18,33/100.000 e 18,42/100.000. Dentre as Unidades da Federação, foram: Roraima (23,51 por 100.000), Rondônia (22,90 por 100.000), Alagoas (22,11 por 100.000), Acre (20,88 por 100.000) e Mato Grosso (20,20 por 100.000). Das Regiões de Articulação Urbana, as maiores taxas foram: Uruguaiana (59,87 por 100.000), Curitiba (47,75 por 100.000), São Félix do Araguaia – Confresa – Vila Rica (44,32 por 100.000), Macaé (42,40 por 100.000) e Marabá (41,91 por 100.000). Na análise de correlação de Pearson, as variáveis com significância estatística e correlação fraca foram: índice de Gini (r=0,394, p<0,001), proporção de idosos residentes em domicílios na condição de outro parente (r=0,222, p<0,005), razão de dependência de idosos (r=-0,399, p<0,001), proporção de idosos que vivem em domicílio adequado (r=-0,147, p<0,06) e mortalidade da população em geral por agressão (r=0,518, p<0,001). As altas taxas de mortalidade por violência em idosos são explicadas pela estrutura social, econômica e de sistemas políticos no território brasileiro que geram iniquidades sociais, onde a violência está arraigada a essa estrutura atingindo toda a população do país.

6
  • NAYARA PRISCILA DANTAS DE OLIVEIRA
  • CAPACIDADE FUNCIONAL DE MULHERES SUBMETIDAS AO TRATAMENTO DO CÂNCER DE MAMA

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • DANIELA MENDES DA VEIGA PESSOA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • TATYANA MARIA SILVA DE SOUZA ROSENDO
  • Data: 20 avr. 2016


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  • O câncer de mama apresenta altas taxas de incidência e atualmente observa-se aumento considerável na taxa de sobrevida, de modo que a qualidade desta sobrevivência passa a ser considerada uma importante questão de saúde pública. O objetivo do estudo foi verificar a prevalência de incapacidade funcional e seus fatores associados em mulheres sobreviventes ao tratamento do câncer de mama. Trata-se de um estudo transversal, realizado com 101 mulheres residentes no município de Natal-RN com diagnóstico de neoplasia maligna da mama, que foram submetidas ao tratamento oncológico há no mínimo um ano e que ainda permanecem em acompanhamento clínico na Liga Norte Riograndense contra o Câncer. O estudo foi composto por duas fases de coleta de dados, realizadas com o acesso aos prontuários das pacientes e com entrevistas individuais. A capacidade funcional foi aferida por meio do instrumento Disabilities of the Arm and Shoulder (DASH). Coletaram-se também variáveis relacionadas às características socioeconômicas, hábitos de vida, condições de saúde, histórico ginecológico e obstétrico, características clínicas do tumor e abordagem terapêutica. A análise bivariada foi realizada por meio do teste teste Qui-quadrado de Pearson (Exato de Fisher). A análise multivariada foi feita por meio da Regressão de Poisson com variância robusta. Considerou-se o nível de confiança de 95%. A idade média das mulheres incluídas no estudo foi de 56,19 anos (±10,6), com renda média mensal de 3,88 (±4,5) salários mínimos e com acesso ao serviço de saúde público predominante (50,5%). Em sua maioria, as pacientes foram submetidas à abordagem cirúrgica conservadora (53,5%). A prevalência de incapacidade funcional foi de 22,8% (IC95%: 13,9-31,6). A capacidade funcional mostrou-se associada de maneira estatisticamente significativa à idade e ao tipo de acesso ao serviço de saúde. Pode-se concluir que as pacientes mais jovens sofreram maior impacto do tratamento do câncer de mama na funcionalidade quando comparadas às mulheres mais idosas. Quanto ao acesso ao serviço de saúde, as mulheres que receberam acompanhamento clínico público apresentaram maior ocorrência de incapacidade funcional, o que aponta para a necessidade de serviços de saúde mais organizados na sua rede assistencial, menos burocráticos e efetivamente resolutivos, minimizando os impactos do tratamento oncológico nas condições de vida e saúde das sobreviventes do câncer de mama.

7
  • LUIZ EDUARDO LIMA DE ANDRADE
  • Evolução da cultura de segurança em hospitais brasileiros após a implantação do Programa Nacional de Segurança do Paciente

  • Leader : ZENEWTON ANDRÉ DA SILVA GAMA
  • MEMBRES DE LA BANQUE :
  • HELAINE CARNEIRO CAPUCHO
  • MARISE REIS DE FREITAS
  • VIVIANE EUZEBIA PEREIRA SANTOS
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 13 mai 2016


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  • Introdução: A promoção de uma Cultura de Segurança do Paciente (CSP) nas organizações de saúde tem sido recomendada como uma prática que contribui para a redução do risco de danos desnecessários associados ao cuidado de saúde, porém não há evidências das intervenções em saúde pública que devem ser implantadas. O sistema de saúde brasileiro regulou uma série de medidas para este objetivo, porém sua efetividade ainda não foi avaliada. Objetivo: Analisar o efeito do Programa Nacional de Segurança do Paciente (PNSP) na Cultura de Segurança do Paciente. Método: Trata-se de um delineamento quase-experimental com abordagem descritivo-analítica. A CSP foi avaliada em três hospitais com diferentes perfis, três meses antes (n=215) e quinze meses após (n=450) a implantação do programa nacional de segurança do paciente. Utilizou-se um instrumento validado e adaptado à realidade brasileira (Hospital Survey On Patient Safety Culture). A evolução da CSP foi avaliada por meio de 14 indicadores simples e 2 compostos. Resultados: A CSP teve evolução positiva de forma consistente após a implementação do PNSP. Os hospitais melhoraram a CSP em 14 dos 16 indicadores avaliados, que incluem 11 das 12 dimensões avaliadas, a Porcentagem de Respostas Positivas total, a média da nota para a segurança do paciente e o índice de CSP. O hospital que apresentou maior melhoria foi o estadual seguido do federal e privado, isto demonstra que o PNSP foi um indutor da homogeneização dos serviços prestados no Brasil, pois esta ordem era inversa do nível de cultura antes do PNSP. Conclusão: O estudo evidencia uma melhoria consistente da CSP em hospitais após o PNSP, apontando para a efetividade da regulação nacional externa, que por sua vez aparentam ser moduladas pela variabilidade do contexto interno.

8
  • ADRIANA TORQUATO DA SILVA RINGEISEN
  • JUDICIALIZATION HEALTH AND MEDIATION: PRACTICES AND PERCEPTIONS ABOUT THE EXPERIENCE "SUS MEDIATED" IN CHRISTMAS.

  • Leader : ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • ELIANA COSTA GUERRA
  • ALBA MARIA PINHO DE CARVALHO
  • Data: 30 mai 2016


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  • In Brazil the twenty-first century twenty-seven years after the promulgation of the Constitution, is still challenging the achievement of fundamental social rights, where par excellence, is the right to health. The growing demand of citizens for full health care promised by the Constitution of 1988 highlighted the difficulties between the constitutional promise and the political, administrative and financial capacity of the Brazilian State to fulfill it. Citizens who do not find the answer to your attention needs actions and health services networks seek, through the judiciary intervention, the solution to your problem, which has resulted in a phenomenon called "Legalization of Health." Parallel to this phenomenon other situation was confirmed: the difficulties of the justice system in dealing with social rights. The model of justice has to be incompatible with the urgent nature involving lawsuits in health, challenging the creativity of legal professionals, health professionals and managers in the search for alternative solutions to deal with the complexity of the issue. This research aimed to analyze the social technology of mediation applied to the phenomenon of legalization of health as an extrajudicial settlement of conflicts, from the experience of SUS CHRISTMAS MEDIATED Program. The research, qualitative approach, accomplished documentary analysis of program records and interviews with actors involved in the same - Law operators, representatives of the Judiciary, technical employees and program managers of the SUS, the municipal and state levels. The study period included the years 2012 to 2014. This was a profile and referrals made during the period studied in relation to quantitative consultations, agreements, actions proposed by the DPE, referrals actions to DPU, resoluteness index and demands index not filed against state and county, and perceptions about the practices experienced by the actors involved. The results showed that the perceptions of actors linked to law and health are contradictory as to the legalization of health phenomenon, between negative and positive aspects. As regards the creation and development of the SUS program MEDIATED at Christmas there was a consensus that it helped to realize the right to health. The mediation similar views were identified considering it is an appropriate tool to deal with the legalization because it reduces the number of actions proposed in the judiciary, directs better skills to federative while searching the administrative resolution of cases. It was noted that the problems that pervade the mediation are much the same identified in the operation of the health system: insufficient offers, difficulty of access to new technologies, deficit and need for better training of human resources, difficulties in the organization of work processes . It is concluded that for these issues or the legalization or mediation will perform as resolute response. It is considered, finally, the educational potential of mediation as an important contribution of the program, as the dialogue on health system issues allow the user orientation and at the same time, positively discloses SUS with the citizens, reconciling -o with the health system. This communication is face to SUS and can contribute simultaneously optimization of Justice and Health Management, and advances in citizenship and realization of social rights.

9
  • CAMILA ALVES DOS SANTOS SIQUEIRA
  • Projeções e tendências da mortalidade por melanoma maligno de pele no Brasil.

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • GILMARA CELLI MAIA DE ALMEIDA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • Data: 3 juin 2016


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  • O melanoma maligno de pele é dos principais tipos de câncer de pele, com baixa incidência, contudo, alta letalidade. OBJETIVO. Realizar projeções e analisar as tendências de mortalidade por melanoma, no período de 1998 a 2032, no Brasil e em suas regiões. METODOLOGIA. Estudo ecológico, com dados de mortalidade por melanoma maligno de pele, obtidos no Sistema de Informação sobre Mortalidade (SIM), e dados populacionais do Instituto Brasileiro de Geografia e Estatística (IBGE). A análise dos óbitos compreendeu o período de 1998 a 2012. Para projeção dos dados, foi usado o software Nordpred, que consta no programa R, considerando-se o modelo idade-período-coorte. Foram calculadas se as modificações ocorridas com o tempo resultam de mudanças populacionais ou no risco de óbito pela doença. Como método de análise de tendências, utilizou-se a Regressão loglineal (Joinpoint regression), com taxas padronizadas pela população mundial, para estimar a porcentagem anual de mudança, com o intervalo de confiança de 95%. RESULTADOS: No período de 2008 a 2012, foram registradas 8.269 mortes por melanoma (4.750 homens e 3.519 mulheres), cujas projeções para períodos futuros revelou, entre 2028 e 2032, um aumento para 13.639 mortes (7.987 homens e 5.652 mulheres). A análise das tendências de mortalidade resultou, no Brasil, em uma tendência a redução para homens (APC = -0,4; IC95%= -0,6; -0,1; p<0,01) e mulheres (APC = -0,8; IC95%= -0,9; -0,7; p<0,01). A região Centro-oeste apresentou aumento para os dois sexos, em oposição ao Sudeste, com redução em ambos. O Norte apresentou estabilidade para homens e aumento para mulheres; o Sul teve redução em homens e estabilidade em mulheres; e, por fim, o Nordeste revelou um joinpoint para cada sexo. Nos homens, com o primeiro período de aumento e outro de estabilidade; e, nas mulheres, com estabilidade seguida de redução.

10
  • MEILY DE MELLO SOUSA
  • HABITS OF USE AND CONSUMPTION OF ORAL HEALTH PREVENTIVE SUPPLIES

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • DANIELA MENDES DA VEIGA PESSOA
  • KENIO COSTA DE LIMA
  • Data: 21 juin 2016


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  • This study aimed to identify the prevalence of the use and the consumption pattern of oral health preventive supplies by the population of two cities with similar demographic characteristics and different oral health status, as well as factors associated with their use. The study was individual, observational and analytical sectional with comparison group. The survey took place in the cities of Natal/RN and Florianópolis/SC. The sample consisted of 963 individuals, divided between both cities, from the age of 20 and up. The sampling was by quotas and the collection was through questionnaires structured with information of socioeconomic and demographic characteristics, usage habits and consumption of oral health preventive supplies and possible associated factors. The interviews took place in busy locations in both cities. The data were submitted to chi-square statistical test and logistic regression type stepwise forward. For all tests it was adopted a 5% significance level. The use of toothbrush and dentifrice was made by 100% of the sample and about 70.0% use them 3 or more times daily. The use of dental floss was 66.0% for Natal/RN and 81.5% for Florianópolis/SC. And the use of mouthwash was 52.9% and 59.3% for Natal/RN and Florianópolis/SC, respectively. The predominant frequency of use in both cases was once a day. The results of Florianópolis/SC were better in the categories socioeconomic status and hygiene habits. There was an association between the use of dental floss and the fact that individuals resided in Florianópolis/SC, were female, were married, were in the age group of 40-49 years, had a higher level of education, attended private dental service, performed oral hygiene more times daily and did not report toothache in the previous six months. The variables associated with the use of mouthwash were predominantly those representing the socio-economic condition of the individual, those in better condition were the ones who most used this product. In conclusion, the access to health services and the education level, which represent socioeconomic status, were the main determinants of the oral hygiene habits of the sample. The main diseases in oral health are reversible and resolvable through basic care procedures in oral health. Therefore, it was identified the need to provide means so that information on the oral health care reach the entire population, so that their preventive effects are achieved.

11
  • DAYANNE MONIELLE DUARTE MOURA
  • THE EFFECT OF A NEW STRATEGY OF CEMENTATION IN THE BOND STRENGTH OF THE ZIRCONIA-DENTIN INTERFACE

  • Leader : RODRIGO OTHAVIO DE ASSUNCAO E SOUZA
  • MEMBRES DE LA BANQUE :
  • ISAUREMI VIEIRA DE ASSUNCAO
  • LUCAS COSTA DE MEDEIROS DANTAS
  • RODRIGO OTHAVIO DE ASSUNCAO E SOUZA
  • Data: 22 juin 2016


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  • The aim of this study was to evaluate the influence of the different strategies of thermal aging and systems of cementation on bonding at zirconia/bovine dentine interface. To accomplish that, the crowns of 120 bovine teeth were embedded in acrylic resin and abraded on buccal surface for dentine exposure (#220,400,600).  A total of 120 sintered zirconia cylinders (Ø: 3.4mm; height: 4 mm) (Vita In-ceram 2000) were fabricated and divided into 12 groups (n=10) based on the system of cementation (Panavia F; RelyX Ultimate) and aging (24h, 30 days and 6 months in distilled water /37°C; 5, 10, 20,000 cycles at 5/55°C,30s). Zirconia cylinders and dentin were treated according to the cement manufacturer. The base paste and the catalyst paste of each cement were handled and the cylinders were cemented on dentine (750g). The samples were aged and submitted to protocol according to the experimental group. Then, the samples underwent shearing (1 mm/min) in a universal testing machine and analysis of failure. The dada obtained from the shearing test was submitted to the Kruskall-Wallis analysis, followed by the Dunn test and by the Wilcoxon test. After 6 months of water storage, the shear bond strength test of the Panavia F and the Rely- X Ultimate significantly differed. As for the Ultimate cement, the group ULT30D was significantly superior to the groups ULT5TC and ULT10TC, and similar to the remaining groups.  As for the Panavia F, the lowest bonding strength was the PAN10TC group, being only statistically different from the control group. Therefore, the cement RelyX Ultimate promoted the best   bonding strength to the interface zirconia- dentin after 6 months of water storage. However, termocycling decreased bond strength to the dentin of both cements.

12
  • ANA CARLA BEZERRA DE CARVALHO JUSTO FERNANDES
  • DEGREE CONVERSION OF EXPERIMENTAL ADHESIVE SYSTEMS CONTAINING DIFFERENT MONOMER CONCENTRATIONS, PHOTOINITIATORS SYSTEMS AND GENERATIONS LED's

  • Leader : BONIEK CASTILLO DUTRA BORGES
  • MEMBRES DE LA BANQUE :
  • BONIEK CASTILLO DUTRA BORGES
  • FABIO ROBERTO DAMETTO
  • JOSE RENATO CAVALCANTI DE QUEIROZ
  • Data: 23 juin 2016


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  • Objective: to evaluate the degree of conversion (CG) of simplified experimental adhesive systems by varying the formulation with different proportions of acid monomer 1,3-glycerol dimethacrylate phosphate (GDMA-P), and the presence of alternatives photoinitiators photoactivated by light-emitting diodes (LED) second and third generations. Methods: Initially the monomer GDMA-P acid was synthesized, and further manipulated 12 adhesives according to the following compositions: monomeric blend containing GDMA-P, Urethane dimethacrylate (UDMA) and 2-hydroxyethyl methacrylate (HEMA) in proportions of 30/20/20; 30/10/30 and 30/30/10% by mass, respectively. The photoinitiator system was composed camphorquinone (QC), bis(acyl)phosphine oxide (BAPO), Ethyl 4-Dimethylamine Benzoate (EDMAB), Diphenyliodonium Hexafluorphosphate (DH) in the following amounts: 1.0/0.0/1.0/0.2; 0.0/1.0/1.0/0.2; 0.0/1.0/0.0/0.2; 0.5/0.5/1.0/0.2 mol%, respectively. As the solvent was used ethanol and water (1:1). The spectral distribution of light from two LEDs was measured using a spectrometer computer controlled. Five samples of each adhesive were subjected to spectroscopy medium infrared Fourier transform (FTIR) spectroscopy with attenuated total reflectance device (RD) before and after curing the samples. For curing procedures were used two LED light sources, a 2nd generation - Flash Lite1401 (2nd generation) and another 3rd generation - Bluephase G2 (3ªG). Results: The increase of GDMA-P had effect on CG of adhesives (p <0.05). In general, the presence of BAPO offered higher CG compared to QC in the adhesive systems when 3ªG photocured for all monomers concentrations tested (p <0.05). The 3ªG LED has increased the GC  than 2ªG LED for all adhesive systems BAPO (p <0.05). The 2ªG was more effective in adhesive systems containing CQ / EDMAB / DH, except concentration 10/30/30 (p <0.05). Analysis of variance and post-hoc Tukey were used to analyze the data (P <0.05). Conclusions: Low concentrations of GDMA-P, using BAPO and 3ªG LED improved degree of conversion of the experimental adhesives.

13
  • LÍVIA MARIA DE AZEVEDO
  • AGEISM IN NATAL/RN MUNICIPALITY: OCCURRENCE AND RELATED FACTORS.

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • DIEGO BONFADA
  • KENIO COSTA DE LIMA
  • Data: 30 juin 2016


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  • This study objectified to verify the occurrence of velhismo and factors related to it in the reality of elderly that are not institutionalized. This is a cross-sectional study with a quantitative approach, involving 188 individuals older than 60 years who were selected for convenience in a sample by quotas. It was used for data collecting a questionnaire containing demographic profile economic, social, health and Map Aged Relations Minimum beyond the Ageism Survey instrument translated and adapted, used to check the occurrence of velhismo. In the treatment the data was done to characterize the sample by descriptive analysis, after that it was obtained the possible significant associations with the chi square test (p <0.20), and then was made a multivariate analysis by logistic regression (p <0.05). It was found as the variable "suffered some form of discrimination" that elderly patients with fewer comorbidities were more discriminated against than the diseased. The same happened to the elder who is responsible for his house, to which suffers more discrimination than who has the son or the family responsible. The elder who used public transportation also suffers from ageism more than that does not use, as well as those who have more time for retirement compared to those who have less time. Similarly, older people had more sons were more victims of ageism, and older women suffer more discrimination than men. In relation the variable "severity of ageism," the elderly who do not receive emotional support or receive from someone who is not family, suffer the most severe form of ageism when compared to those who receive emotional support from a family member. was also noted that older people that have had four or more sons and are female suffered ageism more severe form. With these results, we observed how the ageism is common and is generalized to the majority of elderly respondents, being related to their living conditions and health. This situation is aggravated when the ignorance of the population is observed, including the elder, about this form of discrimination, as well as their gravity and the problems that it can to cause.

14
  • LORENA MACHADO DE ARAUJO
  • PATIENT SAFETY FROM THE PERSPECTIVE OF NURSING PROFESSIONALS INTENSIVE CARE

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • ARDIGLEUSA ALVES COELHO
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • REJANE MILLIONS VIANA MENESES
  • Data: 6 juil. 2016


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  • Introduction: In recent years, patient safety has received worldwide emphasis due to the growing number of adverse events, considered a problem inherent in the modern health care system. According to the World Health Organization, one in ten patients suffer damage / injury arising from supportive care, reflecting the increased hospital costs and avoidable morbidity and mortality. The Intensive Care Unit (ICU), characterized by complexity and specificity, is favorable environments to the occurrence of adverse events, requiring greater attention and prepare technical and scientific professionals. Therefore, it asks-: What is the perception of health professionals, nurses and nursing technicians, about the safety of the patient. Objective: This research aims to understand the significance of patient safety in the hospital environment for nurses and nursing technicians. Methodology: descriptive / exploratory qualitative study with ethnomethodological approach, proposed by Harold Garfinkel. The survey was conducted at a university hospital in Natal / RN in the ICU sector in the period from August to September 2015. The sample consisted of a group of five nurses and five nursing technicians with experience in intensive care for at least two years. Data collection was carried out from a semi-structured individual interview, the same being recorded and analyzed using the content analysis technique, according to Bardin. The defined categories were: meaning of patient safety and humane care; daily practice in the intensive care unit; weaknesses for the development of patient safety and prospects for a secure assistance. Results and Discussion: In the research it became clear that the word security is related to the patient's recovery, their well being, responsibility and quality of care provided by the multidisciplinary team. The types of damage most often cited in the survey were related to medication administration, procedures, the development of pressure ulcers and falls. The multiple factors that hinder the development of actions for care insurance include problems in the work process, such as lack of cooperation / team communication; insufficient resources; reduced number of professionals in contrast to the large number of students and professionals without experience; inappropriate and lack of incentive management. Therefore, professionals adopt as key strategies identifying the patient, infection control, care medication administration, to prevent falls and Pressure Ulcers. It was identified as suggestions training and team training, improvement of work processes, including updating protocols, availability of materials and equipment and the maintenance of an adequate number of professionals. Conclusion: It appears that the meaning of security goes well beyond just protecting the damage to the patient. Despite the difficulties encountered in day to day work, the nursing staff can design a preventive vision and develop actions for the safety of responsibly patient, sensitive and ethics.

15
  • THAIS SOUSA RODRIGUES GUEDES
  • Body Image in Women Submitted to Breast Cancer Treatment

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • KARLA VERUSKA MARQUES CAVALCANTE DA COSTA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 26 juil. 2016


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  • Breast cancer is the most common neoplasia among women. Consequential changes from treating breast cancer are responsible for the way women see their body image and how these patients interact with other people. This study aims to determine the prevalence of women dissatisfaction with their own body perspective and associated factors after surviving to breast cancer treatment. This is a cross-sectional study, which evaluated 103 women living in the city of Natal, Brazil, diagnosed with breast cancer at least one year ago, that were still under treatment against cancer, and remained in clinical follow-up. Data collection was performed by accessing medical records of patients diagnosed with breast cancer and conducting individual interviews. The dependent variable Body Image was measured using the validated questionnaire Body Image Scale (BIS). Socioeconomic variables, gynecological history, clinical and life habits were also collected. The bivariate analysis was performed using Pearson's chi-square test (Fisher's Exact), calculating the prevalence ratio using 95% confidence interval. Multivariate analysis was performed by Poisson regression with robust variance. The statistical significance level of 0.05 was considered. The mean age of patients included in the study was 55.97 years (± 10.6), mostly Caucasian, married, and employed before treatment (81.6%). The prevalence of dissatisfaction with body image was 74.8%, CI (0.65 to 0.82). Body Image showed a statistically significant association with multidisciplinary professionals monitoring the patient and the presence of employment after treatment. We conclude that the prevalence of body image dissatisfaction was high. Women who reported having an occupation after treatment for cancer showed more changes in self-perception regarding their appearance. Concerning the follow up by multidisciplinary professionals, those patients who did not receive care after the treatment reported a negative impact on their body image. This finding highlights the need for strategies to increase the resolvability of services to meet the main demands of this population.

16
  • RAYANNE KARINA SILVA CRUZ
  • Severity index of dental caries : construction and validation.

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • ROGER KELLER CELESTE
  • Data: 1 août 2016


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  • The oral health national survey, known as "SB Brazil Project," is considered as the main oral health surveillance strategy in the production of primary data, cooperating to build a policy based on epidemiologically-orientend assistance models in Brazil. In a low caries prevalence scenario, sometimes the current indices used nowadays can reduce their discriminatory power. Objective: To create and validate a caries severity index, through an arbitrary set of scores according to dental caries and treatment needs. Methods: This study worked with data from SB Brazil 2003 and 2010 for the construction and validation of a Severity Index Dental Caries. The research is individual-based using secondary data having, as unit of analysis, the Brazilian population in the age groups of 12 years, 15-19 years and 35-44 years. The methods were divided into stages, the first was the formulation of proposals with different scores for the progression of caries through the specific assignment of scores for tooth conditions, from sound teeth to those requiring extraction, from the association between the DMFT index and Treatment Need conditions. The second step was the analysis of the coefficients of variation and the third was the construct validation. Results: There were no differences between the proposals, when the variation where analyzed. The construct validation was made considering the variables: region, type of city (capital/ non-capital), ethnic group, family income and years of schooling. It was observed that the new index could discriminate the different stages of decayed teeth. Conclusions: the study product will be useful for planning activities in public health dentistry, as it will be possible prioritizing access to the service for the group with greater severity, adding a more discriminatory power to both caries and treatment needs indexes.

17
  • SANDERSON JOSÉ COSTA DE ASSIS
  • Factors associated with scoliosis in schoolchildren: A case-control study

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • JOSÉ PATRÍCIO BISPO JÚNIOR
  • Data: 1 août 2016


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  • Scoliosis is characterized by three-dimensional, with deviations in the sagittal, coronal, and horizontal planes. School constitute them as a risk group for this deformity by going through the growth spurt phase of growth, coupled with other factors such as sitting for long periods of time, asymmetric straps on school backpacks and/or backpacks overloaded with school supplies, the use of inappropriate footwear, and other factors. Considering the limited literature addressing the risk factors for scoliosis, this study aims to analyze the risk factors for scoliosis in school. Methodology. This is a cross-sectional and quantitative study case-control with school in the city of Santa Cruz, Brazil. We evaluated the presence of scoliosis, physical activity, competitive sports practice and postural habits. In order to identify factors risk with scoliosis, were estimated odds ratio (OR) and confidence intervals (95%) were estimated by means of conditional multiple logistic regression, a significance level of 5% was used. Results.  Seventy-eight pairs participated in the study, totaling 156 students, including 86 girls and the average age of 13.88 years. In conditional logistic regression, physical activity bivariate analysis showed statistical significance (p = 0.041) showing that those who practiced little physical activity (irregularly active) have more risk of having scoliosis when compared with active children (OR: 2.64 ; 95% CI: 1.18 to 5.89), however when compared with sedentary school there was no statistical significance (p = 0.893). This significance remained in the adjusted model, to be set by competitive sports practice and backpack transport. The other variables were not statistically significant. Conclusions. Low physical activity is presented as a risk factor for scoliosis in school and may indicate a physical activity as a protective factor for scoliosis.

18
  • FRANCISCO DE ASSIS DE SOUZA JUNIOR
  • CHANGES IN FACIAL PROFILE IN PATIENTS UNDERGOING SURGERY ORTHOGNATHIC

  • Leader : JOSE SANDRO PEREIRA DA SILVA
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • JOSE SANDRO PEREIRA DA SILVA
  • MARCELO AUGUSTO DE OLIVEIRA SALES
  • Data: 9 août 2016


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  • Orthognathic surgery is the main modality of treatment for dental-facial deformities. Changes to skeletal bases are only performed after predicting surgical movements through cephalometric analysis and determining the optimal placement of the expected hard and soft facial tissues. True Vertical Line (TVL) has been used as a stable reference for diagnostic and predictive verification in cephalometric analysis as it does not change from bone movements performed in orthognathic surgery. The objective of this study was to evaluate the correlation between hard tissue movement on the soft tissue using TVL as a reference in patients undergoing orthognathic surgery, and according to measurements of movements performed in the anteroposterior direction. The study sample consisted of analyzing 54 radiographs of 27 patients (09 males and 18 females) with an average age of 29 years. Imaging studies were performed before and 6 months after orthognathic surgery. Six points, being three for soft tissue (PALS, PALI, Pg') and three for hard tissue (PA, PB, Pg) were marked using a software, and TVL served as an outlined parameter to perform horizontal measurements. All measurements were performed with the Meazure 2.0 program. A higher correlation of movement between the points Pg-TVL/Pg’-TVL was found with =0.49, followed by PB – TVL / PBLI – TVL with =0.45 and PA – TVL / PALS – TVL with =0.41. Soft tissue had the highest average of movement where point Pg '- TVL = 4.6mm had the highest average, followed by point PALI – TVL= 3.0mm and point PALS – TVL= -2.3mm. Points of hard tissue had minor changes compared to soft tissue, being: Pg – TVL= 3.45mm, PB – TVL= 2.40mm; PA – TVL= -2.93. Thus, we conclude that the lower third has a higher correlation of movements after orthognathic surgery when compared to the middle third. Among the analyzed points, Pg and Pg' had the highest correlation index in the lower third. Modifications less than 1mm in the middle third (PA) did not lead to changes in the correlated points (PALS) while changes less than 1mm in the lower third (PB; Pg) had repercussions on correlated soft tissues points (PALI, Pg'), although in different proportions.

19
  • ALINE DE SOUSA BARBOSA FREITAS PEREIRA
  • Effects of metformin in ligature-induced periodontal disease in Wistar rats.

  • Leader : AURIGENA ANTUNES DE ARAUJO
  • MEMBRES DE LA BANQUE :
  • AURIGENA ANTUNES DE ARAUJO
  • LEÔNIA MARIA BATISTA
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • Data: 12 août 2016


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  • Periodontitis is a chronic inflammatory disease characterized by gum inflammation, degeneration of periodontal ligaments, alveolar bone and cementum. It is considered one of the most important cause of tooth loss in adults. Experimental studies have shown pharmacological new alternatives for the treatment of periodontal disease in order to alleviate the inflammation and alveolar bone loss. The aim of this study was to evaluate the effects of metformin (MET) on inflammation, oxidative stress, and bone loss in a rat model of ligature-induced periodontitis. Male Wistar albino rats were randomly divided into 5 groups of 24 rats each and given the following treatments for 10 days: (NL) no ligation + saline, (L) ligation + saline, (MET 50) ligation + 50 mg/kg MET, (MET 100) ligation + 100 mg/kg MET, and (MET 200)  ligation + 200 mg/kg MET. Periodontal tissue was analysed to determine the bone loss and histopathological characteristics. Immunohistochemical was used to examine MMP-9, COX-2, the RANKL/RANK/OPG pathway, SOD-1, and GPx-1. Spectroscopic UV-VIS analysis was used to examine the levels of Malonaldehyde, glutathione, IL-1β and TNF-α. Reverse transcription polymerase chain reaction was used to quantify the gene expression of AMPK, NF-Kβ p65, and Hmgb1. A p-value of <0.05 indicated a significant difference. Treatment with 50 mg/kg MET significantly reduced concentrations of malonaldehyde IL-1β and TNF-α (p < 0.05). Weak staining for COX-2, MMP-9, RANK, RANKL, SOD-1, and GPx-1, and  strong  staining  for  OPG. Increased AMPK expression and decreased expression of NF-Kβ p65 and Hmgb1. Metformin decreases the inflammatory response, oxidative stress  and bone loss in ligature-induced periodontitis in rats.

20
  • RENATO DUARTE DE CARVALHO
  • ANALYSIS OF DIFFERENT METHODS FOR DETERMINING PERIODONTAL BIOTYPE.

  • Leader : BRUNO CESAR DE VASCONCELOS GURGEL
  • MEMBRES DE LA BANQUE :
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • JANAINA CAVALCANTE LEMOS
  • Data: 18 août 2016


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  • AIM: The aim of this study was to determine, through different methods, periodontal biotype of teeth and prosthetic spaces in patients prior to the unitary rehabilitation with dental implants and immediate loading in aesthetic areas. MATERIALS AND METHODS: This is a study of diagnosis through the periodontal evaluation of patients before treatment unit prostheses on dental implants. An initial sample of 34 patients was considered. The study included patients with unit absences in cosmetic area and periodontal health. They excluded patients with multiple candidates absences rehabilitation unit with prosthesis in no aesthetic region. RESULTS: No statistically significant correlation between horizontal mucosal thickness were found in the prosthetic space and vertical mucosal thickness of the prosthetic area (p <0.001) and the horizontal thickness of the mucosa adjacent teeth the Prosthetic space and the horizontal thickness of the prosthetic area (p = 0.001) . There were no correlations between the horizontal / vertical thickness and other variables of interest: the transparency survey, gender, height and width of the crowns and buds, depth vestibular probing and right height / width of crowns and buds. cluster analysis (cluster) resulted in two well defined groups, G1 (thick biotype) and G2 (thin biotype) which, when analyzed for the above variables, showed significant differences for transparency survey (p = 0.04) vertical thickness of the prosthetic area (p <0.001), horizontal thickness of the adjacent teeth (p <0.001), buccal probing depth (p = 0.05) and ratio height / width of the papillae of adjacent teeth (p = 0.02) . The poll transparency test achieved 77.8% sensitivity and 56.3% specificity with overall accuracy of 67.7%. CONCLUSION: Periodontal biotypes are classifiable, have different morphometric parameters and have as key influencers horizontal gingival thickness, vertical gingival thickness and transparency vestibular probing for classification. The method of transparency on probing was effective in diagnosing types evaluated periodontal biotypes.

21
  • DANIELLE LOREN COSTA
  • ANALYSIS OF THE RELATIONSHIP BETWEEN MENTAL HEALTH AND WORK IN UNIVERSITY TEACHERS

  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • DIEGO BONFADA
  • JACILEIDE GUIMARAES
  • SORAYA MARIA DE MEDEIROS
  • Data: 26 août 2016


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  • Mental health and work have been issues of great relevance in studies and research, since the mental illness of the worker is increasingly present in the everyday life of work, entails withdrawals for long periods and provokes losses to both the employer and to the worker itself and its network of relationships. The teaching practice is regarded as a profession with mental and physical risk and therefore deserves a special attention geared towards the health of these professionals. Accordingly, this study is intended to analyze the relationship between the work and the mental health of teachers of a federal public institution of higher education. It is an exploratory and descriptive study, with a qualitative approach, which was divided into two stages. In the first stage, we performed a documentary research with the survey of withdrawals due to leave for health treatment in the UFRN servants, by ICD-F (mental and behavioral disorders), between 2010 and 2014, through a management report obtained from the Federal Public Administration System (SIAPE-SAÚDE, as per its acronym in Portuguese). In the second stage of this study, we performed a field research with the teachers, through a semi-structured interview with guiding questions about pleasure and suffering at work. In order to analyze the interviews, we used the content analysis technique, in its thematic analysis modality, proposed by Minayo (2013), and the theory of Psychodynamics of Work, according to Dejours (1992), as theoretical benchmarks. The data collection period encompassed between November/2015 and June/2016. The results of the first stage showed that mental and behavioral disorders have filled the first places of causes for withdrawing the work because of health reasons in UFRN servants (technical-administrative and teaching staff), and even reached, in 2014, 25% of occurrences of leave for health treatment. The most frequent diagnoses in the withdrawals were the mixed anxiety and depressive disorder (F 41.2), the severe depressive episode without psychotic symptoms (F 32.2) and the recurrent depressive disorder, current episode severe without psychotic symptoms (F 33.2). Regarding the second stage, we extracted two of analytical categories: suffering and pleasure in the teaching work, with three sub-categories corresponding to each, namely: Academic productivism – “Publishing or perishing”; Teacher: is it an omnipresent being?; Wear in work relationships; The enchantment of the classroom; The recognition and Experiences that promote quality of life in the work place. Faced with the results, one can realize that teachers, despite the suffering experienced at work, the uncomfortable conditions, malaise, which occasionally even culminates in illness, recognize their work as a stimulant, as a propelling force, that gives their existence a meaning, and that the simple fact of being a teacher and the exercise of teaching could be considered by them as promoters of pleasure and quality of life in the work place.

22
  • MARIA HELENA PIRES ARAUJO BARBOSA
  • Predictions and trend of mortality in lung cancer in Brasil.

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • MARIANNA DE CAMARGO CANCELA
  • Data: 29 août 2016


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  • Neoplasms represent the second cause of death worldwide. Among them, lung cancer stands out as the most common of all malignant tumors and a major cause of death among men and women in developed countries. The aim of this study is to analyze the trend of mortality from lung cancer from 1998 to 2012 and to realize prediction of mortality by the year 2032. This is an ecological study of mixed type that evaluated the mortality rate lung cancer noting the age of the population, as well as the place of residence of these deaths considering a historical series of 15 years. The predictions of each period were calculated using the model age - period - cohort Nordpred program in software R. The mortality trend analysis was performed using the Joinpoint Regression Program software. The Annual Percentage Chance (APC) was used to assess the trend of each segment analyzed and estimating statistically significant values considering a 95% confidence level. In addition, we evaluated whether changes in the number of deaths are related to the population or the risk of developing lung cancer. In Brazil 2.237.346 deaths were due to cancer in the period from January 1TH 1998 to December 31TH, 2012 and 273.357 (12.21%) were from lung cancer. The age group with the highest number of deaths in both men and women, was understood by persons aged greater than or equal to 60 years. The analysis by Joinpoint showed significant reduction in the standardized mortality rate for the entire Brazilian territory, as well as in all regions for men. For women, the North tended to stability with subsequent joinpoint in 2015 and a significant reduction trend. But the analysis revealed that both Brazil and to other regions, except the North, there was a trend of significant increase and presence of joinpoint with subsequent period of stability. However, these changes in men and women will be related to the size or to change the age of the population. We conclude that in the period investigated, considering men and women, there will be differences in mortality from lung cancer in Brazil and the Brazilian regions. And, among other factors, this change will have regard to the size and age of the study population.

23
  • ISIS CRISTIANE BEZERRA DE MELO CARVALHO
  • ADAPTATION AND VALIDATION OF THE Safe Childbirth Checklist OF THE WORLD HEALTH ORGANIZATION FOR THE BRAZILIAN CONTEXT

  • Leader : ZENEWTON ANDRÉ DA SILVA GAMA
  • MEMBRES DE LA BANQUE :
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • NILBA LIMA DE SOUZA
  • IGOR THIAGO BORGES DE QUEIROZ E SILVA
  • Data: 30 août 2016


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  • Maternal and infant mortality is still a serious public health problem in Brazil, despite the broad access to institutionalized deliveries. The World Health Organization (WHO) has developed the "Checklist for the safe delivery" (LVPS), a potentially useful technology to improve the quality of care during labor and to promote better health outcomes. The objective of this work is culturally adapt and validate the WHO LVPS for Brazilian hospitals, for the simple translation collides with consolidated national clinical practice. After translation into Portuguese of Brazil, there were three stages of adaptation and validation: 1 nominal group panel of experts, three obstetricians and six medical nurses (three obstetricians and three pediatricians), held in person (first two polls ) and completed the distance (final vote); 2 Consensus Conference in two University Hospitals, in extended meetings for all professionals who would use the list; and 3 structured questionnaire for health professionals (n = 40) after 30-day pilot study using the list. The criteria for validation were the face validity and list content, suitability for national protocols, terminology and viability in the local context. In the first stage, all 29 items were approved after 3 rounds and some national adaptations (eg. Rapid test for HIV instead of CD4). In the second stage, there was an increase of 24 items and changes in initial items. In the third stage, was the exclusion of nonviable 3 items, 2 items were joint and 1 item has been added due to their clinical importance in the Brazilian context. The validation process enabled the provision of a LVPS 49 potentially useful items for the Brazilian context, with evidence of validity and feasibility of the national context which must be confirmed in future studies focused on the effectiveness or validity criteria.

24
  • LAURA GÉSSICA DANTAS DA SILVA
  • RELATIONSHIP BETWEEN ANXIETY AND QUALITY OF LIFE WITH TEMPOROMANDIBULAR JOINT DYSFUNCTION.

  • Leader : GUSTAVO AUGUSTO SEABRA BARBOSA
  • MEMBRES DE LA BANQUE :
  • EDUARDO JOSÉ GUERRA SEABRA
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • Data: 30 août 2016


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  • The temporomandibular disorders (TMD) has a multifactorial etiology, and among the contributing factors, the psychosomatic origin may represent a negative influence on the trial of pain to the systemic health and quality of life. Objective: evaluate the relationship between temporomandibular dysfunction, anxiety, quality of life and demographic aspects associated of TMD patients. Methods: We applied 4 questionnaires in 120 patients (60 with TMD and 60 without TMD) to assess signs of anxiety and quality of life. The TMD diagnosis was performed by RDC / TMD (Research Diagnostic Criteria for Temporomandibular Disorders). For the analysis of quality of life used the World Health Organization Quality Of Life-Brief Version (WHOQOL-BREF), and for the analysis of anxiety, three instruments: Inventory Beck Anxiety (BAI), the Anxiety Index State-trait (IDATE- T and E) and the Hospital Anxiety and Depression Scale (HADS). The colected data were analyzed with the Pearson chi-square test (χ2), Student's t test, odds ratio (odds ration- OR), and non conditional logistic regression. Results: Observing a greater percentage of participants with TMD (60%) among women and men, only 30% had dysfunction (p = 0.002). Marital status showed, for individuals without a partner, the highest percentage of TMD (65.1%), and for married 40.0% (p = 0.009). Regarding employment status, participants with DTM represented 71.4% of the professional occupation, and 42.9% among the unemployed (p = 0.008). The questionnaire evaluating anxiety found that most individuals with elevated levels of anxiety presented TMD HADS 75% (p <0.001), STAI, and 55.6% (p = 0.035), STAI 54.9% (p = 0.011) and BAI 63.9% (p = 0.002) compared to individuals without TMD. And the WHOQOL-BREF showed in all areas and in general, higher levels of quality of life for participants without TMD, p <0.001. Among the sociodemographic sex showed greater association with TMD (OR = 3.5), followed by professional status (OR = 3.3) and marital status (OR = 2.8). The WHOQOL showed greater strength of association (OR = 9.2). And anxiety, this was observed in the HADS (OR = 5.0), followed by STAI (OR = 4.2), BAI (OR = 3.2) and STAI-E (2,5). Conclusion: The results suggest that TMD patients have higher levels of anxiety and low quality of life. These aspects can interfere with the course of treatment, which reinforces the need for therapies with a focus on several factors involved in the dysfunction.

25
  • ROBERTA KARLINE LINS DA SILVA
  • ADHERENCE EVALUATION TREATMENT AND CONTROL DIABETES MELLITUS IN PRIMARY HEALTH CARE.

  • Leader : ANTONIO MEDEIROS JUNIOR
  • MEMBRES DE LA BANQUE :
  • ANTONIO MEDEIROS JUNIOR
  • PAULO DE MEDEIROS ROCHA
  • JOÃO BOSCO FILHO
  • Data: 30 août 2016


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  • The number of diabetic patients is increasing due to the growth and aging population, greater urbanization, the increasing prevalence of obesity and sedentary lifestyle. Studies report that non-adherence to treatment in chronic diseases is public health problem. Adherence corresponds to agreement between the medical prescription and the conduct of the patient, and includes values and beliefs, as well as aspects related to the disease and its treatment. Understanding the variables that influence adherence is one of the pillars underlying the planning and implementation of educational interventions, by their relevance to the promotion of self-care. While it is necessary, adherence to treatment is not an easy behavior to acquire. Many are the elements that make the issue of treatment adherence reason of study among researchers. There is evidence in the literature that the higher membership levels, the lower the generated complications, a fact that justifies the effort to obtain better adherence to the proposed treatment. This study aimed to assess adherence to treatment in people living with diabetes living in the coverage area of a Family Health Unit, as well as evaluate the metabolic control measures and weight, used in monitoring the disease and to examine associations between these variables. We evaluated 98 patients with diabetes, 18 years, monitored and registered at the health facility and participating in the self-care group of the unit. This is a cross-sectional study, which were collected clinical information on individual records and conducted direct interviews with diabetes about the self care measures, according to the Self-Care Activities Questionnaire instrument with diabetes "(PAF), adapted and validated in Brazil. Data were arranged in the database for descriptive analysis of socio-demographic variables and control and subjected to statistical analysis for visualization of possible significant associations. The results indicated that the sample was predominantly female, married civil state, received less than or equal to two minimum wages, arising from pensions and benefits. Had less than four years of study and diagnosis of diabetes more than ten years. As for metabolic data and weight were most overweight, changed glycated hemoglobin, normal fasting glucose and half of the sample had normal triglyceride levels. For evaluation of the PAF activities activities that showed better adherence were using medication, foot care, and consumption of sweets and those with poor adherence were blood glucose monitoring and physical activity. In the associations of biochemical parameters and QAD observed moderate association between medication and cholesterol, BMI and triglycerides, fasting glucose and cholesterol, and triglycerides. It was concluded that the sample presented poor adherence to physical activity and blood glucose monitoring, while showed excellent adherence to foot care and medication use, there were no associations between self-care and sociodemographic characteristics, except physical activity and sex , requiring more effective educational approaches to better adhesion.

26
  • ANDRÉ COSTA CARTAXO
  • Impact of radiotherapy in head and neck region on periodontal and oral hygiene conditions

  • Leader : ANA RAFAELA LUZ DE AQUINO MARTINS
  • MEMBRES DE LA BANQUE :
  • ANA RAFAELA LUZ DE AQUINO MARTINS
  • ANDRE LUIS DORINI
  • MARIA DE LOURDES SILVA DE ARRUDA MORAIS
  • Data: 30 août 2016


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  • Radiotherapy consists in a therapeutic method that uses ionizing radiation to combat malignancies, being an extremely effective treatment for handling head and neck tumors, as both a primary mode as an adjuvant to surgery. This treatment has high survival rates in the treatment of cancer in early stages. Radiotherapy in the head and neck cause frequent oral complications. In the oral cavity, the major adverse effects are mucositis, hyposalivation, osteoradionecrosis, trismus, radiation caries and periodontal changes. Despite the reporting of possible adverse effects of radiation therapy in the oral cavity, little is known about the evolutionary process and pathogenesis of these diseases after radiotherapy. Thus, this study conduct a research, evaluating the development of periodontal disease before and after radiotherapy aiming at providing a better understanding of the role of radiotherapy on the periodontal structures and thus contribute to the development of strategies to reduce the incidence and severity of it. 14 patients was evaluated, of whom 12 men and 2 women, which 11 had periodontitis after the radiotherapy, and yet, 9 had poor oral hygiene condition after the radiotherapy. 7 of the 11 subjects with periodontitis presented the tumors in the oral cavity. There was a decrease in PI and GI. The research was unable to establish a significant association between radiation therapy and oral hygiene condition and periodontitis. The poor oral hygiene condition predominated in the sample, which can be associated with the presence of debilitating conditions. The direct radiation on the oral cavity may have influence on the development of periodontitis. The development of gingivitis and periodontitis was not influenced by dose, fraction or duration of radiotherapy in the study period.

27
  • HELICARLOS BATISTA DE MORAIS
  • EFFECT OF gliclazide ON A MODEL EXPERIMENTAL DISEASE PERIODONTAL INDUCED RATS Wistar

  • Leader : AURIGENA ANTUNES DE ARAUJO
  • MEMBRES DE LA BANQUE :
  • AURIGENA ANTUNES DE ARAUJO
  • JEYMESSON RAPHAEL CARDOSO VIEIRA
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • Data: 31 août 2016


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  • Periodontal disease is a group of immuno inflammatory diseases that have the potential to affect both the protective fabrics as support teeth, the principal etiologic agent is bacterial biofilm, but the destruction of periodontal tissue is primarily caused by excessive response the host immune system. Recent studies show anti-inflammatory and antioxidant effect of oral antidiabetic drugs belonging to the sulfonylurea class of some inflammatory diseases. The aim of this study was to evaluate the action of gliclazide (GLI), an oral antidiabetic which has shown anti-inflammatory and antioxidant effect on periodontal disease in rats that were induced by ligation. We used 125 Wistar rats were randomly divided into 5 groups of 25 animals each: (NL) inducing periodontal disease has not been submitted but received saline solution; (L) has undergone induction of periodontal disease and received saline; (GLI 1mg) inducing periodontal disease GLU has been made and received 1 mg / kg; (GLI 5mg) was subjected to induction of periodontal disease GLU and received 5 mg / kg; and (GLI 10mg) was subjected to induction of periodontal disease GLU and received 10 mg / kg. The groups were treated with saline (NL and L) or GLI (1 GLY, GLY GLY 5 and 10mg) over a period of 10 days. After sacrificing the animals, which occurred on the eleventh day, the periodontal tissues were removed and passed the following tests: morphometric histopathologic, immunohistochemical, glutathione (GSH), real-time PCR (RT-PCR), malondialdehyde (MDA) and myeloperoxidase (MPO). It is noted that treatment with GLI 1 mg / kg was able to reduce the MDA (p <0.05) IL-1β (p <0.05), TNF-α (p <0.05) and MPO (p <0.05). also decreased MMP-2 expression, RANK, RANKL, cathepsin K, SOD and increased OPG expression. Still in the dose GLI 1mg / kg simultaneously reduced NF-ҡB p65 expression of AKT Pl3K and also compared to the L group (p <0.01). These results show that the GLI dosage of 1mg / kg could provide the anti-inflammatory action induced periodontal disease because the effects of decreased alveolar bone loss, caused a reduction in the levels of pro-inflammatory cytokines and increase expression of anti-agents inflammatory.

28
  • EMANUELLE LOUYDE FERREIRA DE LIMA
  • Screening Phytochemistry And Spondias mombin L. Antibacterial Action Bacteria On Oral Planktonic.

  • Leader : RUTHINEIA DIOGENES ALVES UCHOA LINS
  • MEMBRES DE LA BANQUE :
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • ISAUREMI VIEIRA DE ASSUNCAO
  • CICERO ROMAO GADE NETO
  • Data: 31 août 2016


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  • Due to the high prevalence of oral diseases and the considerable therapeutic potential of vegetable raw materials, and based on the fact that Brazil is a country of great ethnobotanic variety, the present study sought to phytochemically analyze plant material, as well as determine the antibacterial action of the extract of Spondias mombin L. (caja) on oral planktonic bacteria. To achieve this, phytochemical screening of the plant material was performed, along with the determination of the Minimum Inhibitory Concentration (MIC) and the Minimum Inhibitory Concentration of Adherence (MICA) of Spondias mombin L. extract (caja) against S. mutans and S. oralis, and the bactericidal kinetic extract on S. mutans. It was found that the extract inhibited bacterial growth at all the MICs tested, and prevented the adhesion of the microorganisms to the glass wall at a concentration of 1:512 of the extract. As such it was more effective in these two tests than 0.12% chlorhexidine gluconate. It was also found that crude extract of Spondias mombin L. exhibited antibacterial action after two hours of contact with S. mutans, while the extract in its minimum inhibitory concentration displayed a bactericidal effect after four hours of contact time with S. mutans. Thus, it is concluded that: the Spondias mombin L. extract is shown quite promising as a bactericide against Streptococcus mutans and S. oralis compared to chlorhexidine digluconate.

29
  • EROTIDES TEREZA DE OLIVEIRA DAMASCENO LUCAS
  • SPACE-TIME DISTRIBUTION OF DIABETIC FOOT AND AMPUTATIONS FOR DIABETES PREVALENCES IN BRAZIL BEFORE AND AFTER THE LAW Nº11.347/06 (2002-2012)

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • MARIA ANGELA FERNANDES FERREIRA
  • RODRIGO PINHEIRO DE TOLEDO VIANNA
  • Data: 31 août 2016


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  • The demographic transition that has taken place in the world and in Brazil brings with it a change in the pattern of diseases found in populations. The chronic non-communicable diseases (NCDs) has appeared rather prominently in this epidemiological transition scenario, and its morbidities have affected considerably individuals, such as Diabetes Mellitus (DM) associated with diabetic foot and amputations. The aim of study was analyze the space-time distribution of prevalence rates of diabetic foot and amputations for diabetes mellitus in Brazil, before and after the law 11.347/06. This is an ecological study, which used as units of analysis 161 Urban Articulation Regions intermediate and DATASUS data of individuals over 40 years in 2002-2012. We used the Global Moran and Local Moran tests and joinpoint analysis of rates in the country. We conducted bivariate spatial analysis of the main variables and primary care coverage rates (professionals/institutions). The results showed that in 2002, the prevalence rates of diabetic foot and amputations were higher (4.2/100.000 and 2.8/100.000, respectively). There was an annual reduction of 11.73% in the prevalence of diabetic foot and 9.52% in the amputation rate from 2002 to 2012. There was a higher spatial concentration of diabetic foot rates in the North, Northeast and Midwest. There was negative autocorrelation when performed bivariate analysis with the rate of establishments in primary care (ranging from I= -0,10 a -0,12, p< 0,05). This suggests important relationship between the small number of establishments in the regions and the highest prevalence. It concludes that despite the decrease in prevalence rates, it was not possible to identify direct influence of the law on reduced rates of diabetic foot and amputations for diabetes mellitus in Brazil.

30
  • MARCOS ANDREY ARAÚJO DE AZEVEDO
  • ACUPUNCTURE IN BRAZILIAN PUBLIC HEALTH SYSTEM: TIME SERIES AND SPATIAL ANALYSIS STUDY

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • CLELIA DE OLIVEIRA LYRA
  • LEVI HIGINO JALES JUNIOR
  • Data: 2 sept. 2016


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  • Acupuncture treatment is gaining more demand and importance in Brazilian society and in the professional and scientific culture of health care. This study aims to quantify the historical evolution of Acupuncture in the Brazilian Public National Healthcare System (SUS). We made a time series of the healthcare coverage rates of acupuncture consultations recorded in the Ambulatory Information System of the SUS (SIA/SUS), between the years 2000 and 2014. We calculated the rate of acupuncture consultations for 100,000 health procedures/year in SUS in Brazil and regions. The rate of acupuncture consultations for each group of 10,000 inhabitants per year, was calculated for Brazil; regions and 27 Brazilian federative units, as a relative index of population coverage by acupuncture services offered by SUS. These coverage rates were used to carry out a time series with trend analysis, between 2000 and 2014, associated with an exploratory spatial analysis, performed to do a geographical illustration of the evolution of these rates before and after the implementation of the National Policy on Integrative and Complementary Practices (PNPIC). The trend in the coverage rates in these two periods in Brazil, was also analyzed by comparing the annual percentage change values (APC) of each period. The results showed that there was a gradual increase in the rates of acupuncture consultations/10,000 inhab./year, in the SIA/SUS, in Brazil and in most part of Brazilian regions and units of federation, between the years 2000 and 2014. The emphasis was to the states of São Paulo, Rio de Janeiro and Paraíba, with rates ranging between 52 and 72 acupuncture consultations/10,000 inhab./year, in 2014. In this same year, the lowest number of consultations rates were recorded in the states of Amazonas, Rio Grande do Norte and Mato Grosso do Sul, with rates ranging between 0.3 and 2.8 acupuncture consultations/10,000 inhab./year. Rondônia and Piauí have not showed acupuncture consultations records in the SUS across the time series. In Brazil, during the study period, there was a quantitative increase in the number of acupuncture consultations (5.78 times); in the healthcare coverage rates provided by acupuncture services in SUS (4.74 times) and in the rates of acupuncture consultations compared with all health procedures registered in the SUS (3.12 times). The trend of growth in coverage rates was higher after the start of the implementation of PNPIC (APC=16.6%; p=0.05) than before (APC=1.4%; p=0.05). We conclude that the growth of acupuncture coverage rates occurred heterogeneously, although Brazil and most part of Brazilian regions and federative units showed a growth trend when we compare the beginning and end of the time series. The PNPIC can be an enhancer factor of this growth trend. Coverage rates of acupuncture in public health system of Brazil are low and they have a great growth potential.

31
  • JEFERSON MESSIAS DE ALENCAR CRUZ
  • LIFE AT WORK QUALITY, ANXIETY AND DEPRESSION IN OCCUPATIONAL HEALTH TO PROVIDE CHILD CARE UNITS IN HOSPITARES

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • GERALDO EDUARDO GUEDES DE BRITO
  • Data: 16 sept. 2016


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  • The work plays an important role in the lives of individuals and can often contribute negatively on the health and quality of working life (QWL) of these individuals. The aim of this study was to evaluate the QWL, the prevalence of anxiety and depressive symptoms among health professionals working in hospitals of pediatrics and neonatology in the city of Natal / RN. This is an observational cross-sectional study, conducted from December 2015 to April 2016. We used a convenience sampling (or availability sampling) of 102 healthcare professionals (doctors, nurses / nursing assistants and physiotherapists). In order to check the occupational and sociodemographic profile was used a form developed by the authors. For the evaluation of QWL and the prevalence of anxiety and depression in this population we used specific instruments and questionnaires validated for the Brazilian reality. The profile of health personnel was characterized by a mean age of 36 (± 8.3) years old, female (82.4%), single (44.1%), with income of up to nine Brazilian minimum wages (76.5%), working in intensive care units (69.6%) in part-time (12 hours per duty, day shift) (45.1%) and the mostly of health personals had more than one job in others hospitals (53.9%). The average hours worked in the places surveyed was 33.6 (± 8.4) hours per week and 56.0 (± 20.9) hours per week when all sifts were summed. The main causes of dissatisfaction with the work were “remuneration” (30.4%), “working conditions” (19.6%), “few time for social activities” (17.6%),“shifts and work schedule” (16.7 %) and “professional recognition” (6.9%). The final score of QWL was 65.76 (±11.6) and about QWL’s domains was found 62.86 (± 13.8) for "Physical and Health”, 66.83 (±16 2) for "psychological", 75.31 (±14.46) for "Personal" and 58.03 (±14.05) for the "Professional". The prevalence of anxiety was 17.6% and 12.7% for depressive symptoms among healthcare personnel working in children´s hospitals. In conclusion, we observed in this study that healthcare professionals presented satisfactory QWL in all domains of QWL. However, the prevalence of anxiety and depression was associated to low scores of "Physical and Health" field from QWL, which suggests that interventions towards prevention and health promotion, improvement of work conditions, as well as professional valorization should be more encouraged to safeguard the quality of life in this population.

32
  • ANA KARLA BEZERRA LOPES
  • The Congenital Syphilis in the big cities of Brazil

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • ANA MARIA DE BRITO
  • KENIO COSTA DE LIMA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 27 sept. 2016


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  • The Congenital Syphilis is characterized as infection of the conceptus, predominantly by transplacental transmission, from infected pregnant untreated or inadequately treated. In Brazil, the cities with more than 100,000 inhabitants, considered large cities, concentrated almost 80% of all reported cases of the disease. Thus, the objective of the study is to understand the distribution of congenital syphilis in large cities and assess its correlation with socioeconomic indicators and health services between 2007 and 2013. This is an ecological study and used as the unit of analysis the 283 Brazilian cities with more than 100,000 people. The study population consisted of all cases of congenital syphilis reported in the Notifiable Diseases Information System (SINAN), in these cities. Descriptive analysis of reported cases was performed. Then there was the bivariate analysis using Pearson's correlation coefficient to assess the degree of relationship of the prevalence of congenital syphilis with each of the 14 indicators selected for the study, as IDHM, GINI, percentage of vulnerable to poverty, percentage of black women, unemployment rate, percentage of women aged 10 to 17 years with children, rate of Syphilis Gestational, percentage of live births with 7 or more prenatal visits, primary care coverage and the Family Health Strategy . In the period from 2007 to 2013 were reported 38,533 cases of the disease in Brazil. Most of the cases consisted of children reported before 7 days of life, black, equally distributed between the sexes, mothers who underwent prenatal and were diagnosed in that period or at delivery. The northern and northeastern regions stood out for being the only ones with average prevalence above the national (2.54 / 1.000NV) in the period analyzed. Among the variables related to the quality and coverage of health services, the significant one was the percentage of live births variable with 7 or more prenatal consultations (r = -0.264). The IDHM (r = - 0.151), GINI index (r = 0.166), vulnerable percentage of poverty (r = 0.218), percentage of black women (r = 0.255), unemployment rate (r = 0.286), percentage of women 10 to 17 years with children (r = 0.256), Syphilis rate Gestational (r = 0.480) were significantly correlated. Considering the results reaffirmed the importance of prenatal care in the face of congenital syphilis and the influence of socioeconomic factors in the rates presented by this disease.

Thèses
1
  • MATHEUS FIGUEIREDO NOGUEIRA
  • AVALIAÇÃO MULTIDIMENSIONAL DA QUALIDADE DE VIDA EM

    IDOSOS: UM ESTUDO NO CURIMATAÚ OCIDENTAL PARAIBANO

  • Leader : MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • EDNA MARIA DA SILVA
  • GIGLIOLA MARCOS BERNARDO DE LIMA
  • LUCIANA DANTAS FARIAS DE ANDRADE
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • Data: 29 févr. 2016


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  • O acelerado crescimento da população idosa é uma realidade mundial, configurando-

    se um dos maiores desafios para a saúde pública contemporânea. Considerando o

    envelhecimento um fenômeno multidimensional e a ampliação da expectativa de

    vida, põe-se em evidência a necessidade de investigar se o prolongamento da

    longevidade está acompanhado de níveis satisfatórios de qualidade de vida (QV).

    Objetivou-se neste estudo avaliar a QV facetada e global de idosos da microrregião do

    Curimataú ocidental paraibano, explicada por suas condições de vida e saúde. Consta

    de um estudo observacional transversal com desenho quantitativo realizado com 444

    idosos de cinco municípios: Barra de Santa Rosa, Cuité, Nova Floresta, Remígio e

    Sossego. Para obtenção das informações, foram utilizados os seguintes instrumentos:

    I) Questionário para coleta de dados pró-idoso, para as características

    sociodemográficas, clínicas e comportamentais; e II) Questionário WHOQOL-Old, para

    mensuração e avaliação da QV. Os dados foram processados no software IBM-SPSS

    Statistics 20.0 por meio dos testes ANOVA (one-way), t-Student, Mann-Whitney,

    Kruskal-Wallis e correlação de Pearson, sendo p-valores<0,05 aceitos como

    estatisticamente significativos. Os resultados apontam uma boa QV global

    (ETT=65,69%), com melhor avaliação por idosos do sexo masculino, com idade entre

    60 e 74 anos, casados, morando com cônjuge e filhos, sem cuidador, praticantes de

    exercícios físicos, com até um problema de saúde diante de um aspecto de

    multimorbidade e com muito boa e/ou boa avaliação das necessidades básicas. O

    estresse autorreferido apresentou uma correlação significativa negativa diante da QV

    global, onde quanto maior a percepção do estresse, pior a avaliação da QV. Na

    avaliação facetada da QV, o Funcionamento Sensório apresentou o melhor

    desempenho (ETF=68,86%) e a Participação Social (PSO) o pior (ETF=60,37%). No

    modelo de regressão linear múltipla, a PSO isoladamente é responsável por 51,8%

    (R2=0,518) de explicação da QV global. Na intercorrelação entre as facetas do

    WHOQOL-Old, apenas Morte e Morrer não revelou significância. A harmonia

    evidenciada entre as facetas suscita a necessidade de assegurar uma atenção integral

    à saúde do idoso, em especial na compreensão da participação social como elemento

    intrínseco à QV e que demanda a rediscussão e reconstrução de ações individuais e

    coletivas, familiares e comunitárias, políticas e governamentais. Logo, garantir um

    envelhecimento ativo, saudável, participativo e com QV é o grande desafio.

2
  • ANNA PAULA SEREJO DA COSTA
  • MORTALIDADE DE MULHERES VÍTIMAS DE VIOLÊNCIA RELACIONADA

    ÀS DESIGUALDADES SOCIAIS, ESTILO DE VIDA E VIOLÊNCIA URBANA NO BRASIL

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • CARMEN SIMONE GRILO DINIZ
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • EDMILSON LOPES JUNIOR
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 4 mars 2016


  • Afficher le Résumé
  • Introdução: O Brasil possui um dos maiores índices de homicídios femininos do

    mundo. Entretanto, tal magnitude ainda não pode ser bem dimensionada, pois

    poucas pesquisas de base populacional foram desenvolvidas no país e os estudos, em

    sua maioria, ocorrem de forma isoladas no serviço de saúde e na Secretaria de

    Segurança. Objetivo: Analisar a distribuição espacial e a evolução das taxas de

    mortalidade da violência de gênero no Brasil, no período de 2008-2012 e identificar

    possíveis determinantes ecológicos e sociais. Método: Estudo ecológico cuja variável

    dependente foi a Taxa de Mortalidade de mulheres vítimas de violência com idades

    entre 15 e 59 anos. Para a análise da autocorrelação espacial entre as 161 Regiões de

    Articulação Urbana (RAU) do Brasil foram aplicados os testes de Moran Global e local.

    O LISA e o teste de correlação de Pearson foram usados para avaliar a correlação

    entre a variável desfecho e as variáveis independentes (econômicas, demográficas,

    desigualdade de gênero, pobreza, desigualdade social, vulnerabilidade e de violência

    urbana). A  verificação da evolução da mortalidade das mulheres, comparado a dos

    homens, no período de 2000-2012, foi feita através do JoinPoint.  Resultados: No

    período de 2008 a 2012, 19 mil mulheres morreram vítimas de agressão no Brasil, o

    que resulta um coeficiente de mortalidade médio padronizado de 5,9 óbitos/100.000

    habitantes. Dessas mulheres, a maioria era de jovens, solteiras, negras e de baixa

    escolaridade.  Foi observada autocorrelação espacial para mortalidade por agressão

    em mulheres (I=0,4384;p=0,01), com maior concentração dos óbitos na região

    Sudeste, nas RAUs de Vitória, São Mateus, Colatina; na região Nordeste em Teixeira

    de Freitas, Ilhéus-Itabuna, Arapiraca, Maceió e João Pessoa; na região Norte em

    Redenção e Marabá; na região Sul, em Curitiba e na Região CentroOeste em Rio

    Verde. A violência urbana apresentou uma forte correlação com a mortalidade de

    mulheres vítimas de violência (I=0,38;r=0,88;p<0,05).  Já as variáveis econômicas e

    sociodemográficos apresentaram fraca ou ausência de correlação. Entre os anos de

    2000 a 2012 pode-se visualizar para o Brasil uma tendência crescente significativa da

    mortalidade de mulheres por agressão a partir de 2007, semelhante a encontrada

    também para a violência urbana. Conclusão: Entre as variáveis associadas ao evento,

    destaca-se a mortalidade masculina por agressão, indicando a importância da redução

    da violência estrutural como proteção das mulheres contra a violência. A mortalidade

    por violência contra mulher não se mostrou relacionada às demais características do

    entorno, o que se faz pensar que realmente perpassa fatores de classe, raça,

    escolaridade, religião e estado civil.

3
  • LIDIANE MARIA DE BRITO MACEDO FERREIRA
  • INCIDÊNCIA E FATORES DE RISCO RELACIONADOS A QUEDAS EM UMA COORTE DE IDOSOS INSTITUCIONALIZADOS

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KARYNA MYRELLY OLIVEIRA BEZERRA DE FIGUEIREDO RIBEIRO
  • KENIO COSTA DE LIMA
  • LEANDRO DE ARAUJO PERNAMBUCO
  • MARIA ANGELA FERNANDES FERREIRA
  • MONICA RODRIGUES PERRACINI
  • Data: 13 juin 2016


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  • A queda é uma síndrome geriátrica associada à alta morbimortalidade nos idosos. Este trabalho tem como objetivo determinar a incidência e os fatores de risco relacionados a quedas em idosos institucionalizados na cidade do Natal-RN. Para esse fim, foi realizado um estudo longitudinal tipo coorte com período de duração de um ano. Foram avaliados idosos residentes nas 10 Instituições de longa permanência para idosos (ILPI) do município do Natal-RN, que deambulassem e possuíssem capacidade cognitiva preservada, avaliada a partir do questionário de Pfeiffer. Do total de 364 idosos residentes nas ILPI, 130 foram incluídos de acordo com os critérios estabelecidos para inclusão e exclusão. Foi questionado ocorrência de quedas no último ano. Variáveis referentes à instituição, condições sócio-demográficas e saúde do idoso foram coletadas por meio de questionário aplicados aos idosos ou cuidadores, ou ainda pela coleta nos prontuários. Foram utilizados os questionários Escala de depressão geriátrica, Escala de depressão CES-D, Escala de sonolência de Epworth e o Índice de Barthel. Dados ambientais, antropométricos e de exame físico (Timed up and go – TUG, Escala de Equilíbrio de Berg – EEB, Velocidade de marcha – VM, Força de preensão palmar – FPP e Teste do sentar e levantar - TSL) foram obtidos a partir de dados secundários. As análises estatísticas foram realizadas por meio dos testes de Qui-quadrado ou Exato de Fisher e Regressão Logística, considerando o nível de significância de 5%. Como resultados, na análise ambiental nenhuma instituição cumpriu todas as normas da ANVISA. Pela avaliação físico-funcional, há inferência para risco de quedas. Sessenta e dois idosos caíram ao final dos doze meses de avaliação, com incidência de 47,7% (IC95%=39,59-55,81) e uma taxa de quedas por pessoa/ano de 1,65 (+ 8,43). Para quedas recorrentes, a incidência foi de 26,92% (IC= 22,38 - 31,46), representando 56,45% dos idosos que caíram. A maioria das quedas ocorreu no quarto e foram encontrados como fatores de risco o uso de antiepilépticos e fadiga e como fatores de proteção o declínio de mobilidade e uso de medicamentos antitrombóticos, ajustados pela terapêutica tireoidiana, funcionalidade, sexo e hospitalização. Para duas ou mais quedas, foram identificados fadiga como fator de risco e uso de betabloqueadores como fator de proteção, ajustados pelo uso de medicamento antitrombótico, antiepiléptico, funcionalidade, sexo e idade. Conclui-se que queda é um evento bastante incidente nas ILPI e que a fadiga foi  identificada como fator de risco para queda única ou recorrente, devendo a condição física do idoso e o cansaço serem levados em consideração no momento de sua avaliação.

4
  • DIVIANE ALVES DA SILVA
  • Contextual factors of population aging in Northeastern Brazil

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • DAMIAO ERNANE DE SOUZA
  • KENIO COSTA DE LIMA
  • LARA DE MELO BARBOSA ANDRADE
  • MARIA ANGELA FERNANDES FERREIRA
  • RENATO PEIXOTO VERAS
  • Data: 28 juin 2016


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  • The changing age distribution in Brazil occurs quickly and in an unfavorable environment socio-economically. The Brazilian Northeast, historically, highlighted by the presence of deep social inequality appears as the third most aged region of the country and this fact becomes important, considering its extensive territorial dimension as well as an unfavorable socio-environmental context. The aim of this study was to analyze the relationship between the context and the aging population in the Northeast of Brazil. This is an ecological study, whose scenario corresponds to the Northeast region, consisting of nine states and 1,794 municipalities. We collected demographic data and several socioeconomic indicators in the electronic databases of the Brazilian Institute of Geography and Statistics (IBGE), Applied Economic Research Institute (IPEA), the Human Development Atlas of the United Nations Development Programme (PNUD) and the SUS Department of Informatics (DATASUS). The outcome of the study was the levels of population aging, defined from cluster analysis that grouped municipalities, considering five demographic aging indicators (percentage of elderly, aging index, “sobreenvelhecimento”, senile dependence and population replacement in active age index). The principal component analysis was used to obtain socioeconomic-demographics factors, which represented the independent variables of the study. Other variables with theoretical importance for the outcome were also selected. It was held geoprocessing of the outcome variable data using TabWin 3.6b, for visual identification of Northeast aging profile, according to the levels of aging. In association analyzes used the ANOVA test for the factors and others quantitative variables and the chi-square test for categorical variables. In both tests it was considered a 5% significance level. We used the ordinal logistic regression analysis to verify the actual associations with the outcome. It was observed that aging in the Northeast shows a pattern of heterogeneous distribution, with concentration higher levels in the region belonging to the semi-arid region, covering the interior and south-central of the Ceará state, parts of the western, central and harsh regions of Rio Grande do Norte state, and almost all of the area of Paraiba state, except the coastal region. The high levels of aging were associated with good levels of education, dependence on government income, the net migration of the general population and some states of the region, taking as reference for comparison, the state of Paraiba. It is important the aging situational study in Northeast Brazil, a region that, although unequally, has a large contingent of elderly. The understanding of such distribution, in turn, can lead to the identification of local and/or general determinants of the population aging, to be addressed in the pro-aging policies.

5
  • LARISSA PRACA DE OLIVEIRA
  • MORTALITY AND PROGNOSTIC FACTORS IN THE ELDERLY RESIDENTS IN NURSING HOMES

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • IGOR CONTERATO GOMES
  • KENIO COSTA DE LIMA
  • MARIA ANGELA FERNANDES FERREIRA
  • RENATO PEIXOTO VERAS
  • Data: 29 juin 2016


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  • Population aging is a global phenomenon. In Brazil, the increase in the proportion of elderly in the population has been accompanied by changes in the epidemiological profile, which are prevalent noncommunicable chronic diseases, which are the leading causes of morbidity, disability and mortality, especially in the elderly residing in nursing homes. The shortage of studies involving the situation of health and mortality in institutionalized elderly motivated this research, which aims to determine the mortality and its prognostic factors in institutionalized elderly in the city of Natal-RN. This is a prognostic study with dynamic population, started in October 2013 with duration of 18 months follow-up to all elderly residents (n = 345) in nursing homes, with and without profit. During this period, were realized seven assessment waves, where the following anthropometric variables were measured: weight (kg), height (cm), brachial perimeters (cm) and calf (cm). The nutritional screening was performed using the Mini Nutritional Assessment. Information about the food consumption and serum albumin concentration were obtained from the data analysis of a survey which this study is part. As for the information about morbidities, hospitalizations, diet type and number of medications they were obtained through medical records. Socioeconomic, demographic and sociocultural data were collected through structured interviews with questionnaires assistance. The information on mortality was obtained after analysis of death certificate. The statistical analysis was carried out through the analysis of survival by the Kaplan-Meier method, and then Cox regression at multivariate analysis, with the respective hazards ratios (HR).  Thes 345 elderly evaluated presented mean age equal to 81.2 (9.3) years, with the largest proportion of the population ≥ 75 years. Most institutionalized are female (76.5%), are single (45.8%) and have some degree of schooling (61.4%). A total of 179 elderly (51.9%) have mobility restriction, 89.0% were diagnosed with chronic diseases, 54% with malnutrition and 45.2% use more than five drugs a day. Chronic diseases such as hypertension (45.5%) and diabetes (25.0%) are the most frequent. During follow-up, 70 elderly (20.3%, CI:16.25- 25.00) died, in which respiratory diseases (44.3%) and circulatory (30.0%) were the its main causes. The probability of overall survival of institutionalized elderly was 78.7% (CI: 0.74-0.83) at the end of the cohort, where the main prognostic factors identified in the Cox analysis were age ≥ 75 years (HR = 3 85), calf perimeter equal and less than 31cm (HR = 2.58), tube feeding (HR = 2.59), doughy food (HR = 2.23), with mobility restrictions (HR = 1, 76), male (HR = 1.75) and polypharmacy (HR = 1.55). In this way, improvements in health, with actions directed to prevention of cardiovascular and respiratory diseases, as well as the recovery of nutritional status and fitness on prescription food and medications can result in reducing the risk of early mortality.

6
  • FABIENNE LOUISE JUVÊNCIO PAES DE ANDRADE
  • INCIDENCE AND RISK FACTORS FOR HOSPITALIZATION OF INSTITUTIONALIZED OLDER ADULTS

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • GERALDO EDUARDO GUEDES DE BRITO
  • IGOR CONTERATO GOMES
  • KENIO COSTA DE LIMA
  • WILTON RODRIGUES MEDEIROS
  • Data: 1 juil. 2016


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  • The accelerated aging process of the Brazilian population is associated with an increase in non-transmissible chronic diseases, which in turn increases the demands for health services. The hospitalization rates of older adults are higher than what is observed in other age groups, especially in those that reside in Long Term Institutions for the Elderly (LTIE), due to inherent vulnerability and frailty of these individuals. The objective of the work presented herein was to verify the incidence and risk factors associated with the hospitalization of institutionalized older adults in the city of Natal/RN, Brazil. A prospective cohort study was carried out throughout a monitoring period of 12 months, with older adults over the age of 60, who resided in the 10 LTIE that accepted to participate in the study. Initial data collection included sociodemographic information related to the institution, health conditions and incidence of negative outcomes in the health state of residents. The Stepwise Forward method was utilized for Multiple Logistic Regression Analysis, with a 5% significance level and confidence interval (CI) 95%. Of the participating 320 elderly, there was a predominance of females (75,3%), average age 81.4 years (Standard Deviation, SD: ±9,0). Of these, 20.6% (CI 95%: 16,5-25,4) were hospitalized, with an average permanence time of 16,1 days (SD: ±17,1). The main hospitalization cause was pulmonary disease (30,3%). The final model showed that malnutrition or risk of malnutrition (p=0,016) and the use of medication for the cardiovascular system (p=0,003) were risk factors for hospitalization, adjusted by age, sex and type of institution. These findings indicate a high incidence of hospitalization in institutionalized elderly. Malnutrition or risk of malnutrition and the use of cardiovascular medication were considered to be risk factors for hospitalization. There is a clear need for increased attention in multiprofessional evaluation, as well in interventions and services rendered to institutionalized elderly.

7
  • JAVIER JEREZ ROIG
  • Functioning in a cohort of institutionalized older people

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • LEANDRO DE ARAUJO PERNAMBUCO
  • MARIA ANGELA FERNANDES FERREIRA
  • MARIA VICTORIA ZUNZUNEGUI
  • RICARDO OLIVEIRA GUERRA
  • Data: 23 août 2016


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  • The main objectives of this work were: to verify the prevalence of functional disability (FD) in the basic activities of daily living (BADL) and its associated factors (Study 1) and verify the incidence of functional decline and predictor factors of functional decline (Study 2) in institutionalized older people. The sample of the study was formed by individuals aged 60 years and over belonging to 10 nursing homes (NH) in Natal/RN, being excluded hospitalized or palliative care residents. The Study 1 is a cross-sectional study (October-December 2013) and FD was evaluated by Katz scale and characterized when there was limitation in one or more BADL (eating, sphincter control, transferring, personal hygiene, dressing and bathing). As independent variables sociodemographic, instituition-related health-related variables were considered. The Chi-square test, Fisher's exact test or the linear Chi-square test for the bivariate analysis and logistic regression for multivariate analysis were applied. The sample consisted of 321 individuals and the prevalence of FD was 72.9% (95% CI: 67.8-77.5%). The most affected task was 'bathing', followed by 'dressing' and 'toileting.' The final model found association with private NH (PR=1.33, p<0.001), age 83 and over (RP=1.26, p=0.003), reason for institutionalization “lack of caregiver” (RP=1.17, p=0.033) and osteoporosis (RP=1.23, p=0.045), adjusted by sex. The Study 2 is a 24-months longitudinal study with follow-up every 6 months (5 waves). Apart from the criteria considered in the Study 1, residents with FD for all BADL (bathing, personal hygiene, dressing, toileting, walking, transferring and eating) at baseline were excluded. The presence of functional decline was defined when there was a reduction the total score of BADL, which were assessed by a 5-point Likert scale. All independent variables of the Study 1 were considered, as well as the mobility status, cognitive status (Pfeiffer test), toxic habits, physical activity and time-dependent variables. Statistical analysis was performed using the actuarial method, log-rank test, Cox univariate analysis and Cox regression. The cohort was composed of 280 individuals: 140, 50.0% (95% CI: 44.2-55.8%) experienced functional decline; 94, 33.6% (95% CI: 28.3-39.3%), maintained their functional capacity, and; 40, 14.3% (95% CI: 10.7-18.9%), showed functional improvement at one or more waves. The cumulative probability of functional maintenance was 44.0% (95% CI: 37.7-50.2%) at 24 months. The ability to eat showed the largest decline during the period (-0.54 points), followed by walking (-0.43), dressing (-0.35), transferring (-0.31), bathing (-0.29), personal hygiene (-0.24) and toileting (-0.22). The final model showed that the predictors factors of functional decline were severe cognitive impairment (HR=1.98, p=0.003), continence decline (HR=1.70, p=0.013) and incidence of hospitalizations (HR=1 65, p=0.023).

8
  • LAURA CAMILA PEREIRA LIBERALINO
  • DIETARY PATTERN OF RESIDENTS ELDERLY IN NURSING HOMES

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • CELIA MARCIA MEDEIROS DE MORAIS
  • CLELIA DE OLIVEIRA LYRA
  • FILIPE FERNANDES OLIVEIRA DANTAS
  • FLÁVIA EMÍLIA LEITE DE LIMA FERREIRA
  • KENIO COSTA DE LIMA
  • Data: 26 août 2016


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  • Food is a human need on free demand and with many meanings. However, at the nursing homes it becomes a collective good, with defined schedules and controlled quantities, which may change the eating comportment and compromise the health of the elderly. In this sense, identify dietary patterns based on representative data for the population, can improve the understanding of dietary practices and assist the nutritional and educational interventions. The scarcity of information about food and nutrition situation of institutionalized elderly living in nursing homes in Natal, Rio Grande do Norte, Brazil, motivated to meet the dietary patterns of this group to support the development of strategies to improve the health status of the elderly. This study aimed to identify and characterize the dietary pattern of the elderly living in nursing homes  and propose a Food Frequency Questionnaire (FFQ) for elders living there. This is a cross-sectional study, involving all elderly residents in philanthropic and private nursing homes located in Natal (n = 300). Food and dietary consumption data was obtained in 2013, through the food record method, by direct weighing of food for two alternate days. Dietary patterns were identified from the Principal Component Analysis, considering the average amount of food consumed (in grams). The factor scores of dietary patterns were categorized into tertile (low, moderate and high consumption) and were verified associations with sociodemographic characteristics, lifestyle, health, nutritional status and dietary practices, revealing the existence (or not) of tendency for each feature and the consumption levels for each pattern. To prepare the FFQ, it was previously defined a list of foods from the percentage contribution of energy, carbohydrate, protein, total fat, calcium and vitamin D. Among the most consumed foods are highlighted: dairy products, rice and preparations based on it, fruits and oil seeds, beans and legumes, fruit juices and drinks. It is noteworthy the higher consumption of corn and flour in philanthropic nursing homes, as well juices and drinks, potatoes, cheese and cured higher among the elderly over 70 years. It was observed that pap and porridge are the main contributor to the energy supply, protein, carbohydrate and calcium in the dietary. Three patterns were identified in food consumption, called "rice, potatoes and meat", "Fish and Pasta" and "beans and soups," explaining about 70% of total consumption variability. It was found that physically active elderly has tendency to a high consumption of the "rice, potatoes and meat" pattern. The elderly men, aged between 60-69 years, physically active, smokers, without mobility restrictions, which have excessive intake of energy and do not need help to feed, tend to high consumption of "fish and pasta". Finally, the male elderly with mobility restrictions and with pasty dietary tend to a high consumption of "beans and soups". Thus, the diagnosis of dietary pattern shows that food interventions need to be implemented to prevent the raise of malnutrition prevalence in elders and, when planning the menus, the nursing homes need to encourage the intake of other food groups, especially fruits and vegetables, so that these items made part of the habitual food consumption of institutionalized elderly in Natal.

9
  • ANDRÉ LUIZ BARBOSA DE LIMA
  • FACTORS ASSOCIATED WITH FUNCTIONAL CAPACITY IN ELDERLY IN THE BRAZILIAN CONTEXT.

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • DAMIAO ERNANE DE SOUZA
  • JULIANA MARIA GAZZOLA
  • KENIO COSTA DE LIMA
  • PAULO BORGES DE SOUZA JUNIOR
  • Data: 24 oct. 2016


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  • Activity limitations are difficulties an individual may have to perform certain tasks of daily life and determines part of the individual's disability status. In Brazil, the prevalence of activity limitation reaches 32% of the population of elderly people. Knowing the prevalence of activity limitations in terms of functional capacity of the elderly and to examine the associations between functional capacity and socio-demographic and economic characteristics of individuals, as well as the social gender inequality and socioeconomic characteristics within the Brazilian Federative Units are fundamental to the structure of assistance actions and health surveillance. Therefore, the aim of this study was to create the functional capacity index and thus able to estimate the magnitude of gender differences in functional capacity among the elderly and examine whether these differences could be associated with social gender inequality and socioeconomic contextual factors in terms of Federative Units. This is a cross-sectional and ecological population-based study that included residents aged 60 years old participating in the National Health Survey, conducted in 2013, in Brazil. The functional capacity index was developed and validated from a hybrid model of generalized partial credit and two-parameter logistic of Item Response Theory, provided the assumptions of dimensionality of the latent space and stochastic local independence. Gender differences were estimated in functional capacity in each Federative Unit. To determine if the social gender inequality and socioeconomic contextual variables were associated with gender differences in functional capacity were adjusted multilevel linear regression models with cross-level interaction, controlled by individual- and contextual-level variables, which yielded coefficients and their 95% confidence intervals. For Brazil, the results indicated that 17% of the elderly had some limitation in activities of daily living and 29% in instrumental activities of daily living. Women had higher functional capacity disadvantages than men and was found in the group of octogenarians a prevalence of 70% in activity limitations. The smallest functional capacity indexes were found among older people with older age, especially the group of octogenarians and illiterate. It was noted that the North and Northeast Region had greater disadvantages in functional capacity, especially among women. Amazonas, Rio Grande do Norte, Paraiba and Alagoas detained the worst conditions of functional capacity among the elderly. Moreover, in Alagoas, Pernambuco and Maranhao the magnitude of gender differences, in disadvantage for women, were higher. Based on these results, the hypothesis of this study was confirmed by demonstrating that the Brazilian Federative Units with the largest gender differences in functional capacity were those with the greatest social inequalities of gender, being largely influenced by higher income inequality.

10
  • ROSIRES MAGALI BEZERRA DE BARROS
  • ANALYSIS OF POWER RELATIONS IN THE PROCESS OF DECENTRALIZATION OF HEALTH SURVEILLANCE IN NATAL / RN.

  • Leader : IRIS DO CEU CLARA COSTA
  • MEMBRES DE LA BANQUE :
  • EDNA MARIA DA SILVA
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • GRÁCIA MARIA DE MIRANDA GONDIM
  • IRIS DO CEU CLARA COSTA
  • MARISMARY HORSTH DE SETA
  • Data: 9 déc. 2016


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  • Sanitary surveillance is the promotion, in the field of collective health, of activities aimed at controlling the production and sale of goods, products and services, with a view to eliminating or minimizing risks, for the health of the community. The objective of this study is to analyze the power relations established in the process of decentralization of the sanitary surveillance in the city of Natal / RN and to understand this process from the analysis of the policies formulated by the federal body, from the relations of power between the federative entities and between the actors involved in this process. This research was developed in three stages: the first stage consisted in the study of theoretical and empirical reference that served as a framework for analysing the decentralization sanitary surveillance policy; the second one to constructing the report and the analysis of how the decentralization of sanitary surveillance in Natal / RN happened; the third one contemplated the analysis of the power relations between the different administrative divisions of the Federation in this municipality, in the light of the theoretical reference and the decentralization policy in the country. The methodological approach is qualitative, descriptive and exploratory. Data collection was done through documentary research and interviews with key informants who held management positions in sanitary surveillance in the city of Natal and in the state of Rio Grande do Norte. The review of the literature on the decentralization of sanitary surveillance was carried out from the metassynthesis of publications ranging from 1990 to 2014, with the support of the IRAMUTEQ Program. The analysis of the interviews was also carried out with the support of this software. The results showed that the decentralization of sanitary surveillance in Natal happened as a result of a correlation of forces between the state and municipality, marked more frequently by moments of distension. These power relations were asymmetric and the advances and setbacks in this process happened in function of these relations. At the end of this study, it was possible to broaden the understanding of the decentralization of sanitary surveillance in the city of Natal and contribute to the understanding of this guideline in the field of sanitary surveillance, since this process has not yet been concluded, in Natal, nor in the rest of the country.

2015
Thèses
1
  • SALOMÃO ISRAEL MONTEIRO LOURENÇO QUEIROZ
  • MEDIDAS DE HEMOSTASIA LOCAL PÓS-EXODONTIAS EM PACIENTES QUE FAZEM USO DE VARFARINA: UM ESTUDO CLÍNICO CONTROLADO E RANDOMIZADO

  • Leader : JOSE SANDRO PEREIRA DA SILVA
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • FABRICIO BITU SOUZA
  • JOSE SANDRO PEREIRA DA SILVA
  • Data: 20 janv. 2015


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  • O presente trabalho trata-se de um ensaio clínico, controlado, cego e randomizado com pacientes em terapia anticoagulante com varfarina comparando medidas de hemostáticos locais para o controle do sangramento pós-exodontias. Para isso foram empregados dois métodos de hemostasia local, sendo o grupo I (controle) utilizando somente irrigação, compressão com gaze com soro fisiológico e sutura e o grupo II (estudo) utilizando irrigação, compressa com gaze embebida com ácido tranexâmico e sutura. A amostra foi composta de 37 pacientes com media de idade de 45,5 anos e 62,2% do sexo feminino. Após randomização 20 foram alocados para o grupo controle e 17 para o grupo estudo, sendo realizado um procedimento cirúrgico por paciente. Na avaliação pré-operatória a pressão arterial sistólica teve um media de 122,4 (±15,5) mm/Hg, a pressão arterial diastólica de 74,5 (±8,6) mm/Hg. A frequência cardíaca ficou com uma media de 77,9 (±12,1) batimentos por minuto. O hematócrito com 38,5 (±4,9) %, plaquetas com 306189,1 (±83994,3) por mm3, TP com 29,7 (±7,3) segundos, TTPa com 37,1 (±7,1) e INR 2,4 (±0,7) com mínimo de 1,17 e máximo de 3,61. O tempo de realização do procedimento cirúrgico durou em média 30,9 (±7,5) minutos. Todas essas variáveis semelhantes entre os grupos, não sendo verificadas diferenças significativas (p>0.05). Na avaliação do sangramento imediato a média para conseguir o estancamento do sangramento foi de 9,1 (±3,6) minutos. No grupo estudo o tempo para conseguir essa hemostasia foi bem menor se comparado com o controle, sendo essa diferença (6,018 / IC 95%: 4,677-7,359) estatisticamente significante (p<0,001). Avaliando o controle do sangramento de forma mediata o uso do ácido tranexâmico mostrou-se mais associado significativamente com a não ocorrência de sangramento, principalmente nas primeiras 24h. Assim sendo o uso do ácido tranexâmico de forma tópico com compressa com gazes e irrigação local foi eficaz como um protocolo de hemostasia local na redução do tempo de hemostasia imediata e prevenção da mediata, com as resalvas da dificuldade de avaliação do sangramento.

2
  • ANDERSON NICOLLY FERNANDES DA COSTA
  • Eficácia da clorexidina associada ao tratamento não-cirúrgico de mucosite peri-implantar: uma avaliação de 18 meses

  • Leader : BRUNO CESAR DE VASCONCELOS GURGEL
  • MEMBRES DE LA BANQUE :
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • SUZANA PERES PIMENTEL
  • Data: 29 janv. 2015


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  • A mucosite peri-implantar é uma inflamação da mucosa ao redor do implante em resposta ao acúmulo do biofilme bastante prevalente. Existem diversos protocolos para o seu tratamento da mucosite peri-implantar, mas ainda não existem evidências consistentes para escolha de um protocolo ideal. Em virtude disso, essa pesquisa objetiva verificar a eficácia longitudinal do uso da clorexidina a 0,12% como um adjuvante ao tratamento não-cirúrgico da mucosite peri-implantar. Trinta e sete pacientes previamente diagnosticados com mucosite peri-implantar foram separados aleatoriamente em dois grupos. Todos os pacientes receberam o tratamento não-cirúrgico associado (grupo teste) ou não (grupo controle) a clorexidina a 0,12% além de instrução de higiene bucal individualizada. Os pacientes foram avaliados no baseline, 3, 6, 12 e 18 meses quanto aos índices de placa visível e sangramento gengival, profundidade de sondagem e sangramento à sondagem. Os dados foram analisados estatisticamente pelos testes de Friedman, Wilcoxon, Mann-Whitney, Correlação de Spearman e Qui-quadrado, utilizando um a de 5%. A análise intragrupo mostrou que ambos os tratamentos propostos foram eficazes na redução dos índices de placa visível e sangramento gengival, profundidade de sondagem e sangramento à sondagem (p<0,05). No entanto, nenhum dos grupos alcançou resultados superiores em relação ao outro. As variáveis independentes de interesse também não exerceram influência na redução dos parâmetros clínicos investigados.  Destarte, conclui-se que a terapia mecânica por si só é eficaz na redução dos parâmetros clínicos analisados e que, como os grupos tornaram-se iguais pelo fato do efeito da clorexidina não mais existir, a terapia de suporte peri-implantar fora eficiente em reduzir os índices de placa visível e sangramento gengival, profundidade de sondagem e sangramento à sondagem ao final do estudo.

3
  • IRMA LÚCIA DA SILVEIRA SILVA
  • Formação profissional do cuidador de idosos em Instituições de Longa Permanência

  • Leader : MAISA PAULINO RODRIGUES
  • MEMBRES DE LA BANQUE :
  • ALTAMIRA PEREIRA DA SILVA REICHERT
  • MAISA PAULINO RODRIGUES
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 12 févr. 2015


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  • O trabalho do cuidador de idoso busca minimizar a morbidade advinda das limitações físicas, cognitivas e emocionais deste indivíduo, constituindo-se em uma práxis que tem influências da singularidade dos sujeitos envolvidos e, portanto, está em constante construção. Neste sentido, conhecer as demandas por capacitação, averiguar os conteúdos estudados durante a formação e identificar as percepções e as dificuldades relacionadas ao trabalho do cuidador formal, pode contribuir para o aprimoramento do seu processo de formação profissional. E as Instituições de Longa Permanência para Idosos (ILPIs) são, por excelência, as mais indicadas para levantar tais informações. Desta forma, este estudo de caráter transversal, descritivo e analítico com abordagem quantitativa e qualitativa, objetivou investigar a formação profissional dos cuidadores que trabalham em ILPIs em Natal/RN no ano de 2014. Para tanto, realizou-se uma entrevista semiestruturada com 63 cuidadores em 09 ILPIs, representando 75% do total desses profissionais nessas instituições. As entrevistas captaram dados relativos ao perfil socioeconômico, a formação profissional e a percepção sobre a profissão de cuidador. Para análise dos dados, foram utilizadas a estatística descritiva e a análise do conteúdo de Bardin. De modo geral, identificou-se que a maioria dos cuidadores eram de baixa condição socioeconômica e se inseriam na ocupação sem a realização de um curso específico prévio. Contudo, entre os que realizaram algum curso, a maioria relata que os conteúdos vistos na grade curricular deram segurança para a práxis do cuidado, embora também reportem a necessidade de capacitação. A percepção sobre o cuidado está preponderantemente relacionada ao amar e ao cuidar do outro e a escolha profissional relaciona-se a identificação com a prática do cuidar em si. Diante dos resultados, conclui-se que há a persistência de um baixo nível de preparação formal para a ocupação. Além disso, a formação apresenta fragilidades que se iniciam com a ausência de um currículo básico norteador e se intensificam com a baixa escolaridade requerida para o exercício profissional.

4
  • MARCÍLIA RIBEIRO PAULINO
  • SATISFAÇÃO E IMPACTO DA SAÚDE ORAL NA QUALIDADE DE VIDA EM PACIENTES REABILITADOS COM PRÓTESE TOTAL DUPLA

  • Leader : PATRICIA DOS SANTOS CALDERON
  • MEMBRES DE LA BANQUE :
  • PATRICIA DOS SANTOS CALDERON
  • ADRIANA DA FONTE PORTO CARREIRO
  • ANDRE ULISSES DANTAS BATISTA
  • Data: 23 févr. 2015


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  • Introdução:A reabilitação de pacientes desdentados totais é um dos principais desafios da Odontologia. As próteses totais (PT) convencionais são a base do tratamento para o edentulismo e sua necessidade permanecerá para o futuro previsível devido à suamelhor relação custo-eficácia quando comparada à reabilitação implantossuportada. Objetivo:Avaliar a satisfação e o impacto da saúde oral na qualidade de vida de pacientes reabilitados com PT duplas convencionais. Método:Realizou-se um ensaio clínico com 25 pacientes reabilitados com PT duplas convencionais. Avaliou-se o impacto da saúde oral na qualidade de vida dos indivíduos através da versão brasileira do OHIP-EDENT e a satisfação do paciente com as próteses através de questionário específico. Os instrumentos foram aplicados antes e 3 meses após a reabilitação.Resultados:Houve uma melhora estatisticamente significante (p<0,001) do impacto na qualidade de vida dos usuários de prótese total dupla após a nova reabilitação.A análise dos 4 domínios do OHIP também apresentaram melhora estatisticamente significativa(p<0,001).A satisfação geral final com as próteses foi estatisticamente superior à satisfação inicial (p<0,001).Quando analisados os aspectos específicos de satisfação com a PT após 3 meses da reabilitação tambémobservamos resultados importantes de melhoria em todos os aspectos.Conclusão:Pacientes usuários de prótese total dupla, insatisfeitos com suas próteses, após nova reabilitação convencional melhoraram a qualidade de vida, com diminuição do impacto negativo das próteses na saúde oral, e melhoraram o índice de satisfação.

5
  • LIVIA MARIA RODRIGUES DE PONTES MEDEIROS
  • A Gestão do Programa Saúde na Escola no município de Natal/RN: Um estudo de caso

  • Leader : CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • MEMBRES DE LA BANQUE :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • FRANKLIN DELANO SOARES FORTE
  • MAISA PAULINO RODRIGUES
  • Data: 25 févr. 2015


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  • A atual concepção de saúde envolve diversos fatores determinantes, dentre eles a educação. É fundamental a organização intersetorial para o atendimento à saúde de jovens e adultos. Nesse contexto foi instituído o Programa Saúde na Escola (PSE), que prevê uma articulação contínua entre saúde e educação auxiliando na efetivação do Sistema Único de Saúde. Objetivo: Analisar o Programa Saúde na Escola no município de Natal/RN, considerando a intersetorialidade das ações na perspectiva da gestão. Metodologia: O método escolhido foi o estudo de caso, com abordagem qualitativa. A amostra foi do tipo intencional incluindo todos os componentes do Grupo de Trabalho Intersetorial Municipal de Natal-RN, formado por representantes da Secretaria Municipal de Educação, Secretaria Estadual de Educação e Secretaria Municipal de Saúde. A técnica de coleta de dados foi a entrevista semi-estruturada. A análise dos dados foi realizada por meio da técnica de análise de conteúdo. Para apresentação dos dados foram consideradas as seguintes categorias de análise: Significado da intersetorialidade; Planejamento das ações; Formação continuada e permanente para a autonomia na promoção da saúde; Dificuldades e potencialidades para a operacionalização das ações. Resultados: Os resultados permitem identificar no PSE de Natal práticas intersetoriais ainda incipientes. Os profissionais gestores, da saúde e educação ainda não conseguem reconhecer o potencial da intersetorialidade. O planejamento é realizado de forma setorializada e sem a participação ativa dos educandos e comunidade. O grupo gestor destaca como dificuldades acúmulo de funções, desestímulo por parte de alguns servidores do grupo gestor e a falta de compromisso de alguns profissionais, inadequação estrutural e dificuldade na continuidade das ações do programa. Apesar da fragmentação existente, o grupo gestor do programa tem contribuído com a qualificação profissional e o desenvolvimento das ações de educação em saúde junto aos educandos. Conclusão: Conclui-se portanto, que a saúde, a educação e a sociedade têm muitos desafios a enfrentar para a consolidação da intersetorialidade e do Programa Saúde na Escola, bem como a concretização das diretrizes do Sistema Único de Saúde em Natal/RN.

6
  • MARQUIONY MARQUES DOS SANTOS
  • AIDS EM IDOSOS NO BRASIL NO PERÍODO DE 2000 A 2012: uma análise da série temporal e dos fatores contextuais associados.

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ANA MARIA DE BRITO
  • KENIO COSTA DE LIMA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 27 févr. 2015


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  • O perfil epidemiológico dos indivíduos que desenvolvem aids no Brasil mudou no decorrer do tempo. Dentre estas modificações, um dado preocupante é o aumento da incidência de aids em idosos em todo país. Mas, no entanto, ainda não está claro se o aumento dos casos de aids é suficiente para produzir uma mudança nas medidas de tendência nos últimos anos nos estados brasileiros, e se esse aumento possui um efeito a partir dos indicadores socioeconômico-demográficos. Neste sentido, o objetivo do presente estudo é analisar as taxas de incidência de aids em idosos no Brasil e o seu efeito nas desigualdades socioeconômico-demográficas, no período de 2000 a 2012. Trata-se de um estudo ecológico de séries temporais para conhecer o comportamento da série histórica das taxas de incidência de aids em idosos no período de 2000 a 2012. As taxas foram calculadas utilizando os dados secundários do Sistema de Informação de Agravos de Notificação e do Instituto Brasileiro de Geografia e Estatística. Os dados foram submetidos a tratamento estatístico para conhecer as tendências das taxas de incidência, através do modelo de regressão polinomial e do modelo de regressão log-linear joinpoint, como também, a análise de regressão linear simples para conhecer a relação das tendências com as variáveis socioeconômico-demográficas. Foram utilizados os programas SPSS 20.0® e Joinpoint 4.1.1. Todos os testes foram realizados considerando uma significância estatística de 5%. Após a análise, no Brasil foram notificados 62.052 casos novos de aids em idosos no período de 2000 a 2012. Neste período, foi encontrado um crescimento significativo para o sexo masculino, tanto na faixa etária de 50 a 59 anos (APPC: 3,46%; p<0,001), como acima de 59 anos de (AAPC: 4,38%; p<0,001). Para o sexo feminino, o crescimento foi significativo e possui os maiores incrementos da série histórica, quando comparado ao sexo masculino, nas duas faixas etárias, (AAPC: 4,62%; p<0,001 e AAPC: 6,53%; p<0,001) respectivamente. Os maiores incrementos são observados em mulheres e nos estados das Regiões Norte e Nordeste. Nos estados da Região Sudeste observa-se estabilização das taxas em toda série histórica. As tendências da razão entre os sexos tiveram uma redução significativa, como também, uma aproximação nas duas faixas etárias do estudo, chegando a uma proporção de 1,7 homens para cada mulher na faixa etária mais jovem. As tendências estiveram relacionadas com as taxas de analfabetismo, com o aumento da desigualdade social e com o menor desenvolvimento humano nos estados brasileiros. Conclui-se que no Brasil a incidência de aids em idosos segue uma tendência de aumento em indivíduos maiores de 50 anos. Destacam-se os maiores índices do estudo em mulheres e nos estados das Regiões Norte e Nordeste. Nesse sentido, o país precisa aprimorar as políticas voltadas aos idosos com DST/aids, capacitando profissionais de saúde e  desenvolvendo medidas eficazes para a prevenção e diagnóstico precoce das pessoas contaminadas, principalmente em locais com recursos limitados e com alta desigualdade social. Em longo prazo, cabe desenvolver novos estudos para compreender se as medidas tomadas foram eficazes para reduzir as tendências apontadas neste estudo.

7
  • HUGO DE ALMEIDA VARELA
  • Efeito da Azilsartana sobre a doença periodontal em um modelo de doença periodontal com ratos wistar

  • Leader : AURIGENA ANTUNES DE ARAUJO
  • MEMBRES DE LA BANQUE :
  • AURIGENA ANTUNES DE ARAUJO
  • RAIMUNDO FERNANDES DE ARAUJO JUNIOR
  • RENATA FERREIRA DE CARVALHO LEITÃO
  • Data: 19 mars 2015


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  • O objetivo desse estudo foi avaliar os efeitos da azilsartana (AZT) na perda óssea alveolar, inflamação, expressão das metaloproteinases da matriz (MMP), ligante do receptor do fatornuclear kapa B (RANKL), receptor ativador do fator  nuclear kapa B (RANK), osteoprotegrina (OPG), ciclooxigenase-2 (COX-2), e catepsina K no modelo de doença periodontal induzida por ligadura em ratos.

     

    Materiais e métodos: 50 ratos wistar foram divididos randomicamente em 5 grupos com 10 ratos cada: (1)não ligados, água; (2) ligados, água; (3) ligados, AZT 1mg/kg; (4) ligados, AZT 5 mg/kg; e (5) ligados, AZT 10 mg/kg.  Todos os grupos foram tratados com solução salina ou AZT por 10 dias.  Os tecidos periodontais sofreram análise histopatológica e imunohistoquímica para detecção de MMP-2, MMP-9, RANKL, RANK, OPG e catepsina K.  Níveis deIL-1β, IL-10, TNF-α, mieloperoxidase (MPO), e glutationa (GSH) foram determinados  por ELISA.

    Resultados: O tratamento com AZT 5 mg/kg reduziu  o MPO (p<0.05) e IL-1β (p<0.05), elevou os níveis de  IL-10 (p<0.05), e reduziu a expressão de MMP-2, MMP-9, RANK, RANKL, catepsina K, e elevou a  expressão de OPG .

     

    Conclusões: Os achados revelam que a AZT melhora a resposta anti-inflamatória de citocinas e GSH, diminuindo a perda óssea na periodontite induzida por ligadura em ratos

8
  • JULIANA GONÇALVES
  • Formação do Profissional Sanitarista: caminhos e percalços

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • KÁTIA SUELY QUEIROZ SILVA RIBEIRO
  • LUIZ ROBERTO AUGUSTO NORO
  • MAISA PAULINO RODRIGUES
  • Data: 23 mars 2015


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  • A Saúde Coletiva é um projeto de luta por uma saúde democrática, resolutiva, equânime e que pretende assistir o corpo social e coletivo a partir de suas reais necessidades, estando totalmente envolvida com questões de desigualdades, de determinação social. Desse modo, é de fundamental importância formar um profissional engajado com este projeto. O presente estudo se propõe a compreender o processo de formação do Profissional Sanitarista no Brasil. Para tanto, procura-se responder ao seguinte questionamento: Que elementos são relevantes para a construção do profissional sanitarista? Trata-se de uma pesquisa de campo, descritiva e exploratória, com abordagem qualitativa. Para coleta dos dados, foi utilizada a técnica da entrevista semiestruturada junto a profissionais veteranos enquanto Sanitaristas e docentes da área de Saúde Coletiva. Os dados foram analisados à luz da técnica de análise temática de conteúdo proposta por Bardin. Tal técnica consiste em estruturar o texto em unidades, em categorias segundo reagrupamento analógico. Nesse sentido, foram organizadas três categorias de análise, cujos títulos foram guiados de acordo com os objetivos do estudo, a saber: “A Formação Institucional de Sanitaristas”; “Elementos que contribuem para a formação Sanitarista” e “Caminhos possíveis na formação Sanitarista”. Destacou-se quatro principais elementos de formação sanitarista: Capacidade técnica para desenvolver o trabalho de sanitarista, alicerçada nos três pilares conceituais da Saúde Coletiva; Arcabouço, alicerce e respaldo nas Ciências Sociais, no pensamento social em saúde; História de vida do discente, implicação deste com o objeto da Saúde Coletiva; Atuação em campo, no território, diretamente integrado ao serviço e sistema de saúde. Os entrevistados imaginam um caminho para formação sanitarista: a Saúde Coletiva deve ser bem trabalhada em sua teoria e prática na graduação, seja em qualquer área da saúde e obviamente na graduação em Saúde Coletiva; os cursos lato sensu, especialmente as residências, precisariam de uma readaptação teórica, dada a criação de cursos de graduação na área; os cursos stricto sensu mantêm sua função de formar pesquisador e docente da área, com produções envolvidas com o sistema de saúde e o objeto da Saúde Coletiva, de modo a trazer um retorno efetivo, em termos de aplicabilidade, no sistema de saúde. Sugere-se que tal caminho deveria ser complementar, no sentido de agregar conhecimento à medida que se percorre pela graduação, pós-graduação lato sensu e pós-graduação stricto sensu. A ideia, no geral, é que o conjunto graduação-residência/especialização-mestrado/doutorado componha uma formação linear, ascendente e complementar. Para acompanhar todo esse processo de forma efetiva, faz-se necessário, e urgente, pensar em estratégias de regulação dos procedimentos formativos. Recomenda-se também mais estudos sejam realizados nesta área, principalmente uma avaliação mais criteriosa das graduações em Saúde Coletiva, que é uma questão atual e relativamente nova sobre a formação na área.

9
  • TAIANA BRITO MENEZES FLOR
  • A FORMAÇÃO DO NUTRICIONISTA PARA ATUAÇÃO NO SUS: Um olhar sobre a produção científica obrigatória dos cursos do Rio Grande do Norte

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • ANDHRESSA ARAÚJO FAGUNDES
  • CELIA MARCIA MEDEIROS DE MORAIS
  • LUIZ ROBERTO AUGUSTO NORO
  • Data: 24 mars 2015


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  • As Diretrizes Curriculares Nacionais (DCN) para o curso de Nutrição preveem uma formação direcionada à atuação no Sistema Único de Saúde (SUS), assim como a realização obrigatória do Trabalho de conclusão de curso (TCC). Nesse sentido, foi objetivo deste estudo analisar a formação de nutricionistas no Rio Grande do Norte (RN) para atuação no SUS, à luz da produção científica obrigatória prevista para formação. Trata-se de um estudo bibliométrico, de abordagem quantitativa, realizado com os TCC de 5 cursos de graduação em Nutrição do RN a partir do ano de 2013. A partir da leitura dos trabalhos, foram coletadas as seguintes variáveis: natureza da instituição, categoria administrativa da instituição, local, título do trabalho, número de autores, formato do trabalho, titulação do professor orientador, tipo de estudo, área de interesse, cenário de realização, submissão ao comitê de ética, adequação dos descritores e, se pertencente ao campo da saúde coletiva, o subcampo da saúde coletiva e a temática abordada. Também foi realizada a leitura dos Projetos Pedagógicos dos Cursos e identificação das oportunidades de desenvolver pesquisa na graduação. Para detecção de categorias significativas foi aplicado o teste Qui-Quadrado de Pearson. Foram analisados 195 trabalhos, oriundos em sua maioria de cursos pertencentes a universidades (79,0%) e de instituições privadas (56,4%). Observou-se maior frequência de artigos (68,2%), desenvolvidos por um aluno (65,6%), orientados por professores mestres (57,9%), com desenho de estudo transversal (49,2%), realizados em laboratório (25%) e sem necessidade de submissão a comitê de ética em pesquisa (49,2%). A mediana de adequação dos descritores correspondeu a 50%. Quanto ao interesse do estudo, houve maior frequência de trabalhos no campo da saúde coletiva (p<0,001), dentro desta destacando-se o subcampo Epidemiologia nutricional (63,0%) (p<0,001) e a temática avaliação nutricional (57,4%) (p<0,001). Em recorte sobre três grandes áreas de atuação do nutricionista, foi significativa a realização de trabalho no campo da saúde coletiva em instituições públicas (p<0,05). A presença de atividades complementares foi unânime nos projetos de curso. Os resultados do estudo revelaram algumas fragilidades metodológicas nos contornos das pesquisas, assim como uma formação hegemonicamente positivista. Apesar do destaque à saúde coletiva, percebeu-se pouca aproximação das políticas e programas de nutrição no contexto da pesquisa obrigatória dos cursos do RN.

10
  • DANIELLE BEZERRA DE FARIAS
  • AVALIAÇÃO DOS TECIDOS PERIIMPLANTARES EM PACIENTES REABILITADOS COM SOBREDENTADURAS E PRÓTESES FIXAS IMPLANTOSSUPORTADAS

  • Leader : ADRIANA DA FONTE PORTO CARREIRO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • ANA CLÁUDIA PAVARINA
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • Data: 16 avr. 2015


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  • Avaliar as condições dos tecidos periimplantares e suas características anatômicas, bem como a quantidade de biofilme após 3 e 12 meses de reabilitação, em pacientes desdentados totais reabilitados com prótese total convencional superior e prótese fixa implantossuportada ou sobredentadura mandibulares. Materiais e Métodos: Realizou-se um ensaio clínico não randomizado com uma amostra de 32 pacientes desdentados bimaxilares usuários de próteses totais convencionais duplas que tiveram sua prótese convencional inferior substituída por prótese sobre implantes (fixa ou removível). Os pacientes foram divididos em dois grupos: reabilitados com sobredentaduras sobre dois implantes com sistema de retenção barra clipe (grupo 1-G1) e reabilitados com próteses totais fixas implantossuportadas sobre 4 ou 5 implantes (grupo 2-G2). O acompanhamento se deu por meio de controles periódicos nos períodos de 3 meses (T1) e 12 meses (T2) desde a instalação das próteses sobre os implantes. Foram avaliados: índice de biofilme no implante e no mini pilar, índice de sangramento, grau de inflamação periimplantar, faixa de mucosa ceratinizada, profundidade de sondagem e nível da margem da mucosa. Resultados: Ao comparar as avaliações nos períodos T1 e T2 observou-se um aumento no índice de biofilme no mini pilar (p=0,033) e grau de inflamação (p=0,002) no G1; bem como aumento do índice de biofilme no mini pilar (p=0,007) e índice de sangramento (p=0,016) no G2. Comparando-se a influência do tipo de reabilitação sobre os índices avaliados, o índice de biofilme no mini pilar, profundidade de sondagem e nível da margem da mucosa apresentaram resultados menos satisfatórios nos sítios periimplantares dos pacientes do grupo reabilitado com prótese fixa. Conclusão: Indivíduos reabilitados com próteses fixas apresentaram maior quantidade de biofilme e condições dos tecidos periimplantares menos favoráveis quando comparados com aqueles reabilitados com sobredentaduras. As diferenças nos tempos de avaliação refletiram em aumento dos índices periimplantares em ambos os grupos. Entretanto, nos pacientes que desenvolveram mucosite, a mesma ocorreu apenas na forma leve.

11
  • LORENA MARQUES FERREIRA DE SENA
  • Comparação entre análises cefalométricas obtidas por ortodontistas e radiologistas.

  • Leader : HALLISSA SIMPLICIO GOMES PEREIRA
  • MEMBRES DE LA BANQUE :
  • HALLISSA SIMPLICIO GOMES PEREIRA
  • JULIANA DE GODOY BEZERRA MEDRADO
  • SERGEI GODEIRO FERNANDES RABELO CALDAS
  • Data: 24 avr. 2015


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  • A análise cefalométrica é caracterizada pela mensuração de grandezas lineares e angulares, através da demarcação de pontos, distâncias e linhas na telerradiografia e é considerada de fundamental importância para o diagnóstico e planejamento ortodôntico. O objetivo desta pesquisa  foi avaliar grandezas cefalométricas oriundas da análise de Steiner, obtidas por cirurgiões-dentistas ortodontistas e radiologistas, a partir da análise cefalométrica de uma mesma telerradiografia em norma lateral, no programa computadorizado Radiocef Studio 2®. Após a construção do banco de dados, foi realizada uma análise descritiva das grandezas cefalométricas geradas. O erro intra-examinador foi analisado por meio dos coeficientes de correlação intraclasse (CCI); e a variabilidade dentro de cada grupo, através dos coeficientes de variação (CV). A comparação inter grupos deu-se através do teste t de Student, para as variáveis com distribuição normal, e através do teste de Mann-Whitney, para aquelas com distribuição não normal. No grupo dos ortodontistas, as grandezas Pog e 1-NB, SL, Linha S-Ls, Linha S-Li e 1.NB apresentaram variabilidade interna acima do esperado. No grupo dos radiologistas, o mesmo ocorreu com as grandezas Pog e 1-NB, Linha S-Ls, Linha S-Li e 1.NA. Na comparação entre os grupos, todas as grandezas lineares analisadas e duas angulares apresentaram diferença estatisticamente significante entre radiologistas e ortodontistas (p≤0,05).

12
  • IVANILDA MARIA FREIRE MASULLO
  • O ATENDIMENTO AO IDOSO NA UNIDADE DE SAÚDE DA FAMÍLIA:  UM ESTUDO DE REPRESENTAÇÕES SOCIAIS


  • Leader : MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MEMBRES DE LA BANQUE :
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • ANTONIO MEDEIROS JUNIOR
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • Data: 20 mai 2015


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  • Introdução: A atenção para as questões de saúde no envelhecimento tem aumentado e torna-se um desafio para as políticas públicas direcionadas ao idoso. Ao se pensar em saúde enquanto um bem público no contexto das representações sociais, busca-se fornecer pistas para desvelar o atendimento oferecido aos idosos no serviço público, mais especificadamente, em Unidade de Saúde da Família. Objetivo do estudo: Apreender as representações sociais construídas por idosos sobre o atendimento na Unidade de Saúde da Família. Metodologia: Trata-se de um estudo exploratório, subsidiado pela Teoria das Representações Sociais. Foi realizado na Unidade de Saúde da Família de Felipe Camarão, localizado no bairro de Felipe Camarão no Município de Natal/RN-Brasil. Participaram da pesquisa cento e dois idosos/as. Os dados foram obtidos por meio do Teste de Associação Livre de Palavras e entrevista semiestruturada, e analisados com o auxílio do software EVOC. As entrevistas foram submetidas à Análise de Conteúdo.  A pesquisa teve a aprovação do Comitê de Ética em Pesquisa do Hospital Universitário Onofre Lopes, sob o parecer 704.323. Resultados: Os resultados permitiram identificar representações sociais sobre o atendimento com conotações negativas, relacionando-o ao valor simbólico de péssimo e desrespeito. Sendo o horário limitado de atendimento, dificuldade para agendar consultas e exames e a infraestrutura inadequada, os aspectos mais assinalados. No entanto, expressam satisfação quanto ao atendimento médico. Apresentam aspectos positivos os idosos que frequentam com regularidade e fazem parte do grupo de convivência desenvolvido na unidade, que traz como proposta reunir os idosos, em que se realizam atividades educativas, recreativas e ações de cidadania. Os problemas apontados no estudo revelam a existência de restrições no sistema que podem comprometer a estrutura de organização e funcionamento da Estratégia Saúde da Família. E mais, pode implicar a exclusão de idosos cujas condições precárias de vida já os mantém à margem da sociedade. Considerações finais: Apreender os sentidos atribuídos ao atendimento em Unidades Saúde da Família pelo idoso, não se limitou apenas a analisar as produções mentais que visam identificar e classificar os objetos dos contextos nos quais as pessoas estão inseridas, mas apontar a necessária implementação de medidas que visem melhorar a qualidade do atendimento prestado ao idoso. A pouca atenção do poder público com a saúde dessa população, reforça o sentimento de isolamento e desamparo apreendidos nas falas do grupo alvo dessa pesquisa.

13
  • NATALIA MARIA CONCEICAO FIGUEIROA
  • O efeito do treino resistido na capacidade funcional e reatividade pressórica de pacientes renais crônicos.

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • GILMARA CELLI MAIA DE ALMEIDA
  • RODRIGO AZEVEDO DE OLIVEIRA
  • Data: 1 juin 2015


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  • Pacientes com doença renal crônica (DRC) submetidos ao treinamento resistido durante a hemodiálise apresentam benefícios substanciais dos sistemas muscular e cardiovascular, da capacidade funcional e da sua qualidade de vida. Entretanto, as melhorias na reatividade pressórica ainda não estão bem esclarecidas. O objetivo foi analisar o efeito do treino resistido na melhora da capacidade funcional e da reatividade pressórica em pacientes hemodialisados, em Natal/RN no ano de 2014. Trata-se de um ensaio clínico controlado e randomizado, com amostra de 64 pacientes, com média de idade de 42,28 (±11,48) anos, distribuídos em grupo experimental (GE) e controle (GC). Para mensurar os ganhos de força de membros inferiores foram utilizados os testes de sentar e levantar e de levantar e caminhar, já para a reatividade pressórica o teste cold pressor, em ambos os grupos antes e após a intervenção. Além disso, apenas o GE participou do treinamento resistido durante a hemodiálise em 16 semanas, composto por 3 sessões semanais, 3 séries de 10 repetições máximas (RM) estimadas (para extensores de joelho e flexores de quadril e joelho), entre 50 a 70% de 10 RM. Para a intensidade do treinamento foi utilizada a escala de Borg entre 11 a 14 durante as seções. Os dados foram analisados utilizando o Teste t para amostras independentes (inter-grupos) bem como para comparar a diferença das médias nos grupos pré e pós-intervenção (intra-grupos) a partir do Teste t para amostras repetidas. Para todas as variáveis foi considerada a significância estatística de 5% executados no software SPSS® 20.0. O estudo foi aprovado pelo comitê de ética do Hospital Universitário Onofre Lopes (HUOL – UFRN) número 37992214.2.0000.5292.  Após a intervenção, verificou-se que os pacientes do GE tiveram um desempenho melhor nos testes de força (p<0,001) em comparação ao GC. Resultado também observado na pressão arterial sistólica e diastólica (PAS e PAD) ambas de repouso que apresentaram redução dos níveis pressóricos apenas no GE (p<0,001). Na reatividade pressórica tanto nos períodos pré bem como após 2 minutos também demonstraram reduções estatisticamente significativas do GE (p<0,001 e p=0,012) respectivamente quando comparado ao GC. Conclui-se que o treinamento resistido melhorou desempenho nos testes de força de membros inferiores beneficiando a capacidade funcional dos pacientes em hemodiálise, como também a pressão arterial de repouso e os níveis de reatividade pressórica obtiveram reduções significativas de seus valores após a intervenção. Além disso, este tipo de treinamento também pode ser utilizado como uma estratégia de proteção aos fatores de risco cardiovascular em pacientes renais crônicos.

14
  • KELIENNY DE MENESES SOUSA FREITAS
  • AVALIAÇÃO DO ACESSO AOS SERVIÇOS DE REABILITAÇÃO FÍSICA PARA VÍTIMAS DE ACIDENTES DE TRÂNSITO: CAMINHOS PARA MELHORIA DA QUALIDADE DO SISTEMA DE SAÚDE

  • Leader : ZENEWTON ANDRÉ DA SILVA GAMA
  • MEMBRES DE LA BANQUE :
  • ANTONIO MEDEIROS JUNIOR
  • CLAUDIA MARIA DE REZENDE TRAVASSOS
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 1 juin 2015


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  • Os serviços de Reabilitação Física (RF) têm importância fundamental no enfrentamento da epidemia global dos Acidentes de Trânsito (AT). Considerando as inúmeras sequelas físicas e sociais dos sobreviventes, problemas de qualidade no acesso à RF constituem um agravo à recuperação das vítimas. Faz-se necessário implementar a gestão da qualidade destes serviços, avaliando dimensões prioritárias e intervindo nos seus fatores determinantes, a fim de garantir RF disponível em tempo e condições oportunas. Objetivou-se identificar barreiras de acesso à RF considerando a percepção das vítimas de AT e dos profissionais de saúde, bem como estimar o acesso à RF e seus fatores associados. Trata-se de uma pesquisa quali-quantitativa de natureza exploratória desenvolvida em Natal/RN com entrevistas semiestruturadas a 19 profissionais de saúde e de inquérito telefônico a 155 vítimas de AT. Para explorar as barreiras de acesso os discursos foram transcritos e analisados com o software Alceste, versão 4.9. Durante as entrevistas utilizou-se a seguinte pergunta norteadora: “Que barreiras dificultam ou impedem o acesso à reabilitação física para vítimas de acidentes de trânsito?”. A denominação das classes e eixos resultantes do Alceste foi realizada por consulta ad hoc a três pesquisadores externos com posterior consenso da denominação mais representativa. Realizou-se análise multivariada da influência das variáveis do acidente, sociodemográficas, clínicas e assistenciais sobre o acesso à RF. As associações que apresentaram p<0,20 na análise bivariada foram submetidas à regressão logística, passo a passo, com p<0,05 e Intervalo de Confiança (IC) de 95%. As principais barreiras identificadas foram: “Regulação burocrática do acesso”, “Demora para o acesso”, “Não encaminhamento pós-cirurgia” e “Ineficiência dos serviços públicos”. Essas barreiras foram distribuídas em um modelo teórico construído a partir do diagrama de causa-efeito, no qual se observou que o acesso insuficiente à RF é produto das causas associadas à estrutura organizacional, processos de trabalho, profissionais e usuários. Construíram-se dois modelos de regressão: “Acesso geral à RF” e “Acesso ao serviço público de RF”. Obtiveram acesso à RF 51,6% dos usuários, sendo 32,9% na rede pública e 17,9% no serviço privado. O modelo de regressão “Acesso Geral à RF” foi composto pelas variáveis “Renda Familiar” (OR: 3,7), “Trabalhador informal” (OR: 0,11), “Desempregado”, “Necessidade percebida de RF” (OR:0,15) e “Encaminhamento para RF” (OR: 27,5). O modelo “Acesso à RF no serviço público” foi representado pelo “Encaminhamento para RF” (OR: 23,0) e “Plano Privado de Saúde” (OR: 0,07). Apesar da conhecida influência dos determinantes sociais sobre o acesso aos serviços de saúde, situação de difícil controle pela gestão pública, este estudo encontrou que os processos organizativos e burocráticos estabelecidos na assistência em saúde determinam sobremaneira o acesso à RF. As falhas no acesso sinalizam a importância do problema, e os fatores associados apontam para intervenções na gestão do cuidado integral, a fim de melhorar a qualidade e o acesso à reabilitação física e evitar prolongamento desnecessário do sofrimento dos sobreviventes da epidemia de AT.

15
  • WAGNER IVAN FONSECA DE OLIVEIRA
  • validação e aplicação do instrumento dos indicadores observáveis da qualidade do cuidados nas Instituições de longa permanência para idosos.

  • Leader : ZENEWTON ANDRÉ DA SILVA GAMA
  • MEMBRES DE LA BANQUE :
  • Darlene Mara dos Santos Tavares
  • KENIO COSTA DE LIMA
  • ZENEWTON ANDRÉ DA SILVA GAMA
  • Data: 9 juin 2015


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  • Apesar da importância das Instituições de Longa Permanência para Idosos (ILPIs) como alternativa de cuidados em todo mundo, o Brasil ainda não dispõe de instrumento válido para monitorar a qualidade do cuidado nesse contexto. Nos Estados Unidos, utiliza-se o Observable Indicators of Nursing Home Care Quality Instrument (IOQ)1 o qual avalia a qualidade do cuidado nas ILPIs a partir dos indicadores de estrutura e processo relacionados à dimensão da qualidade atenção centrada no usuário. Objetivou-se neste estudo adaptar transculturalmente o IOQ para avaliar a qualidade do cuidado das ILPIs no contexto brasileiro. Realizou-se a equivalência conceitual e de itens para avaliar a pertinência e viabilidade do IOQ à realidade nacional através do Índice de Validade do Conteúdo (IVC) junto a um comitê de especialistas formado por 10 participantes e diretamente envolvidos com o objeto de estudo. Em seguida, cumpriu-se a equivalência operacional, idiomática e a semântica concomitantemente. Esta constituiu-se em 5 fases: (1) duas traduções e (2) respectivas retraduções; (3) apreciação formal referente ao significado referencial e geral; (4) revisão por um segundo comitê de especialistas; (5) aplicação do pré-teste em três ILPIs por pares de diferentes entes sociais: profissionais de saúde, reguladores da vigilância sanitária e potenciais consumidores. Avaliou-se a equivalência de mensuração a partir do teste de alfa de Cronbach para verificar a consistência interna do instrumento. Para mensurar a concordância entre os pares de avaliadores, utilizou-se o Índice de Concordância Geral (ICG) e o coeficiente Kappa. O IVC apresentou resultados elevados tanto para relevância (95,3%) quanto para viabilidade (94,3%) ao contexto brasileiro. Quanto ao significado referencial, observou-se similaridade variando entre 90-100% para a primeira retradução e 70-100% para a segunda. Com relação ao significado geral, a versão 1 foi melhor avaliada, recebendo classificação “inalterado” em 80% dos itens, enquanto a versão 2 apresentou apenas 47%. No pré-teste, o IOQ mostrou-se compreensível e de fácil aplicação. Obteve-se um alfa de Cronbach elevado (0,93), ICG satisfatório (75%) e concordância substancial através do coeficiente Kappa (0,65) entre os pares de avaliadores: profissionais de saúde, reguladores da Subcoordenadoria da Vigilância Sanitária (SUVISA) e potenciais consumidores. Piores resultados estiveram relacionados ao processo (média=2,85), enquanto a estrutura obteve uma média de 3,75, considerando uma escala de 1-5. A menor pontuação foi alusiva à dimensão referente à prestação de cuidados (média=2). Identificou-se o IOQ como sendo válido e confiável no contexto brasileiro. Sugere-se o uso para monitorar a qualidade do cuidado nas ILPIs por profissionais de saúde, reguladores e potenciais consumidores.

16
  • LUISA MARIA BEZERRA DE SOUSA
  • Associação da depressão e distúrbio do sono em pacientes com e sem disfunção temporomandibular.

  • Leader : GUSTAVO AUGUSTO SEABRA BARBOSA
  • MEMBRES DE LA BANQUE :
  • EDUARDO JOSÉ GUERRA SEABRA
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • Data: 21 juil. 2015


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  • Objetivo: avaliar a inter-relação entre a DTM, a depressão e o distúrbio do sono. Métodos: trata-se de um estudo do tipo caso-controle com aplicação de questionários em 50 pacientes com e 50 sem DTM, alocados ambos do departamento de Odontologia da UFRN, Natal-RN, no período de setembro de 2014 a junho de 2015, para avaliação de sintomas depressivos e distúrbio do sono. Os pacientes foram diagnosticados como portadores de DTM através do RDC/TMD; para a análise na qualidade do sono, pelo PSQI e para análise da depressão, pelo IDB. Todos os índices foram aplicados por um único examinador previamente treinado e calibrado. Os dados coletados foram analisados, através do SPSS, com os testes de Qui-quadrado de Pearson (χ2) e a regressão logística não condicional. Resultados: as mulheres apresentaram um risco de 2,85 vezes maior de desenvolverem DTM (p=0,046). A Odds Ratio (OR) mostra que o paciente casado tem 2,56 vezes mais chances de apresentar DTM (p=0,087); o distúrbio do sono aumenta em 2,19 as chances de ter DTM (p=0,062) e os sintomas depressivos aumentam o risco em 3,16 vezes em desenvolver a disfunção (p=0,053). Conclusão: pacientes do gênero feminino, casadas, com sintomas depressivos e alterações do sono são mais propensas a desenvolverem a disfunção temporomandibular.

17
  • LEONARDO NUNES MAIA PIMENTEL
  • Aplicação de agentes remineralizantes sobre o esmalte clareado: eficácia contra o manchamento por café.

  • Leader : ISAUREMI VIEIRA DE ASSUNCAO
  • MEMBRES DE LA BANQUE :
  • ISAUREMI VIEIRA DE ASSUNCAO
  • JOAO PAULO DA SILVA NETO
  • RAPHAEL VIEIRA MONTE ALTO
  • Data: 27 juil. 2015


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  • O objetivo desse estudo foi avaliar a influência de agentes remineralizantes

    sobre a susceptibilidade do esmalte clareado à pigmentação por café durante o

    clareamento de consultório. Noventa incisivos bovinos foram selecionados e divididos

    aleatoriamente em 5 grupos (n=10) em função dos agentes remineralizantes: G1 sem

    pigmentação e sem agente remineralizante; G2, flúor neutro; G3, Nano-P, G4, CPP-ACP

    e; G5 sem remineralizante. A solução pigmentante foi confeccionada com café solúvel

    (Nescafé) de acordo com as orientações do fabricante. As amostras foram imersas no

    café, em temperatura de 55C, por 1 minuto/4x ao dia. Todos os grupos foram clareados

    com Peróxido de Hidrogênio a 35%. As medidas de cor foram realizadas pelo

    espectrofotômetro Easyshade (VITA), pelo método CIE Lab, antes e depois das 3

    sessões de clareamento. Os dados foram submetidos à Análise de Variância ANOVA a

    dois critérios para medidas pareadas e ao pós-teste de Tukey para múltiplas comparações

    (p<0,05). Os resultados mostraram haver diferenças estatisticamente significantes entre

    as substâncias remineralizantes para os parâmetros *L, *a, *b e ∆E (p<0,0001). Os

    valores de L*, para o grupo G5, e os de *b, para os grupos G2 e G5, diferiram do grupo

    controle. Após a 3ª sessão de clareamento, os grupos do Fluor (G2) e aquele sem agente

    remineralizante (G5) apresentaram valores de ∆E inferiores ao grupo controle, não

    pigmentado. Concluiu-se que a apenas os agentes remineralizantes CPP-ACP e Nano-P

    foram capazes de reduzir a interferência do café na eficácia clareadora do peróxido de

    hidrogênio.

18
  • VALÉRIA DAMASCENO SILVESTRE
  • CARACTERÍSTICAS DO REBORDO ÓSSEO ALVEOLAR DE PACIENTES CLASSE I DE KENNEDY

  • Leader : JOSE SANDRO PEREIRA DA SILVA
  • MEMBRES DE LA BANQUE :
  • EDUARDO JOSÉ GUERRA SEABRA
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • JOSE SANDRO PEREIRA DA SILVA
  • Data: 28 juil. 2015


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  • Este foi um estudo transversal, que teve como objetivo avaliar as condições do

    rebordo ósseo alveolar remanescente, por meio de Radiografias Panorâmicas e

    Tomográfica Computadorizada do tipo cone Beam, dos pacientes classe I de Kennedy.

    Informações do paciente como sexo, idade, extensão da extremidade livre e tempo de

    uso das próteses foram coletadas dos prontuários para ficha de coleta personalizada,

    assim como as classificações do rebordo alveolar, altura e espessura de três regiões do

    rebordo alveolar obtidas a partir da Radiografias Panorâmicas e Tomografia

    Computadorizada do tipo feixe cônico. A amostra foi composta por 69 pacientes, a

    maioria do sexo feminino (84,1%) usuários de Prótese Parcial Removível (51,7%) há

    mais de 10 anos (62,3%), com média de 59,720 (± 8,573) anos de idade, média de

    8,640 (± 1,455) número de dentes perdidos. A maioria dos rebordos avaliados foram

    classificados quanto a direção em descendente para distal; a forma em triangular e a

    altura em alto, tendo a altura variado entre 7,73 a 8,53mm (tabela 1) e a espessura, 6,18

    a 6,71mm ao longo da extremidade livre. Em razão da distribuição da amostra ter sido

    normal para comparação entre as médias das alturas e espessuras com as variáveis

    independentes tempo de edentulismo e uso de Prótese Parcial Removível, foi utilizado

    o teste t, sendo diferença estatisticamente significativa entre a altura e espessura do

    rebordo em região de primeiro molar com a variável uso de Prótese Parcial Removível.

    Levando em consideração os resultados pode-se observar que a reabsorção óssea

    alveolar é frequente na região de 1º molar de mulheres na 6ª década de vida usuárias de

    Prótese Parcial Removível.

19
  • JOAO LUIZ DE ALENCAR PANDOLPHI
  • PERFIL DAS LER/DORT NOTIFICADOS NO ESTADO DO RIO GRANDE DO NORTE, DE 2010 A 2014: Um alerta importante na implementação de ações preventivas da Saúde do Trabalhador.

  • Leader : IRIS DO CEU CLARA COSTA
  • MEMBRES DE LA BANQUE :
  • FABIA BARBOSA DE ANDRADE
  • GUSTAVO BARBALHO GUEDES EMILIANO
  • IRIS DO CEU CLARA COSTA
  • Data: 30 juil. 2015


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  • A alta prevalência das Lesões por esforço repetitivo e Distúrbios Osteomusculares Relacionados ao Trabalho (LER/DORT) tem sido explicada por transformações do trabalho e das empresas cuja organização tem se caracterizado pelo estabelecimento de metas e produtividade, considerando suas necessidades, particularmente de qualidade dos produtos e serviços e aumento da competitividade de mercado, sem levar em conta os trabalhadores e seus limites físicos e psicossociais. Diferentemente do que ocorre com doenças não ocupacionais, as doenças relacionadas ao trabalho têm implicações legais que atingem a vida dos pacientes e das empresas. Esse estudo teve como objetivo descrever o perfil das LER/DORT notificados no estado do Rio Grande do Norte, Brasil, de 2010 a 2014. Trata-se de um estudo epidemiológico descritivo, do tipo transversal e retrospectivo, que utilizou como área de abrangência o Estado do Rio Grande do Norte. A fonte de dados foi o Sistema de Informação de Agravos de Notificação (SINAN), através do Centro de Referência em Saúde do Trabalhador (CEREST) e a coleta dos dados secundários ocorreu em maio de 2015. Os resultados apresentaram um total de 403 notificações de LER/DORT, onde a grande maioria (72%) foi notificada no município de Natal. Com relação ao perfil dos trabalhadores notificados, 36,2% possuem idade entre 35 e 44 anos, 62,78% eram do feminino, e em relação a escolaridade, 31,51% tinham ensino médio completo. As ocupações mais acometidas foram entre os trabalhadores da indústria de confecção, com 30,8%, seguido de pedreiros, da construção civil com 3,23% e de operadores de caixa com 2,99%. Sobre a situação de trabalho, 75,93% tinham carteira assinada, entretanto, foram emitidas a CAT somente em 67,0% dos casos. Em relação aos sinais e sintomas, a dor foi apontada em 98,01% das notificações, seguido de limitação dos movimentos, com 95,04%. Das notificações, 94,29% apontaram exposição a movimentos repetitivos em seu local de trabalho. O diagnóstico específico de maior ocorrência foram as Sinovites e tenossinovite (CID M 65), com 30,02% das notificações, seguido de Dorsalgias (CID M 54) com 19,35% e Lesões no ombro (CID M 75) com 15,88%. Foram afastados do trabalho 81,64% dos trabalhadores notificados com LER/DORT, com duração do afastamento mais prevalente em dias (43,67%). A evolução que mais predominou entre os casos com este agravo foi a incapacidade temporária (75,68%). Concluiu-se que o SINAN representa uma ótima base de dados para caracterizar o perfil das LER/DORT, porém necessitando de uma melhora nos registros tanto de cobertura quanto na qualidade dos dados para o alcance de um melhor monitoramento sistemático e um maior planejamento das ações em Saúde do Trabalhador.

20
  • CÍNTIA MIRELA GUIMARÃES NOBRE
  • AVALIAÇÃO DA RESPOSTA CLÍNICA PERIODONTAL E DO CONTROLE GLICÊMICO EM DIABÉTICOS TIPO II PORTADORES DE PERIODONTITE CRÔNICA FRENTE AO TRATAMENTO PERIODONTAL NÃO CIRÚRGICO.

  • Leader : BRUNO CESAR DE VASCONCELOS GURGEL
  • MEMBRES DE LA BANQUE :
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • KENIO COSTA DE LIMA
  • POLIANA MENDES DUARTE
  • Data: 5 août 2015


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  • A doença periodontal (DP) e o diabetes mellitus (DM) apresentam uma associação bidirecional, na qual o diabetes favorece o desenvolvimento da DP e esta, quando não tratada, pode piorar o controle metabólico do DM. Logo, a DP deve ser tratada para restabelecer a saúde dos tecidos periodontais e diminuir as complicações do diabetes. Portanto, objetiva-se avaliar clinicamente o efeito da terapia periodontal de descontaminação da boca completa (Full Mouth Scaling and Root Planning – FMSRP) em pacientes diabéticos tipo II portadores de periodontite crônica durante 12 meses. Trinta e um participantes no grupo controle (GC), sem diabetes e com periodontite crónica, e 12 no grupo teste (GT) foram avaliados no baseline, aos 03, 06, 09 e 12 meses. Foram analisados os seguintes parâmetros clínicos periodontais: índice de sangramento a sondagem (ISS), índice de placa visível (IPV), profundidade de sondagem (PS), nível clínico de inserção (NCI) e recessão gengival (RG). Para o GT, também foram realizados exames laboratoriais para avaliar os parâmetros sanguíneos de glicose em jejum e hemoglobina glicada (HbA1c). Os resultados foram analisados de duas formas distintas: uma utilizando todos os sítios presentes na boca e outra apenas com os sítios doentes. Foram utilizados o teste de Mann-Whitney, Friedman e Wilcoxon com um nível de significância de 5%. Na análise intergrupo de todos os sítios, percebe-se que não houve diferença significativa ao longo do tempo em relação à PS, ISS, IPV, NCI e RG (p>0,05). Entretanto, ao avaliar os sítios doentes, observamos diferença significativa somente para o NCI, sendo maior para o GT. A análise intragrupo de todos os sítios mostrou uma redução estatisticamente significativa para a PS, IPV e ISS em ambos os grupos. Para os sítios doentes, a análise intragrupo mostrou uma redução estatisticamente significativa na PS, ISS e NCI em ambos os grupos. Apesar de haver diminuição nos valores no ISS nos dois grupos, apenas no GC pode-se perceber uma redução estatisticamente significativa. Não houve alteração no grupo teste em relação à HbA1c e a glicemia em jejum nos períodos avaliados. Logo, conclui-se que houve melhoras nos parâmetros clínicos periodontais ao longo dos 12 meses da pesquisa, porém sem alterações nos níveis glicêmicos dos pacientes diabéticos. Portanto, a terapia periodontal mostrou-se eficiente para os cuidados da saúde bucal.

21
  • ZILANE SILVA BARBOSA DE OLIVEIRA
  • Avaliação clínica e da qualidade de vida utilizando dois protocolos para recuperação oromiofuncional em pacientes que se submeteram à cirurgia ortognática.

  • Leader : ADRIANO ROCHA GERMANO
  • MEMBRES DE LA BANQUE :
  • JOSE SANDRO PEREIRA DA SILVA
  • PATRICIA FROES MEYER
  • PETRUS PEREIRA GOMES
  • Data: 5 août 2015


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  • O objetivo desse estudo prospectivo foi comparar a dor, o edema, os movimentos mandibulares, a eficiência mastigatória e a qualidade de vida, nos primeiros 60 dias de pós-operatório, utilizando 2 diferentes protocolos clínicos para recuperação miofuncional, em pacientes que se submeteram à cirurgia ortognática.  Esse estudo consistiu de 19 pacientes , onde o grupo controle foi composto por 10 pacientes que não tiveram a reabilitação fonoaudiológica e do grupo experimental participaram 9 pacientes que receberam o protocolo de reabilitação fonoaudiológica. As variáveis dor, edema e movimentos mandibulares foram analisadas 48h, 96h, 7 dias, 14 dias , 30 e 60 dias pós cirúrgicos. A eficiência mastigatória foi classificada com 60 dias de pós operatório e a qualidade de vida foi verificada com 60 dias e 6 meses após a cirurgia. Os dados foram submetidos à análise de variância, teste t de Student e de independência de Fisher , em nível de 5% de probabilidade .  Identificou-se que os pacientes do grupo experimental não obtiveram melhora mais rápida nos parâmetros de dor, edema, movimentos mandibulares e eficiência mastigatória quando comparados com os pacientes do grupo controle, com exceção dos valores da percepção de  dor ,  que foi reduzido nos primeiros quatorze dias de acompanhamento no grupo experimental. O impacto na qualidade de vida não mostrou resultados diferentes estatisticamente significantes entre os dois grupos. Conclui-se que o protocolo de reabilitação fonoaudiológica  utilizado  para os pacientes desse estudo não obteve resultados mais rápidos de recuperação pós cirúrgica que o protocolo controle.

22
  • IRAPUAN MEDEIROS DE LUCENA
  • QUEDAS EM IDOSOS ASSISTIDOS NA ESTRATÉGIA SAÚDE DA FAMÍLIA: FREQUÊNCIA E FATORES ASSOCIADOS

  • Leader : MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MEMBRES DE LA BANQUE :
  • ANTONIO MEDEIROS JUNIOR
  • CRISTINA KATYA TORRES TEIXEIRA MENDES
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • Data: 18 août 2015


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  • O crescimento da população idosa é um fenômeno mundial e, no Brasil, essa transformação está acontecendo de forma bastante acelerada. Com o envelhecimento populacional atual, essa faixa etária emergente necessitará de mais atenção e cuidados à saúde. Uma das características do envelhecimento da população é o acúmulo progressivo de incapacidades, o que a deixa mais vulnerável a quedas. Este estudo foi desenvolvido com o propósito de conhecer o episódio quedas no âmbito de uma população idosa atendida em uma Unidade de Saúde da Família. Trata-se de uma pesquisa de natureza transversal, com uma amostra constituída de 122 idosos. A pesquisa foi aprovada pelo Comitê de Ética do HUOL, com parecer nº 816.022. Foi aplicado um questionário junto aos participantes e os resultados foram analisados estatisticamente, sendo o teste de Qui-Quadrado e o Exato de Fisher utilizados para verificar a associação entre variáveis. Para a análise multivariada, usou-se o método da Regressão Logística Binomial. Para ambos os testes, admitiu-se significância p<0,05 e IC de 95%. Os resultados demonstram que a maioria é do sexo feminino, (76,9%); a faixa etária de pessoa idosa de 88,4% e 11,6% de sobrenvelhecida; com relação ao estado civil, 35,3% são casados e 29,4% viúvos; 92,1% com renda familiar entre um e dois salários mínimos; e 91,8% moram com o cônjuge e/ou filhos. Com relação a frequência das quedas, constatou-se que 61,2% dos idosos sofreram uma ou mais quedas em 2014. Como fatores associados, ficou evidente que 73,8% foram decorrentes de fatores extrínsecos, 6,4% de fatores intrínsecos e 21,4% de ambos os fatores. Como consequência da queda, constatou-se que 89,2% têm medo de cair novamente, 37,3% manifestaram ansiedade e em 13,3% o andar foi afetado. No que diz respeito à exposição aos fatores de riscos, os locais de maior prevalência foram: rua/avenida (31,0%), calçada (19,0%), sala (14,3%) e pátio/quintal (10,7%). O estudo comprovou a associação estatística significativa entre o sexo feminino (p=0,001), entulhos/objetos no quintal (p=0,015) e mobiliários que podem causar acidentes (p=0,005). Ficou evidenciado, entre os idosos pesquisados, que 72,7% receberam poucas informações sobre quedas, e o não conhecimento sobre essa temática torna-se um fator de risco para as quedas. Concluímos que existe uma elevada frequência de quedas em idosos pesquisados, constituindo um dado preocupante, visto que esse evento na população idosa é bastante grave, sendo necessário garantir-lhes um ambiente seguro em seu domicílio e, sobretudo, fora deste. As informações prestadas pela equipe da Estratégia Saúde da Família são importantes para evitar estas ocorrências, reforçando o desenvolvimento de atividades educativas em saúde junto à população como forma de prevenção e redução da ocorrência de quedas, melhorando, assim, a qualidade de vida dos idosos.

23
  • LANA SARITA DE SOUZA OLIVEIRA
  • Laser terapia combinada a esponja de colágeno em um modelo de reparo ósseo

  • Leader : JOSE SANDRO PEREIRA DA SILVA
  • MEMBRES DE LA BANQUE :
  • JOSE SANDRO PEREIRA DA SILVA
  • CARLOS AUGUSTO GALVAO BARBOZA
  • HECIO HENRIQUE ARAUJO DE MORAIS
  • Data: 31 août 2015


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  • O presente estudo tem por objetivo avaliar o efeito do laser terapia combinados com arcabouço de esponja de colágeno na cicatrização de um defeito crítico na calvária de ratos. Metodologia: Foram utilizados 45 ratos Wistar, divididos em 5 grupos. O grupo G0: foi o grupo controle positivo (com defeito e sem tratamento); O grupo G1: foi o grupo tratado com esponja de colágeno; O grupo G2: foi o grupo tratado apenas com laser; O grupo G3: foi o grupo tratado com esponja de colágeno e laser; O grupo C é o grupo controle negativo: foi sem nenhum defeito ósseo e sem nenhum tratamento. O laser foi utilizado na dosagem de 120J/cm2 (potência de 50mW, tempo de exposição de 10 s), comprimento de onda de 780nm, aplicações realizadas em 4 pontos, após o procedimento e a cada 48hrs, duas vezes. Foram feitas avaliações através de raio x, lâminas histológicas e imunohistoquímica. Resultados: Os resultados histológicos e imunohistoquímicos apresentaram-se positivos para os grupos de 30 dias, com diferença significativa entre o grupo controle positivo (G0) e o grupo Colágeno mais Laser (G3). Conclusão: Observamos que a terapia de laser de baixa intensidade combinada ao arcabouço de colágeno apresentou resultados positivos para regeneração óssea no período de 30 dias.

24
  • FRANCILENE AMORIM XAVIER
  • ANÁLISE DA INTERVENÇÃO DO MINISTÉRIO PÚBLICO ESTADUAL NA ASSISTÊNCIA MATERNO INFANTIL DO RIO GRANDE DO NORTE

  • Leader : IRIS DO CEU CLARA COSTA
  • MEMBRES DE LA BANQUE :
  • EDNA MARIA DA SILVA
  • GUSTAVO BARBALHO GUEDES EMILIANO
  • IRIS DO CEU CLARA COSTA
  • Data: 29 oct. 2015


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  • A mortalidade materna e infantil no Brasil tem se constituído como um grave problema de saúde pública, principalmente nas regiões nordeste e norte. No Rio Grande do Norte, os altos índices de óbitos de mães e bebês têm preocupado não só as autoridades de saúde como órgãos da justiça como o Ministério Público. Em 2011, o Ministério Público Estadual – MPE criou um projeto chamado “Nascer com Dignidade”, voltado para o acompanhamento da atenção prestada no pré-natal, parto e puerpério nos municípios. O objetivo desse estudo foi investigar como se dá a intervenção do MPE na atenção materno infantil. O método adotado para levantamento dos dados foi o estudo de caso mediante análise dos relatórios das perícias realizadas em quatro, das oito Unidades Regionais de Saúde Pública (URSAP). Foram selecionados 26 municípios e os resultados mostram fragilidades especialmente na atenção pré-natal, que podem resultar em complicações no parto e pós-parto como: equipes de saúde da família incompletas (em 05 municípios), falta de acesso ou acesso dificultado a exames laboratoriais (em 16 municípios) e falta de vinculação da gestante ao local do parto (em 26 municípios). Com base nessa realidade, o MPE tem adotado medidas relevantes como ajuizamento de Ações Civis Públicas, celebração de Termos de Ajustamento de Conduta com os gestores municipais e realizado intervenções em unidades de saúde e maternidades do Estado. Dessa forma, entende-se que a intervenção do Ministério Público é de suma importância para indicar as adequações necessárias ao enfrentamento da mortalidade materna e infantil estadual (que é em média de 65/100.000 e 16/100.000 respectivamente) e responsabilizar as prefeituras pela qualidade na assistência de saúde prestada a seus munícipes; exigindo que se cumpram os princípios da universalidade e integralidade, com vistas a redução das iniquidades sociais.

25
  • GIORDANO BRUNO PAIVA CAMPOS
  • ANÁLISE COMPARATIVA DE DOIS PROTOCOLOS DE ANTIBIÓTICOTERAPIA NO CONTROLE DE INFECÇÃO NAS CIRURGIAS DE TRAUMA DE FACE.

  • Leader : ADRIANO ROCHA GERMANO
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • ANIBAL HENRIQUE BARBOSA LUNA
  • JOSE SANDRO PEREIRA DA SILVA
  • Data: 11 nov. 2015


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  • Este estudo teve o objetivo de avaliar a eficácia de dois regimes de profilaxia antibiótica utilizados em cirurgias traumatológicas do complexo buco-maxilo-facial. Este é do tipo prospectivo e randomizado em pacientes operados no Serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial do Hospital Universitário Onofre Lopes - UFRN, no período de dezembro de 2011 a março de 2014. Um total de 160 pacientes foram admitidos na pesquisa, divididos em dois grupos, denominados de GI, que recebeu uma dose única de 2g de Cefazolina, via endovenosa (EV), 20 minutos antes da incisão e GII, que recebeu 2g de Cefazolina EV, 20 minutos antes da incisão e após a cirurgia recebeu 1g de Cefazolina EV em intervalos de 6h, durante 24h. A amostra final foi composta de 147 pacientes, sendo 84% dos paciente do gênero masculino e a maioria na faixa etária de 21-30anos (36,7%). A etiologia do trauma mais frequente foi o acidente motociclístico (55%), o diagnóstico de fraturas faciais mais comuns foram as do complexo zigomático-orbitário (38%), seguido pelas fraturas de mandíbula com (35%). O GI foi composto por 97 pacientes e o GII por 50 pacientes. A incidência de infecção no pós-operatório foi de 10% em ambos grupos, sendo nove no GI e cinco no GII. Não houve diferença estatística entre os grupos (p=0,888). Diante dos resultados, a utilização da profilaxia antibiótica com dose única mostra-se como a melhor alternativa para prevenção da infecção em cirurgias para tratamento de fraturas faciais.

26
  • ANGELA CAROLINA BRANDÃO DE SOUZA GIUSTI
  • MORTALITY FOR STOMACH AND ESOPHAGUS CANCER IN BRAZIL BETWEEN THE YEARS OF 1995 TO 2009 AND PROJECTIONS UNTIL 2029

  • Leader : DYEGO LEANDRO BEZERRA DE SOUZA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • Data: 27 nov. 2015


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  • Studies that provide estimates of incidence, mortality, trends and projections are of paramount importance to health, since based on these data, new prevention and intervention policies are developed. In this research, the objective was to analyze the mortality of stomach and esophageal cancer in the 5 Brazilian regions and in Brazil, from 1995 to 2009, and to carry out projections until the year 2029. All data from deaths from these types of cancer were Obtained in the Mortality Information System (SIM) of the Brazilian Ministry of Health. Population data from 1995 to 2009 were obtained from the website of the Brazilian Institute of Geography and Statistics (IBGE). Death data were corrected through proportional redistribution of general deaths. The deaths included in the category of deaths due to signs, symptoms and ill-defined conditions were reallocated, obeying the proportional distribution with which the deaths occurred in each of the chapters among the deaths due to defined causes. Standardized rates were calculated using the standard world population as the basis for the Nordpred program, as well as projections of case numbers and rates up to year 2029 using the age-period-cohort model. The results of the projections show that for stomach cancer and for esophageal cancer, an increase in the total number of deaths is expected in Brazil and in all Brazilian regions. When comparing the evolution of standardized mortality rates for stomach cancer, there is an increase for males in the North and Northeast regions and females in the Northeast region. In the Midwest, South and Southeast regions, as well as in the pooled analysis for Brazil, the projections indicate a reduction in male mortality rates and female stability. In relation to esophageal cancer, in the North and Northeast regions, it is expected that the standardized mortality rates will rise until the last projected period in males and females. In the Midwest, Southeast and South regions, the projections indicate a reduction in rates, as well as in males in the grouped analysis for Brazil. In the data from Brazil for females, there is a stability in rates over the observed and projected periods. It can be concluded that mortality due to gastroesophageal cancer is unevenly distributed in the Brazilian regions, but the projections indicate a reduction of these inequalities by the year 2029.

27
  • LAERCIO ALMEIDA DE MELO
  • Perda óssea peri-implantar de implantes Hexágono Externo e Cone Morse em usuários de sobredentaduras mandibulares com carga imediata.

  • Leader : ADRIANA DA FONTE PORTO CARREIRO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • AMILCAR CHAGAS FREITAS JÚNIOR
  • ERIKA OLIVEIRA DE ALMEIDA FREITAS
  • Data: 4 déc. 2015


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  • Objetivou-se avaliar a perda óssea peri-implantar de implantes Hexágono Externo (HE) e Cone Morse (CM) em usuários de sobredentaduras mandibulares com carga imediata por um período de acompanhamento de 1 ano. O presente estudo trata-se de um ensaio clínico controlado e não randomizado, no qual foram analisados 18 implantes CM e 22 HE. Radiografias periapicais foram obtidas na instalação das sobredentaduras e 1 ano após. A perda óssea peri-implantar foi analisada a partir da digitalização e análise dessas radiografias no programa CorelDRAW X7. Para tal, a medição foi feita da plataforma dos implantes até a crista óssea nas faces mesiais e distais de cada implante. Como resultado, verificou-se uma taxa de sucesso elevada nos grupos HE e CM, com taxas de 100% e 94,4% respectivamente. Ao analisar os níveis ósseos peri-implantares, observou-se uma diferença significantiva entre os grupos (p=0,032), com maiores perdas ósseas no grupo HE. Em média, a perda óssea no grupo HE foi de 0,85mm (±0,82), enquanto no grupo CM foi de 0,10mm (±1,0). Conclui-se, que por um período de 1 ano, maiores perdas ósseas estão relacionadas ao grupo HE em comparação com o grupo CM.

28
  • ANNIE KAROLINE BEZERRA DE MEDEIROS
  • FATORES ASSOCIADOS À PERFORMANCE MASTIGATÓRIA EM IDOSOS INSTITUCIONALIZADOS TOTALMENTE EDÊNTULOS

  • Leader : ADRIANA DA FONTE PORTO CARREIRO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • ARCELINO FARIAS NETO
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • Data: 4 déc. 2015


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  • A perda de todos os dentes corresponde a uma condição crônica intimamente associada à redução do potencial mastigatório, um dos fatores de risco relacionados à má condição nutricional, a qual é crítica, principalmente, em indivíduos idosos e residentes de instituições de longa permanência. Com base nisso, o presente estudo teve o objetivo de avaliar fatores gerais e protéticos associados à performance mastigatória (PM) em idosos desdentados totais residentes em Instituições do Longa Permanência para Idosos (ILPIs). Foram incluídos todos idosos (idade igual ou superior a 60 anos) que residem em ILPIs da região metropolitana de Natal/RN, independentes e com condições sistêmicas e cognitivas satisfatórias (diagnosticadas por um médico). A performance mastigatória foi analisada pelo método da análise granulométrica, após a mastigação de um alimento artificial pelo idoso. Após a mastigação, o material foi submetido a um sistema de tamises e o peso das partículas em cada peneira foi utilizado para determinar o tamanho mediano das partículas (X50), obtido por meio da aplicação da equação de Rosim-Rammler. Além da performance mastigatória, os idosos foram indagados quanto a aspectos relacionados à sua função mastigatória. As variáveis independentes consistiram em: sexo, idade, presença e número de doenças crônicas, uso de próteses totais (PT), tempo de uso das próteses e qualidade técnica das PT (estabilidade e retenção da PT inferior, oclusão em relação cêntrica e em movimentos excursivos). Para a análise dos dados, foram utilizados os testes não-paramétricos de Mann-Whitney, Qui-quadrado de Pearson e Exato de Fisher (nível de significância de 5%). Das 18 ILPIs existentes na região metropolitana de Natal, 14 aceitaram participar do estudo. O número de idosos residentes foi de 457, em que 247 eram totalmente edêntulos. Desses, 40 se enquadraram nos critérios de inclusão e participaram do estudo. Os resultados mostraram que a PM foi consideravelmente baixa na população estudada. O X50 médio foi de 7,631 mm (± 0,41). A ausência de PT inferior foi alta e a qualidade técnica das próteses foi considerada ruim em 88,2% dos casos. Dentre todos os fatores analisados, apenas o uso de próteses esteve significativamente relacionado à melhor PM. Apesar disso, a maior parte dos idosos relataram não sentir dificuldade para mastigar algum alimento (67,5%) ou sentir desconforto ao comer (87,5%). Diante desse cenário, conclui-se que a PM em idosos que residem em ILPIs é baixa, principalmente porque eles não utilizam próteses totais inferiores. Contudo, essa condição parece não afetar a mastigação ou limitar a sua função mastigatória.

29
  • AVERLANDIO WALLYSSON SOARES DA COSTA
  • O ENVELHECIMENTO NO ESPAÇO MIDIÁTICO: A PRODUÇÃO DE SENTIDOS PELOS MEIOS JORNALÍSTICOS

  • Leader : MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MEMBRES DE LA BANQUE :
  • EDNA MARIA DA SILVA
  • MAISA PAULINO RODRIGUES
  • MARCELO VIANA DA COSTA
  • Data: 15 déc. 2015


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  • O envelhecimento como um fenômeno social pauta-se nos modos de produção e reprodução, que atrelados a peculiaridades e conformidades da estrutura social influenciam nos valores e sentidos erguidos. A busca pelo entendimento da realidade dar-se-á pela apropriação do conhecimento/informação, que na contemporaneidade cada vez mais são atrelados aos meios midiáticos, de forma que esses ultrapassam a condição de meros meios de comunicação, chegando a condição de instrumentos de produção direta de valores, posturas e opiniões. Dentre os instrumentos midiáticos, tem-se os meios jornalísticos, que são importantes meios de disseminação de informação e consequentemente de produção de sentidos, inclusive sobre o envelhecimento. Assim, de forma geral objetiva-se: conhecer as representações da mídia acerca do envelhecimento, tendo como foco jornais circulantes no Rio Grande do Norte. Aliado ao objetivo geral, elegem-se como específicos: apreender os fatores que possam influenciar nesse processo; e refletir sobre os entendimentos estabelecidos sobre o envelhecimento. Para tanto valer-se-á da Teoria da Representação Social. Para coleta dos dados, foram estudadas 57 notícias online dos três principais jornais do estado, quais sejam: Tribuna do Norte, Gazeta do Oeste e Jornal de Hoje, que foram captadas através de instrumento de busca dos sítios dos próprios jornais, utilizando os termos de busca: “envelhecimento”, “idoso”. Essas matérias foram analisadas valendo-se da Análise de Conteúdo Temática de Bardin, que permitiu o estabelecimento de cinco categorias, a saber: Envelhecimento e violência; Envelhecimento na contemporaneidade; Envelhecimento e saúde; Envelhecimento e cidadania; e Envelhecimento, trabalho e ação. Na primeira categoria são enquadradas notícias que denunciam situações violentas, que independente da condição de vítima ou acusado pela violência, a fragilidade do idoso persiste. Em Envelhecimento na contemporaneidade percebeu-se as tentativas da mídia jornalística em explicar as mudanças demográficas do aumento quantitativo de idosos, os ônus que isso pode gerar para o pleno desenvolvimento do país. No Envelhecimento e saúde é percebido a condição de fim iminente trazido no envelhecer, como sinônimo de doenças e debilidades. Na quarta categoria, Envelhecimento e cidadania, são visualizados situações em que peculiaridades e necessidades dos idosos precisam virar obrigação para serem cumpridas, denunciando condição de baixa expressão e poder social da classe. Por fim, em Envelhecimento, trabalho e ação são trazidas situações que denunciam a não expectativa do idoso a interação com as novas tecnologias e participação nos rumos decisórios da sociedade. De forma geral e específica tal análise permitiu apreender os modos de produção de sentidos sobre envelhecimento pelos jornais, já que esses tendem a representar o envelhecimento por meio de situações intencionadas, conforme necessidades hegemônicas, construindo a representação social do idoso como um ser frágil, submisso, inativo, passível à violência e susceptível ao adoecer.

Thèses
1
  • BIANCA NUNES GUEDES DO AMARAL ROCHA
  • AVALIAÇÃO DA ATENÇÃO HUMANIZADA AO ABORTAMENTO EM MATERNIDADE - ESCOLA  EM NATAL,  RIO GRANDE DO NORTE.

  • Leader : SEVERINA ALICE DA COSTA UCHOA
  • MEMBRES DE LA BANQUE :
  • SEVERINA ALICE DA COSTA UCHOA
  • PAULO DE MEDEIROS ROCHA
  • NILMA DIAS LEAO COSTA
  • MARIA GUADALUPE MEDINA
  • MARIA TERESA SEABRA SOARES DE BRITTO E ALVES
  • Data: 3 mars 2015


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  • A gravidez não planejada é vivenciada por milhões de mulheres em todo o mundo, esse fato aumenta o risco de morbimortalidade ligada ao aborto que, por sua vez, representa um grave problema de saúde pública. Este estudo objetivou avaliar os avanços e desafios da implantação da Atenção Humanizada ao Abortamento em Maternidade-Escola em Natal,  Rio Grande do Norte. A Pesquisa foi avaliativa, precedida por um Estudo de Avaliabilidade e seu delineamento um Estudo de Caso. A amostra intencional totalizou 102 sujeitos, sendo 60 usuárias, 39 profissionais e 3 gestores. As técnicas de coleta foram análise documental, entrevista-semiestruturada e observação com diário de campo. A análise documental foi descritiva e  para  entrevistas e o diário de campo utilizou-se a Análise de Conteúdo de Bardin. No estudo de avaliabilidade verificou-se que a atenção humanizada ao abortamento é um programa avaliável com elaboração e pactuação do modelo lógico, da matriz dos indicadores e das perguntas avaliativas. No Estudo de Caso, as usuárias demonstraram satisfação quanto à resolutividade do atendimento e ao acesso, porém, identificaram inadequação na ambiência, na escuta qualificada e no planejamento reprodutivo. Os profissionais retrataram que a deficiência do serviço consiste na  infra-estutura e na ambiência consideradas insuficientes e inadequadas para uma assistência humanizada, sobretudo, em relação às acomodações das pacientes, à escassez de leitos, ao  número reduzido de salas no centro cirúrgico e à falta de laboratório dentro da maternidade; além disso, o planejamento reprodutivo não consiste em uma prática  institucionalizada no serviço, bem como, não se efetiva a integralidade com outros serviços e nem a parceria com a comunidade. A direção da maternidade reforça que uma das razões que impossibilitam a devida implementação da norma técnica se deve a demanda excessiva de pacientes. Conclui-se que a pré-avaliação evidenciou que o contexto da Maternidade justifica a escolha do local da avaliação; e por ser a Norma Técnica um programa avaliável, é possível dimensionar os processos que possibilitam a sua adequada operacionalização. Desse modo, foi identificada a satisfação das usuárias quanto à resolutividade do atendimento e facilidade no acesso; porém há necessidade da implementação dos sistemas de escuta qualificada para usuários e trabalhadores da saúde, como ouvidorias, e pesquisas de satisfação; não prevaleceu o direito de escolha compartilhada entre as mulheres e os profissionais acerca da opção pelo procedimento de esvaziamento uterino; a ambiência foi a categoria apontada como a que mais necessita de mudanças, devido à insuficiência das acomodações e espaços físicos, visto como um fator limitante para o desenvolvimento de práticas humanizadas e acolhedoras; os profissionais de saúde não instituem uma rotina periódica de planejamento das condutas e estas não estão articuladas com a Norma Técnica; é preciso haver a incorporação  de orientações  e disponibilização de uma pluralidade de métodos e possibilidades de escolhas para o planejamento familiar; não há institucionalização da referência e contra-referência e nem parcerias com a comunidade, inviabilizando a integralidade da atenção. A Norma precisa ser incluída nos planos de ações dos gestores como uma das prioridades na construção das estratégias de atenção à saúde da mulher, de maneira a viabilizar, aliada a outras iniciativas, a real integração entre serviço de conduta segura, rede de cuidados primários e organizações sociais, a fim de garantir o respeito aos direitos humanos e um atendi­mento humanizado adequado, como forma de atenção e prevenção do aborto.

2
  • ANA KARINE MACEDO TEIXEIRA
  • TRAJETÓRIAS DE VIDA E A SAÚDE BUCAL DE JOVENS NO NORDESTE BRASILEIRO: UM ESTUDO DE COORTE

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • JOSÉ LEOPOLDO FERREIRA ANTUNES
  • KENIO COSTA DE LIMA
  • LUIZ ROBERTO AUGUSTO NORO
  • MARIA ANGELA FERNANDES FERREIRA
  • ROGER KELLER CELESTE
  • Data: 3 mars 2015


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  • A trajetória de vida percorrida pelo indivíduo determina sua forma de adoecer e manter-se saudável; além disso, os determinantes sociais da saúde influenciam a saúde da população ao longo do seu curso de vida. O objetivo deste trabalho foi investigar a saúde bucal e seus fatores determinantes ao longo do curso de vida dos jovens no município de Sobral, Ceará. Tratou-se de um estudo de coorte, com três ondas: 2000, 2006 e 2012. Foram examinados e entrevistados 482 indivíduos nas três ondas, atualmente, na faixa etária de 17 a 21 anos. Investigaram-se a cárie dentária, má oclusão, doença periodontal, edentulismo e traumatismo dentário. As variáveis independentes coletadas na última onda foram as características sociodemográficas, utilização de serviços e ações de saúde bucal, autopercepção de saúde bucal e hábitos e comportamentos de saúde bucal. Foi analisada a incidência de cárie de 2006 para 2012, a trajetória da cárie dentária, a trajetória da assistência odontológica e a trajetória da condição socioeconômica familiar. Os dados foram analisados no programa SPSS versão 20, no qual foram utilizados os testes t de student, ANOVA e regressão de Poisson. A incidência média de cárie de 2006 para 2012 foi de 2,95 dentes. As condições socioeconômicas apresentaram-se como fatores de risco para todos os desfechos investigados nas diferentes ondas. O capital social apresentou-se como fator de proteção para saúde bucal, enquanto a utilização dos serviços de saúde bucal implicou no aumento da recidiva de cárie e mutilação dentária. As teorias explicativas do life course (período crítico, mobilidade socioeconômica e acumulação de risco) foram comprovadas neste estudo. Aqueles que nunca foram pobres apresentaram melhores condições de saúde bucal, enquanto empobrecer acarretou uma piora no quadro de saúde bucal. Porém, o risco foi maior para aqueles que permaneceram sempre pobres e com maior experiência de pobreza ao longo da vida. Verificou-se a presença de iniquidades em saúde bucal e de assistência odontológica na população investigada.

3
  • TALITHA RODRIGUES RIBEIRO FERNANDES PESSOA
  • CAMINHOS PARA A AVALIAÇÃO DA FORMAÇÃO EM ODONTOLOGIA: DESENVOLVIMENTO, VALIDAÇÃO E APLICAÇÃO DE CRITÉRIOS

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • CLÁUDIA HELENA SOARES DE MORAIS FREITAS
  • GEORGE DANTAS DE AZEVEDO
  • LUIZ ROBERTO AUGUSTO NORO
  • MARIA ERCILIA ARAUJO
  • RAFAEL AROUCA HOFKE COSTA
  • Data: 5 mars 2015


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  • A necessidade da universalização do acesso à saúde e a falência do modelo pedagógico centrado na mera transmissão de conhecimento tem levado a mudanças na formação de profissionais de saúde. O objetivo deste estudo foi proporcionar uma nova alternativa para avaliação de cursos de Odontologia por meio do desenvolvimento, validação e aplicação de critérios de avaliação com base nas Diretrizes Curriculares Nacionais (DCN) da área. Para tanto, o estudo foi desenvolvido em três etapas: desenvolvimento e validação de critérios de avaliação de cursos de odontologia com base nas DCN; estudo piloto para verificação da aplicabilidade dos critérios validados e avaliação de cursos de Odontologia da região nordeste. Na primeira etapa foi formulado modelo lógico sobre o percurso necessário para a formação em saúde bucal, o que permitiu a construção de matriz de critérios, validada por meio da técnica de consenso Delfos modificado. A matriz validada apresenta as seguintes dimensões: Abordagem pedagógica, Perfil do egresso, Integração ensino-serviço e Orientação do cuidado em saúde. O detalhamento destas dimensões em subdimensões e critérios mensuráveis permitiu aprofundar elementos estruturantes das DCN pouco explorados em outros estudos sobre avaliação de cursos de graduação em Odontologia. O estudo piloto foi realizado com cinco cursos de Odontologia, por meio de um estudo documental dos Projetos Pedagógicos dos Cursos (PPC), aplicação do questionário validado e entrevista com os coordenadores de curso.  Os resultados do estudo piloto indicam a possibilidade de serem verificados, por meio dos critérios desenvolvidos e validados, utilizando-se diferentes propostas metodológicas, avanços e limitações curriculares frente à proposta de reorientação da formação recomendada pelas DCN e apontam para desafios e caminhos já percorridos nessa busca. A avaliação de cursos de Odontologia da região Nordeste foi realizada a partir da aplicação do questionário validado a coordenadores de 30 cursos, os quais compuseram uma amostra definida por critérios que incluíram por estado, proporcionalmente, instituições públicas e privadas. Os dados do questionário foram submetidos à análise descritiva e os cursos classificados quanto ao seu desempenho. Foi ainda testada a diferença entre médias, a correlação e a associação entre o desempenho do curso nas dimensões e na avaliação geral e as variáveis: categoria administrativa, tempo decorrido da última atualização curricular e participação em programas de reorientação da formação de profissionais e saúde. Na avaliação de cursos da região nordeste brasileira, foi constatada correlação positiva (p<0,01) entre as médias obtidas pela percepção dos coordenadores na maior parte das dimensões e entre estas e o desempenho geral do curso, demonstrando coerência entre os critérios validados e seus valores para a composição do instrumento proposto neste estudo para a avaliação da formação em saúde. A partir das médias de desempenho nas dimensões e no escore geral dos cursos, observou-se que não houve diferenças significativas entre a percepção dos coordenadores quanto ao desempenho dos cursos e a categoria administrativa (público/privado). Essa diferença é um pouco maior quando compara-se as médias de desempenho com relação ao tempo decorrente da última atualização curricular, obtendo melhor desempenho os cursos com atualização curricular mais recente, mesmo não sendo esta diferença significativa. Já com relação à participação em programas de reorientação da formação profissional, obtiveram melhores médias de desempenho os cursos que não participam de programas de reorientação da formação profissional, com diferença significativa (p<0,05) para o escore geral e para todas as dimensões, exceto a dimensão Integração ensino-serviço (p=0,064). O instrumento final proposto neste estudo representa alternativa diferenciada de avaliação da formação, tanto de cirurgiões-dentistas como de outros profissionais, considerando que as DCN de todos os cursos da área da saúde preveem a formação com foco nas necessidades de saúde da população, integrada ao SUS e baseada na aprendizagem centrada no estudante.

4
  • WILTON RODRIGUES MEDEIROS
  • Mortalidade em Idosos Longevos e “Mais Jovens” no Brasil

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • DALIA ELENA ROMERO MONTILLA
  • DAMIAO ERNANE DE SOUZA
  • KENIO COSTA DE LIMA
  • LARA DE MELO BARBOSA ANDRADE
  • RENATO PEIXOTO VERAS
  • Data: 27 mars 2015


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  • O envelhecimento populacional se constitui em um fenômeno mundial que apresenta características específicas para a realidade brasileira. Com o aumento da expectativa de vida há uma evidente polarização da mortalidade nos idosos e nas causas típicas de morte em populações mais longevas. O estudo em questão propõe analisar o perfil da mortalidade na década de 2000 nas duas faixas etárias limítrofes entre os idosos, aqueles com 60 a 69 anos (mais jovens) e 80 ou mais (longevos), através da caracterização da mortalidade, estudo da tendência, identificação de perfis de mortalidade distintos nas microrregiões no Brasil, e relacioná-los ao Índice de Privação Socioeconômica e Sanitária (IPSS), obtido a partir das variáveis contextuais. Ademais, buscou relacionar a qualidade dos dados nos dois estratos, tendo como parâmetros os coeficientes de óbitos com causas mal definidas (CMId) e geral de mortalidade (CGMId) com o IPSS. Para tanto, se processou a coleta de dados no Sistema de Informação sobre Mortalidade (SIM) e Instituto Brasileiro de Geografia e Estatística (IBGE). Através do modelo de regressão polinomial avaliou-se a tendência dos CMId e da razão de seus valores nos dois estratos, a avaliação mostrou uma diminuição da maior parte dos indicadores, principalmente das taxas de mal definidas, especialmente entre os longevos. Realizou-se uma Análise de Agrupamento por técnica não hierárquica (K-Means) da qual resultaram quatro grupos que discriminaram os perfis de mortalidade no Brasil nas duas faixas etárias de interesse. Nos idosos mais jovens o Perfil do Desenvolvimento, Perfil da Modernidade, Perfil do Paradoxo Epidemiológico e Perfil do Desconhecimento. Nos longevos, emergiram perfis denominados igualmente aos três últimos e mais o Perfil das Baixas Taxas de Mortalidade.  Na comparação das médias de IPSS, entre os perfis encontrados, verificou-se que no aspecto global todos os grupos diferiam entre si, em ambos os estratos etários. Foi feita a comparação do Perfil do Desconhecimento com os demais perfis, através do uso de contrastes ortogonais, isoladamente ou agrupados. Verificou-se que para “mais jovens”, esse perfil possuía microrregiões com IPSS mais desfavoráveis e no confronto com os demais grupos diferiam, na sua maioria, de forma significativa. Nos longevos, o Perfil do Desconhecimento e Baixas Taxas de Mortalidade, se assemelhavam entre si. O Perfil do Paradoxo Epidemiológico possuía IPSS mediano para ambas as faixas etárias. Aquelas com melhores indicadores, para os longevos, foram agrupadas como Perfil da Modernidade e nos “mais jovens”, classificadas no Perfil da Modernidade e Perfil do Desenvolvimento. Também, foi encontrada associação entre os indicadores de qualidade da informação e o IPSS das microrregiões, onde era maior a privação socioeconômica sanitária, mais desfavoráveis foram as taxas encontradas. Diante dos achados, considera-se que apesar da diminuição dos coeficientes de mortalidade, há diferenças marcantes de perfis e estes estão relacionados às condições contextuais, como também às desigualdades regionais em relação à qualidade da informação. Onde ainda persistem as altas taxas de sub-registro e mal definidas são exatamente as regiões em maior privação socioeconômica e sanitária, fato que potencializa a vulnerabilidade da faixa etária estudada e as iniquidades em saúde já presentes.

5
  • ISABELLE RIBEIRO BARBOSA MIRABAL
  • Tendências e projeções da mortalidade pelos cânceres específicos ao gênero no Brasil.

  • Leader : IRIS DO CEU CLARA COSTA
  • MEMBRES DE LA BANQUE :
  • IRIS DO CEU CLARA COSTA
  • MARIA ANGELA FERNANDES FERREIRA
  • MARIA PAULA CURADO
  • MARIANNA DE CAMARGO CANCELA
  • TATYANA MARIA SILVA DE SOUZA ROSENDO
  • Data: 30 mars 2015


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  • Os cânceres que acometem os órgãos genitais masculinos e femininos, em conjunto com o câncer de mama, são responsáveis por cerca de 20% dos óbitos por câncer no mundo. Conhecer os padrões de mortalidade por esses cânceres no Brasil, as mudanças que se produziram ao longo do tempo, os grupos mais vulneráveis e a carga de mortalidade que se apresentará no futuro são elementos básicos para a estruturação das ações assistenciais e de vigilância do câncer. O objetivo desse estudo foi analisar as tendências de mortalidade pelos cânceres que acometem órgãos que são específicos a cada gênero e projetar a mortalidade por esses cânceres até o ano de 2030, para o Brasil, regiões e estados da federação. Trata-se de um estudo ecológico de base populacional que analisou os óbitos, ocorridos no período 1996 a 2010, decorrentes dos cânceres de colo do útero, corpo do útero, mama feminina, ovários, vulva, vagina, próstata, pênis e testículos, registrados no Sistema de Informação sobre Mortalidade; as informações sobre população foram obtidas do Instituto Brasileiro de Geografia e Estatística. Foi aplicada a Regressão loglineal (Joinpoint regression) com taxas padronizadas (população mundial: ASR-W) para estimar o Annual Percentage Change (APC), o Average Annual Percentage Change (AAPC), o intervalo de confiança 95% e os pontos de inflexão da curva; as projeções foram calculadas através do programa Nordpred, inscrito no programa R, utilizando o modelo idade-período-coorte, analisando posteriormente se as mudanças que se produzirão no futuro serão decorrentes da exposição aos fatores de risco e/ou da estrutura da população exposta ao risco. Todas as análises também foram aplicadas para o conjunto de todos os óbitos por câncer (com exceção dos cânceres de pele não-melanoma). Para o Brasil, a mortalidade pelos cânceres de pênis (APC=1,5% IC95% 0,7;2,3 p<0,05), testículos (APC=1,6% IC95% 0,5;2,8 p<0,05) e ovários (APC=0,8% IC95% 0,1; 1,5 p<0,05), mostraram tendência de aumento, enquanto os cânceres de vulva e vagina (APC=-0,1% IC95% -0,9; 0,7 p=0,8), corpo de útero (APC=-0,3 IC95% -1,0; 0,5 p=0,4), mama (APC=0,4% IC95% -0,2;1,0 p=0,2) e de próstata (AAPC= 1,1% IC95% -0,2; 2,4 p=0,1) apresentaram tendência de estabilidade. A mortalidade por câncer de colo de útero apresentou tendência de redução (APC=-1,7% IC95%-2,2; -1,1 p<0,05). A análise do agrupamento de todos os óbitos por câncer observou tendência de aumento na mortalidade para o sexo masculino até o ano de 2006 (APC= 1,2% IC95% 0,6;1,8 p<0,01), seguido de um período de estabilidade. Para o sexo feminino, a tendência é de estabilidade (APC=0,4% IC95% -0,2;-1,8 p=0,2). As taxas de mortalidade para todos os cânceres analisados mostraram, de maneira geral, tendência de redução nas regiões sul e sudeste, tendência de aumento nas regiões norte e nordeste, e estabilidade para a região centro oeste. Na projeção da mortalidade para o ano 2030, as regiões norte e nordeste responderão pelas maiores taxas de mortalidade para os cânceres analisados; todavia, para as demais regiões, será observada redução nas taxas em comparação com o último período observado. Destaca-se o câncer de testículo, para o qual será observado aumento de 33% na carga da mortalidade até o ano 2030. Para os demais cânceres, não serão observadas grandes variações nas taxas de mortalidade para o Brasil entre o último período observado e o último período projetado. A estrutura e o tamanho da população brasileira serão os fatores que explicarão os padrões de mortalidade por esses cânceres no futuro, embora para a região nordeste, as variações serão explicadas, em maior medida, pelo aumento do risco para esses cânceres. Conclui-se, portanto, que existe uma marcante desigualdade na distribuição da mortalidade pelos cânceres específicos ao gênero no Brasil, onde as regiões mais pobres apresentam um quadro de aumento significativo do número de óbitos ao longo de uma série histórica, e que em 2030, essas regiões responderão pelas maiores taxas de mortalidade no país, com ênfase para os cânceres de pênis, testículos e ovários.

6
  • LEANDRO DE ARAUJO PERNAMBUCO
  • Envelhecimento; Idoso; Voz; Distúrbios da Voz; Disfonia; Estudos Transversais

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • JULIANA MARIA GAZZOLA
  • ALCIONE GHEDINI BRASOLOTTO
  • LEONARDO WANDERLEY LOPES
  • RENATO PEIXOTO VERAS
  • Data: 8 juin 2015


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  • No idoso, a alteração vocal (AV) pode interferir negativamente na comunicação, estado emocional e qualidade de vida, condições que correspondem a maior exposição ao adoecimento e isolamento social, com consequente impacto econômico para o sistema de saúde. Supõe-se que os cenários de confinamento, fragilidade e morbidade associados às Instituições de Longa Permanência para Idosos (ILPI) contribuam para que a AV seja especialmente prevalente em idosos institucionalizados, inclusive naqueles sem restrições cognitivas. Nesse sentido, o objetivo do presente estudo foi determinar a prevalência e fatores associados à AV em idosos institucionalizados com capacidade cognitiva preservada. Em virtude da ausência de instrumentos de diagnóstico epidemiológico da AV em idosos, a primeira etapa desse estudo foi dedicada à elaboração e análise das propriedades psicométricas de um questionário curto, de baixo custo e fácil utilização denominado Rastreamento de Alterações Vocais em Idosos (RAVI). Os procedimentos metodológicos dessa etapa seguiram as diretrizes do Standards for Educational and Psychological Testing e contemplaram a obtenção das evidências de validade baseadas no conteúdo do teste, nos processos de resposta, na estrutura interna e nas relações com outras variáveis, além da análise de confiabilidade e dos indicadores de consistência clínica. O resultado do processo de validação mostrou que o escore final do RAVI gera interpretações válidas e confiáveis para o diagnóstico epidemiológico da AV em idosos, o que referendou a utilização do questionário na segunda etapa do estudo, realizada em dez ILPI do município de Natal/RN. Foram coletadas variáveis socioeconômico-demográficas, de estilo de vida, condições gerais de saúde e caracterização da instituição. Foi realizada análise bivariada por meio do teste do qui-quadrado de Pearson ou teste exato de Fisher, de acordo com a distribuição dos casos nas tabelas de contingência. Como medida de magnitude da associação, calculou-se a razão de prevalência com intervalo de confiança de 95%. As variáveis com valor de p menor que 0,20 foram incluídas no modelo de regressão logística múltipla que seguiu método de seleção Forward. As variáveis foram mantidas de acordo com ausência de multicolinearidade e ajuste do modelo conforme resultado dos testes de razão de verossimilhança (-2 log likelihood) e de Hosmer and Lemeshow. A razão de chances encontrada no modelo multivariado foi convertida em razão de prevalência e o nível de significância foi de 5%. A amostra foi composta por 117 indivíduos com predomínio do sexo feminino e média de 79,68 (±7,92) anos de idade. A prevalência de AV foi de 39,3%. O modelo multivariado apontou associação estatisticamente significativa entre AV e depressão, fumar ou já ter fumado por um ano ou mais e autorreferência de perda auditiva. Conclui-se, portanto, que a AV é uma condição de saúde prevalente em idosos institucionalizados com capacidade cognitiva preservada e está associada à depressão, tabagismo e perda auditiva autorreferida. Estratégias de incentivo à comunicação e integração social, combate ao tabagismo e minimização dos efeitos da perda auditiva devem ser consideradas pelos gestores das instituições no intuito de estimular o bem estar vocal e a manutenção do potencial comunicativo dos idosos residentes que possuem capacidade cognitiva preservada.

7
  • LYGIA MARIA DE FIGUEIREDO MELO
  • Apoio institucional em saúde: desafios para democratização na Atenção Básica.

  • Leader : PAULO DE MEDEIROS ROCHA
  • MEMBRES DE LA BANQUE :
  • PAULO DE MEDEIROS ROCHA
  • ANA KARENINA DE MELO ARRAES AMORIM
  • CIPRIANO MAIA DE VASCONCELOS
  • ANA MATTOS BRITO DE ALMEIDA
  • LIANE BEATRIZ RIGHI
  • Data: 3 août 2015


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  • Objetivou-se analisar o Apoio Institucional na Atenção Básica ofertado às equipes pelas gestões municipais das capitais brasileiras que aderiram ao Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). Possuiu caráter exploratório descritivo, com abordagens qualitativa e quantitativa para análise dos dados. A coleta de dados foi realizada no período de fevereiro a outubro de 2014 com dois grupos amostrais, sendo o primeiro composto pelos respondentes do módulo II que correspondeu a 2941 equipes, das 23 capitais que aderiram ao Programa e o segundo por 22 gestores da Atenção Básica das capitais brasileiras que responderam ao módulo IV (on line). Na fase quantitativa as variáveis foram analisadas através da estatística descritiva, com uso do Software IBM SPSS Statistics 20 e os resultados organizados e agrupados em três dimensões: características do Apoio Institucional; processo de trabalho do Apoiador Institucional e Apoio às equipes para administrar e planejar processos de trabalho. Na fase qualitativa, analisaram-se as diretrizes gerais para o Apoio Institucional no município, descritos pelo gestor municipal no formulário on line. Para organização e categorização dos dados qualitativos foi utilizado o Atlas ti.7.1, e como método de interpretação, a análise de conteúdo. A partir da concepção do Apoio como ferramenta democratizante, procedeu-se a aproximação de conceitos do Apoio Paideia (Campos), das relações de poder (Foucault) e da análise institucional (Lourau). Elencou- se as seguintes categorias de análise: Categoria 1- Dimensão administração e planejamento de processos de trabalho com as Subcategorias: Apoio à organização do processo de trabalho das equipes; Apoio ao planejamento, monitoramento e avaliação; Apoio às ações das equipes; Apoio ao fortalecimento das redes de atenção à saúde e ações intersetoriais e estrutura organizacional e administrativa do Apoio no município. Categoria 2- Dimensão Política com as Subcategorias: Apoio aos processos participativos de gestão e estímulo ao controle social; Apoio a construção de relações democráticas, cooperativas e dialógicas; Apoio às ações vinculadas ao PMAQ; descrição do Apoio Institucional utilizando a mesma redação dos documentos oficiais do MS. Categoria 3- Dimensão Pedagógica com a Subcategoria: processos de formação e qualificação de profissionais e gestores. Observou-se que o Apoio Institucional é uma realidade no contexto da Atenção Básica no Brasil, porém identificou-se que, tanto nas ações apoiadas quanto nas diretrizes propostas pelas gestões evidencia-se um traço normalizador e burocrático nesse processo. Houve avaliação positiva pelas equipes do Apoiador Institucional, embora esses profissionais encontrem-se sobrecarregados no exercício dessa função pelo número excessivo de equipes sob sua responsabilidade, evidenciando-se a necessidade de um dimensionamento que leve em consideração o modo de operar a função Apoio. Nas capitais brasileiras observaram-se fragilidades nas condições de gerir os processos para a institucionalização do Apoio, inferindo-se que as gestões e equipes de gestão da Atenção Básica precisam ser apoiadas na condução desse processo. Propõe-se, assim, o aprofundamento da temática e que nos outros ciclos do PMAQ-AB haja adequação dos instrumentos utilizados na avaliação externa, referente à dimensão Apoio Institucional, a fim de avançar na valorização das singularidades do Apoio, principalmente, no tocante à cogestão enquanto processo coletivo e democrático.

8
  • LYGIA MARIA DE FIGUEIREDO MELO
  • Apoio institucional em saúde: desafios para democratização na Atenção Básica. 

  • Leader : PAULO DE MEDEIROS ROCHA
  • MEMBRES DE LA BANQUE :
  • PAULO DE MEDEIROS ROCHA
  • ANA KARENINA DE MELO ARRAES AMORIM
  • CIPRIANO MAIA DE VASCONCELOS
  • ANA MATTOS BRITO DE ALMEIDA
  • LIANE BEATRIZ RIGHI
  • Data: 3 août 2015


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  • Objetivou-se analisar o Apoio Institucional na Atenção Básica ofertado às equipes pelas gestões municipais das capitais brasileiras que aderiram ao Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). Possuiu caráter exploratório descritivo, com abordagens qualitativa e quantitativa para análise dos dados. A coleta de dados foi realizada no período de fevereiro a outubro de 2014 com dois grupos amostrais, sendo o primeiro composto pelos respondentes do módulo II que correspondeu a 2941 equipes, das 23 capitais que aderiram ao Programa e o segundo por 22 gestores da Atenção Básica das capitais brasileiras que responderam ao módulo IV (on line). Na fase quantitativa as variáveis foram analisadas através da estatística descritiva, com uso do Software IBM SPSS Statistics 20 e os resultados organizados e agrupados em três dimensões: características do Apoio Institucional; processo de trabalho do Apoiador Institucional e Apoio às equipes para administrar e planejar processos de trabalho. Na fase qualitativa, analisaram-se as diretrizes gerais para o Apoio Institucional no município, descritos pelo gestor municipal no formulário on line. Para organização e categorização dos dados qualitativos foi utilizado o Atlas ti.7.1, e como método de interpretação, a análise de conteúdo. A partir da concepção do Apoio como ferramenta democratizante, procedeu-se a aproximação de conceitos do Apoio Paideia (Campos), das relações de poder (Foucault) e da análise institucional (Lourau). Elencou- se as seguintes categorias de análise: Categoria 1- Dimensão administração e planejamento de processos de trabalho com as Subcategorias: Apoio à organização do processo de trabalho das equipes; Apoio ao planejamento, monitoramento e avaliação; Apoio às ações das equipes; Apoio ao fortalecimento das redes de atenção à saúde e ações intersetoriais e estrutura organizacional e administrativa do Apoio no município. Categoria 2- Dimensão Política com as Subcategorias: Apoio aos processos participativos de gestão e estímulo ao controle social; Apoio a construção de relações democráticas, cooperativas e dialógicas; Apoio às ações vinculadas ao PMAQ; descrição do Apoio Institucional utilizando a mesma redação dos documentos oficiais do MS. Categoria 3- Dimensão Pedagógica com a Subcategoria: processos de formação e qualificação de profissionais e gestores. Observou-se que o Apoio Institucional é uma realidade no contexto da Atenção Básica no Brasil, porém identificou-se que, tanto nas ações apoiadas quanto nas diretrizes propostas pelas gestões evidencia-se um traço normalizador e burocrático nesse processo. Houve avaliação positiva pelas equipes do Apoiador Institucional, embora esses profissionais encontrem-se sobrecarregados no exercício dessa função pelo número excessivo de equipes sob sua responsabilidade, evidenciando-se a necessidade de um dimensionamento que leve em consideração o modo de operar a função Apoio. Nas capitais brasileiras observaram-se fragilidades nas condições de gerir os processos para a institucionalização do Apoio, inferindo-se que as gestões e equipes de gestão da Atenção Básica precisam ser apoiadas na condução desse processo. Propõe-se, assim, o aprofundamento da temática e que nos outros ciclos do PMAQ-AB haja adequação dos instrumentos utilizados na avaliação externa, referente à dimensão Apoio Institucional, a fim de avançar na valorização das singularidades do Apoio, principalmente, no tocante à cogestão enquanto processo coletivo e democrático.

9
  • GEORGIA COSTA DE ARAUJO SOUZA
  • Análise do impacto das estratégias de implantação da Política Nacional de Saúde Bucal em capitais brasileiras na primeira década do século XXI

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • GILBERTO ALFREDO PUCCA JÚNIOR
  • IRIS DO CEU CLARA COSTA
  • LUIZ ROBERTO AUGUSTO NORO
  • SAMUEL JORGE MOYSÉS
  • Data: 3 août 2015


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  • A Política Nacional de Saúde Bucal (PNSB) incorpora diversos elementos inovadores que tiveram o objetivo de impactar sobre o quadro epidemiológico e a vigilância em saúde bucal. Ao mesmo tempo, as duas edições do mais abrangente inquérito de saúde bucal do País, o SBBrasil, demonstraram uma importante tendência de redução nos principais indicadores, particularmente aqueles relativos à cárie dentária, entre os anos de 2003 e 2010. Desta forma, objetiva-se analisar o efeito da implementação da PNSB sobre a tendência nos principais indicadores de saúde bucal em capitais brasileiras. Trata-se de um estudo de avaliação de políticas desenvolvido em três fases: 1) Análise de implantação da PNSB nas capitais; 2) Análise da tendência dos indicadores epidemiológicos entre 2003 e 2010; 3) Análise do impacto da implantação sobre a tendência dos indicadores de saúde bucal. Para a realização da fase 1, os dados de Saúde Bucal disponíveis nos Sistemas de Informação em Saúde foram analisados, possibilitando a geração de 4 fatores de caracterização da atenção em saúde bucal em cidades brasileiras com mais de 100.00 habitantes, a partir da qual foram selecionadas as capitais para uma análise mais aprofundada. A fase 2 consistiu na definição das capitais a serem investigadas in loco através da aplicação de questionário face a face com Coordenadores de Saúde Bucal de 13 capitais selecionadas. A fase 3 foi realizada por meio dos dados do SBBrasil 2003 e 2010, disponíveis pelo Ministério da Saúde com avaliação dos efeitos das variáveis independentes, referentes à caracterização da Atenção em Saúde Bucal e variáveis socioeconômicas de nível populacional, sobre as dependentes, modificação nos indicadores de saúde bucal entre 2003 e 2010. Os resultados apontam para a não associação entre as características da Atenção em Saúde Bucal e a redução da morbidade bucal na maioria das capitais selecionadas. Observa-se que o Modelo de atenção em saúde bucal anda em consonância com as estratégias de Promoção da Saúde Bucal, Organização da oferta de serviços em saúde bucal e com a presença de flúor nas águas de abastecimento público. Contudo, isso não reflete na modificação dos indicadores de saúde bucal entre 2003 e 2010. A condição socioeconômica parece estar mais associada ao CPO-D satisfatório aos 12 anos em 2010 do que o reflexo do Modelo de atenção em saúde bucal. Conclui-se que a oferta de serviços e a atenção em saúde bucal pós PNSB não produzem uma resposta direta sobre a modificação nos indicadores de saúde bucal entre 2003 e 2010.

10
  • MARIA JALILA VIEIRA DE FIGUEIREDO LEITE
  • Efeito de diferentes divisões territoriais na flutuação aleatória de indicadores socioeconômicos relacionados à determinação social da saúde

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • CHRISTOVAM DE CASTRO BARCELLOS
  • DAMIAO ERNANE DE SOUZA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 14 août 2015


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  • Esta pesquisa teve como objetivo analisar o efeito de diferentes divisões territoriais na flutuação aleatória de indicadores socioeconômicos relacionados à determinação social da saúde. Trata-se de um estudo ecológico, com manipulação de cinco bancos de dados oriundos da base de informações do censo demográfico brasileiro 2010 - Resultados gerais da amostra. Estes dados foram agrupados nos seguintes níveis: Domicílios; Áreas de Ponderação; Municípios; Regiões Imediatas de Articulação Urbana e Regiões Intermediárias de Articulação Urbana. Foi utilizado um modelo teórico relacionado à determinação social da saúde, tendo como variável dependente Domicílio com óbitos e como variáveis independentes: Raça; Renda; Frequência à escola ou creche; Analfabetismo; e Escolaridade baixa. Os dados foram analisados através da estatística descritiva e inferencial, utilizando regressões de Poisson de base individual, regressão multinível de Poisson e regressões lineares múltiplas, à luz do referencial teórico da área. Identificou-se uma maior proporção de domicílios com óbitos dentre aqueles com pelo menos um morador preto, de menor renda, analfabeto, que não frequenta ou frequentou escola e creche e menos escolarizado. A análise do modelo ajustado demonstrou que a variável Renda obteve a maior razão de prevalência, sendo observado um valor de risco de 1,33 para domicílios com pelo menos um morador com renda média menor que R$ 655,00. A análise multinível identificou a existência de efeitos de contexto, na medida em que os efeitos randômicos foram significativos em todos os modelos e com razões de prevalência diferentes, sendo maiores nas áreas com menores dimensões - Áreas de Ponderação, com β de 0,035 e Municípios, com β de 0,024. As análises lineares múltiplas demonstraram que as variáveis Renda e Escolaridade baixa apresentaram potencial explicativo para o desfecho em todos os modelos, tendo a Renda um maior poder de determinação dos óbitos domiciliares, especialmente nos modelos relacionados às Regiões Imediatas de Articulação Urbana, com um coeficiente padronizado de -0,616 e Regiões Intermediárias de Articulação Urbana, com um coeficiente padronizado de -0,618. Conclui-se que ocorreu um efeito de contexto sobre a flutuação aleatória dos indicadores socioeconômicos relacionados à determinação social da saúde. Este efeito foi explicado pelas características das divisões territoriais e dos indivíduos que ali vivem ou trabalham. Os efeitos de contexto foram mais bem identificados nas áreas com dimensões menores, sendo estas mais favoráveis para explicação de fenômenos relacionados à determinação social da saúde, especialmente em estudos de sociedades marcadas pelas desigualdades sociais. Os efeitos de composição foram mais bem identificados nas regiões de articulação urbana, conformadas através de mecanismos semelhantes aos do fenômeno em estudo.

11
  • GILMAR AMORIM DE SOUSA
  • HEPATITE C CRÔNICA EM SERVIÇO DE REFERÊNCIA NO NORDESTE DO BRASIL: UM ESTUDO RETROSPECTIVO DE DEZOITO ANOS DE ACOMPANHAMENTO

  • Leader : IRIS DO CEU CLARA COSTA
  • MEMBRES DE LA BANQUE :
  • IARA MARQUES DE MEDEIROS
  • IRIS DO CEU CLARA COSTA
  • JOSÉ MILTON DE CASTRO LIMA
  • MARIA ANGELA FERNANDES FERREIRA
  • MARIA DE FÁTIMA DUQUES DE AMORIM
  • Data: 11 sept. 2015


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  • A hepatite C crônica é a principal causa de doença hepática crônica avançada em estágio final, de carcinoma hepatocelular (CHC) e de morte relacionada à doença hepática. Evolui de forma progressiva no espaço de tempo de 20 a 30 anos. Taxas evolutivas variam na dependência de fatores do vírus, do hospedeiro e comportamental. Este estudo objetivou fazer uma avaliação do impacto da hepatite C, no serviço de referência em Hepatologia do Hospital Universitário Onofre Lopes – Núcleo de Estudos do Fígado - de maio de 1995 a dezembro de 2013. Foi realizada uma avaliação retrospectiva em 10.304 prontuários, com a finalidade de se construir uma coorte de pacientes com hepatite C, em que todos os indivíduos tivessem o seu diagnóstico confirmado pelo teste padrão ouro de biologia molecular. Os dados foram obtidos diretamente dos prontuários dos pacientes e registrados em planilha Excel, previamente construída, seguindo uma codificação elaborada com as variáveis de estudo, os quais se constituem em dados individuais e em fatores de prognóstico definidos pela literatura na progressão da hepatite C crônica. O projeto foi aprovado pelo Comitê de Ética em Pesquisa do HUOL-UFRN com o número de parecer 448.243. Os resultados foram analisados estatisticamente, sendo o teste de Qui-Quadrado e o Exato de Fisher utilizados para verificar a associação entre as variáveis. Para a análise multivariada, usou-se o método de regressão Logística Binomial. Para ambos os testes, admitiu-se significância p<0,05 e IC de 95%. Os resultados mostraram que a prevalência de Hepatite C crônica no NEF foi estimada em 4,96%. A prevalência de cirrose por Hepatite C foi 13,7%. A prevalência de diabetes em pacientes com Hepatite C foi 8,78% e de diabetes em cirróticos com hepatite C 38,0%. A prevalência de CHC foi estimada em 5,45%. As taxas de descontinuidade do acompanhamento clínico foram estimadas em 67,5%. A mortalidade nos casos confirmados sem cirrose foi 4,34% e nos pacientes cirróticos 32,1%. Os fatores associados ao desenvolvimento de cirrose foram genótipo 1 (p =  0,0015) e bilirrubina > 1.3 mg% (p = 0,0017) . Os fatores associados à mortalidade foram idade acima de 35 anos, abandono do tratamento, diabetes, uso de insulina, AST > 60 UI, ALT > 60 UI, bilirrubina total alta, TAP alargado, INR alto, albumina baixa, suspensão do tratamento, cirrose e hepatocarcinoma. A ocorrência de diabetes mellitus elevou a mortalidade de pacientes com hepatite C em 7,2 vezes. Variáveis associadas ao diagnóstico de cirrose por US foram doador de sangue (odds ratio 0,24, p= 0,044) e atleta profissional (odds ratio 0,18, p = 0,35). É razoável considerar uma reavaliação nos modelos de screening para CHC propostos atualmente. A condição de cirrose e diabetes modifica a evolução clínica de pacientes com hepatite C crônica, tornando-a uma doença com maior mortalidade. Entretanto, ser doador de sangue ou atleta profissional é fator de proteção que reduz o risco de cirrose, independente do consumo de álcool. Políticas públicas para melhor acessso, acolhimento e resolutividade são necessárias para esta população.

12
  • DIEGO BONFADA
  • Gasto com a internação de idosos em Unidades de Terapia Intensiva

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • MARIA ANGELA FERNANDES FERREIRA
  • PAULO BORGES DE SOUZA JUNIOR
  • RENATO PEIXOTO VERAS
  • VALERIA RODRIGUES LEITE
  • Data: 29 sept. 2015


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  • O envelhecimento populacional no Brasil ressalta a necessidade de discutir o gerenciamento adequado do orçamento destinado à saúde, em especial nos setores de alta complexidade, onde coexistem procedimentos onerosos, recursos limitados e necessidade de contenção de despesas, mesmo diante de uma demanda crescente e diretamente proporcional ao aumento do número de idosos.  Objetivo: Desta forma, esta pesquisa tem como objetivo geral analisar os gastos decorrentes da internação de idosos em Unidades de Terapia Intensiva (UTI) e seus fatores associados. Métodos: Trata-se de um estudo seccional, de abordagem quantitativa e com caráter descritivo-exploratório. Os dados foram coletados em prontuários de idosos internados em UTI em Natal-RN, entre primeiro de novembro de 2013 e 31 de janeiro de 2014. As variáveis coletadas relacionam-se ao perfil sócio demográfico, quadro de morbidade e caracterização da internação. A variável dependente foi categorizada pelo quartil 75, em alto e baixo gasto de internação e submetida ao teste de Qui-quadrado com as variáveis independentes da pesquisa. As associações que apresentaram p<0,20 na análise bivariada foram submetidas à técnica da regressão logística múltipla. Optou-se pela construção de três modelos de regressão a partir do algoritmo supracitado: um chamado de modelo de regressão geral, composto por todas as 493 internações do estudo, outro somente para os 181 indivíduos internados no Sistema Único de Saúde (SUS) e um terceiro referente aos 312 casos provenientes da rede de assistência privada. Resultados: No modelo de regressão geral, as variáveis doenças respiratória, instituição privada, paciente desorientado e acidente vascular cerebral prévio foram associadas à maior probabilidade de alto gasto na internação em UTI. Por sua vez, nas internações do SUS, essa probabilidade foi associada à paciente desorientado, com 80 anos ou mais, com Sepse e Internação por motivo clínico. Já nos casos provenientes da rede privada, o alto gasto foi associado à doença respiratória, ventilação mecânica, internação por motivo clínico e aos pacientes desorientados. Conclusão: O aumento dos gastos com a internação de idosos em terapia intensiva depende das condições clinicas dos indivíduos. Isso evidência a importância de evitar internações decorrentes de agravos sensíveis à atenção primária, por meio da prevenção a saúde e garantia de assistência integral ao idoso. Além disso, a obtenção de modelos explicativos distintos, segundo a esfera administrativa do hospital, demonstra a importância da organização dos serviços de saúde na composição dos gastos da internação de idosos. Outro destaque foi a necessidade de melhorar o financiamento em saúde em termos quantitativos e qualitativos, usando de maneira racional os recursos disponíveis e evitando internações desnecessárias de idosos inseridos nos extremos de gravidade. Diante da carência de toda ordem de recursos, internar em UTI um idoso em condições não críticas ou em estado terminal pode comprometer a qualidade dos serviços prestados àqueles que realmente necessitam de cuidado intensivo.

13
  • LAVINIA UCHOA AZEVEDO DE ARAUJO
  • A produção do cuidado no período gravídico-puerperal: experiências DE MULHERES USUÁRIAS DE SERVIÇOS PÚBLICOS DE SAÚDE.

  • Leader : ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MEMBRES DE LA BANQUE :
  • CARMEN SIMONE GRILO DINIZ
  • CLAUDIA SANTOS MARTINIANO SOUSA
  • EDNA MARIA DA SILVA
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 29 oct. 2015


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  • A despeito das inúmeras iniciativas governamentais com vistas à reorganização e qualificação da atenção obstétrica e neonatal no Brasil, essa atenção permanece problemática, com repercussões sobre a mortalidade materna e neonatal e sobre a humanização do cuidado à mulher e à criança. Este estudo teve como objetivo geral analisar a produção do cuidado à mulher no período gravídico-puerperal, a partir de relatos de usuárias de serviços públicos de saúde sobre suas experiências de gestar e parir, tomando por referência a integralidade e a humanização. O estudo é de abordagem qualitativa e teve como estratégia metodológica escutar as mulheres para, a partir dos sentidos e significados de suas falas sobre suas experiências com os serviços de saúde, identificar continuidades e descontinuidades do cuidado no período gravídico puerperal. As usuárias participantes do estudo são mulheres que tiveram seus filhos em uma maternidade pública municipal, residiam em bairros de Natal e que estavam, no momento da entrevista, com mais de dez dias e até 42 dias de pós-parto. Foram entrevistadas sete mulheres que relataram suas experiências de gestar e parir acompanhadas pelos serviços públicos. À medida que foram sendo realizadas as entrevistas e a observação, também foi sendo analisado o material produzido, buscando-se articulação simultânea entre produção e análise de dados. A partir da sistematização foi estabelecido o diálogo entre as falas das mulheres e a produção no campo da Saúde Coletiva, relativa a conceitos e discussões sobre a atenção obstétrica e neonatal e às elaborações sobre Integralidade e Humanização do cuidado. Ressaltaram-se aspectos das falas relacionados com o cuidado pré-natal, desde a gravidez e suas repercussões nos cuidados pré-natais, bem como o acompanhamento pré-natal pelos serviços de saúde; aspectos relativos ao cuidado no parto e nascimento, abordando as questões diretamente relacionadas ao trabalho de parto e ao parto e aspectos das falas relativos ao pós-parto na maternidade, tanto no que se refere aos cuidados com o bebê quanto com a mãe/mulher; e por último, os cuidados relacionados ao puerpério, após a alta da maternidade. Na análise dos resultados, buscou-se identificar linhas de continuidade e descontinuidade na integralidade e humanização do cuidado. A partir dessas linhas e a título de contribuições finais do estudo, foram traçadas pistas para buscar integralidade e humanização da produção do cuidado à mulher no período gravídico puerperal: pista 1- Repensar a gestão do cuidado na rede de atenção à saúde materno-infantil, tendo como perspectiva a integralidade no sentido de responder à necessidade de garantia de acesso aos diversos serviços e recursos tecnológicos disponíveis para melhorar a saúde e a vida. Pista 2- Reorganizar os processos de trabalho com vistas ao alcance da integralidade e da humanização na atenção às mulheres no período gravídico-puerperal. Pista 3 - Qualificar a relação profissional-usuária na gestão do cuidado no período gravídico-puerperal. Pista 4 - Investir na qualificação dos processos comunicacionais nas diversas dimensões da gestão do cuidado no período gravídico-puerperal.

14
  • LÍGIA MORENO DE MOURA
  • VALIDAÇÃO DO INSTRUMENTO DE INVESTIGAÇÃO DO CONHECIMENTO DE GESTANTES SOBRE A SUA SAÚDE BUCAL E A SAÚDE BUCAL DO SEU BEBÊ: PERSPECTIVA DO CUIDADO EM SAÚDE

  • Leader : MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MEMBRES DE LA BANQUE :
  • EDNA MARIA DA SILVA
  • ISABELITA DUARTE AZEVEDO
  • MAISA PAULINO RODRIGUES
  • MARIA ALICE PIMENTEL FUSCELLA
  • RICARDO CAVALCANTI DUARTE
  • Data: 18 déc. 2015


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  • A sociedade está em constante mudança e a ciência deve acompanhar tais transformações, de modo a entendê-las, analisá-las e propor soluções para eventuais problemas que surjam. Dessa forma, no Brasil, a Política Nacional de Saúde também vem se adequando aos atuais problemas, e dentre eles pretende-se reduzir mortalidade infantil. Por isso, vem desenvolvendo uma série de políticas para melhorar a qualidade da atenção à gestante, na perspectiva da integralidade. Uma atenção pré-natal e puerperal de qualidade e humanizada é fundamental para a saúde materna e neonatal, bem como a atenção à saúde bucal. Atualmente, a Política Nacional de Saúde Bucal visa à ampliação da assistência odontológica às gestantes. Sendo assim, as políticas de promoção da saúde bucal e de atenção ao pré-natal devem estar integradas, entretanto, há pouca adesão das gestantes. Dessa forma, faz-se necessário verificar o conhecimento das gestantes relacionado à saúde bucal buscando estimar a qualidade dos cuidados odontológicos oferecidos durante o pré-natal, sendo essencial para a Estratégia da Saúde da Família dimensionar pessoal, planejar custos e garantir o padrão de qualidade da assistência. OBJETIVO: Este estudo objetivou validar instrumento de investigação sobre o conhecimento das gestantes sobre a sua saúde bucal e do seu bebê. MÉTODO: Trata-se de um estudo de validação, realizado com 93 gestantes em Unidades de Saúde da Família e Clínicas privadas especializadas em Obstetrícia, da cidade do Natal/RN. Foi autorizado pelo Comitê de Ética do Hospital Universitário Onofre Lopes da Universidade Federal do Rio Grande do Norte sob o Parecer número 421.163/13. Para que o instrumento fosse válido, confiável e sensível, sua construção seguiu as etapas: criação e redução dos itens (elaboração do instrumento), validade de conteúdo e teste do instrumento e validação das hipóteses. Depois de construído o instrumento, ele foi avaliado por dezenove expertises, que sugeriram modificações. Estas foram analisadas por um comitê de juízes. Logo foi criada uma nova versão do instrumento que consultou a população-alvo. Só então foi realizada a consistência interna através da calibração intra e interexaminadores, e da aplicação do teste-reteste. Depois foram validadas as hipóteses. Um banco de dados foi construído no Statistical Package for Social Sciences (SPSS®) na versão 22.0. Na validação de critérios, após criação das hipóteses, esta associação foi verificada entre cada uma das questões específicas para cada critério estabelecido considerando nível de significância de 5%. A análise dos dados foi realizada através da descrição das frequências absolutas e relativas das variáveis concernentes à caracterização das questões relativas ao conhecimento sobre saúde bucal das gestantes e bebês. Para avaliar a consistência interna e a reprodutividade do instrumento (teste-reteste) no processo de validação, foi utilizado o coeficiente alfa de Cronbach. Além disso, o teste do qui-quadrado foi utilizado para cruzar a variável dependente com as variáveis independentes as quais foram dicotomizadas. RESULTADOS: A análise da consistência interna mostrou que as questões do instrumento apresentaram ótima confiabilidade nas respostas (α de Cronbach˃0,7). Na investigação da relação entre as variáveis dependentes (conhecimento sobre saúde bucal) e as variáveis independentes (trimestre da gravidez, escolaridade, renda e multíparas) verificou-se que nenhuma destas variáveis independentes teve associação significativa. CONCLUSÃO: O instrumento criado foi válido, tendo em vista que se mostrou consistente e com boa reprodutividade e pode ser usado para avaliar o conhecimento das gestantes sobre a sua saúde bucal e a saúde bucal do seu bebê.

2014
Thèses
1
  • KARYNA DE MELO MENEZES
  • Eficácia do tratamento não-cirúrgico em indivíduos com mucosite peri-implantar

  • Leader : BRUNO CESAR DE VASCONCELOS GURGEL
  • MEMBRES DE LA BANQUE :
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • EULER MACIEL DANTAS
  • MARCIO ZAFFALON CASATI
  • Data: 20 févr. 2014


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  • Tem sido demonstrado que o desenvolvimento da mucosite peri-implantar está associado ao acúmulo de biofilme dentário. Acredita-se que as abordagens terapêuticas utilizadas nas doenças periodontais podem apresentar efeito positivo nos casos de doenças peri-implantares. O objetivo desse estudo foi avaliar a eficácia do tratamento não cirúrgico da mucosite peri-implantar, com ou sem a utilização de clorexidina a 0,12%, em indivíduos reabilitados com implantes osseointegrados. Desta forma, os pacientes foram divididos aleatoriamente em grupo teste (terapia não cirúrgica + clorexidina) e controle (terapia não cirúrgica). Esta terapia consistiu de uma adaptação do protocolo não-cirúrgico FMSRP (Full Mouth Scalling and Root Planing), porém, sem a utilização do ultrassom. Os parâmetros clínicos índice de placa visível (IPV), índice de sangramento gengival (ISG), profundidade de sondagem (PS), sangramento à sondagem (SS) e mucosa queratinizada foram avaliados no baseline e em diferentes períodos após o tratamento. Os dados não apresentaram distribuição normal e o implante foi considerado a unidade amostral. Os dados foram analisados por meio dos testes de Friedman, Wilcoxon e Qui-quadrado (a=5%), utilizando o Statistical Package for Social Sciences 17.0 (SPSS). Desta forma, 119 implantes foram avaliados, sendo 61 no grupo teste e 58 no grupo controle. Os resultados mostraram que houve diferença estatisticamente significativa para as variáveis: média do IPV dos implantes em ambos os grupos (p<0,001); média do ISG dos implantes tanto no grupo teste (p<0,001), como controle (p=0,006) dos implantes; PS para o grupo teste (p<0,001) e controle (p=0,015) e SS (p<0,001) dentro dos dois grupos de tratamento. No entanto, não houve diferença estatisticamente significativa quando os grupos foram comparados. As variáveis PS e SS não mostraram diferença estatisticamente significativa com nenhuma variável independente de interesse para este estudo (idade, sexo, fumo, grupo de tratamento, mucosa ceratinizada nos diferentes tempos, biótipo peri-implantar, média do IPV e ISG nos implantes). Desta forma, pode-se concluir que tanto a terapia mecânica isolada como sua associação com bochechos de clorexidina a 0,12% podem ser usados para o tratamento da mucosite peri-implantar. Além disso, a condição de higiene bucal melhorou entre o baseline e seis meses e a profundidade e sangramento à sondagem reduziram após três e seis meses.

2
  • JAVIER JEREZ ROIG
  • PREVALÊNCIA DE INCONTINÊNCIA URINÁRIA E FATORES ASSOCIADOS EM IDOSOS INSTITUCIONALIZADOS

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • MARIA ANGELA FERNANDES FERREIRA
  • RENATO PEIXOTO VERAS
  • Data: 24 févr. 2014


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  • A incontinência urinária (IU) é uma síndrome geriátrica especialmente prevalente em indivíduos institucionalizados, que gera um forte impacto econômico e social derivado principalmente dos custos de tratamento e da sobrecarga dos cuidadores. Além disso, acarreta consequências físicas à saúde do idoso, como infecção urinária ou úlceras por pressão, entre outros agravos à saúde. No entanto, os trabalhos realizados no país sobre este agravo à saúde são escassos e contêm sérios vieses metodológicos. Sendo assim, o objetivo do presente trabalho é verificar a prevalência da incontinência urinária e fatores associados nos idosos institucionalizados. Trata-se de um estudo transversal realizado entre outubro e dezembro de 2013 e desenvolvido em 10 instituições de longa permanência para idosos da cidade do Natal. A IU foi aferida mediante o Minimum Data Set versão 3.0, que também se utilizou para avaliar a incontinência fecal, os dispositivos urinários e as medidas de controle da IU. Foram coletadas variáveis sociodemográficas, de caracterização da IU e relacionadas à instituição e às condições de saúde (comorbidades, medicação, cirurgias do assoalho pélvico, Índice de Barthel de capacidade funcional e Teste de Pfeiffer de capacidade cognitiva). Foi realizada a análise bivariada mediante os testes qui-quadrado de Pearson (ou teste de Fisher) e o teste qui-quadrado de tendência linear, calculando a razão de prevalência com intervalo de confiança de 95%. Por fim, as variáveis com valor de p menor que 0,20, foram incluídas na análise múltipla, que foi realizada mediante regressão logística do tipo Stepwise Forward. A permanência das variáveis no modelo final deu-se segundo o teste da razão de verossimilhança, ausência de multicolinearidade e teste de Hosmer and Lemeshow. Foi considerado o nível de significância estatística de 0,05. Foram excluídos 6 (1,8%) indivíduos hospitalizados, 1 (0,3%) em fase terminal e 1 (0,3%) menor de 60 anos. A amostra foi composta por 321 idosos, a maioria do sexo feminino e com média de idade de 81,5 anos. A prevalência de IU foi de 59,43% e o modelo multivariado mostrou associação estatisticamente significativa da IU com a raça branca, inatividade física, acidente cerebrovascular, restrição da mobilidade e declínio cognitivo. O tipo mais frequente foi a IU funcional por incapacidade física ou cognitiva, e as medidas de controle da incontinência foram aplicadas apenas em uma minoria dos residentes (aproximadamente 8%). Pode-se concluir que a IU é um agravo à saúde que afeta a mais da metade dos idosos institucionalizados, e que está associado à raça branca, inatividade física, acidente vasculocerebral e outras síndromes geriátricas como a imobilidade e incapacidade cognitiva. A maior parte destes fatores associados são modificáveis e, portanto, os achados deste estudo alertam para a importância de ações de prevenção e tratamento da IU no âmbito das instituições, que incluam medidas gerais, como atividades físicas e psicossociais, e específicas, como a evacuação precoce.

3
  • TAMIRES CARNEIRO DE OLIVEIRA MENDES
  • Perfil de mortalidade de idosos no Rio Grande do Norte: estudo comparativo entre duas faixas etárias e fatores relacionados.

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • LARA DE MELO BARBOSA ANDRADE
  • RENATO PEIXOTO VERAS
  • Data: 24 févr. 2014


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  • As medidas de mortalidade representam um dos mais importantes indicadores das condições de saúde. Por concentrar a maior carga de mortes, o estudo da mortalidade da parcela idosa da população se configura como essencial para a compreensão da situação de saúde. Nesse sentido, o presente trabalho se propõe a analisar o perfil de mortalidade da população de 60 a 69 anos (idosos mais jovens) e de 80 anos ou mais de idade (idosos longevos) no estado do Rio Grande do Norte no período de 2001 a 2011, bem como identificar os fatores contextuais e de qualidade do Sistema de Informações sobre Mortalidade (SIM) relacionados. Para tanto, foram calculados a Mortalidade Proporcional (MP) para o estado e o Coeficiente de Mortalidade Específico por Idade (CMId), segundo capítulo CID-10, para os municípios do Rio Grande do Norte, a partir dos dados do Sistema de Informações sobre Mortalidade (SIM) e do Instituto Brasileiro de Geografia e Estatística (IGBE). A fim de identificar os grupos de municípios com perfis de mortalidade similares para CMIds, foi realizada a Análise de Conglomerados não Hierárquicos do tipo K-means e, para a redução das variáveis independentes contextuais, recorreu-se à Analise Fatorial pelo método de Análise de Componentes Principais. As distribuições espaciais de tais grupos  e fatores produzidos foram visualizadas através da técnica Análise Espacial de Áreas. No período investigado, foram registrados 21.813 óbitos de idosos mais jovens, com predomínio das mortes por doenças do aparelho circulatório (32,75%) e neoplasmas (22.9%). Entre os idosos longevos, foram registrados 50.637 óbitos, sendo 35,26% por doenças do aparelho circulatório e 17,27% por causas mal definidas. A Análise de Conglomerados formou três grupos para as duas faixas etárias de interesse e a Análise Fatorial reduziu as variáveis independentes contextuais em três fatores, sendo considerada também a soma dos escores fatoriais. Entre os idosos mais jovens, formaram-se os grupos perfil do desconhecimento, perfil do desenvolvimento e paradoxo do desenvolvimento, que obtiveram associação estatisticamente significativa com os fatores educação e pobreza, extrema pobreza, soma fatorial, e com a variável relacionada à subnotificação dos óbitos. O grupo perfil do desconhecimento permaneceu na faixa etária longeva, acompanhado do perfil de transição epidemiológica e do paradoxo epidemiológico,que foram estatisticamente associado ao fator desenvolvimento e saúde e às variáveis que indicam a qualidade SIM: proporção de campos “em branco” sobre a escolaridade e de sub-registro. Depreende-se que os perfis de mortalidade de idosos mais jovens e longevos apresentam diferenças quanto à importância das causas básicas e que são influenciados por distintos aspectos contextuais, sendo os idosos de 60 a 69 anos mais afetados por tais aspectos. Medidas direcionadas à melhoria dos níveis de educação e pobreza dos municípios podem contribuir para a redução das desigualdades em saúde relacionadas aos idosos mais jovens, principalmente, bem como a otimização da utilização dos serviços de saúde, que se relaciona mais expressivamente ao quadro de saúde dos idosos longevos, especialmente no que diz respeito à qualidade das informações para os dois grupos de idade.

4
  • YAN NOGUEIRA LEITE DE FREITAS
  • PRODUÇÃO E VALIDAÇÃO DE UM INDICADOR DE SAÚDE BUCAL PARA IDOSOS A PARTIR DE DADOS SECUNDÁRIOS DO SB BRASIL 2010.

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • FABÍOLA BOF DE ANDRADE
  • KENIO COSTA DE LIMA
  • Data: 25 févr. 2014


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  • Dentre os vários aspectos da saúde do idoso, a saúde bucal merece atenção especial pelo fato de que, historicamente, nos serviços odontológicos, não se considera esse grupo populacional como prioridade de atenção. Por isso, se faz necessária a produção de um indicador multidimensional capaz de mensurar todas as alterações bucais encontradas em um idoso, facilitando a categorização da saúde bucal como um todo. Tal indicador representará um importante instrumento capaz de elencar prioridades de atenção voltadas à população idosa. Portanto, o estudo em questão propõe a produção e validação de um indicador de saúde bucal a partir dos dados secundários coletados pelo projeto SB Brasil 2010 referente ao grupo etário de 65 a 74 anos. A amostra foi representada pelos 7619 indivíduos do grupo etário de 65 a 74 anos que participaram da pesquisa nas 5 (cinco) regiões do Brasil. Tais indivíduos foram submetidos à avaliação epidemiológica das condições de saúde bucal, a partir dos índices CPO-d, CPI e PIP. Além disso, verificou-se o uso e necessidade de prótese, bem como características sociais, econômicas e demográficas. Uma análise fatorial identificou um número relativamente pequeno de fatores comuns, através da análise de componentes principais. Após a nomenclatura dos fatores, foi realizada a soma dos escores fatoriais por indivíduo. Por último, a dicotomização dessa soma nos forneceu o indicador de saúde bucal proposto. Para esse estudo foram incluídas na análise fatorial 12 variáveis de saúde bucal oriundas do banco de dados do SB Brasil 2010 e, também 3 variáveis socioeconômicas e demográficas. Com base no critério de Kaiser, observa-se que foram retidos cinco fatores que explicaram 70,28% da variância total das variáveis incluídas no modelo. O fator 1 (um) explica sozinho 32,02% dessa variância, o fator 2 (dois) 14,78%, enquanto que os fatores 3 (três), 4 (quatro) e  5 (cinco) explicam 8,90%, 7,89% e 6,68%, respectivamente. Por meio das cargas fatoriais, o fator um foi denominado “dente hígido e pouco uso de prótese”, o dois “doença periodontal presente”, o três “necessidade de reabilitação”, já o quarto e quinto fator foram denominados de “cárie” e “condição social favorável”, respectivamente. Para garantir a representatividade do indicador proposto, realizou-se uma segunda análise fatorial em uma subamostra da população de idosos investigados. Por outro lado, a aplicabilidade do indicador produzido foi testada por meio da associação do mesmo com outras variáveis do estudo. Por fim, Cabe ressaltar que, o indicador aqui produzido foi capaz de agregar diversas informações a respeito da saúde bucal e das condições sociais desses indivíduos, traduzindo assim, diversos dados em uma informação simples, que facilita o olhar dos gestores de saúde sobre as reais necessidades de intervenções em relação à saúde bucal de determinada população.

5
  • MARCOS PRETTO MOSMANN
  • 18F-FDG PET/CT ONCOLÓGICO NO ESTADO DO RIO GRANDE DO NORTE: CARACTERIZAÇÃO DOS USUÁRIOS E INDICAÇÕES DO EXAME

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • GUSTAVO PINA GODOY
  • Data: 26 févr. 2014


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  • O câncer tem contribuído drasticamente em termos de morbidade, mortalidade e custos para os sistemas de saúde no mundo. O manejo desses pacientes é complexo e novas tecnologias têm emergido para o seu melhor cuidado. A tomografia por emissão de pósitrons associada à tomografia computadorizada (PET/CT) é um método diagnóstico disponível mais recentemente no Brasil e determinou uma mudança de paradigma no fluxo do acompanhamento para muitos dos pacientes com câncer. Nesse sentido, o objetivo desse trabalho é  avaliar o acesso ao exame 18F-FDG PET/CT Oncológico no Estado do Rio Grande do Norte, segundo as características dos usuários, as indicações e as fontes de financiamento do método. Trata-se de um estudo individuado, observacional e transversal. Foram incluídos todos os pacientes que realizaram o exame 18F-FDG PET-CT com fins oncológicos na Liga Norteriograndense Contra o Câncer no período de 01/05/2011 a 30/04/2013. Coletaram-se dados relativos à data de realização do exame, sexo, idade, indicação (diagnóstico / estadiamento / monitorização da resposta ao tratamento / reestadiamento / suspeita de recidiva e controle), tipo de câncer ou condição que determinou a realização do exame e a fonte de financiamento (público ou particular). Nos dois anos que compreenderam o período de coleta de dados do estudo, foram realizados 924 exames 18F-FDG PET/CT, em 718 pacientes. A média de idade foi 51,4 (19,1) anos, variando entre 4 e 88 anos. Houve maior realização do exame entre as mulheres, com um total de 539 exames (58,3%). Observou-se aumento da realização do exame do primeiro ano (37,4%) para o segundo ano (62,6%). Quanto às indicações do exame 18F-FDG PET/CT, foram realizados 3,8% com fins de diagnóstico, 6,6% para estadiamento, 1,0% para monitorização da resposta ao tratamento, 49,8% para reestadiamento e 38,9% na suspeita de recidiva/controle, ou seja, apenas 10,4% dos exames foram realizados como estratégia inicial (diagnóstico e estadiamento). Em relação ao financiamento do 18F-FDG PET/CT, a maioria dos exames foi realizada com o convênio firmado com a Secretaria de Estado de Saúde Pública (45% dos exames). Os principais tipos de câncer encaminhados para o exame foram o linfoma (36,7%), câncer colorretal (10,6%), pulmão (9,7%) e mama (8,5%). Foram realizados poucos exames PET/CT em alguns tipos de câncer, em especial esôfago (0,4%), pâncreas (0,9%), estômago (1,2%) e cabeça e pescoço (2,1%). De todos os exames em pacientes classificados como estratégia inicial, apenas 21% tiveram acesso ao exame pelo sistema público, o que denota a pouca realização do 18F-FDG PET/CT Oncológico no estado para esse fim. Para os sistemas de saúde, é fundamental promover o uso racional desse método.

6
  • ANÍZIA AGUIAR NETA
  • Preceptoria em Saúde: inovação e geração de conhecimento para o trabalho no SUS.

  • Leader : MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MEMBRES DE LA BANQUE :
  • LUIZ ROBERTO AUGUSTO NORO
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • RICARDO BURG CECCIM
  • Data: 28 févr. 2014


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  • A formação dos estudantes de graduação da área da saúde, os quais são acompanhados pelos preceptores em saúde, apresenta-se como um tema de importância reconhecida pelos estudiosos da área de Educação em Saúde. A Política Nacional de Educação Permanente em Saúde propõe a disseminação de capacidade pedagógica no SUS, de modo que a rede pública de saúde passe a constituir-se num espaço de ensino-aprendizagem no exercício do trabalho, o que significa que a formação dos estudantes e profissionais deve acontecer dentro do próprio serviço, em situações reais. A discussão atual sobre Educação e Saúde tem mostrado que ainda é tênue na formação dos profissionais a apropriação do Sistema Único de Saúde. Há a necessidade de maior integração entre os serviços de saúde e a academia. Objetivos: conhecer a atuação dos preceptores, em serviço, no que diz respeito à sua participação no processo de formação dos estudantes dos cursos de graduação da área da saúde na UFRN; e estudar a atividade de preceptoria em sua complexidade, considerando sua importância para a formação dos estudantes. A Metodologia qualitativa nos possibilitou, a partir do uso das técnicas de Entrevista Semi Estruturada e Observação Direta, alcançar estes objetivos. A análise dos dados, feita a partir da Abordagem Hermenêutica-Dialética, tendo como mediadores os conhecimentos das áreas da Educação, Educação em Saúde e da Saúde Coletiva, mostrou que os preceptores em saúde educam-se enquanto educam. O processo educativo é permeado por saberes e experiências heterogêneas, fator altamente favorável à formação dos estudantes e profissionais. Práticas educacionais inovadoras revelaram-se capazes de, a partir da mediação dos preceptores e demais profissionais atuantes no Projeto PET Saúde, ampliar o aprendizado. Os componentes curriculares Saúde e Cidadania - SACI e Programa de Orientação Tutorial Integrado para o Trabalho em Saúde - POTI, escolhidos como base para esta experiência estabeleceram, para os preceptores, a necessidade de buscar novos conhecimentos, possibilitando a cada ator extrapolar sua área específica de formação acadêmica e interagir com as demais áreas, o que torna o aprendizado mais interessante, prazeroso e significativo.

7
  • ANA CLARA SOARES PAIVA TORRES
  • FALHAS E COMPLICAÇÕES COM O USO DE PRÓTESE PARCIAL REMOVÍVEL INFERIOR DE EXTREMIDADE LIVRE BILATERAL

  • Leader : ADRIANA DA FONTE PORTO CARREIRO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • EDUARDO JOSÉ GUERRA SEABRA
  • PATRICIA DOS SANTOS CALDERON
  • Data: 11 mars 2014


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  • Verificar a frequência e tipo de complicações relacionadas à prótese parcial removível (PPR) inferior, classe I de Kennedy, ao longo do tempo. Materiais e Métodos: Este estudo observacional foi composto por uma amostra de 65 usuários de PPR inferior em arcos Classe I de Kennedy e prótese total superior, reabilitados no Departamento de Odontologia da Universidade Federal do Rio Grande do Norte (UFRN). Os pacientes foram acompanhados por meio de controles periódicos nos períodos de 60 dias, 6 meses e 1 ano desde a instalação. Após o primeiro ano de controle os demais retornos tiveram periodicidade anual. A ocorrência de complicações ou falhas protéticas foi observada e registrada em ficha clínica específica ao longo de 39 meses. Os padrões de falhas observados foram enquadrados nas seguintes situações: ocorrência de úlceras traumáticas depois de 2 meses de instalação, ausência de retenção, fratura de nicho ou cárie sob o nicho, fratura ou descolamento dos dentes artificiais, fratura do conector maior, fratura de grampo, fratura do apoio, suporte deficiente (necessidade de reembasamento da prótese) e fratura da prótese. Resultados: A ocorrência de complicações apresentou baixa frequência, sendo maior a partir do segundo ano de uso da prótese. Dentre as complicações que mais aconteceram está a perda de retenção (31,57%). Falhas de maior gravidade e de difícil resolução como a fratura de elementos da estrutura metálica da PPR tiveram baixa ocorrência e foram representadas por apenas um caso de fratura do conector maior (5,3%). Conclusão: Próteses parciais removíveis de extremidade livre mandibulares opostas a próteses totais convencionais apresentam baixo índice de complicações após 39 meses de uso quando submetidas a controles periódicos.

8
  • MONICA BAUMGARDT BAY
  • Prevalência e fatores associados à testagem para HIV em homens que fazem sexo com homens

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANA MARIA DE BRITO
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • KENIO COSTA DE LIMA
  • Data: 18 mars 2014


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  • A infecção por HIV/Aids (vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida) constitui um importante problema mundial de Saúde Pública. Dados do último boletim apresentado pela UNAIDS (Organização das Nações Unidas para Aids) em 2013, apontam que mais de 35 milhões de pessoas vivem com HIV em todo mundo. No Brasil, a epidemia é concentrada,  com prevalência de infecção menor que 1% na população de 15 a 49 anos, porém chegando a 10,5% entre homens que fazem sexo com homens (HSH). O diagnóstico precoce do HIV se associa a uma redução da morbidade, mortalidade e também da transmissão desta infecção. O presente estudo tem o objetivo de avaliar a prevalência e fatores associados à testagem prévia para HIV na população de HSH dos municípios de Natal/RN e Parnamirim/RN. Os participantes respondiam a um questionário contendo perguntas referentes a dados sociodemográficos, padrões de relacionamento sexual, conhecimentos sobre HIV/Aids, uso de preservativo, consumo de álcool, drogas e busca de testagem para HIV e sífilis. Em seguida, os que desejassem poderiam realizar teste rápido para HIV e sífilis. No total, foram pesquisados 101 sujeitos, destes, 70 foram recrutados com a utilização da técnica Respondent Driven Sampling, e 31 com uma amostra de conveniência. O teste de HIV havia sido realizado por 63,3% dos homens pelo menos uma vez na vida. A testagem prévia para HIV foi associada à idade (27 anos ou mais), realização prévia do teste para sífilis, conhecimento sobre locais onde o teste de HIV é feito gratuitamente e resultado positivo para sífilis no momento da pesquisa. A prevalência de testagem para HIV na amostra foi baixa, semelhante ao verificado em outros estudos com a população HSH. Ações que priorizem a divulgação de locais onde o anti-HIV pode ser realizado gratuitamente e direcionadas para o público jovem parecem ser as mais adequadas para a ampliação da testagem entre os HSH na nossa realidade.

9
  • RENATA MELO MAROTO
  • AVALIAÇÃO DO PRÉ-NATAL NA ATENÇÃO PRIMÁRIA À SAÚDE NO RIO GRANDE DO NORTE: VISÃO DAS USUÁRIAS

  • Leader : SEVERINA ALICE DA COSTA UCHOA
  • MEMBRES DE LA BANQUE :
  • PAULO DE MEDEIROS ROCHA
  • PAULO ROBERTO DE SANTANA
  • SEVERINA ALICE DA COSTA UCHOA
  • Data: 20 mars 2014


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  • Com a priorização da Atenção Primária à Saúde (APS) no Brasil pelo Ministério da Saúde (MS), a saúde reprodutiva da mulher é considerada uma área estratégica. No ano 2000 foi instituído o Programa de Humanização no Pré-natal e Nascimento (PHPN), cujo foco é a realização de práticas assistenciais mínimas a serem concretizadas durante o pré-natal de baixo risco, extensivo a todas as unidades de APS. Este trabalho objetiva avaliar, na perspectiva das usuárias, a qualidade dos processos da assistência pré-natal prestadas pelas Equipes de Atenção Básica do Rio Grande do Norte (RN) no contexto do Programa de Melhoria do Acesso e da Qualidade (PMAQ) do MS. Trata-se de uma pesquisa avaliativa, observacional, transversal, com abordagem quantitativa. Nesse sentido, o trabalho de campo, que foi realizado no período de maio a agosto de 2012, contou com uma amostra de 156 usuárias selecionadas a partir dos seguintes critérios: adscrição à equipe avaliada; não ter acionado atendimento no dia; não ser o primeiro atendimento, nem o último ter ocorrido há mais de 12 meses; ser mãe de criança de até 2 anos de idade e; ter acessado e realizado o pré-natal na mesma unidade de saúde da equipe. Foi aplicado por 20 avaliadores com a mesma capacitação técnica, um questionário online sobre pré-natal com as categorias: consultas mínimas; atendimento profissional; agendamento de consultas; exames; vacinação antitetânica; participação em ações educativas individuais e em grupo; orientações; procedimentos clínico-obstétricos e; prescrição de sulfato ferroso e ácido fólico. A análise foi descritiva com distribuição de frequência simples e utilizou o programa SPSS versão 17.0. Para interpretação dos dados, utilizou-se como parâmetro os procedimentos mínimos do pré-natal recomendados pela PHPN e pelo Manual técnico do MS. Observou-se que 92% das usuárias realizaram seis ou mais consultas, de acordo com os padrões recomendados e valores encontrados na literatura; 84% tiveram continuidade do atendimento com o mesmo profissional e; 94% obtiveram as consultas subsequentes agendadas. Os exames obrigatórios previstos alcançaram os percentuais acima de outros estudos nacionais: Urina/EAS (98%); HIV (96%); VDRL (88%) e; Glicemia (91%). A vacinação antitetânica foi feita em 93% dos casos; 56% das mulheres sabiam da existência de grupos educativos, apenas 36% participavam das atividades e 59% foram orientadas sobre o lugar onde faria o parto. A realização de exames clínico-obstétricos das mamas (65%), preventivo (33%) e ginecológico (43%) teve baixo percentual, diferentemente do exposto em outros estudos nacionais. Observou-se, ainda, que 98% receberam suplementação de Sulfato Ferroso e 96% Ácido Fólico. A avaliação averiguou que os processos relativos à assistência estão sendo realizados como recomendado pelos critérios mínimos das práticas assistenciais e alcançaram um alto percentual no RN. No entanto, ainda há fragilidades acerca das práticas de saúde promocionais e educativas, bem como, da realização de alguns procedimentos clínicos que precisam ser valorizados. Recomenda-se para a gestão e para os profissionais, o incentivo a essas práticas devido ao potencial de melhoria da qualidade de vida e saúde do binômio mãe-filho.

10
  • CAMILLA DANIELLE SILVA DE LIMA QUEIROZ
  • INICIAÇÃO SEXUAL E FATORES ASSOCIADOS: um estudo com adolescentes escolares
  • Leader : IRIS DO CEU CLARA COSTA
  • MEMBRES DE LA BANQUE :
  • IRIS DO CEU CLARA COSTA
  • KENIO COSTA DE LIMA
  • MARIA DO CARMO EULÁLIO
  • Data: 14 avr. 2014


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  • A sexualidade é de fundamental importância na adolescência, sendo parte integrante do desenvolvimento da personalidade e da manutenção da saúde mental e física dos adolescentes. A qualidade do relacionamento intra e interpessoal, ou seja, o repertório de habilidades sociais adquiridos por eles, bem como sua autoestima, podem influenciar tanto positivamente seu desenvolvimento biopsicossocial, como negativamente, tornando-os mais vulneráveis as adversidades da vida, como a iniciação sexual que pode ter como consequência a gravidez precoce e a infecção por HIV/aids e outras DST. Dessa forma, esta pesquisa teve por objetivo investigar a correlação entre autoestima, habilidades sociais, e comportamento sexual de risco, em adolescentes de 16 a 19 anos, de ambos os sexos, estudantes dos cursos técnicos de nível médio na forma integrada, do Instituto Federal de Educação, Ciências e Tecnologia do Rio Grande do Norte. Trata-se de um estudo transversal, cuja amostra foi constituída aleatoriamente por 200 alunos que responderam de forma anônima a três instrumentos: o questionário da Pesquisa de Conhecimentos, Atitudes e Práticas na População Brasileira (PCAP), a Escala de Autoestima de Rosenberg e o Inventário de Habilidades Sociais para Adolescentes de Del-Prette (IHSA). A análise estatística dos dados foi feita através do teste qui-quadrado. A média para a primeira relação sexual foi de 15,96 anos, com início mais precoce para o sexo masculino. Observou-se associações estatisticamente significativas entre iniciação sexual e as seguintes variáveis: idade, sexo, situação conjugal, renda familiar e o repertório de habilidades sociais. Verificou-se ainda que apenas 11% dos adolescentes possuem conhecimento correto acerca das formas de transmissão do HIV/aids. Conclui-se que os esforços para a prevenção das DST/aids, especialmente na adolescência, precisam ser direcionados a programas e campanhas informativas mais eficazes, contemplando intervenções para o desenvolvimento do repertorio de habilidades do adolescentes, pois estes se mostraram medidas protetivas ao inicio da vida sexual.

11
  • MARIA HELENA DE SIQUEIRA TORRES MORAIS
  • Análise do desajuste vertical na interface pilar/implante de infraestruturas confeccionadas pelo método mad/mam e cad/cam.

  • Leader : ADRIANA DA FONTE PORTO CARREIRO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • PATRICIA DOS SANTOS CALDERON
  • EDUARDO JOSÉ GUERRA SEABRA
  • Data: 15 avr. 2014


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  • A adaptação marginal é um critério importante usado para avaliação do sucessodo tratamento com prótese implantossuportada. A sua dimensão está diretamenteligada  aos  vários  passos  envolvidos  no  processo  laboratorial,  podendo  sertraduzida  como somatória  de  distorções,  que  são  inerentes  a  cada  etapa  deconfecção  e  das  características  dos  materiais  empregados. O objetivo deste estudo foi comparar o desajuste vertical de infraestruturas sobre implantes, fabricadas por tecnologia CAD/CAM, MAD/MAM e pelo método da fundição convencional (Grupo controle) em zircônia e Cobalto-Cromo. Vinte infraestruturas em monobloco, para prótese fixa de três elementos, foram obtidas a partir de uma matriz metálica contendo três implantes Brånemark compatíveis de plataforma regular (4,1mm) 3,75x9mm (Titamax Cortical Ti, Neodent, Curitiba, Brasil). Oito infraestruturas foram confeccionadas pelo sistema CAD/CAM (NeoShape, Neodent, Curitiba, Brasil): quatro em Zircônia estabilizada por ítrio (ZirCAD),  e quatro em Cobalto-cromo (CoCrCAD). Quatro foram construídas pelo método MAD/MAM (Zirkonzahn) em Zircônia (MADZir) e outras oito infraestruturas foram obtidas pelo método da fundição convencional: quatro em Cobalto-Cromo com pilar UCLA cinta Co-Cr (CoCrUCci) e quatro em Cobalto-cromo com pilar UCLA calcinável(CoCrUCcl). O desajuste vertical foi mensurado em micrômetros usando Microscopia Eletrônica de Varredura com aumento de 250x. Os dados foram analisados usando os testes Kruskal-Wallis e Mann-Whitney (P< 0,05). Observaram-se os seguintes valores de média e desvio padrão em micrômetros: CADZir (5,9 ± 3,6), CADCoCr (1,2 ± 2,2), MADZir (7,6 ± 9,2), CoCrUCci (11,8 ± 9,8), CoCrUCcl (12,9 ± 11,0). Observaram-se diferenças estatísticas entre os grupos estudados (p=0,000), sendo o menor valor para o CADCoCr. O teste Mann-Whitney revelou diferenças estatísticas (p<0,05) entre todos os grupos, exceto entre CoCrUCci e CoCrUCcl (p=0,619) e MADZir x CADZir (p= 0,885). Pode-se concluir que infraestruturas fabricadas por tecnologia CAD/CAM e MAD/MAM apresentam menores valores de desajuste vertical que aquelas fabricadas pelo método da fundição convencional. Infraestruturas em Co-Cr obtidas por CAD/CAM podem fornecer um menor desajuste vertical que infraestruturas em Zircônia fabricadas pelo mesmo método. E ainda, infraestruturas em Zircônia apresentaram os mesmos desajustes tanto pelo método CAD/CAM quanto o MAD/MAM.

12
  • RAFAELLY DOMINGOS CAMPOS DE SOUZA CHIANCA
  • *

  • Leader : PATRICIA DOS SANTOS CALDERON
  • MEMBRES DE LA BANQUE :
  • PATRICIA DOS SANTOS CALDERON
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • ANDRE ULISSES DANTAS BATISTA
  • Data: 9 mai 2014


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  • *

13
  • JOSILENE MARIA FERREIRA PINHEIRO
  • ATENÇÃO À CRIANÇA NO PERÍODO NEONATAL: Chamada Neonatal – Rio Grande do Norte, 2010.

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • JULIANA SOUZA OLIVEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • NILBA LIMA DE SOUZA
  • Data: 4 juin 2014


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  • O período neonatal, que compreende os primeiros 27 dias pós-parto, é uma fase considerada de vulnerabilidade à saúde infantil, fazendo-se necessário uma maior vigilância pelo profissional de saúde através de ações que valorizam o binômio mãe/filho e o atendimento integral ao recém-nascido. Para tanto, esse trabalho objetivou avaliar as ações de atenção, a partir das estratégias preconizadas pelo Ministério da Saúde. Trata-se de um estudo de corte transversal realizado a partir do banco de dados da pesquisa nacional de base populacional intitulada “Chamada Neonatal: avaliação da atenção ao pré-natal e aos menores de um ano nas regiões Norte e Nordeste”. Utilizou-se como unidade amostral as mães e as crianças menores de 1 ano que compareceram a campanha de vacinação do dia 12 de junho de 2010 nos nove municípios potiguares prioritários para o Pacto de Redução da Mortalidade Infantil e Neonatal. Para compor as variáveis de estudo foram selecionadas as questões/ações referentes ao período neonatal e aos fatores sociodemográficos, seguidas de uma análise descritiva e inferencial. Obteve-se uma amostra de 837 pares mãe/filho, sendo 57,6% na capital e 42,4% no conjunto dos interiores, que foi ponderada para representar os municípios do Estado. Predominaram as mães com idade entre 20-29 anos, ensino médio completo, não beneficiário de programa de transferência de renda; e crianças do sexo masculino (51,2%). A freqüência das ações de âmbito hospitalar variou de 35% a 96% e as realizadas na Unidade Básica de Saúde (UBS) de 57% a 91,2%.  A maioria das ações teve associação com os hospitais de natureza pública e com a capital do estado (p<0,05). Os resultados para a maioria das ações estão abaixo do preconizado nos programas e políticas de atenção à criança, e revelam as iniqüidades regionais em saúde e a necessidade de envolvimento dos serviços e dos profissionais na busca da integralidade do cuidado para possibilitarem melhor assistência através de práticas humanizadas nesse período de maior vulnerabilidade.

14
  • NATERCIA JANINE DANTAS DA SILVEIRA
  • A PRODUÇÃO DAS DESIGUALDADES: ANÁLISE DA RELAÇÃO ENTRE TRABALHO INFANTIL E INDICADORES SOCIAIS

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • CARLA ALEXANDRA DA SILVA MOITA MINERVINO
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 8 août 2014


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  • A Organização Internacional do Trabalho (OIT) estima que haja cerca de 118 milhões de crianças em todo o mundo submetidas ao trabalho infantil. No Brasil, há 3,5 milhões de trabalhadores entre 5 e 17 anos. Esse exercício de exploração constitui um grave problema da sociedade, inclusive de Saúde Pública, já que esses trabalhadores estão expostos a uma gama de riscos, quais sejam à saúde, à integridade física e até à vida, podendo torná-los adultos doentes e/ou interrompendo precocemente suas vidas. Diante do exposto, esta pesquisa tem como objetivo investigar a relação entre a frequência de trabalho infantil na faixa etária de 10 a 13 anos e alguns indicadores socioeconômicos. Trata-se de uma pesquisa quantitativa em um desenho ecológico cujos níveis de análise são os municípios brasileiros agrupados em 161 regiões, definidas a partir de critérios socioeconômicos. A variável dependente deste estudo foi a prevalência de trabalho infantil na faixa etária de 10 a 13 anos. As variáveis independentes foram selecionadas após realizada uma correlação entre o Censo de 2010 do trabalho infantil na faixa etária de 10 a 13 anos e dados secundários, adotando duas variáveis independentes principais: recursos do Programa Bolsa Família (PBF) por 1000 habitantes e Recursos do Programa de Erradicação do Trabalho Infantil (PETI) por mil habitantes. Foi realizada inicialmente uma análise descritiva das variáveis do estudo, posteriormente, uma análise bivariada, e construída a matriz de correlação. Por fim, foi feita a análise de Regressão Liner Múltipla. Foram construídos dois modelos de Regressão. O primeiro modelo, no qual os recursos do PBF é a variavél independente principal, explica 57,8% de toda a variação do trabalho infantil e a equação final permite inferir que a cada 100 reais de recursos do PBF alocados produz uma diminuição de 1,4% na taxa de trabalho infantil na faixa etária de 10 a 13. No segundo, no qual os recursos do PETI explicam 58,8% de todo o modelo, constatou-se que a cada R$ 100 reais investidos, a taxa de trabalho infantil diminui em 2,16%.  Outras variáveis de ajuste mostraram significância, entre elas o IDH municipal, anos de Estudos aos 18 anos, analfabetismo em 15 anos ou mais, empregados sem carteira com 18 anos e o Índice de Gini. Compreende-se que a questão do trabalho infantil é complexa. O problema está associado, embora não esteja restrito à pobreza, à desigualdade e à exclusão social existentes no Brasil, mas há outros fatores de natureza cultural, econômica e de organização da produção, respondem também pelo seu agravamento. Para enfretamento do trabalho infantil necessita de uma ampla articulação intersetorial compartilhada e integrada com diversas políticas públicas entre elas saúde, esporte, cultura, agricultura, trabalho e direitos humanos, tendo, como horizonte, a garantia da integralidade dos direitos de crianças e adolescentes em situação de trabalho e de suas respectivas famílias.

15
  • GABRIELA MONTEIRO DE ARAUJO
  • PASSIVIDADE NA INTERFACE PRÓTESE/PILAR INTERMEDIÁRIO DE INFRAESTRUTURAS IMPLANTOSSUPORTADAS CONFECCIONADAS PELA TECNOLOGIA CAD/CAM E MÉTODO CONVENCIONAL

  • Leader : GUSTAVO AUGUSTO SEABRA BARBOSA
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • EDUARDO JOSÉ GUERRA SEABRA
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • Data: 28 août 2014


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  • O objetivo desta pesquisa foi avaliar a passividade e a tensão induzida em infraestruturas parafusadas sobre pilares, confeccionadas por tecnologia CAD / CAM, e comparar com infraestruturas fabricadas por fundição convencional. Usando a tecnologia de CAD / CAM, 4 infraestruturas de 3 elementos foram confeccionadas em zircônia (ZirCAD)e 4 em cobalto-cromo (CoCrcad). Para o grupo controle foram utilizadas 4 infraestruturas em cobalto- cromo, confeccionadas por fundição em monobloco (CoCrci), totalizando 12 infraestruturas. Para avaliar a passividade, as infraestruturas foram instaladas sobre os pilares. Uma extremidade foi apertada e a diferença vertical entre a infraestrutura e o pilar protético na outra extremidade foi medida com microscopia eletrônica de varredura (250 ×). A tensão média gerada aos implantes foi analisada por meio do teste de fotoelasticidade. Análise de Variância (ANOVA) foi aplicada a fim de comparar as médias entre os grupos para a passividade e área de tensão. Com isso, para a comparação dois a dois entre os grupos, o teste T foi utilizado para a avaliação da passividade e teste Tukey para a área de tensão. Foi observada uma diferença significativa (p = 0,000) na passividade entre os grupos controle (CoCrci) e demais amostras (CoCrcad e CoCrci). CoCrcad exibiu o menor valor de passividade (48,76 ± 13:45 µm) e CoCrci o maior (187,55 ± 103,63 µm), Zircad apresentou um valor intermediário (103.81 ± 43.15 µm). Quando comparado com os outros grupos, CoCrci apresentou a maior média tensão ao redor dos implantes (17,19 ± 7,22 kPa). Concluiu-se que a tecnologia CAD/CAM é mais precisa para a passividade de infraestrutura aparafusada sobre pilares, em comparação com as técnicas de fabricação convencionais.

16
  • ANGELO JOSE PIMENTEL DE AZEVEDO
  • CONSUMO DE ANSIOLÍTICOS BENZODIAZEPÍNICOS E SUA CORRELAÇÃO COM INDICADORES SOCIAIS NAS CAPITAIS BRASILEIRAS

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • MARIA ANGELA FERNANDES FERREIRA
  • AURIGENA ANTUNES DE ARAUJO
  • PAULO SÉRGIO DOURADO ARRAIS
  • Data: 29 août 2014


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  • Introdução: Os benzodiazepínicos (BDZs) alcançaram grande popularidade dentre os membros da classe médica e na população como indicação para sintomatologia de ansiedade, comum na sociedade moderna. Os fatores psicossociais, econômicos e culturais, parecem estar associados aos crescentes prejuízos à saúde mental dos indivíduos e ao consumo desses medicamentos. Objetivo: o presente trabalho busca a compreensão de como se relaciona, na capital do Distrito Federal e demais capitais estaduais brasileiras, o uso/consumo dessas drogas – através de dados agregados agora mais confiáveis – com características demográficas, epidemiológicas, econômicas e, sobretudo sociais. Metodologia: estudo ecológico tendo como unidade amostral as capitais brasileiras e fonte de dados o Censo demográfico 2010 e informações do IBGE, DATASUS e da ANVISA referentes aos anos entre 2007 e 2010. Foi utilizada regressão linear múltipla como método de análise. Resultados: A análise descritiva resultou no conhecimento que Salvador é a capital que mais consumiu esses medicamentos com 10,64 DDD por mil habitantes por dia e que dentre eles o Alprazolam é o mais dispensado pelas farmácias e drogarias particulares 2,63 DDD/1000hab/dia das capitais brasileira. Após análise de regressão linear o modelo apenas com percentual de idosos foi responsável por explicar 51,3% da variação no consumo dos medicamentos.

17
  • CLARA DE ALMEIDA MOURA
  • AVALIAÇÃO DO TRATAMENTO CIRÚRGICO DO AMELOBLASTOMA: ESTUDO MULTICÊNTRICO

  • Leader : ADRIANO ROCHA GERMANO
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • JOSÉ RODRIGUES LAUREANO FILHO
  • JOSÉ WILSON NOLETO JÚNIOR
  • Data: 2 sept. 2014


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  • Este trabalho teve como objetivo avaliar a relação do tipo de tratamento cirúrgico do ameloblastoma com o índice de satisfação dos pacientes e com as recidivas. Participaram da pesquisa 45 pacientes que receberam tratamento cirúrgico para o ameloblastoma, atendidos nos Serviços de Cirurgia e Traumatologia Buco-Maxilo-Facial da Universidade Federal do Rio Grande do Norte - UFRN, da Universidade de Fortaleza – UNIFOR e do Hospital das Clínicas de São Paulo – HC/USP-SP, no período compreendido entre 2000 e 2012. Inicialmente foi realizada uma coleta de dados dos prontuários e em seguida os pacientes foram solicitados para a realização de exames clínicos de controle, além do preenchimento de um questionário. Foram analisados dados demográficos e epidemiológicos de cada paciente (sexo, idade, cor, profissão, data de diagnóstico, localização do tumor, etc.), além do tipo de tratamento cirúrgico oferecido, bem como a reconstrução, a ocorrência de recidivas, as complicações de cada abordagem terapêutica e o índice de satisfação. O tempo mínimo de acompanhamento foi 12 meses e o máximo 180. Os tratamentos conservadores foram eleitos em 81,81% dos casos e os radicais em 17,64%. O método de reconstrução mais empregado nas cirurgias conservadoras foi o preenchimento da cavidade com o coágulo sanguíneo, correspondendo a 76,6% da amostra, seguido pela placa de reconstrução associada ao osso autógeno livre com 12,7%, nos casos radicais. A parestesia do nervo alveolar inferior (NAI) foi a sequela mais comum, estando relacionada principalmente às cirurgias de ressecção. O índice de recidiva foi 28,8%. Dois casos de recidiva aconteceram na maxila, 11 na mandíbula, sendo três do tipo unicístico e 10 do tipo sólido/multicístico. Foi possível determinar que o padrão histológico mais presente na recidiva, dos casos sólido/multicísticos, foi o folicular, com 80%. As técnicas mais conservadoras determinaram 30,5% de recidivas, já a mais radicais, representadas pelas ressecções, tiveram 20% de recidivas. As médias obtidas nos questionários, utilizando a escala visual analógica (EVA), para a avaliação da estética facial, o índice de satisfação geral, a habilidade de falar, deglutir e mastigar, foram superiores para os pacientes tratados por técnicas conservadoras, apesar dos métodos conservadores exigirem múltiplos procedimentos cirúrgicos para garantir a erradicação desta patologia. A necessidade de seguimentos desses grupos de pacientes se faz necessária para corroborar nossos achados, além de contribuir com a literatura acerca do tema que, apesar das várias publicações, ainda se mostra controverso.

18
  • DANNIELLY AZEVEDO DE OLIVEIRA
  • UM ESTUDO SOBRE O PERFIL DAS ADOLESCENTES DE UM SERVIÇO DE REFERÊNCIA NO MUNICÍPIO DE NATAL/RN

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • JOVANKA BITTENCOURT LEITE DE CARVALHO
  • MARIA ANGELA FERNANDES FERREIRA
  • SILVIA REGINA JAMELLI
  • Data: 12 sept. 2014


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  • A adolescência é vista como uma fase da vida marcada por uma série de transformações físicas e comportamentais, o que leva a determinada situações de risco, como o início precoce da atividade sexual, a gravidez e a ocorrência de doenças sexualmente transmissíveis. Baseado nessa afirmação, a pesquisa objetivou de forma geral: conhecer o perfil sexual e reprodutivo das adolescentes de um serviço de referência no município de Natal. De maneira específica: descrever as características sócioeconômicas, sexuais e reprodutivas individuais e familiares da população em questão, como também, verificar possível associação entre gravidez e idade de início da atividade sexual com os aspectos socioeconômicos. O Estudo seccional realizado em banco de dados a partir dos registros de 463 adolescentes que buscaram atendimento num serviço de referência em saúde Sexual e Reprodutiva, no período de março de 2011 a junho de 2012. Os dados coletados foram submetidos à análise realizada pelos programas Excel 2007 e Statiscal Package for the Social Sciences (SPSS) 17.0. Para análise dos dados foi utilizada a estatística descritiva, com números absolutos e percentuais, sendo a sua apresentação feita por meio de tabelas de distribuição e frequências. Os resultados mostraram que os pais dessas adolescentes (65,7% - pai; 57,8% - mãe), possuíam ensino fundamental; renda familiar inferior a dois salários mínimos (66,2%); algum tipo de dependência química na família (33,5%) e presença de violência doméstica (20,6%). Foi verificada ocorrência de gravidez quando a mãe apresentava ensino fundamental (26,3%), outras pessoas que não o pai ou a mãe contribuíam com a renda familiar (33,3%) e (26%) quando havia dependência química na família O início precoce da atividade sexual foi observado quando a mãe apresentava ensino fundamental (57,3%), outras pessoas que não o pai ou a mãe contribuíam com a renda familiar (63,1%) e o uso de drogas/álcool como um problema familiar (67,6%). Concluiu-se que tais vulnerabilidades aparecem como reflexo da baixa condição social dessas jovens, agravadas pela herança afetiva que é ofertada a cada indivíduo desde o nascimento. Estes achados poderão quiçá, subsidiar as políticas públicas de vigilância da saúde às adolescentes em diversas áreas.

19
  • BARBARA CÁSSIA DE SANTANA FARIAS SANTOS
  • Reorientação da formação em saúde: a contribuição do programa PET-Saúde

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • ANA ESTELA HADDAD
  • LUIZ ROBERTO AUGUSTO NORO
  • STELA MARIA MENEGHEL
  • Data: 10 déc. 2014


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  • A formação de profissionais de saúde no Brasil, como em outros países, passou a ser objeto de análise e reflexão nas últimas décadas e a partir de então esforços articulados têm sido empreendidos buscando a construção de uma política de orientação de práticas formativas de profissionais de saúde tendo como princípios norteadores as Diretrizes Curriculares Nacionais (DCN) e o Sistema Único de Saúde (SUS). Nesse contexto, parcerias entre o Ministério da Saúde e o da Educação renderam políticas de integração entre as Instituições de Ensino Superior (IES) e os serviços de saúde, entre as quais o Programa de Educação pelo Trabalho para a Saúde (PET-Saúde). O objetivo desse estudo é avaliar a contribuição do PET-Saúde para a formação de alunos de Odontologia, Medicina e Enfermagem a partir dos resultados do Exame Nacional de Desempenho dos Estudantes 2010 (ENADE 2010). A presente pesquisa é caracterizada como estudo de intervenção. Trata-se de um estudo analítico no qual foi avaliado o desempenho dos alunos concluintes de IES que desenvolveram o PET-Saúde em comparação com aqueles que não participaram do programa. A população do estudo foi composta por 49.758 alunos concluintes do ENADE 2010. Desses, 761 participaram do PET-Saúde nos anos de 2009 e 2010. Foram estudadas as características das IES, desempenho no ENADE e itens do Questionário do Estudante, segundo a participação ou não dos alunos concluintes no PET-Saúde. Os resultados sinalizam que os alunos que participaram do PET-Saúde eram, em sua grande maioria, de universidades públicas. A maioria era do sexo feminino, solteira, na faixa etária entre 18 e 25 anos, não trabalhava, dependia financeiramente da família ou de outras pessoas e terminou o ensino médio tradicional em escola particular. Observa-se que esses alunos participaram mais de atividades complementares que os alunos não participantes do programa e tinham uma percepção mais crítica sobre as IES quando se referem às condições físicas, aos aspectos pedagógicos dos cursos e à contribuição desses na sua formação. Para compararmos o desempenho dos alunos entre os dois grupos (participantes e não participantes do PET-Saúde), as variáveis de confusão como iniciação científica, monitoria e programas de extensão foram analisadas buscando a influência dessas sobre o desempenho dos alunos no ENADE na expectativa de isolar a contribuição do PET-Saúde no desempenho dos alunos concluintes em formação geral, conhecimentos específicos e saúde coletiva. Essas variáveis não influenciaram no desempenho do aluno. Posteriormente foi analisado o desempenho dos alunos do PET-Saúde com o desempenho dos alunos que não participaram do Programa e percebe-se que o aluno PET-Saúde teve um desempenho melhor que o outro grupo. No entanto, quando essa análise é realizada apenas entre alunos concluintes em universidades públicas essa diferença deixa de existir. Esse estudo revela que os alunos participantes do PET-Saúde são mais críticos que os demais e têm uma participação mais efetiva na universidade. Entretanto, não há evidências de que ele ter participado do PET-Saúde melhore o seu desempenho no ENADE.

20
  • GIOVANNA DE FATIMA ALVES DA COSTA BORGES
  • RUGOSIDADE SUPERFICIAL E ADESÃO BACTERIANA EM COMPÓSITOS NANOPARTICULADOS APÓS ACABAMENTO E POLIMENTO

  • Leader : ISAUREMI VIEIRA DE ASSUNCAO
  • MEMBRES DE LA BANQUE :
  • ANA KARINA MACIEL DE ANDRADE
  • ISAUREMI VIEIRA DE ASSUNCAO
  • MARIA CELESTE NUNES DE MELO
  • Data: 12 déc. 2014


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  • Objetivo: avaliar in vitro a rugosidade superficial e a adesão bacteriana de compósitos nanoparticulados, após serem submetidas a diferentes sistemas de acabamento e polimento. Materiais e Métodos Foram confeccionados 60 corpos de prova, distribuídos em 6 grupos (n=10). Em todos os grupos foi utilizada tira matriz de poliéster sobre a superfície das amostras, e cada tipo de resina foi submetido aos sistemas de acabamento e polimento: discos Sof-Lex Pop-On (3M ESPE, St.Paul, USA) e sistema AstropolTM (Ivoclar Vivadent,NY,USA), caracterizando o grupo experimental; o grupo controle não foi submetido a nenhum tipo de técnica de acabamento e polimento. A rugosidade média (Ra) em ambos os grupos foi mensurada através de um rugosímetro (Taylor Hobson Brazil, Ltda., São Paulo, SP, Brazil) na configuração de 0,25mm (cut off) e as imagens da superfície obtidas com fotomicrografias captadas por um microscópio eletrônico de varredura (MEV) com aumento de 500 vezes. A adesão bacteriana foi avaliada por meio da leitura de espectrofotometria com configuração de 570ŋm. Os resultados foram submetidos à análise de variância (ANOVA dois fatores. Resultados: Foram encontradas diferenças estatísticas significativas entre os grupos quanto à rugosidade e à adesão bacteriana. Para a resina Filtek Z350 XT houve diferenças entre os sistemas de acabamento e polimento testados, onde o sistema que apresentou menor rugosidade superficial foi o Sof-lex Pop-On. Para a resina IPS Empress Direct, o sistema de acabamento e polimento Astropol, obteve menores resultados de rugosidade superficial. Quanto à adesão bacteriana, o menor valor de densidade óptica para a resina Filtek Z350 XT foi para o grupo que utilizou o sistema de acabamento e polimento Sof-Lex Pop-On e para a resina IPS Empress Direct o grupo que utilizou o sistema Astropol. Além disso, verificou-se uma correlação positiva entre a rugosidade superficial e adesão bacteriana nas superfícies polidas (r = 0,612, p <0,001) Conclusões: a rugosidade superficial e a adesão bacteriana estão estreitamente relacionadas. O sistema de acabamento e polimento Sof-Lex Pop-On está mais indicado para a resina nanoparticulada   Filtek Z350 XT e o sistema de acabamento e polimento Astropol para a resina nanohíbrida IPS Empress Direct.

21
  • ANDIARA ARAUJO CUNEGUNDES DE BRITO
  • Matriciamento em saúde mental: atuação de Núcleos de Apoio à Saúde da Família

  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • JACILEIDE GUIMARAES
  • ANA KARENINA DE MELO ARRAES AMORIM
  • JOÃO BOSCO FILHO
  • Data: 16 déc. 2014


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  • No contexto de ruptura com a instituição manicomial, a Reforma Psiquiátrica brasileira é um processo histórico de reformulação dos saberes e práticas em saúde mental. Contribuindo com o fortalecimento desse processo, os Núcleos de Apoio à Saúde da Família (NASF) atuam na oferta de apoio matricial em saúde mental. Nesse sentido, a presente pesquisa objetiva analisar as ações desenvolvidas pelo NASF referentes ao apoio matricial em saúde mental no município de Natal/RN. Trata-se de uma pesquisa descritiva e exploratória com abordagem qualitativa. Para a coleta de dados, foram realizadas as técnicas de observação direta não participante e entrevista semiestruturada junto aos profissionais de saúde dos NASF’s. Os dados foram tratados à luz do método de análise temática, que consiste em investigar núcleos de significados que compõem a comunicação referente ao objeto investigado. Foram organizadas três categorias de análise, cujos títulos foram inspirados na perspectiva do efeito Paidéia e da clínica ampliada, a saber: 1. “Doença mental entre parênteses: dimensões de trabalho do NASF em interface com o sujeito concreto”, abordando o processo de trabalho do NASF; 2. “Liberdade e engajamento no arranjo do apoio matricial em saúde mental”, explorando as limitações do matriciamento em saúde mental em Natal/RN a partir dos profissionais entrevistados dos NASF’s; 3. “Entre o desejo e o interesse: influência do matriciamento em saúde mental na Rede de Atenção Psicossocial (RAPS)”, referente ao apoio matricial em saúde mental como um arranjo organizacional incumbido de garantir intersetorialidade e integralidade do cuidado, estratégias inerentes à constituição da RAPS. Podemos extrair e considerar que as ações das equipes de NASF em Natal-RN ainda não compõem um elo estruturado junto às redes de atenção à saúde, pois acontecem com carência de discussões e escassez de profissionais empenhados no apoio matricial. Além disso, uma dificuldade marcante para se realizar matriciamento em saúde mental é a insuficiência de recursos humanos e de serviços substitutivos, trazendo à tona a discussão acerca da consolidação e ampliação da RAPS na realidade investigada.

22
  • PAOLA DA COSTA SILVA
  • LIMITES E POSSIBILIDADES DA ARTICULAÇÃO ENTRE SAÚDE MENTAL INFANTO-JUVENIL E A ATENÇÃO BÁSICA EM NATAL-RN.

  • Leader : JACILEIDE GUIMARAES
  • MEMBRES DE LA BANQUE :
  • GLAUCINEIA GOMES DE LIMA
  • JACILEIDE GUIMARAES
  • MAISA PAULINO RODRIGUES
  • MAURICIO ROBERTO CAMPELO DE MACEDO
  • Data: 18 déc. 2014


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  • O processo de Reforma Psiquiátrica brasileira foi deflagrado no final da década de 1970 e lançou novas luzes à problemática da saúde mental infanto-juvenil, constatando lacunas importantes no que tange às necessidades, serviços e ações sobre adoecimento psíquico de crianças e adolescentes. Com a criação dos Centros de Atenção Psicossocial Infanto-Juvenil (CAPS i), torna-se possível a inserção em rede e a articulação dos serviços de saúde na assistência à saúde mental infanto-juvenil, constituindo-se como lugar de acolhimento e trazendo visibilidade ao sofrimento psíquico de crianças e adolescentes até então negligenciado nos grandes hospitais psiquiátricos. A partir desse entendimento empreendemos a presente pesquisa com o objetivo geral de analisar as ações e práticas de saúde mental infanto-juvenil articuladas entre o Centro de Atenção Psicossocial Infanto-juvenil (Caps i) e a atenção básica em Natal-RN, e especificamente, identificar os limites e possibilidades para essa articulação e maior resolubilidade do cuidado prestado em rede. Após submissão ao Comitê de Ética em Pesquisa (CEP) do Hospital Universitário Onofre Lopes (HUOL) da Universidade Federal do Rio Grande do Norte (UFRN) obteve-se aprovação contido no Parecer número 777.067/ 2014. Trata-se de um estudo com abordagem qualitativa de caráter descritivo e exploratório. Para a coleta de dados, inicialmente realizamos pesquisa documental na Secretaria Municipal de Saúde de Natal acerca do fenômeno estudado, posteriormente, aplicamos entrevista semiestruturada com os sujeitos da pesquisa que foram os trabalhadores do Caps i de Natal-RN. A análise foi tecida conforme a técnica de análise temática, compreendida dentro do método de análise de conteúdo. Os resultados e discussões foram organizados por meio de categorias e subcategorias, a saber: CATEGORIA 1. Limites e fragilidades da articulação para a assistência em saúde mental infanto-juvenil, com as subcategorias: 1.1 Insuficiência de serviços especializados e de dispositivos articuladores na rede; 1.2 Complexidade da atenção em saúde mental na infância e adolescência: demanda e clínica; CATEGORIA 2: Possibilidades para uma rede efetiva, com a subcategoria: 2.1 Intersetorialidade em saúde mental infanto-juvenil como instrumento de articulação e integralidade. Concluímos que a integração e articulação dos serviços de saúde mental infanto-juvenil e a atenção básica no município de Natal-RN, possui iniciativas incipientes e/ou insuficientes para a resolubilidade intersetorial, onde os dispositivos de atenção à saúde envolvidos não conseguem estabelecer vínculos efetivos e duradouros na perspectiva da corresponsabilidade e do compartilhamento do cuidado. Por outro lado, verificamos que as ações existentes e praticadas, configuram um exercício de aproximação para o diálogo entre saúde mental infanto-juvenil e atenção básica. Destacamos que o cuidado compartilhado e o estabelecimento de intersetorialidade dentro e fora do setor saúde constitui possibilidade de favorecimento do diálogo necessário entre os serviços e profissionais envolvidos, assim, potencializando-se uma melhor perspectiva de resolubilidade da Rede de Atenção Psicossocial para o público infanto-juvenil na realidade investigada.

23
  • NATALIA LOUISE DE ARAUJO CABRAL
  • CONSUMO DE ENERGIA E NUTRIENTES EM IDOSOS RESIDENTES EM INSTITUIÇÕES DE LONGA PERMANÊNCIA DO MUNICÍPIO DE NATAL/RN

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • ELISEU VERLY JÚNIOR
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 18 déc. 2014


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  • O envelhecimento populacional é um fenômeno demográfico exponencial. À medida que a população envelhece, aumenta a procura por Instituições de Longa Permanência para Idosos (ILPI), como alternativa para aqueles que apresentam algum grau de dependência, bem como para as famílias que não dispõem de meios financeiros, físicos ou emocionais para a prestação dos cuidados necessários. A institucionalização provoca mudanças na rotina dos idosos, especialmente na alimentação, que, somadas às alterações fisiológicas do envelhecimento, podem levar à ingestão inadequada de alimentos e nutrientes, comprometendo o seu estado nutricional. Objetivo: Avaliar a ingestão habitual de nutrientes de idosos residentes em Instituições de Longa Permanência de Natal/RN. Metodologia: Trata-se de um estudo transversal, com idosos residentes em ILPI cadastradas na Vigilância Sanitária (n=416). A ingestão alimentar foi determinada por dois registros alimentares pesados, com pesagem do rejeito, realizados com intervalo de 30 a 45 dias. Para determinar a quantidade consumida, foi feita a diferença entre a quantidade servida e o rejeito. As dietas foram analisadas no ambiente do software Virtual Nutri Plus®. A ingestão habitual de cada nutriente foi estimada removendo-se o efeito das variâncias intra e interpessoal, pelo método da Iowa State University. Os dados de ingestão dietética foram ajustados pela energia utilizando o método dos resíduos. A adequação dos macronutrientes foi verificada de acordo os intervalos de distribuição aceitável e considerando os fatores associados. A prevalência de inadequação foi estimada pelo método da Estimated Average Requirement (EAR) como ponto de corte, e verificou-se a associação com sexo, faixa etária, tipo de instituição e necessidade de ajuda para alimenta-se por regressão logística múltipla. Resultados: Dos 416 residentes em ILPI, 313 idosos foram avaliados. Observou-se que os homens apresentaram ingestão energética média abaixo dos requerimentos nutricionais. Identificou-se que 52,4% dos idosos apresentaram consumo de energia inferior às recomendações. Verificou-se que 57,3% apresentaram consumo de gordura total abaixo do intervalo recomendado. Com relação aos carboidratos, 10,5% apresentaram consumo menor e 32,9% maior que as recomendações, sendo o consumo excessivo associado ao sexo feminino, à idade igual ou superior a 75 anos e à necessidade de ajuda para se alimentar. O consumo de proteínas estava no intervalo recomendado para todos os idosos. Elevadas prevalências de inadequação foram observadas, independentemente dos fatores associados, para quase todos os micronutrientes analisados, ressaltando-se as inadequações para as vitaminas tiamina, riboflavina, piridoxina e vitamina D, e os minerais ferro, magnésio e potássio. A ingestão de fibras apresentou percentual elevado de idosos com consumo aquém dos requerimentos nutricionais. Conclusão: Os idosos institucionalizados apresentaram baixa ingestão de energia e desequilíbrio na contribuição dos macronutrientes da dieta, representados pelo consumo excessivo de carboidratos e insuficiente de gordura total. Além disso, apresentam elevadas prevalências de inadequação de micronutrientes, importantes na prevenção de doenças crônicas comuns em idosos.

24
  • MARCOS FELIPE SILVA DE LIMA
  • Aplicabilidade das equações de estimativa de peso e altura em idosos residentes em Instituições de Longa Permanência no município de Natal-RN.

  • Leader : CLELIA DE OLIVEIRA LYRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • SANCHA HELENA DE LIMA VALE
  • URSULA VIANA BAGNI
  • Data: 19 déc. 2014


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  • A avaliação antropométrica é importante para a detectar precocemente alterações no estado nutricional e para subsidiar intervenções médicas e nutricionais. Na impossibilidade de mensuração do peso e estatura em idosos, métodos de estimativa podem ser empregados. Entretanto, tais métodos nem sempre são aplicáveis. Objetivo: Comparar e validar métodos de estimativa de peso e estatura em idosos residentes em ILPI de Natal-RN. Coletou-se peso, estatura, perímetros, dobras cutâneas e comprimentos corporais. Metodologia: Avaliaram-se as equações qualitativamente pela reprodutibilidade das medidas antropométricas que as compunham e, quantitativamente, análise e plotagem das diferenças de médias, coeficiente de determinação (R²), raiz do erro quadrático médio (REQM), coeficiente de correlação intraclasse (CCI), e análise gráfica de resíduos. Nas equações de estimativa de estatura, realizou-se análise de conglomerados, para verificar a similaridade dos diferentes métodos avaliados. Considerou-se aplicável quando o método de estimativa apresentava R² > 0,7; o menor REQM dentre os métodos avaliados; CCI > 0,7; e respectivo intervalo de confiança 95% com menor distância entre os limites inferior e superior. Resultados: Avaliaram-se 315 idosos de 10 ILPI da cidade de Natal-RN. Desses, 76,8% eram do sexo feminino. O peso corporal médio foi maior nos idosos mais jovens e sem restrição de mobilidade. Mediu-se a estatura somente nos 168 idosos sem restrição de mobilidade. A análise qualitativa das equações de peso mostrou a equação II de Rabito et al. (2006) como a de melhor reprodutilidade, uma vez que não se utiliza de medidas de dobras cutâneas. A análise quantitativa revelou a equação II de Rabito et al. (2006) como a de melhor aplicabilidade em toda a população avaliada e nos diferentes sexos, faixas etárias (60 a 69 anos, 70 a 79 anos e 80 anos ou mais) e condição de restrição de mobilidade. Em relação à estatura, considerou-se os métodos que usam a hemi-envergadura como de menor reprodutibilidade. A análise de conglomerados agrupou as equações latino americanas em um cluster, as americanas em outro e não agrupou os métodos que utilizavam hemi-envergadura e comprimento da ulna. A equação IV de Bermúdez; Tucker (1999) foi a de melhor aplicabilidade para toda a população. Quando analisados os diferentes estratos, verificou-se que para idosos do sexo masculino e de 60 a 69 anos o método IV de Bermúdez; Tucker (1999) foi aplicável. Considerações finais: Não houve nenhum método aplicável para a estimativa de estatura de idosos do sexo feminino ou com 70 anos ou mais de idade. Dessa forma, faz-se necessária a realização de novas pesquisas que desenvolvam métodos de estimativa de estatura e peso específicos para a população idosa institucionalizada brasileira.

Thèses
1
  • FLAVIA CHRISTIANE DE AZEVEDO MACHADO
  • Construção de indicadores para avaliação de Centros de Especialidades Odontológicas via técnica de consenso

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • MARIA ANGELA FERNANDES FERREIRA
  • IRIS DO CEU CLARA COSTA
  • MAISA PAULINO RODRIGUES
  • OLGA MARIA RAMALHO DE ALBUQUERQUE
  • SHIRLEY SUELY SOARES VERAS MACIEL
  • Data: 23 janv. 2014


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  • Os Centros de Especialidades Odontológicas (CEOs) foram instituídos pela Política Nacional de Saúde Bucal (PNSB) para ampliar o acesso aos serviços de atenção bucal secundária, atuar de forma integrada à atenção primária e terciária e assim, reduzir as desigualdades sociais em saúde. Devido à relevância social dos serviços de saúde, esses Centros devem ser avaliados em uma perspectiva formativa para a melhoria contínua de sua qualidade. Assim, o objetivo geral deste estudo é construir indicadores para avaliação de desempenho de CEOs baseado na técnica da modelagem e validado pela técnica de consenso tipo grupo nominal. O modelo lógico do desempenho dos CEOs foi elaborado a partir de análise documental da Política Nacional de Saúde Bucal (MS, 2004), Portaria 599 e 600/2006, Manual de Especialidades em Saúde Bucal (MS, 2008) e artigos sobre CEOs indexados no LILACS captados mediante uma revisão integrativa. Após a elaboração do modelo, foi construída uma matriz de indicadores organizados em componentes e critérios estruturados segundo o modelo lógico. Esta matriz foi avaliada por um comitê de professores e gerentes/gestores quanto à pertinência dos indicadores propostos. Tais indicadores foram avaliados segundo sua: validade; sensibilidade; especificidade; relevância; simplicidade; custo-efetividade e oportunidade. Ao final deste estudo, pretende-se estruturar um conjunto de indicadores possam potencialmente viabilizar processos de avaliação, planejamento e monitoramento das ações desenvolvidas nos CEOs em prol da qualidade do seu processo de trabalho e efetivação de sua missão organizacional.

2
  • LARISSA GRACE NOGUEIRA SERAFIM DE MELO
  • Avaliação das condicionalidades em saúde do Programa Bolsa Família

  • Leader : SEVERINA ALICE DA COSTA UCHOA
  • MEMBRES DE LA BANQUE :
  • ELAINE THUMÉ
  • GRASIELA PIUVEZAM
  • NILMA DIAS LEAO COSTA
  • PAULO ROBERTO DE SANTANA
  • SEVERINA ALICE DA COSTA UCHOA
  • Data: 20 mars 2014


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  • Os programas de transferência condicionada de renda estão disseminados em países em desenvolvimento na América Latina  com ênfase no Brasil como um novo paradigma nas políticas sociais para erradicação da pobreza. Consistem  no repasse de recusros monetários de renda do governo diretamente para familias  pobres mediante  cumprimento das condicionalidades em educação e saúde. Na  saúde, memos com variçãoes entre os países as condicionalidades tem como público alvo  gestantes e crianças com vistas  à redução de indicadores de saúde da criança, como cescimento e desenvolvimento,  mortalidade infantil e incemento do pré-natal. Os objetivos  deste trabalho são  comparar o programa de transferencia  condicionada de renda   brasileiro, o Bolsa Familia  e os programas semelhantes na América Latina em relação aos seus efeitos no crescimento e desenvolvimento de crianças  até  7 anos   de idade e avaliar a prevalencia das condicionalidades  em saúde da mulher e da criança  entre usuárias   dos serviços de saúde   brasileiros cujas equipes aderiram ao Programa  de Acesso e Qualidade da Aenção Básica  (PMAQ). Para o primeiro objetivo foi realizada uma revisão sistemática onde selecionaram-se dez artigos entre mais de mil encontrados nas bases de dados Embase, Pubmed, Scopus, Scielo e Lilacs. Os artigos são estudos epidemiológicos observacionais dos tipos descritivos transversais e analíticos de coorte e casos-controle.  Para o estudo de prevalencia,  análise estatística utilizou a regressão de Poisson com variância robusta para investigar como a prevalência do cumprimento das condicionalidades na área de saúde foi influenciada pelas diversas variáveis explicativas. Foram estimadas razões de prevalências brutas e ajustadas, com seus respectivos intervalos de confiança de 95%. O cadastro no programa bolsa família foi considerado como principal variável de exposição. As variáveis de confundimento foram: idade da mãe, escolaridade, raça/cor, saber ler, viver sozinha e região de moradia. Na análise dos dados foi utilizado o software R 3.0.1 (RDevelopment Core Team, 2013).Em relação a comparação do Bolsa Familia com demais programas da América Latina, a revisão mostrou  resultados  semelhantes quanto ao efeito positivo dos programas de transferência de renda no estado nutricional de crianças beneficiárias, sendo que estes efeitos são mais evidenciados em crianças menores de dois anos de idade, bem como pertencentes às famílias de mais baixo nível socioeconômico. Para a prevalencia das condicionalidades entres os diferentes grupos de usuárias do Bolsa Família e não usuárias Os resultados apontaram que não houve diferença estatística significativa entre respondentes (com filhos menores de dois anos) cadastrados e não cadastrados no PBF quanto às questões referentes aos seguintes aspectos: cumprimento do calendário vacinal da criança, realização de pelo menos sete consultas de pré natal, realização do acompanhamento do crescimento e desenvolvimento da  criança e receber orientação da equipe de saúde quanto a alimentação da criança.  Conlui-se de um lado que aumento de renda mínima para familias de exterma pobreza mostrou impacto possitivo na saúde das cranças  no Brasil  e América Latina. Do outro não confirmou, no Brasil,  uma incremento das condicionalidades  expressas numa   utlização dos serviços de atenção básica por parte das usuárias do Bolsa Familia.

3
  • TATYANA MARIA SILVA DE SOUZA ROSENDO
  • Prevalência e fatores associados ao near miss materno em Natal/RN

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • GEORGE DANTAS DE AZEVEDO
  • JOÃO PAULO DIAS DE SOUZA
  • MARIA ANGELA FERNANDES FERREIRA
  • MARY ANGELA PARPINELLI
  • Data: 5 juin 2014


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  • A morbidade materna grave, também conhecida como near miss materno, tem sido utilizada como alternativa ao estudo da mortalidade materna, pois além de ser mais frequente, compartilha os mesmos determinantes e possibilita a implementação da vigilância epidemiológica dos casos. Desde então, auditorias em hospitais têm sido realizadas a fim de determinar as taxas de near miss materno, suas principais causas e seus fatores associados. Mais recentemente, inquéritos populacionais a partir da morbidade auto-referida também têm sido apresentados como viáveis na identificação desses casos. OBJETIVO: O objetivo deste estudo foi determinar a prevalência de near miss materno e de complicações no período gravídico-puerperal no município de Natal/RN e estudar seus fatores associados. MÉTODO: Trata-se de um estudo seccional, de base populacional realizado no município de Natal/RN, Brasil, que tem como população-alvo as mulheres de 15 a 49 anos que engravidaram nos últimos cinco anos. Realizou-se um processo de amostragem probabilístico com desenho de amostras complexas, no qual foram sorteados 60 setores censitários distribuídos em três estratos (norte, sul-leste e oeste). Em seguida sortearam-se os domicílios que deveriam ser incluídos na pesquisa a fim de obter uma amostra de 1.135 mulheres elegíveis nas quais foi aplicado um questionário. Nas análises descritivas e de associações bivariadas aplicando o teste Qui-quadrado, calculando a Razão de Prevalência (RP) com intervalo de confiança de 95% e considerando os pesos e efeitos do delineamento. A análise de regressão de Poisson, também com significância de 5% e IC de 95%, foi utilizada para as análises dos fatores associados RESULTADOS: Foram entrevistadas 848 mulheres das 1.132 mulheres elegíveis identificadas em 8.227 domicílios percorridos, totalizando uma taxa de não-resposta de 7%. A prevalência de near miss materno foi de 41/1.000NV, sendo a internação em UTI (19/1.000NV) o marcador mais referido. A prevalência de complicações no período gravídico puerperal foi de 21,2%, sendo a hemorragia (10,7%) e a infecção urinária (10,7%) as condições clínicas mais relatadas e a permanência no hospital por mais de uma semana após o parto a intervenção mais frequente (5,4%). Quanto aos fatores associados, a análise bivariada mostrou associação entre o maior número de complicações nas mulheres da raça preta/parda (RP=1,23; IC95%=1,04-1,46) e com pior situação socioeconômica (RP=1,33; IC95%=1,12-1,58), nas mulheres que fizeram o pré-natal no serviço público (RP=1,42; IC95%=1,16-1,72), que não foram orientadas durante o pré-natal sobre lugar onde deveriam fazer o parto (RP=1,24; IC95%=1,05-1,46), que fizeram o parto no serviço público (RP=1,63; IC95%=1,30-2,03), que percorreram mais de um hospital para realizar o parto (RP=1,22; IC95%=1,03-1,45) e que não tiveram acompanhante durante o parto (RP=1,19; IC95%=1,01-1,41) ou em todos os momentos da assistência ao parto - antes, durante e depois do parto - (RP=1,25; IC95%=1,05-1,48). Além disso, o número de dias de internação pós-parto foi maior nas mulheres que tiveram mais complicações (RP=1,59; IC95%=1,36-1,86). No modelo final da regressão tanto o local do parto (RP=1,21; IC95%=1,02-1,44) como a condição socioeconômica (RP=1,54; IC95%=1,25-1,90) mantiveram a associação. CONSIDERAÇÕES FINAIS: A realização de inquéritos populacionais utilizando a definição pragmática de near miss é factível e pode acrescentar informações importantes sobre esse evento. Foi possível perceber a expressão das iniquidades em saúde relacionadas à saúde materna tanto na análise das condições socioeconômicas como na questão da utilização dos serviços de saúde.

2013
Thèses
1
  • DIEGO MOURA SOARES
  • Influência da laserterapia na proliferação de células-tronco do ligamento periodontal humano

  • Leader : CARLOS AUGUSTO GALVAO BARBOZA
  • MEMBRES DE LA BANQUE :
  • JOSE SANDRO PEREIRA DA SILVA
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • EDUARDO JOSÉ GUERRA SEABRA
  • Data: 25 janv. 2013


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  • O laser de baixa intensidade (LBI) tem sido utilizado na Odontologia com a finalidade de promover cicatrização e regeneração dos tecidos. A literatura mostra um efeito positivo do LBI na proliferação celular, porém pouco se sabe sobre a sua eficácia na proliferação de células-tronco. O objetivo deste estudo foi avaliar o efeito da irradiação do LBI na taxa proliferativa de células-tronco do ligamento periodontal humano (CTLPH). Extratos de ligamento periodontal foram isolados de dois terceiros molares hígidos removidos por indicação cirúrgica e/ou ortodôntica. Após a digestão enzimática, as células foram cultivadas em meio de cultura α-MEM suplementado com antibióticos e 15% de soro fetal bovino. No terceiro subcultivo, as células foram irradiadas com um laser diodo InGaAlP, utilizando-se duas diferentes densidades de energia (0,5J/cm2 - 16 segundos e 1,0J/cm² - 33 segundos), comprimento de onda de 660nm e potência de 30mW. Uma nova irradiação, utilizando os mesmos parâmetros, foi realizada 48 h após a primeira. Um grupo controle (não irradiado) foi mantido nas mesmas condições experimentais de cultivo. O método exclusão por azul de Trypan e a atividade mitocondrial das células medida através do ensaio de MTT [brometo de 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazólio], nos intervalos de 0, 24, 48 e 72 h pós-irradiação, foram utilizados a fim de avaliar a proliferação celular. Os dados das contagens celulares foram submetidos a testes estatísticos não paramétricos de Kruskal-Wallis e Mann-Whitney, considerando um intervalo de confiança de 95%. Com o objetivo de verificar possíveis alterações morfológicas nucleares induzidas pelo laser, as células foram submetidas à marcação com DAPI (4’-6-Diamidino-2-phenylindole) no intervalo de 72 h. Os resultados do presente estudo mostraram que a densidade de energia de 1,0 J/cm² promoveu maior proliferação das células em comparação com os outros grupos (controle e laser 0,5 J/cm²) nos intervalos de 48 e 72 h. A atividade mitocondrial, medida pelo ensaio de MTT, apresentou resultados semelhantes às contagem celulares com azul de Trypan, com o grupo irradiado com 1,0J/cm² exibindo uma atividade significativamente maior do MTT nos intervalos de 48 e 72 h, quando comparado com o grupo irradiado com 0,5J/cm². Nenhuma alteração morfológica nuclear foi observada, tanto das células do grupo controle quanto nas células irradiadas. Conclui-se que o LBI apresenta efeitos estimulantes sobre a proliferação de CTLPH. Portanto, a aplicação da laserterapia neste tipo celular pode ser importante para futuros avanços na regeneração periodontal.

2
  • CARLOS HENRIQUE BEZERRA DE OLIVEIRA
  • Frequência de enteroparasitoses em usuários do Serviço Público de Saúde na Mesorregião do Oeste Potiguar

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • LUIZ ROBERTO AUGUSTO NORO
  • TERTULIANO AIRES NETO
  • Data: 5 févr. 2013


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  • Em um mundo de grande pobreza, as enteroparasitoses podem exercer um papel importante no que se refere às desigualdades sociais, pois estas mazelas se apresentam, em sua grande maioria, na população mais carente. Estas mesmas doenças causam inúmeros casos de faltas ao trabalho e a escola, gerando preocupação dos profissionais de saúde, já que estes parasitas podem agravar ou desencadear quadros de anemia e desnutrição. O trabalho procurou pesquisar a prevalência de enteroparasitas na Mesorregião do Oeste Potiguar, em uma população que utiliza o sistema público de saúde, buscando associar as variáveis, como: sexo, faixa etária, período sazonal, renda familiar e número de parasitas. Foi utilizada a técnica de Hofmann (sedimentação espontânea) e o material fecal foi analisado pelos funcionários do Laboratório Central de Mossoró e Pau dos Ferros. Foi realizado no período de 02 de março de 2010 a 28 de março de 2011 o exame coprológico em 16.246 pessoas no laboratório Central de Mossoró (Lacen) e Pau dos Ferros, RN. A análise dos exames mostrou que 69,23% dos infectados eram mulheres e 33,07% eram homens. A maior prevalência ocorreu com Endolimax nana (41,61%), seguido de Entamoeba coli (18,46%) e Giardia lamblia (18,59%) em 3.407 parasitas encontrados. Dentre os exames realizados, o Endolimax nana foi o mais prevalente entre os organismos encontrados. A diferença nos resultados entre mulheres e homens pode determinar um foco domiciliar, pelo descaso do poder público com as políticas de saneamento básico e falta de higiene da população, e pela atividade das mesmas com trabalhos domésticos.

3
  • IRAMARA LIMA RIBEIRO
  • APRENDIZAGEM NA INTERAÇÃO ENSINO-SERVIÇO-COMUNIDADE: A FORMAÇÃO NA PERSPECTIVA DIALÓGICA COM A SOCIEDADE

  • Leader : ANTONIO MEDEIROS JUNIOR
  • MEMBRES DE LA BANQUE :
  • ANTONIO MEDEIROS JUNIOR
  • JOÃO BOSCO FILHO
  • ROSANA LUCIA ALVES DE VILLAR
  • Data: 8 févr. 2013


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  • O ensino superior em saúde exerce papel fundamental na sociedade brasileira, pois os egressos dos cursos ofertados na área serão os profissionais que deverão prestar assistência de boa qualidade à população.  OBJETIVO: analisar o componente ensino do Pet-Saúde da Família-Natal-RN na formação de estudantes dos cursos de graduação em saúde da UFRN. MÉTODOS: estudo de objetivo exploratório que realizou análise de documentos da Saci e Poti datados entre 2009 e 2011 (portfólios, avaliações de desempenho e oficina de avaliação), mediante o auxílio do software Alceste© de Classificação Hierárquica Descendente e análise de conteúdo, segundo Bardin. RESULTADOS: Como potencialidades foram encontradas: o alunato trabalhando em grupo tutorial multidisciplinar, cuja interação e contato com a Unidade de Saúde da Família, incluídos os profissionais, bem como a comunidade, instiga nos aprendizes o diálogo consigo mesmo e com o outro, numa construção dos ser/agir no mundo. Os textos trabalhados permitem refletir e teorizar a respeito da realidade observada, auxiliando-os na identificação dos problemas e a traçar estratégias de intervenção. Já a observação da realidade reveste o aluno de humanização que passa a captar as necessidades e dificuldades enfrentadas pelo outro. Nas fragilidades ficaram evidenciados problemas de relações interpessoais entre os alunos da Saci, a maioria dos projetos de intervenção ocorrendo numa perspectiva paternalista, reproduzindo o modelo de prestação de serviços na saúde mais praticado nas sociedades brasileiras; dificuldades em se trabalhar no aluno a importância da teorização dos assuntos; problemas de financiamento de projetos de intervenção; não cumprimento do plano de ensino em alguns grupos tutoriais, além do trabalhar competências específicas; e, por fim, dificuldades dos alunos e monitores em acompanhar as atividade do Pet, pela falta de integração dos projetos políticos pedagógicos dos cursos. CONCLUSÕES: Este estudo encontrou o componente ensino do Pet-Saúde da Família adotando metodologias ativas de ensino pela inserção de alunos na Atenção Primária em Saúde, proporcionando uma formação dentro de princípios éticos e humanísticos a partir do trabalho em equipe e da inserção reflexiva dos alunos em seus futuros lócus de trabalho. Apesar da existência de fragilidades concernentes às relações interpessoais, descompasso entre as proposições do Pet e as dificuldades de pô-las em prática, além do seguimento do ensino num sentido contra-hegemônico em relação à maioria das concepções tradicionais do ensino, as potencialidades suplantam as dificuldades. Ao fim das disciplinas, os discentes apresentam uma nova visão do cuidado com a saúde, próxima às necessidades da população, iniciando uma tomada de postura crítica e reflexiva, entendendo-se com sujeitos ativos no construir a saúde coletivamente.

4
  • FERNANDA GINANI ANTUNES
  • Atividade biológica de células-tronco da polpa de dentes decíduos humanos submetidas à criopreservação

  • Leader : CARLOS AUGUSTO GALVAO BARBOZA
  • MEMBRES DE LA BANQUE :
  • CARLOS AUGUSTO GALVAO BARBOZA
  • JEAN NUNES DOS SANTOS
  • LELIA BATISTA DE SOUZA
  • Data: 14 févr. 2013


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  • O uso de células-tronco oriundas do tecido pulpar humano tem sido amplamente investigado, uma vez que estas células apresentam capacidade de se diferenciar em tecidos relacionados com as estruturas dentárias e ainda podem ser utilizadas em  outras estratégias de regeneração e terapias envolvendo a engenharia de tecidos. A técnica de criopreservação celular pode constituir uma alternativa viável para a conservação dessas células, já que este processo cessa reversivelmente, de forma controlada, todas as funções biológicas dos tecidos vivos em uma temperatura ultra-baixa. O presente estudo teve como objetivo avaliar, através de experimentos in vitro, a influência da criopreservação na atividade biológica de células-tronco da polpa de dentes humanos decíduos esfoliados (SHED). Foram utilizadas no experimento 3 (três) polpas obtidas de dentes decíduos em estágio final de esfoliação ou com exodontia indicada. Após expansão em meio de cultivo α-MEM suplementado com antibióticos e 15% de soro fetal bovino, uma parte das células foi submetida à criopreservação por 30 dias em DMSO diluído a 10% em soro fetal bovino, a 80ºC negativos. Para análise da proliferação celular em ambos os grupos (criopreservado e não criopreservado), o método de coloração por azul de Tripan foi utilizado nos intervalos de 24, 48 e 72 horas após o plaqueamento. Eventos relacionados à morte celular foram analisados por citometria de fluxo nos intervalos de 24 e 72 horas. Para reforçar os dados relacionados à proliferação celular, foi realizada a análise do ciclo celular das SHEDs submetidas ou não ao protocolo de criopreservação. A presença de alterações morfológicas nucleares foi avaliada através da marcação por DAPI no intervalo de 72 horas. Observou-se que ambos os grupos exibiram uma curva de proliferação celular ascendente, sem alterações consideráveis na viabilidade celular. A distribuição das células nas fases do ciclo celular foi coerente com células em proliferação, para todos os grupos estudados. Não foram observadas alterações morfológicas nucleares no intervalo final do experimento. Deste modo, conclui-se que o protocolo de criopreservação proposto é eficiente para o armazenamento do tipo celular estudado, permitindo a sua utilização em futuros estudos experimentais.

5
  • GERLIENE MARIA SILVA ARAÚJO
  • Fatores socioeconômicos contextuais associados à condição bucal de adolescentes no Brasil.

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • FABÍOLA BOF DE ANDRADE
  • KENIO COSTA DE LIMA
  • Data: 22 févr. 2013


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  • Muitas pesquisas são realizadas confrontando condições de saúde bucal com variáveis individuais, como as socioeconômicas e demográficas. No entanto, da mesma forma que os indivíduos divergem entre si, os grupos também possuem características próprias e os efeitos dessa diferenciação precisam ser pesquisados. O Brasil, apesar de ser uma das maiores potências econômicas do mundo e vir apresentando uma melhoria no valor médio de seus indicadores de saúde, é também o 3º em desigualdade social segundo dados do PNUD (2011) e permanece entre os países com maiores iniquidades em saúde, que surgem como produto de grandes desigualdades entre os diversos estratos sociais e econômicos da população brasileira. A proposta deste estudo foi pesquisar a importância dos determinantes sociais a nível contextual na saúde bucal de adolescentes brasileiros, através de uma abordagem ecológica. Utilizando dados do SBBrasil 2010, foram avaliados desfechos menos comuns (perda do 1º molar, índice de cuidados odontológicos e t-health) que fornecem informações sobre o grau de morbidade da doença cárie e o nível de saúde dentária, além de abordar aspectos relacionados à qualidade e oferta de serviços. A associação destes indicadores de saúde bucal com fatores socioeconômicos como renda, emprego, educação e desigualdade, coletados do CENSO 2010, foi analisada através de regressão linear simples e múltipla e comparação de médias. Os domínios do estudo incluíram as 27 capitais brasileiras e 4 clusters representativos dos municípios do interior do país. Os resultados sugerem que municípios com saneamento adequado estão associados a uma menor taxa de perda dentária em adolescentes e aqueles com melhores condições de emprego apresentam uma melhor saúde dentária nesta faixa etária. De forma geral, a variável renda apresentou forte associação com todos os desfechos da pesquisa.

6
  • HAROLDO ABUANA OSORIO JUNIOR
  • Estudo da Descelularização Tecidual na Produção de Arcabouços Biológicos para Enxerto

  • Leader : JOSE SANDRO PEREIRA DA SILVA
  • MEMBRES DE LA BANQUE :
  • JOSE SANDRO PEREIRA DA SILVA
  • CARLOS AUGUSTO GALVAO BARBOZA
  • PEDRO PAULO DE ANDRADE SANTOS
  • Data: 1 mars 2013


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  • A regeneração de defeitos ósseos com perda de substância permanece um desafio terapêutico na área médica. É consenso ser o osso autógeno, o material mais adequado para esta finalidade, porém há limitações até para o seu uso, especialmente a quantidade insuficiente no próprio doador. Pesquisas de engenharia tecidual evidenciam que os componentes da matriz extracelular (MEC) são geralmente conservados entre as diferentes espécies sendo bem toleradas, mesmo em receptores xenógenos. Assim, diversos estudos têm sido realizados na busca por um arcabouço substituto do osso autógeno através da técnica de descelularização. Para a obtenção destes arcabouços, os tecidos devem passar por um processo de remoção celular (descelularização), minimizando quaisquer efeitos adversos na composição, atividade biológica e integridade mecânica na matriz extracelular remanescente.  Entretanto, há controvérsias acerca do melhor protocolo de descelularização, já que cada um desses tratamentos interfere de maneira diferente na composição bioquímica, ultraestrutura e comportamento mecânico da matriz extracelular (MEC) remanescente, afetando o tipo de resposta imunológica ao material. Ademais o baixo arsenal de pesquisas envolvendo a descelularização de tecidos ósseos representa mais um obstáculo à chegada de um consenso protocolar. O presente estudo teve como objetivo avaliar a influência dos métodos de descelularização na produção de arcabouços biológicos a partir de órgãos ósseos de camundongos, visando sua utilização para enxertia.  Trata-se de um estudo laboratorial, sequenciado em duas etapas distintas. Na primeira fase foram avaliadas 12 hemi-calvárias de camundongos, divididas em três grupos (n=4) e submetidas a três diferentes protocolos de descelularização (SDS [Grupo I], Tripsina [Grupo II], Triton X-100 [Grupo III]). Buscou-se identificar aquele que promove a mais eficiente remoção celular, simultaneamente a melhor preservação estrutural da MEC óssea. Para tanto, foram realizadas a análise quantitativa do número de células remanescentes e a análise descritiva dos arcabouços, possibilitadas por microscopia. Na segunda etapa, foi realizado um estudo in vitro para avaliar a adesão de células mesenquimais da medula óssea de camundongos, cultivadas sobre estes arcabouços, previamente descelularizados. Através da contagem manual de células nos arcabouços, verificou-se total remoção celular no Grupo II, remoção praticamente completa no Grupo I, e permanência de células e remanescentes no Grupo III. Os achados permitiram observar diferença significativa apenas entre os Grupos II e III (p=0,042). Melhor manutenção da estrutura colágena foi obtida com o Triton X-100, ao passo que a descelularização com Tripsina foi responsável pelas maiores alterações estruturais nos arcabouços. Após o cultivo, a adesão de células mesenquimais ósseos só foi observada nas calvárias descelularizadas com Tripsina. Devido ao potencial de remoção total das células e à capacidade de permitir a adesão destas, o protocolo baseado no uso da Tripsina (Grupo II) foi considerado o mais adequado para uso em experimentos futuros, que envolvam enxertia de arcabouços ósseos descelularizados.

7
  • LAISA FLAVIA SOARES FERNANDES PEIXOTO BUARQUE
  • Desempenho auditivo ao longo do tempo e satisfação dos usuários de implante coclear com perda auditiva pós-lingual.

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • LUCIANA PIMENTEL FERNANDES DE MELO
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 5 mars 2013


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  • O Implante Coclear (IC) permite à maioria dos seus usuários acometidos por perda auditiva pós-lingual, o alcance significativo da sensação auditiva e da compreensão da fala. Predizer o tempo no qual o benefício máximo do IC é obtido é um dado objetivo para aconselhar pacientes no que diz respeito às suas expectativas sobre o dispositivo. De forma subjetiva, a avaliação da satisfação dos usuários deve ser o interesse primário das intervenções médicas, pois é um importante retorno para a equipe clínica envolvida. O objetivo desta pesquisa é analisar o desempenho auditivo ao longo do tempo e a satisfação dos usuários do IC. Portanto, o estudo possui dois delineamentos: a) coorte retrospectivo através da análise dos prontuários de 59 indivíduos, avaliando seus resultados auditivos antes e após a cirurgia. Os achados foram submetidos ao estimador de Kaplan-Meier para probabilidade acumulada. Foram também comparados aos fatores prognósticos do desempenho auditivo conhecidos na literatura através do teste de logrank; b) o estudo seccional foi conduzido para avaliar a satisfação dos 51 usuários incluídos, através de dois questionários específicos (Satisfaction with Amplification in Daily Life – SADL e International Outcome Inventory Cochlear Implant – IOI- CI). Os resultados indicam uma diferença estatisticamente significante (p<0,001) no desempenho auditivo pré e pós-implante coclear. O resultado satisfatório é obtido pela grande maioria nos primeiros seis meses de uso e o teste de logrank não indicou correlação significativa entre as covariáveis analisadas e o tempo em que ocorre a percepção adequada da fala. Os questionários SADL e IOI-CI indicaram que a maioria dos indivíduos está satisfeita com seus dispositivos. O SADL detectou 27,5% dos usuários insatisfeitos no que diz respeito aos serviços e custos envolvidos com o IC. Na análise do IOI, 4% dos indivíduos mostraram-se insatisfeitos com o uso do IC e o meio social no qual está inserido. Conclui-se que o implante coclear é capaz de reabilitar a função social auditiva em um curto espaço de tempo e que os usuários encontram-se satisfeitos com os ganhos auditivo, social e psicológico oferecidos por esse dispositivo.

8
  • BEATRIZ AGUIAR DO AMARAL
  • Diferenças entre critérios normativos e autopercebidos na identificação da necessidade de tratamento ortodôntico, satisfação com a aparência e mastigação em adolescentes.

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • HALLISSA SIMPLICIO GOMES PEREIRA
  • KENIO COSTA DE LIMA
  • ROGÉRIO LACERDA DOS SANTOS
  • Data: 21 mars 2013


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  • Tratamentos ortodônticos são realizados na expectativa de melhorar a aparência e função mastigatória dos indivíduos e geralmente são indicados por meio de critérios clínicos, não levando em consideração a percepção do indivíduo. O objetivo desse estudo foi avaliar a relação entre as necessidades ortodônticas tecnicamente definidas (critérios normativos) e a satisfação com a aparência, mastigação e necessidade de tratamento percebida em um grupo de adolescentes. Um estudo transversal com 215 alunos entre 15 e 19 anos foi realizado no Instituto Federal de Educação, Ciência e Tecnologia (IFRN). Um questionário na forma de entrevista estruturada foi aplicado com perguntas a respeito da satisfação com a aparência, satisfação com a mastigação e percepção quanto à necessidade de tratamento ortodôntico. Um único examinador, treinado e calibrado, coletou os dados normativos de necessidade de tratamento ortodôntico através de critérios estabelecidos pelo Dental Aesthetic Index (DAI). Os resultados, demostraram que existe associação significativa entre o escore do DAI e a percepção do paciente quanto à necessidade de tratamento ortodôntico (p < 0,001), satisfação com a aparência (p = 0,003) e satisfação com a mastigação (p = 0,047). Os alunos que possuíam necessidade normativa de tratamento se perceberam mais com problemas. Quando as características oclusais foram analisadas separadamente, uma maior quantidade de problemas estava associada à necessidade percebida pelo paciente e à satisfação com a aparência, dentre eles o apinhamento, a irregularidade da maxila, a irregularidade da mandíbula e o trespasse maxilar acentuado (p< 0,05). Na análise com a satisfação com a mastigação, associação foi encontrada apenas com a mordida aberta (p= 0,003). Esses achados demostram uma tendência dos indivíduos de relacionar os problemas oclusais mais à estética, tornando esse aspecto indispensável ao tratamento ortodôntico.

9
  • RACHEL GOMES CARDOSO
  • Eficiência mastigatória e impacto da saúde oral na qualidade de vida em pacientes reabilitados com próteses totais removíveis implanto-suportadas

  • Leader : ADRIANA DA FONTE PORTO CARREIRO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • FLÁVIO DOMINGUES DAS NEVES
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • Data: 21 mars 2013


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  • Pacientes edêntulos que relatam problemas com o uso da prótese total convencional mandibular podem ter a função mastigatória prejudicada, bem como impacto negativo da saúde bucal na qualidade de vida. O objetivo deste ensaio clínico foi avaliar o efeito da reabilitação com sobredentudura mandibular sobre o impacto da saúde oral na qualidade de vida e sobre a eficiência mastigatória em pacientes usuários de prótese total convencional mandibular. O pacientes desdentados totais (n = 16) foram reabilitados com novas próteses totais convencionais na maxila e na mandíbula e, após 3 meses, as próteses mandibulares foram convertidas em sobredentaduras retidas por 2 implantes (sistema barra clipe). A versão brasileira do questionário OHIP-Edent foi utilizada para avaliar o impacto da saúde oral na qualidade de vida. A eficiência mastigatória foi avaliada através do método colorimétrico com o uso da cápsula mastigatória. O valor da mediana do OHIP-Edent com o uso de próteses totais convencionais foi 8,5 pontos, após a conversão da prótese total convencional mandibular em sobredentadura o valor da mediana do OHIP-Edent foi 2 pontos, resultando em um impacto positivo da saúde oral na qualidade de vida após o tratamento com as sobredentaduras (p = 0,001). A eficiência mastigatória com o uso de próteses totais convencionais obteve valor de absorbância com mediana de 0,025 e após a sua conversão em sobredentadura retida por 2 implantes, a mediana da absorbância foi 0,073. Houve diferença estatística significativa entre a eficiência mastigatória dos pacientes reabilitados com prótese total dupla antes e após a intervenção com implantes (p=0,003). No entanto, não foi observada nenhuma correlação entre eficiência e OHIP (p>0,05). Pacientes desdentados totais insatisfeitos com a prótese total convencional mandibular, após a reabilitação com sobredentadura mandibular retida por dois implantes, melhoram a qualidade de vida e a eficiência mastigatória.

10
  • PATRÍCIA NÓBREGA GOMES
  • Qualidade de Vida Relacionada à Saúde Bucal de crianças portadoras de cárie precoce severa na infância

  • Leader : ISAUREMI VIEIRA DE ASSUNCAO
  • MEMBRES DE LA BANQUE :
  • ANA FLÁVIA GRANVILLE GARCIA
  • ISAUREMI VIEIRA DE ASSUNCAO
  • KENIO COSTA DE LIMA
  • Data: 22 mars 2013


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  • A cárie precoce na infância, especialmente a sua forma severa, caracterizada pela natureza aguda e agressiva, pode produzir um impacto negativo na qualidade de vida da criança, como dificuldade na mastigação, diminuição do apetite, perda de peso, dificuldade em dormir, alteração no comportamento e diminuição do rendimento escolar, entre outros. Além disso, a qualidade de vida da família da criança portadora desse tipo de cárie também pode ser afetada, pois os quadros de dor e desconforto causados resultam em perdas de dias de trabalho dos pais, gastos com tratamentos odontológicos, alteração nos padrões de sono e estresse. O objetivo deste estudo foi avaliar o impacto da cárie precoce severa na infância na Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) de crianças pré-escolares por meio da Escala de Impacto da Saúde Bucal na Primeira Infância, versão brasileira do Early Childhood Oral Health Impact Scale (ECOHIS). Um único examinador calibrado avaliou, por meio do índice ceo-s, a saúde bucal de 116 crianças entre 3 e 5 anos de idade, as quais foram incluídas em um dos três grupos de estudo: “livre de cárie”, “cárie precoce não severa” e “cárie precoce severa”. Os pais responderam ao ECOHIS, para avaliar sua percepção em relação à QVRSB de seus filhos, além de um questionário sobre condições socioeconômicas. A QVRSB foi mensurada por meio dos escores total e por domínios do ECOHIS. Dentre as crianças avaliadas, 38,8% eram livres de cárie, 27,6% apresentavam cárie precoce não severa e 33,6% apresentavam cárie precoce severa. Em relação ao escore total do ECOHIS, a cárie precoce severa na infância teve um maior impacto negativo na QVRSB em comparação aos grupos livre de cárie e cárie precoce não severa (p<0,001). Em relação à subescala da criança, houve diferença estatisticamente significativa entre o grupo “cárie precoce severa” e os outros grupos em todos os domínios, com exceção do domínio de auto-imagem / interação social. Nos domínios da subescala da família, houve significância estatística entre os grupos “cárie precoce severa” e o “livre de cárie” em todos os domínios (p<0,001); já entre os grupos “cárie precoce severa” e “cárie precoce não severa”, houve diferença significativa somente no domínio de angústia dos pais (p<0,001). O modelo multivariado ajustado mostrou que o aumento na severidade da cárie dentária resultou em maior impacto negativo sobre a QVRSB (RPaj = 6,016; IC95% = 3,12-11,56; p<0,001). A presença de cárie precoce severa na infância teve um impacto negativo na QVRSB de crianças pré-escolares e de sua família.

11
  • DANILO GONZAGA BERNARDO DE FRANÇA
  • Influência da técnica de fabricação sobre o ajuste da interface pilar/implante

    em infraestruturas implantossuportadas 

  • Leader : GUSTAVO AUGUSTO SEABRA BARBOSA
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • FLÁVIO DOMINGUES DAS NEVES
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • Data: 22 mars 2013


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  • Um ajuste preciso entre as superfícies de contato dos componentes protéticos ao implante é um pré-requisito essencial para a manutenção do equilíbrio mecânico e biológico na interface pilar/implante. O método de fabricação e o material usado são fatores que podem influenciar diretamente nas distorções e no inadequado ajuste de próteses sobre implantes. O objetivo deste estudo foi comparar o desajuste vertical, horizontal e a passividade de infraestruturas fabricadas em zircônia e Cobalto-Cromo por tecnologia CAD/CAM e pelo método da fundição convencional. Dezesseis infraestruturas em monobloco, para prótese fixa de três elementos, foram obtidas a partir de uma matriz metálica contendo três implantes Brånemark compatíveis de plataforma regular (Titamax Cortical Ti, Neodent, Curitiba, Brasil). Oito infraestruturas foram confeccionadas pelo sistema CAD/CAM (NeoShape, Neodent): quatro em zircônia (Zircad),  e quatro em Cobalto-cromo (CoCrcad). Outras oito infraestruturas foram obtidas pelo método da fundição convencional: quatro em Cobalto-Cromo com pilar UCLA cinta Co-Cr (CoCrUCci) e quatro em Cobalto-cromo calcinável (CoCrUCc). O ajuste vertical, horizontal e a passividade pelo teste do parafuso único foram mensurados usando Microscopia Eletrônica de Varredura com aumento de 250x. Inicialmente avaliou-se a passividade pelo teste do parafuso único, e posteriormente para avaliar o desajuste vertical e horizontal, apertou-se todos os parafusos, com torque de 20Ncm. Média, desvio padrão, valor mínimo e máximo foram calculados para cada grupo. As medidas de desajuste horizontal foram transformadas em frequência cumulativa para categorização da variável e posterior comparação grupos a grupo. Para avaliar a existência de diferenças quantitativas entre os grupos testados para desajuste vertical e passividade, foi usado o teste Kruskal-Wallis. O teste Mann-Whitney foi usado para comparar as diferenças estatísticas grupo a grupo(p<0,05). Foram observados os respectivos valores de média e desvio padrão em micrômetros para desajuste vertical e passividade: Zircad (5,9 ± 3,6; 107,2± 36), CoCrcad (1,2 ± 2,2; 107,5± 26), CoCrUCci (11,8 ± 9,8; 124,7± 74), CoCrUCc (12,9 ± 11,0; 108,8± 85). Observaram-se diferenças estatísticas para medidas de desajuste vertical (p=0,000). O teste Mann-Whitney revelou diferenças estatísticas (p<0,05) entre todos os grupos, exceto entre CoCrUCci e CoCrUCc (p=0,619). Nenhuma diferença estatística foi observada para a passividade das infraestruturas. Em relação ao desajuste horizontal os grupos ZirCAD e CoCrcad não apresentaram melhores valores em relação a CoCrUCci e CoCrUCc. Baseado nos resultados pode-se concluir que infraestruturas confeccionadas por tecnologia CAD/CAM obtiveram melhores valores de ajuste vertical que aquelas fabricadas pelo método da fundição, apesar disso a passividade das infraestruturas não foi influenciada pela técnica de fabricação e material utilizado.  O ajuste horizontal obtido pelas infraestruturas fabricadas por CAD/CAM não foi superior àquelas fabricadas por fundição. Uma menor variabilidade no ajuste vertical foi observada quando infraestruturas foram fabricadas por CAD/CAM.

12
  • ARTHUR COSTA RODRIGUES FARIAS
  • BOLTON FREEWARE: APLICATIVO DE AVALIAÇÃO DE DISCREPÂNCIA DE MASSA DENTÁRIA DESENVOLVIDO PELO PROGRAMA DE PÓS-GRADUAÇÃO EM ODONTOLOGIA/UFRN.

  • Leader : HALLISSA SIMPLICIO GOMES PEREIRA
  • MEMBRES DE LA BANQUE :
  • ANDRE LUIS DORINI
  • FERNANDO ANTÔNIO LIMA HABIB
  • HALLISSA SIMPLICIO GOMES PEREIRA
  • Data: 22 mars 2013


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  • O cálculo da discrepância de massa dentária, imprescindível para uma adequada finalização ortodôntica, quando realizado manualmente, além de trabalhoso, exige um considerável consumo de tempo. O BoltonFreeware, um programa de computador para avaliação da discrepância de massa dentária entre as arcadas, está sendo arquitetado para minimizar esse tempo de forma menos onerosa. A análise digital no software é feita por meio da digitalização bidimensional de modelos de estudos de gesso. O objetivo desse trabalho foi o desenvolvimento e teste do BoltonFreeware para a análise de discrepância de massa dentária, segundo Bolton. A análise digital foi comparada com a avaliação manual (padrão-ouro), utilizando 75 pares de modelos de estudo em gesso pedra, divididos em dois grupos conforme a magnitude da Curva de Spee. Todos os modelos possuiam dentadura permanente e se encontravam em perfeito estado de conservação. A avaliação manual foi realizada com paquímetro digital e calculadora e o tempo requerido para realização da análise nos dois métodos foi cronometrado e comparado. Além disso o programa foi avaliado por ortodontistas quanto ao seu uso, por meio de questionários desenvolvidos especialmente para essa finalidade. Foi realizado calibração prévia para análise manual quando se obteve ótimos níveis de concordância interexaminador, com CCI>0,75 e r>0,9 para a discrepância total e anterior. Observou-se, na avaliação do erro do método digital, que alguns dentes apresentaram um erro sistemático significante, sendo o maior quantificado em  0,08mm. A análise da discrepância de tamanho total dentário realizada pelo Boltonfreeware, para aquele casos de Curva de Spee Leve e Moderada, diferiu da análise manual, em média, de 0,09mm e 0,07mm,  para cada dente avaliado, respectivamente, com r>0,8 para proporção total e anterior. Conforme os teste de especificidade e sensibilidade, o BoltonFreeware possui uma melhor capacidade de detectar os verdadeiros negativos, ou seja, a presença da discrepância. A análise de Bolton realizada digitalmente foi mais rápida, com a média das diferenças dos tempos consumidos para realização da análise de Bolton entre os dois métodos de aproximadamente 6 minutos. A maioria dos especialistas entrevistados (93%)  aprovou a usabilidade do programa.

13
  • LIDIANE MARIA DE BRITO MACEDO FERREIRA
  • TONTURA EM IDOSOS INSTITUCIONALIZADOS DA CIDADE DO NATAL/RN: UM ESTUDO CASO-CONTROLE EM VESTIBULOPATAS E NÃO-VESTIBULOPATAS.

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • KENIO COSTA DE LIMA
  • ÉRIKA FERREIRA GOMES
  • Data: 25 mars 2013


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  • O idoso institucionalizado apresenta, por ser mais frágil, várias alterações do equilíbrio corporal, podendo levar a quedas e debilidade de sua saúde. Estas alterações do equilíbrio são exteriorizadas através do sintoma tontura, que pode ser de origem vestibular ou não. Este trabalho tem o objetivo de identificar os fatores de risco relacionados com tontura em idosos institucionalizados, vestibulopatas e não-vestibulopatas, na cidade de Natal-RN. Método: trata-se de um estudo caso-controle realizado nas 12 Instituições de longa permanência para idosos de Natal-RN, regulamentadas pela Vigilância Sanitária. Foram selecionados idosos com bom nível cognitivo e capazes de deambular, totalizando 115 indivíduos. Foram divididos em 3 grupos caso com seus respectivos grupos controle: caso 1, para idosos com tontura e sem vestibulopatia (n=38); caso 2, para idosos com tontura e com vestibulopatia (n=13) e caso 3, para todos os idosos com tontura (n=51). Foram analisadas variáveis referentes a características da instituição, aos hábitos de vida dos idosos e relacionadas com sua saúde. Para a análise estatística, utilizou-se o teste do Qui-quadrado ou exato de Fisher para um nível de significância de 5% e cálculo da magnitude da associação entre as variáveis, através da medida da Odds Ratio. Resultados: como fatores de risco para tontura sem vestibulopatia, foram achados a presença de hipertenção arterial sistêmica e doença cardiovascular, assim como a presença de 3 ou mais patologias por idoso e o uso de medicamentos protetores gástricos. Para os idosos do grupo caso 2, não foi encontrado nenhum fator de risco associado. Para os idosos com tontura pertencentes ao grupo caso 3, foram observados os mesmos fatores de risco encontrados para os idosos do grupo caso 1, acrescido da presença da patologia osteoartrose, que também se mostrou significativa para este grupo. Conclusão: a tontura no idoso institucionalizado está associada a doenças sistêmicas comuns nesta faixa etária, e a vestibulopatia apresenta-se como patologia de forma isolada, sem fatores de risco associados.

14
  • ANNA ANGÉLICA ARAÚJO BARROS
  • Perfil Metodológico da Ciência Odontológica no Brasil

  • Leader : DELANE MARIA REGO
  • MEMBRES DE LA BANQUE :
  • DELANE MARIA REGO
  • ALEX JOSE SOUZA DOS SANTOS
  • GISELLE GASPARINO DOS SANTOS COLUCHI
  • Data: 26 mars 2013


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  • Este estudo de caráter observacional, transversal e retrospectivo teve como objetivo analisar o perfil metodológico da ciência em odontologia no Brasil, no período de 2007 a 2012, a partir das apresentações realizadas na Sociedade Brasileira de Pesquisa Odontológica (SBPqO), identificando as áreas de maior interesse em pesquisa e os tipos de estudos priorizados nesses trabalhos. Dos 13.452 resumos publicados, foram avaliados 6.734 em termos do seu desenho metodológico (agregado ou individuado; observacional ou de intervenção; transversal ou longitudinal), natureza geral (revisões, estudos com seres humanos ou pesquisas laboratoriais). De acordo com os resultados houve um aumento quantitativo da pesquisa científica odontológica no Brasil. Quanto ao desenho metodológico 14,3% dos resumos eram do tipo operativo agregado e 85,7% do tipo individuado (p = 0,0022). Os estudos observacionais contabilizaram 65% e os de intervenção 35% (p = 0,00220). O percentual de estudos transversais e longitudinais foram respectivamente 66,2% e 33,8% (p = 0,0152). Na classificação da natureza geral da pesquisa, 40,1% tratavam de estudos laboratoriais. As pesquisas em humanos compreenderam 58,7% e as revisões 1,2%. Não houve diferença estatisticamente significante entre o número de estudos laboratoriais e humanos (p > 0,05), ao contrário do que se observou entre os estudos em humanos e de revisão (p = 0,0119) e entre laboratoriais e de revisão (p =0,005).  A Dentística Restauradora manteve a liderança na produção, apresentando os seguintes valores de média e desvio padrão no período de 2007 a 2012 (285,4+26,3 resumos/ano). A Saúde Coletiva (145,8+9,28 resumos/ano), a Prótese buco-dentária (150,6+13,45 resumos/ano) e a Endodontia (131,8+23,53 resumos/ano) obtiveram um crescimento relevante quando comparadas às demais áreas do conhecimento odontológico. É possível concluir que a ciência odontológica brasileira privilegia os estudos individuados, observacionais e transversais e que as áreas de maior interesse e produção em pesquisa são ainda reflexo dos principais problemas e necessidades odontológicas do povo brasileiro: prevenção e tratamento da cárie dental e edentulismo.

15
  • ISABELLE DE SOUSA DANTAS
  • Prevalência da disfunção temporomandibular em estudantes de odontologia por meio de diferentes índices

  • Leader : GUSTAVO AUGUSTO SEABRA BARBOSA
  • MEMBRES DE LA BANQUE :
  • ANDRE ULISSES DANTAS BATISTA
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • PATRICIA DOS SANTOS CALDERON
  • Data: 11 avr. 2013


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  • A epidemiologia das Disfunções Temporomandobulares apresenta grande variação na literatura. O objetivo deste estudo foi verificar a prevalência da DTM nos estudantes do curso de Odontologia da Universidade Federal do Rio Grande do Norte avaliada por diferentes índices. A amostra constou de 101 indivíduos selecionados por um processo de amostragem probabilística, cujo delineamento geral foi de amostragem sistemática. Para avaliação dos sinais e sintomas da DTM utilizou-se um índice anamnésico, o protocolo de Fonseca e dois índices clínicos, o RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders), ou índice padrão, e o Índice de Disfunção Clínica de Helkimo. Os dados foram analisados por meio do teste Qui-quadrado e teste de concordância kappa, além da verificação da sensibilidade e especificidade dos mesmos (significância de 95%). O diagnóstico de DTM pelos diferentes índices revelou uma prevalência variando entre 64,4% (índice anamnésico de Fonseca), 72,3% (índice clínico de Helkimo) e 35,6% (RDC/TMD). Não houve diferença estatística entre os sexos para o RDC/TMD, embora essa diferença tenha sido encontrada para os índices de Fonseca e Helkimo (p<0,05). O tipo de DTM mais frequente foi a DTM articular (Grupos II e III), nos subtipos deslocamento de disco com redução (14,9%) e a artralgia (15,8%). A maioria dos indivíduos apresentou a forma mais leve da DTM (45,5%) para ambos índices, Fonseca e Helkimo. Quando comparados os tipos de diagnósticos, RDC/TMD com o Fonseca e Helkimo, baixas concordâncias foram encontradas (k=0,17 e k=0,35, respectivamente). Uma concordância entre a severidade da DTM moderada foi obtida (kponderado=0,53).  Alta sensibilidade e baixa especificidades foram vistas para ambos os diagnósticos em relação ao padrão, resultando em excesso de falsos-positivos. Dentro das limitações do estudo, conclui-se que a prevalência das DTMs pode apresentar grandes variações, dependendo do índice que foi utilizado para seu diagnóstico.

16
  • ANNA HELOÍSA FERNANDES DE SOUZA
  • QUALIDADE DE VIDA DE PACIENTES COM DEFORMIDADE DENTO-FACIAL GRAVE

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • JOSE SANDRO PEREIRA DA SILVA
  • JOSÉ AUGUSTO MENDES MIGUEL
  • KENIO COSTA DE LIMA
  • Data: 22 avr. 2013


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  • Na última década, um número crescente de estudos enfocando o impacto de deformidades orais na qualidade de vida têm sido publicados,. No entanto, a avaliação de pacientes em fases distintas do tratamento não tem sido realizada. Sendo assim, o propósito deste estudo foi determinar o impacto que as deformidades dentofaciais têm sobre a de qualidade de vida dos pacientes, bem como a influência exercida por fatores sócio-econômico-demográficos e ortodônticos, tipo e severidade da oclusopatia. Foi feito um estudo bicêntrico, envolvendo duas cidades, Natal e Rio de Janeiro, do tipo transversal de painéis repetidos. Um total de 227 pacientes participaram do estudo: 71 pacientes na fase inicial de tratamento (antes de qualquer procedimento orto-cirúrgico), 119 pacientes na fase pré-cirúrgica (com aparelho ortodôntico) e 41pacientes na fase pós-cirúrgica. A qualidade de vida foi mensurada utilizando o Questionário de Qualidade de Vida para Pacientes Orto-Cirúrgicos (Orthognatic Quality of Life Questionnnaire – OQLQ), traduzido e validado para o português. A necessidade normativa e estética de tratamento foi avaliada com o Índice de Necessidade de Tratamento Ortodôntico (IOTN) e com o Índice de Estética Dental (DAI), também foram avaliados os fatores sócio-econômico-demográficos, tipo de serviço e oclusopatia. Os dados foram analisados através  do qui-quadrado/exato de Fisher para buscar a associação entre as variáveis categóricas nominais nas três fases de tratamento, teste de Mann Whitney e Kruskal-Wallis para aferirem a existência de diferença significativa entre dois e três grupos em relação a cada um dos domínios do OQLQ, respectivamente. Para todos os testes foi adotado um nível de significância de 5%. Houve diferença estatisticamente significativa (p<0,001) nos escores gerais do OQLQ, e nos domínios aspectos social, estética facial e função oral, quando o grupo pós cirúrgico foi comparado aos grupo inicial e preparo ortodôntico. As mulheres, solteiras, com idade entre 31 e 59 anos, residentes em Natal, apresentaram maior impacto na qualidade de vida entre os pacientes do grupo de preparo. Apenas a variável renda ( de 2 a 3 salários mínimos) , para o grupo inicial e gênero (feminino) para o pós-cirúrgico, apresentou associação significativa com a qualidade de vida. A variável normativa IOTN  ( DHC e AC)  apresentou associação significativa com o OQLQ no grupo inicial e o IOTN-AC-auto no grupo de preparo ortodôntico, sendo menos importante para as mulheres. Conclui-se que a terapia orto-cirúrgica tem efeitos positivos na qualidade de vida após a cirurgia ortognática.

17
  • JANE SUELY DE MELO NÓBREGA
  • AVALIAÇÃO DAS AÇÕES DO NÚCLEO DE APOIO À SAÚDE DA FAMÍLIA (NASF) EM MACAÍBA/RN

  • Leader : IRIS DO CEU CLARA COSTA
  • MEMBRES DE LA BANQUE :
  • FABIA BARBOSA DE ANDRADE
  • IRIS DO CEU CLARA COSTA
  • WALDA VIANA BRÍGIDO DE MOURA
  • Data: 30 avr. 2013


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  • Esta pesquisa objetivou avaliar a contribuição do Núcleo de Apoio à Saúde da Família (NASF) em relação à sua atuação nas Unidades de Saúde da Família através da percepção dos profissionais da Estratégia de Saúde da Família (ESF) e do próprio NASF, além da satisfação dos usuários em relação a esta atuação.  Os dados foram coletados na rede pública de serviços de saúde do município de Macaíba-RN em 2012, através de questionário semiestruturado e observação sistemática não participante, tendo como sujeitos investigados 272 indivíduos (60 profissionais da ESF, 12 profissionais do NASF e 200 usuários representantes das 20 unidades pesquisadas).  Para análise das respostas obtidas pela questão aberta foi usado o processo de categorização e, em relação ao método observacional, este se baseou na verificação da organização do espaço no ambiente, as características dos sujeitos participantes e o conjunto específico das atividades realizadas pelas equipes do NASF segundo um roteiro de observação. Os resultados sinalizam para uma boa aceitação da atuação das equipes do NASF pela maioria dos profissionais da ESF, os quais relataram uma participação ativa do NASF na rotina das Unidades de Saúde, sua integração às atividades das equipes da ESF com ações resolutivas e de caráter de promoção à saúde. Em relação aos profissionais dos NASF, estes também relataram contribuição positiva por participarem ativamente na rotina das Unidades integrando-se às atividades das equipes da ESF, desenvolvendo ações resolutivas. Para os usuários, o NASF trouxe garantia de melhor acesso aos serviços com atendimento especializado, resolutivo e acolhedor. A observação sistemática não participante ratificou os dados obtidos pelo questionário. Foi percebida a necessidade de implantar ações voltadas à saúde do homem, de investir na ampliação do número de equipes do NASF, na maior oferta de medicamentos, no aperfeiçoamento do processo de regulação e no planejamento conjunto como estratégia fundamental de promover uma integração mais efetiva entre as equipes NASF/ESF.

18
  • ANA CRISTINA GONDIM FILGUEIRA
  • Influência das Condições de Saúde Bucal no Desempenho das Atividades Diárias de Adolescentes Escolares 

  • Leader : ISAUREMI VIEIRA DE ASSUNCAO
  • MEMBRES DE LA BANQUE :
  • ISAUREMI VIEIRA DE ASSUNCAO
  • KENIO COSTA DE LIMA
  • SAUL MARTINS DE PAIVA
  • Data: 30 avr. 2013


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  • Cada indivíduo, comunidade ou grupo populacional tem necessidades e riscos específicos às suas características físicas, psicossociais, geográficas e culturais que se traduzem em perfis de saúde-doença peculiares, inclusive os de saúde bucal. O reconhecimento desta questão levou a um aumento na utilização de indicadores de Qualidade de Vida. No campo odontológico, utilizam-se instrumentos de Qualidade de Vida Relacionada à Saúde Bucal (QVRSB), como o Oral Impacts on Daily Performances (OIDP), para dimensionar o quanto a condição bucal interfere nos âmbitos funcionais, psicológicos e sociais da vida das pessoas. Assim, a adolescência, marcada por importantes alterações físicas, psíquicas e sociais, requer uma análise mais específica das questões que influenciam em sua qualidade de vida. Portanto, o principal objetivo deste estudo consistiu em investigar a existência de associação entre o desempenho de atividades diárias e a condição de saúde bucal de adolescentes escolares de 15 a 19 anos de idade. Para tanto, foi realizado um estudo observacional do tipo seccional, com 215 alunos do Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Norte (IFRN). Esses alunos foram examinados para obtenção dos índices normativos CPO-D, CPI e DAI e responderam ao questionário subjetivo de avaliação da qualidade de vida relacionada à saúde bucal (QVRSB) OIDP. Os dados referentes à caracterização socioeconômica dos alunos foram obtidos do próprio banco de dados do IFRN. Foi realizada a análise descritiva de todas as variáveis do estudo, obtendo-se as frequências absolutas e relativas. O teste do qui-quadrado foi utilizado para verificar a associação existente entre a variável dependente e as variáveis independentes categóricas e o teste t para as quantitativas. Realizou-se ainda uma análise múltipla, pela regressão de Poisson com variância robusta, entre o desfecho “presença de impacto” e as variáveis independentes que apresentaram valor de p<0,20. Para todos os testes estatísticos foi adotado um nível de significância de 5%. O impacto das condições de saúde bucal na qualidade de vida dos adolescentes apresentou uma prevalência de 51,16%, dos quais, comer ou mastigar bem os alimentos, escovar os dentes ou higienizar a boca e sorrir ou mostrar os dentes sem embaraço foram as atividades diárias mais afetadas. Existiu uma associação significativa entre a prevalência do impacto e a presença de um ou mais dentes cariados (p=0,012), a presença de sangramento gengival (p=0,012) e a necessidade de tratamento ortodôntico (p=0,003). Os resultados da pesquisa demonstraram que as condições de saúde bucal da população estudada tem associação positiva com os impactos na qualidade de vida.

19
  • PRYSCILA ARAÚJO DE GOES
  • O Cuidador familiar do idoso com Alzheimer: percepções e sentimentos

  • Leader : MAISA PAULINO RODRIGUES
  • MEMBRES DE LA BANQUE :
  • JOÃO BOSCO FILHO
  • MAISA PAULINO RODRIGUES
  • REJANE MARIA PAIVA DE MENEZES
  • Data: 28 mai 2013


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  • A longevidade é, sem dúvida, um triunfo da humanidade, pois o envelhecimento, antes considerado um fenômeno, hoje faz parte da realidade da maioria das sociedades, mas se apresenta também como um dos nossos grandes desafios, neste milênio. Não só a constituição etária da população vem sofrendo transformações, fruto da crescente redução da taxa de natalidade; observa-se também o surgimento de novos arranjos familiares que apontam o comprometimento da oferta de cuidado aos idosos no domicilio e gera uma nova problemática: quem cuidará dos idosos? A Constituição Federal Brasileira defende que o cuidado com o idoso é uma responsabilidade compartilhada entre o Estado, a família e a sociedade. As Políticas públicas voltadas à pessoa idosa vêm corroborar com esse entendimento ao defender o domicilio como espaço privilegiado para o cuidado do idoso, determinando assim a participação do familiar, como cuidador. Nos últimos anos, apesar da busca incessante pela saúde e qualidade de vida, é cada vez mais crescente a incidência de idosos com doenças demenciais que levam à incapacidade funcional, em especial a doença de Alzheimer. Essa doença compromete de forma grave e irreversível a cognição, memória e independência do idoso; tornando-o dependente de terceiros para executar atividades básicas da vida diária, por toda sua vida. Diversas políticas e portarias almejam alterar o modelo de atenção ao idoso, na busca da integralidade, favorecendo sua permanência no domicilio em detrimento da hospitalização e institucionalização, porém não existem estratégias de assistência voltadas às necessidades do cuidador familiar, que se sente desamparado e desassistido na sua responsabilidade de cuidado com o idoso no domicilio. Diante dessa realidade crescente, o presente estudo teve como objetivo conhecer a percepção dos cuidadores familiares de idosos com Alzheimer sobre o papel de cuidador. Trata-se de um trabalho descritivo e exploratório com abordagem qualitativa, realizado com cuidadores familiares de idosos com Alzheimer, pertencentes ao Grupo de cuidadores do Centro de Atenção em Saúde do Idoso - CEASI, localizado em Natal/RN. Por meio de entrevista semi-estruturada a pesquisa buscou investigar os sentimentos e as mudanças ocorridas na vida pessoal após tornar-se cuidador e identificar necessidades e limitações do cuidador na prática do cuidado. O conteúdo dos dados foi organizado em categorias, com base nas questões da pesquisa e analisados pela técnica de análise de conteúdo temática, segundo Bardin. Os relatos originaram três categorias: 1. O significado do papel do cuidador; 2. Sentimentos relacionados ao ato de cuidar e ao Ser cuidado e 3. Mudanças ocorridas no cotidiano do cuidador. Dessa maneira, foi constatado que, no grupo estudado, que a exigência proveniente da dedicação ao cuidado gera perdas na vida pessoal e profissional do familiar que assume essa responsabilidade. Além disso, falta de suporte, familiar e social, acentua a sobrecarga do cuidado ao idoso dependente. As Políticas públicas de saúde do idoso reconhecem a importância e as necessidades dos familiares cuidadores, porém não assistem de forma a suprir suas reais necessidades e auxiliá-los em suas limitações. Os resultados da pesquisa demonstraram a urgência na tomada de medidas de assistência aos cuidadores de idosos com Alzheimer, reconhecendo-as como uma ação de promoção da qualidade de vida e saúde do idoso e proteção da saúde do cuidador.

20
  • RODRIGO FALCÃO CARVALHO PORTO DE FREITAS
  • EFICÁCIA DO ACONSELHAMENTO NO TRATAMENTO DAS DISFUNÇÕES TEMPOROMANDIBULARES

  • Leader : PATRICIA DOS SANTOS CALDERON
  • MEMBRES DE LA BANQUE :
  • PATRICIA DOS SANTOS CALDERON
  • GUSTAVO AUGUSTO SEABRA BARBOSA
  • ANDRE ULISSES DANTAS BATISTA
  • Data: 6 juin 2013


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  • O objetivo do presente ensaio clínico controlado foi avaliar a eficácia do aconselhamento no tratamento aos pacientes com Disfunção Temporomandibular (DTM). Para tanto, 51 pacientes consecutivos foram alocados para um dos grupos da pesquisa. Para o Grupo I, foi instituída terapia com aconselhamento e para o Grupo II, foi realizado tratamento convencional por meio de dispositivos oclusais. Os pacientes foram acompanhados em retornos de 7, 15, 30 e 60 dias após o baseline. No baseline, todos os pacientes foram examinados e diagnosticados como portadores de DTM através do índice RDC/TMD, que foi aplicado por um único examinador treinado e calibrado, além disso, os pacientes foram encaminhados para o tratamento específico de acordo com o grupo ao qual pertenciam. O grau de comprometimento clínico e funcional foi avaliado em cada uma das visitas por meio do Índice Temporomandibular (TMI). Em cada sessão, os pacientes foram ainda inquiridos a respeito do nível de dor por meio de uma Escala Visual Analógica (EVA). Para a análise do impacto da dor na qualidade de vida, foi utilizado o questionário OHIP-14. Os resultados apresentaram 26 pacientes do Grupo I com idade média de 35,15 ± 10,79 anos, e variação compreendida entre 18 e 52 anos. Destes, 4 pacientes (15,4%) apresentaram, ao exame inicial, diagnóstico de DTM muscular, 2 (7,7%) DTM articular e 20 (76,9%), DTM mista. No Grupo II foram tratados 25 pacientes, com faixa etária média de 27,36 ± 10,34 anos e variação de 13 a 48 anos. Destes, 5 pacientes (20%) apresentaram ao exame inicial, diagnóstico de DTM muscular, 3 (12%) DTM articular e 17 (68%), DTM mista. O aconselhamento foi eficaz na redução da intensidade de dor (EVA), com melhora significativa observada já com 7 dias de acompanhamento (p<0,001). Para o comprometimento funcional (TMI), resultados significativos foram observados com 15 dias de acompanhamento (p=0,002). O aconselhamento também foi responsável pela melhora significativa do impacto da DTM na qualidade de vida (OHIP) em todos os momentos da análise (p<0,001). Quando da comparação entre os grupos de pesquisa, não foi observada diferença significativa para nenhum dos índices analisados (P>0,05) nas avaliações em curto prazo (7 dias) e em longo prazo (60 dias). Pôde-se concluir, portanto que, para a amostra estudada, o aconselhamento constituiu-se em uma opção de tratamento eficaz para o controle de sinais e sintomas da DTM, com resultados similares, em curto e em longo prazo, aos do grupo tratado por meio de dispositivos oclusais. 

21
  • MÁRCIA CAVALCANTE VINHAS LUCAS
  • CARTOGRAFIA DE UMA INTERVENÇÃO COMUNITÁRIA PARA PREVENÇÃO DE DST/HIV/AIDS

  • Leader : ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ANA KARENINA DE MELO ARRAES AMORIM
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • JOÃO BOSCO FILHO
  • Data: 25 juin 2013


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  • As intervenções de base comunitária têm sido apresentadas como proposta de operacionalização do conceito de vulnerabilidade para a prevenção das DST/Aids. Esta pesquisa teve por objetivo analisar a intervenção comunitária desenvolvida através do projeto Fortalecimento de redes de ação comunitária para a prevenção em DSt/Aids: conhecer e intervir, no bairro de Mães Luiza, na cidade de Natal, estado do Rio Grande do Norte, Brasil. O estudo foi realizado no mesmo local onde ocorre a intervenção e tomou como referência temporal os primeiros 30 meses do processo  de sua construção e implantação, desde abril de 2010 até dezembro de 2012. Trata-se de pesquisa com abordagem qualitativa, de caráter participativo, desenvolvida a partir da imersão da pesquisadora em campo, sendo este a própria intervenção comunitária. Nessa perspectiva, o estudo aproxima-se ao método cartográfico no qual a relação pesquisador-pesquisado é engendrada nos atos e efeitos da investigação. As fontes geradoras de dados foram o registro de memórias da pesquisadora a partir das anotações de campo, narrativas escritas de sujeitos implicados na intervenção e documentos referentes ao projeto. No caminho metodológico da cartografia, a imagem do rizoma apresentada por Deleuze e Guattari (1995) tem acompanhado a imersão em campo dada a natureza de pesquisa-intervenção a qual aproximamos à noção de objeto-rizoma. A apresentação de resultados foi composta por tentativa de representação rizomática e um hipertexto, tomando como base a narrativa descritiva extraída da análise documental e as narrativas multifacetadas com as vozes, os olhares e os afetos narrados pelos sujeitos implicados, respectivamente. No caminho percorrido, três pistas foram traçadas como síntese do aprendizado produzido pela experiência-intervenção, que podem contribuir para compreender o processo em estudo, em seu caráter singular, e orientar reflexões sobre outras experiências de intervenção comunitária: pista 1 – A intervenção comunitária como espaço ativo-reflexivo e um modo de fazer com; pista 2 – A inclusão como potência e desafio da intervenção comunitária; pista 3 – A sustentabilidade como desafio da intervenção comunitária.  O estudo indica que a intervenção comunitária se apresenta como potencial produtora de saúde à medida que também produz práticas e sujeitos, potencializando capacidades criativa e inventiva presentes no cotidiano da comunidade numa perspectiva de reinventar saberes e práticas para prevenção das DST/HIV/Aids.

22
  • NEUMA LUCIA DE OLIVEIRA
  • PRÁTICAS EDUCATIVAS E INTEGRALIDADE NA SAÚDE DA FAMÍLIA:UM ESTUDO ETNOGRÁFICO

  • Leader : ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • JACILEIDE GUIMARAES
  • LUCIANE MARIA PEZZATO
  • Data: 27 juin 2013


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  • Na Atenção Primária em Saúde, sobretudo, na Estratégia Saúde da Família, espera-se que ocorra articulação das ações assistenciais e de promoção da saúde. O Ministério da Saúde (BRASIL, 2007) define a educação em saúde como uma estratégia potencializadora das ações de prevenção e promoção da saúde, fundamentada em práticas reflexivas, que possibilitem ao usuário sua condição de sujeito histórico, social e político, sob a visão de uma clínica ampliada por parte dos profissionais de saúde. Nesse sentido, há diretrizes para que profissionais desenvolvam ações educativas e que estas possam interferir no processo de saúde-doença da população, na perspectiva do desenvolvimento de autonomia dos sujeitos. Esta pesquisa teve como objetivo compreender, à luz da integralidade do cuidado, como se dá a produção das práticas de educação em saúde, no âmbito da Estratégia Saúde da Família a partir de estudo etnográfico em uma Unidade de Saúde da Família (USF).  O local da pesquisa foi a Unidade de Saúde Felipe Camarão II, no Distrito Sanitário Oeste, no município de Natal, RN, Brasil, selecionada a partir de mapeamento preliminar de práticas educativas implantadas nas unidades de saúde da família deste município, com base em critérios entre os quais tempo de implantação da USF e sustentabilidade das ações existentes. A imersão em campo constou de observação participante com registro em diário, realizada durante o período de agosto de 2012 a janeiro de 2013, em que a pesquisadora acompanhou processos de trabalho das equipes em ações clinico-assistenciais, na própria USF, em domicílios e em ações educativas de caráter grupal.  Os resultados apresentados na descrição etnográfica foram analisados com base nos eixos propostos por Ayres (2009) para identificação da integralidade nas práticas de saúde: o eixo das necessidades; o eixo das finalidades; o eixo das articulações; e o eixo das interações. As evidências descritas a partir da observação apontam presença de cada eixo acima nas práticas de educação em saúde desenvolvidas pelas equipes, mesmo que de forma incipiente, quais sejam: articulação e valorização de saberes e práticas da cultura popular com iniciativas locais (Pastoril do Peixe Boi Encantado, Auto de Natal e Grupo Terapia e Arte); integração da clínica com as ações de promoção da saúde e articulação de saberes multiprofissional, com vínculo profissional-usuário (Curso para Gestantes). No entanto, alguns desafios foram identificados a serem enfrentados para se avançar nessas práticas numa perspectiva do cuidado integral: necessidade de ruptura com a fragmentação das ações; fortalecimento do trabalho em equipe; necessidade de maior sustentabilidade política das ações coletivas; trabalho intersetorial com vistas a uma melhor atuação do Estado no enfrentamento do processo saúde-doença, somando-a à ação dos indivíduos-sujeitos. A análise produzida a partir da observação dos processos vivenciados indica haver necessidade de um melhor reconhecimento por parte dos gestores locais de que ações semelhantes as que ocorrem na USF Felipe Camarão possibilitam avanços na integralidade à medida que permite inclusão dos atores implicados nos processos de trabalho em saúde, e estimulam participação e corresponsabilização no enfrentamento de situações de saúde-doença. 

23
  • MARIA TERESA FREIRE DA COSTA
  • PERCEPTIONS, PRACTICES AND POSSIBILITIES OF CHANGES IN COGESTÃO IN HISPITAL GISELDA TRIGUEIRO / NATAL-RN

  • Leader : MAISA PAULINO RODRIGUES
  • MEMBRES DE LA BANQUE :
  • MAISA PAULINO RODRIGUES
  • MARIA DALVA HORACIO DA COSTA
  • JOÃO BOSCO FILHO
  • Data: 15 août 2013


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  • To produce changes in the models of care and management is to enable and constitute new institutional arrangements and devices in health services, re-signifying health work. A path where management and attention are indissociable, aiming to generate health and subjects with greater capacity for analysis and intervention in the face of daily life. This study discusses the topic of Humanization and Management in health. It aims to report the changes produced at the Giselda Trigueiro Hospital in the city of Natal / RN, after the implementation of the institutional arrangements and devices proposed by the National Humanization Policy of the Ministry of Health, which begins in 2007. It is a Case Study conducted with 24 workers, using documental research and semi-structured interviews, seizing the categories: perception about participative management; Perceived changes with participatory management and perceived difficulties. The data were analyzed through the Bardin Content Analysis. The results showed: co-responsibility of professionals with management; Improvements in the work process; Implementation of the Permanent Education Policy; Improvement of indicators; Creation of Functional Units reflecting humanization; Constitution of collegiate managers and creation of ombudsman. The difficulties are related to the lack of institutional support and the fragmentation of the health network. It was concluded that there have been advances and effective products, however, it is necessary to stimulate and intensify the participation of users and workers respectively.

24
  • CÉLIA ALVANIR DE AQUINO SILVA
  • INFLUÊNCIA DO PRÉ-AQUECIMENTO NA ADAPTAÇÃO MARGINAL DE DOIS MATERIAIS SELADORES DE FÓSSULAS E FISSURAS, ANALISADA ATRAVÉS DE TOMOGRAFIA DE COERÊNCIA ÓTICA.

  • Leader : ISAUREMI VIEIRA DE ASSUNCAO
  • MEMBRES DE LA BANQUE :
  • ISAUREMI VIEIRA DE ASSUNCAO
  • BONIEK CASTILLO DUTRA BORGES
  • MARCOS ANTONIO JAPIASSÚ RESENDE MONTES
  • Data: 23 août 2013


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  • Entre as técnicas não invasivas empregadas na prevenção de cáries destaca-se o selamento de fóssulas e fissuras que consiste em uma manobra conservadora, com o intuito de obliterá-las protegendo-as do ataque ácido bacteriano. Influenciado pelos estudos de pré-aquecimento das resinas compostas, em que se observou grande melhora em algumas de suas propriedades físicas, este trabalho objetivou analisar, in vitro, a adaptação marginal superficial de diferentes materiais seladores e em situações de pré aquecimento ou não. Foram utilizados 40 terceiros molares humanos extraídos que tiveram suas superfícies oclusais preparadas para receber o material selador. Foram testados dois tipos de materiais seladores: selante resinoso (Fluoroshield) e resina de baixa viscosidade (resina Permaflow), onde 50% destes receberam material  aquecido previamente e a outra metade recebeu material selador em temperatura ambiente. Todas as amostras foram submetidas à Ciclagem Térmica e de Ph, simulando um ambiente bucal  cariogênico, e posteriormente foram analisadas em aparelho de OCT (Tomografia de coerência ótica). As imagens obtidas tiveram suas alterações registradas e analisadas estatísticamente. Como alteração foi considerado o surgimento de bolhas, Gaps e fendas no material selador. Comparações para o mesmo material, avaliando o fato do mesmo ser ou não selado com material pré aquecido, bem como comparações entre os diferentes materiais submetidos à mesma temperatura, foram realizadas. O teste não paramétrico de Mann Whitney foi empregado (p<0,05). Os resultados  mostraram não ter havido diferença estatísticamente significativa tanto entre os materiais analisados, como entre as situações em que o material selador foi submetido (pré aquecido ou não). Pode-se sugerir que ambos os materiais testados, bem como o fato serem pré aquecidos ou não, possuem o mesmo comportamento em relação à adaptação marginal superficial visto através da tomografia de coerência ótica.

25
  • STELLA ROSA DE SOUSA LEAL
  • SOBRE A PELEJA DA FLUORETAÇÃO DAS ÁGUAS NO RIO GRANDE DO NORTE: UM ESTUDO À LUZ DAS DIRETRIZES DO BRASIL SORRIDENTE

  • Leader : ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MAISA PAULINO RODRIGUES
  • MARIA ENEIDE LEITÃO DE ALMEIDA
  • Data: 29 août 2013


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  • No ano de 2004 é lançada a Política Nacional de Saúde Bucal (PNSB), Brasil Sorridente, com o objetivo de ampliar o atendimento e melhorar as condições de saúde bucal da população brasileira através ações de promoção e proteção da saúde, recuperação e reabilitação.  Dentre destas ações de promoção de saúde, está prevista a ampliação da implantação da fluoretação das águas nos municípios com sistemas de tratamento de água existentes através da viabilização de políticas públicas. Apesar da inclusão da fluoretação das águas de abastecimento público nas diretrizes do Brasil Sorridente, a adesão às outras estratégias da política como a implantação de equipes de Saúde Bucal e dos Centros de Especialidades Odontológicas – CEOS e dos Laboratórios Regionais de Saúde Bucal, têm ocorrido de forma muito mais frequente que a primeira. Esta pesquisa teve como geral investigar, no Rio Grande do Norte, como se deu o processo de implantação do Subcomponente Fluoretação das Águas de Abastecimento da Política Nacional de Saúde Bucal - Brasil Sorridente.  Trata-se de um estudo de caso realizado através de pesquisa documental e entrevistas com agentes institucionais.  Além das instituições envolvidas na fluoretação das águas no âmbito estadual, Secretaria Estadual de Saúde Pública do Rio Grande do Norte-SESAP/RN, Fundação Nacional de Saúde-FUNASA e Companhia de Águas e Esgotos do Rio Grande do Norte-CAERN. o campo foi composto pelo único município do estado que fluoretou suas águas durante a vigência do Brasil Sorridente. A análise foi realizada a partir da sistematização dos conteúdos extraídos dos documentos e das entrevistas, grupados em uma matriz contendo trechos das falas dos entrevistados que serviram de referência para recompor o processo de implantação do subcomponente fluoretação da PNSB Brasil Sorridente a partir dos aspectos relevantes identificados que emergiram na fase de campo de pesquisa. O conteúdo das falas foi sistematizado e analisado a partir dos discursos sobre o tema avaliado, buscando-se identificar movimentos/posicionamentos favoráveis e desfavoráveis, contradições, conflitos e consensos, resultando em quadro analítico do município e da unidade da federação estudada.

26
  • JACYANE MELO DE OLIVEIRA SANTOS
  • CUIDADO À SAÚDE DO ADOLESCENTE EM UMA UNIDADE DE SAÚDE DA FAMÍLIA: QUE PAPO É ESSE DE INTEGRALIDADE?

  • Leader : ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MARLOS ALVES BEZERRA
  • MOEMIA GOMES DE OLIVEIRA MIRANDA
  • Data: 30 août 2013


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  • Este estudo faz um recorte para a população adolescente compreendendo a idade ente 10 e 19 anos de idade, empregado pelo Ministério da Saúde (MS), e remete ao pressuposto que a integralidade seja um princípio a ser considerado de forma expressiva no cotidiano das práticas em saúde em sua dimensão cuidadora na atenção ao adolescente. O objetivo geral do estudo é investigar como se dá a produção do cuidado à saúde do adolescente em uma Unidade de Saúde da Família (USF), buscando analisá-la à luz do princípio da integralidade. Trata-se de pesquisa com abordagem qualitativa, aproximando-se do estudo de caso. Este foi a Unidade de Saúde da Família de Mangabeira, no município de Macaíba/RN. Utilizou-se a observação participante, a técnica grupal de construção de fluxograma descritor do processo de trabalho e entrevistas individuais com roteiros semi-estruturados com trabalhadores e usuários. A análise tomou como referência quatro eixos propostos por Ayres (2009) para identificação da integralidade nas práticas de saúde: necessidades; finalidades; articulações e integração entre os sujeitos. Os resultados do estudo apontam que os profissionais da USF apreendem o cuidado à saúde do adolescente no desenvolvimento de suas atividades cotidianas a partir da demanda espontânea e em ações no âmbito escolar com a implementação das ações do PSE. A maneira como se estabelece os encontros constituídos pelos sujeitos implicados nesse processo podem fazer a diferença no sentido de aproximações ou distanciamentos do cuidado integral à saúde dos adolescentes. Evidencia-se necessidade do reconhecimento das singularidades e especificidades, bem como a pluralidade e diversidade dos adolescentes com oferta de produção de cuidado, baseada em processo dialógico que possibilite a construção de um sujeito-cidadão a partir da participação juvenil e superação do paradigma normativo e prescritivo.

27
  • BIANCA ARNOUD RODRIGUES
  • Doce Vida: um estudo sobre a experiência alimentar e desafios para o tratamento dietético em pessoas vivendo com Diabetes Mellitus

  • Leader : ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • MEMBRES DE LA BANQUE :
  • ELIZABETHE CRISTINA FAGUNDES DE SOUZA
  • ROSANA LUCIA ALVES DE VILLAR
  • JOÃO BOSCO FILHO
  • Data: 30 août 2013


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  • O diabetes mellitus é uma doença cujo interesse da saúde pública se dá pelo aumento crescente dos casos como também pelo desafio individual de conviver com a mesma. O tratamento consiste, entre outros, na adoção de uma alimentação equilibrada e, de certo modo restritiva. Em sendo a alimentação um evento complexo que envolve aspectos biológicos e sócio-culturais, tê-la regida em virtude da doença não parece tarefa simples. O objetivo desse estudo é analisar como se dá a experiência alimentar e sua interface com os desafios para o tratamento dietético em pessoas vivendo com diabetes mellitus. A pesquisa foi guiada por uma abordagem qualitativa, a partir de entrevistas com cinco pessoas vivendo com diabetes sobre a experiência e modos de lidar com o adoecimento. Os entrevistados foram selecionados a partir de critérios e identificação no cadastro do Programa Hiperdia na Unidade de Saúde da Família (USF) do bairro de Bom Pastor situado na cidade de Natal, Rio Grande do Norte, Brasil. O material produzido foi constituído pelos relatos dos participantes entrevistados e as anotações de campo. A análise considerou os relatos dos entrevistados, buscando dialogar com a literatura pesquisada. Os resultados assinalam que as pessoas que vivem com diabetes tendem a realizar ajustes nos padrões das prescrições como forma de sentir-se bem em relação ao adoecimento e, para tanto, adotam estratégias pessoais para o seu gerenciamento alimentar e modo de lidar com o cotidiano. As escolhas, por sua vez, são guiadas pela cultura que permeiam os fatores objetivos e subjetivos os quais, de acordo com a circunstância e não somente pela doença, estabelecem o que deve ou não ser consumido. Conclui-se que a compreensão dos aspectos culturais cria uma nova perspectiva analítica para estudos acerca da experiência alimentar e seu reflexo na adesão ao tratamento dietético, para além do campo explicativo e normativo do modelo biomédico. Compreender o impacto que o adoecer por diabetes mellitus produz na vida das pessoas, e por sua vez no próprio estado de adoecimento, são desafios para uma Clínica Ampliada e Compartilhada em Nutrição na qual a intervenção nutricional resgate sua dimensão cuidadora e dê voz e escuta aos doentes, em diálogo criativo entre saberes, profissional e do usuário, para que este seja capaz de criar sua própria forma de lidar com a dieta, buscando ressignificação de suas práticas alimentares e recriação no seu modo de viver e conviver com a doença.

28
  • SAULO VICTOR E SILVA
  • Prevalência e fatores associados ao risco e à desnutrição em idosos institucionalizados

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • KENIO COSTA DE LIMA
  • DYEGO LEANDRO BEZERRA DE SOUZA
  • SANCHA HELENA DE LIMA VALE
  • Data: 30 août 2013


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  • Um dos problemas mais relevantes na população idosa é a deficiência nutricional. Várias alterações fisiológicas e o uso de múltiplos medicamentos interferem no apetite, no consumo de alimentos e na absorção dos nutrientes, podendo levar ao risco e à desnutrição nos idosos, especialmente entre os institucionalizados. O presente estudo objetivou avaliar a prevalência de desnutrição e do risco para desnutrição e seus fatores associados em idosos institucionalizados. O mesmo se caracterizou por ser do tipo individuado, observacional e transversal. A obtenção da amostra se deu através do cadastro de indivíduos das instituições de longa permanência de idosos da cidade do Natal-RN. Os idosos foram avaliados através da Mini Avaliação Nutricional (MAN) e da dobra cutânea triciptal (DCT) e cada idoso ou cuidador respondeu a um questionário acerca de informações como tipo e restrição alimentar, acessibilidade ao alimento, uso de bebida alcoólica e tabaco, prática de atividade física e inapetência. Variáveis como idade, gênero, escolaridade, estado civil, tempo que o idoso vive na instituição, o motivo da institucionalização e as comorbidades foram aferidas a partir dos prontuários de cada idoso. A frequência de consumo alimentar de vários grupos de alimentos foi aferida a partir do questionário de frequência de consumo alimentar do estudo Saúde, Bem estar e Envelhecimento (SABE). Os dados foram apresentados na forma de médias e desvios padrão, frequências absoluta e relativa. Para análise da frequência de consumo, realizou-se uma análise fatorial com extração dos fatores a partir da análise de componentes principais com rotação varimax. A análise bivariada foi realizada através do teste do qui-quadrado e verificada a magnitude do efeito através da razão de prevalência (IC 95%). A regressão robusta de Poisson avaliou o efeito líquido das variáveis independentes sobre os dois desfechos, considerando um nível de significância de 5%. Foram estudadas 12 ILPI, totalizando 381 idosos elegíveis para o estudo. A prevalência do risco de desnutrição foi de 46,1% (45,9 - 46,2) e a de desnutrição foi de 31,4% (31,2 - 31,5). O risco de desnutrição esteve associado significativamente à presença de incontinência urinária (RP = 1,444; 1,113-1,874) e a desnutrição esteve associada à falta de apetite (RP = 1,757; 1,246-2,476), ao fato dos idosos não terem acesso a alimentos fora da instituição (RP= 0,565; 0,337-0,946), ao baixo consumo de água (RP = 1,646; 1,101-2,459) e à demência (RP= 1,537; 1,072-2,204). A alta prevalência de desnutrição e do risco de desnutrição no estudo sugere que devemos nos atentar a informações relacionadas aos hábitos alimentares e à presença de comorbidades, pois estes podem influenciar no estado nutricional desta população.

29
  • LYANE RAMALHO CORTEZ
  • Análise Espacial da Gravidez na Adolescência no Rio Grande do Norte

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • MARIA ANGELA FERNANDES FERREIRA
  • MARILIA SÁ CARVALHO
  • SEVERINA ALICE DA COSTA UCHOA
  • Data: 22 nov. 2013


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  • A gravidez na adolescência está comumente associada a condições de vida desfavoráveis, em que múltiplos fatores podem estar envolvidos com o seu acontecimento. Desta forma entende-se que para se propor estratégias efetivas de enfrentamento desta problemática no estado do Rio Grande do Norte, necessário se faz, a incorporação do espaço e dos fatores demográficos, sociais e econômicos como determinantes deste processo. Neste sentido, realizou-se um estudo ecológico, com o objetivo de analisar a distribuição espacial da gravidez na adolescência e sua correlação com fatores socioeconômicos, demográficos e de saúde no estado do Rio Grande do Norte no período de 2001 a 2010. Para tanto, utilizou-se o Sistema de Informações sobre Nascidos Vivos (SINASC) como fonte de dados, em relação aos nascimentos cujas mães eram adolescentes neste período e adotou-se como unidades de análise os municípios do estado do Rio Grande do Norte. Para o estudo foi considerada como variável desfecho a proporção de nascidos vivos de mães adolescentes e como variáveis independentes contextuais aquelas relacionadas com fatores demográficos, de desenvolvimento, de mercado de trabalho, de renda, de educação e relacionadas à assistência à saúde e assistência social. Foi feita a análise exploratória da variável dependente e das variáveis independentes e construídos mapas temáticos utilizando o SIG terraview 4.1.0. Com este mesmo SIG, foi calculada a autocorrelação espacial para todas as variáveis e o índice de Moran local - LISA mapeou a intensidade dos aglomerados, considerando a significância estatística o valor de p < 0,05. Com o programa estatístico GeoDA, as variáveis foram submetidas a uma análise bivariada, onde também se utilizou o índice de Moran, para testar a correlação entre os pares.

30
  • LORENA DOS SANTOS TINOCO
  • ALEITAMENTO MATERNO E ALIMENTAÇÃO COMPLEMENTAR

    EM CRIANÇAS MENORES DE UM ANO: CHAMADA NEONATAL, RN, 2010.

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • CLELIA DE OLIVEIRA LYRA
  • LEOPOLDINA AUGUSTA SOUZA SEQUEIRA DE ANDRADE
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 12 déc. 2013


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  • Avaliar os dados de aleitamento materno e alimentação complementar de crianças menores de um ano, do Rio Grande do Norte (RN), de acordo com o que é preconizado pelas políticas e ações de alimentação e nutrição. Métodos: Foi analisado o banco de dados da Chamada Neonatal do RN, pesquisa realizada pelo Ministério da Saúde em 2010. A amostra analisada foi de 837 pares mãe/filho que responderam ao questionário da pesquisa nos municípios investigados. Foram analisadas a prevalência de dados de aleitamento materno exclusivo (AME), na primeira hora de vida, parcial (AMP) e total (AMT), assim como dos alimentos ingeridos, pelas crianças, nas ultimas 24 horas anterior a entrevista. As frequências e médias foram feitas pelo comando Complex samples, no SPSS® 20.0, com IC95%. Foram estimadas as medianas de tempo de AME e AMT, assim como a mediana de tempo de introdução dos grupos de alimentos consumidos, em relação a idade da criança pelo método de probitos. Foi feita associação das probabilidades de tempo de AME e AMT com as variáveis sociodemográficas e de pré-natal (p<0.05). Resultados: Foram encontradas médias de idades de 5,28 ± 3,4 meses e 25,9 ± 6,4 anos, para crianças e mães, respectivamente. A prática de aleitamento na primeira hora de vida foi considerada boa (66,6%) e o percentual de AME (20%) razoável,segundo a Organização Mundial da Saúde, 2008. Mais da metade das crianças (55,1%) estavam em AMP. No total 60% estavam sendo amamentadas (AMT) ao final do primeiro ano de vida. O AME teve mediana de 63 dias e AMT de 358 dias. Estes dados não se diferenciaram muito entre a capital e os municípios do interior. A maioria das mães entrevistadas (73,8%) referiu ter tido orientação sobre aleitamento no pré- natal, tendo associação (p=0,03) com a probabilidade de tempo de AME, porém com pouca explicabilidade (R2= 0,011). Água ou chá, alimentos lácteos, frutas, legumes e verduras foram introduzidos precocemente com medianas menores que 180 dias. O aleitamento tende a diminuir e os alimentos tendem a aumentar o consumo de acordo com a idade da criança, com aumento exponencial do grupo “calorias vazias”. Conclusões: Conclui-se que mesmo com maioria das crianças amamentadas até um ano de vida, poucas estavam em AME e introduziram alimentos precocemente, não tendo resultado satisfatório frente ao preconizado pelas políticas públicas de alimentação e nutrição.

31
  • ADRIANA SOUZA DA SILVA ROCHA
  • QUALIDADE DA ATENÇÃO AO PRE-NATAL E PARTO NO RIO GRANDE DO NORTE: CHAMADA NEONATAL, 2010.

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • ANA TANIA LOPES SAMPAIO
  • LEOPOLDINA AUGUSTA SOUZA SEQUEIRA DE ANDRADE
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 12 déc. 2013


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  • Realizou-se um estudo de corte transversal, a partir de dados originários da pesquisa nacional “Chamada Neonatal, 2010”, cujo objetivo foi avaliar a qualidade da atenção ao pré-natal e parto oferecido às gestantes no Rio Grande do Norte (RN) segundo os critérios do Ministério da Saúde (MS). A amostra foi de 837 pares, mãe e filho menor de um ano, que responderam ao questionário nos 9 municípios prioritários para o Pacto para Redução da Mortalidade Infantil no estado. Foi realizada análise descritiva dos dados com elaboração de médias e frequências para amostras complexas (IC 95%). Nas análises chama atenção a baixa proporção de pré-natal adequado (4,8%), o predomínio do parcialmente adequado (50,2%) e 45% de inadequação. Entre os componentes de pré-natal mais prejudicados estão: realização e recebimento de exames em tempo adequado, recebimento de orientação sobre aleitamento materno e sobre o local de realização do parto e realização de exame de mamas. Com relação ao parto, a adequação observada não chegou a 1%. O maior percentual se encontra inadequado (56,9%), com adequação parcial atingindo 42,4%. Os critérios mais prejudicados foram: parto no local indicado, acompanhante para a mulher durante atendimento e período de espera para internamento. Mesmo assim, a opinião da gestante tanto em relação ao atendimento no pré-natal quanto no parto foi boa ou muito boa em mais de 80% das entrevistas. Percebe-se que, de modo geral, esse contexto ajuda a contribuir com a manutenção das taxas de mortalidade materna e infantil na região e que mesmo havendo melhora no acesso a rede de serviços, os gestores e os profissionais de saúde precisam ser melhores preparados para poderem oferecer o acompanhamento à gestante que preconiza o MS e seus programas e políticas.

32
  • IVANA MARIA ZACCARA CUNHA ARAUJO
  • Atividade biológica de células-tronco da polpa dental humana submetida à irradiação laser de baixa intensidade

  • Leader : CARLOS AUGUSTO GALVAO BARBOZA
  • MEMBRES DE LA BANQUE :
  • CARLOS AUGUSTO GALVAO BARBOZA
  • RUTHINEIA DIOGENES ALVES UCHOA LINS
  • ÁGUIDA CRISTINA GOMES HENRIQUES LEITÃO
  • Data: 18 déc. 2013


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  • O laser de baixa intensidade (LBI) tem sido utilizado na Odontologia com a finalidade de promover cicatrização e regeneração dos tecidos. A literatura mostra um efeito positivo do LBI na proliferação celular, porém pouco se sabe sobre a sua eficácia na proliferação de células-tronco dentais. O objetivo deste estudo foi avaliar o efeito da irradiação do LBI na atividade biológica de células-tronco da polpa de dente permanente (DPSCs). Extratos de polpa dental foram isolados de cinco terceiros molares hígidos removidos por indicação cirúrgica e/ou ortodôntica. Após a digestão enzimática, as células foram caracterizadas e cultivadas em meio de cultura αMEM suplementado com antibióticos e 15% de soro fetal bovino. No terceiro subcultivo, as células foram irradiadas com um laser diodo InGaAlP, utilizando-se duas diferentes densidades de energia (0,5 J/cm2 - 16 segundos e 1,0 J/cm² - 33 segundos), comprimento de onda de 660nm e potência de 30mW. Uma nova irradiação, utilizando os mesmos parâmetros, foi realizada 48 h após a primeira. Um grupo controle (não irradiado) foi mantido nas mesmas condições experimentais de cultivo. A fim de avaliar a proliferação celular, foram utilizados o método exclusão por Azul de Tripan e a atividade mitocondrial das células medida através do ensaio de MTT [brometo de 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazólio], nos intervalos de 24, 48, 72 e 96 h pós-irradiação. Nos mesmos intervalos foram avaliados os eventos do ciclo celular. Eventos relacionados à morte celular foram analisados por citometria de fluxo nos intervalos de 24 e 72 horas. Os dados das contagens celulares foram submetidos a testes estatísticos não paramétricos de Kruskal-Wallis e Mann-Whitney, considerando um intervalo de confiança de 95%. Os resultados mostraram que os dois grupos irradiados exibiram uma curva de proliferação mais ascendente, com diferença estatisticamente significante (p<0,05) em relação ao grupo controle nos intervalos de 72 e 96h, sem alterações consideráveis na viabilidade celular ao longo do experimento. A distribuição das células nas fases do ciclo celular foi coerente com células em proliferação nos três grupos. Conclui-se que, de acordo com a metodologia utilizada, um melhor efeito positivo sobre a proliferação in vitro de DPSC foi observado quando utilizado LBI com potência 30 mW, comprimento de onda 660nm e uma densidade de energia de 1,0 J/cm2.

2012
Thèses
1
  • FILIPE FERNANDES OLIVEIRA DANTAS
  • Prevalência e fatores associados aos sintomas osteomusculares em dentistas do município de Natal – RN.

  • Leader : KENIO COSTA DE LIMA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • KENIO COSTA DE LIMA
  • MARIA CHRISTINE WERBA SALDANHA
  • Data: 11 oct. 2012


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  • Os distúrbios osteomusculares são uma das mais importantes questões de saúde ocupacional relacionadas à saúde dos trabalhadores, especialmente, dentre os dentistas, nos quais têm sido encontradas altas prevalências de dores em diferentes regiões anatômicas do corpo relacionadas à sua atividade profissional. Nesse sentido, este trabalho teve como principal objetivo determinar a prevalência dos sintomas osteomusculares em dentistas, além de analisar esta prevalência em diferentes regiões anatômicas. Adicionalmente, foi verificado se existe associação entre a ocorrência dos sintomas com variáveis demográficas, antropométricas, ocupacionais, hábitos, estilo de vida, variáveis ergonômicas e estressoras do ambiente de trabalho em dentistas do município de Natal – RN. Para tanto, foi aplicado em 387 dentistas do município de Natal, à versão brasileira validada do Nordic Musculoskeletal Questionnaire, a fim de avaliar a presença dos distúrbios. Também foi utilizada a versão reduzida da escala de estresse no ambiente de trabalho, validada para a população brasileira, e um questionário apresentando itens relacionados à ergonomia na sala do dentista. Inicialmente foi realizada uma análise descritiva de todos os dados relativos às variáveis dependentes e independentes. Os dados relativos às variáveis dependentes (sintomas osteomusculares das várias regiões anatômicas) foram submetidos a uma análise fatorial exploratória, a fim de produzir novas variáveis dependentes fatoriais. A análise bivariada entre as variáveis dependentes fatoriais e as variáveis independentes foi conduzida através do teste estatístico qui-quadrado para o nível de significância de 5%. Dentre os principais resultados obtidos, observou-se uma alta prevalência de sintomas osteomusculares (86%). Considerando as regiões anatômicas analisadas, a região lombar teve a maior prevalência de sintomas (58,4%). Com relação às associações observadas, as variáveis relacionadas à exigência física do trabalho foram significativamente associadas com a ocorrência de sintomas osteomusculares, especialmente nas articulações ligadas ao tronco. No tocante as variáveis ergonômicas, apenas a inadequação ergonômica do armário odontológico se associou significativamente com as dores na região do tronco e no punho/mão/dedos. Já com relação às variáveis estressoras observou-se que tais variáveis não estiveram associadas com a ocorrência de sintomas osteomusculares. Nesse sentido, foi considerado como relevante o trabalho de estabilização segmentar lombar, o qual pode ser indicado como uma alternativa não medicamentosa para auxiliar na prevenção e na melhora dos principais sintomas de dores dos profissionais.

2
  • KÁSSIA DE CARVALHO DIAS
  • Estudo clínico comparativo entre duas técnicas de moldagem funcional em próteses parciais removíveis de extremidade livre. 

  • Leader : ADRIANA DA FONTE PORTO CARREIRO
  • MEMBRES DE LA BANQUE :
  • ADRIANA DA FONTE PORTO CARREIRO
  • CARLOS EDUARDO VERGANI
  • PATRICIA DOS SANTOS CALDERON
  • Data: 6 déc. 2012


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  • A literatura científica é carente de estudos clínicos que avaliem a eficiência de técnicas de moldagem funcional para arcos parcialmente desdentados. Objetivou-se realizar um ensaio clínico controlado não randomizado duplo-cego, para comparar a eficiência da técnica de moldagem funcional do modelo alterado (TMMA) com a técnica de moldagem funcional do modelo direto (TMD) em relação ao número de unidades oclusais dos dentes na instalação de novas próteses, a integridade da fibromucosa nas sessões de controle de 24 horas e a extensão da base de prótese. A amostra foi constituída por 51 pacientes, com média de idade de 58,96 anos, portadores de arco totalmente desdentado maxilar e classe I de Kennedy mandibular, de ambos os sexos, reabilitados nas clínicas do Departamento de Odontologia da UFRN, dividida em dois grupos: O grupo TMMA (n=29) e Grupo TMD (n=22). Foram verificados o número de unidades oclusais de dentes naturais e/ou artificiais, a integridade da fibromucosa no retorno programado de 24 horas e extensão da base da prótese. Para análise estatística do número de unidades oclusais e a técnica de moldagem foi utilizado o teste t; para verificar a associação entre a integridade da fibromucosa e a técnica, foi utilizado o teste qui-quadrado. O teste exato de Fisher foi usado para verificar a associação entre a extensão da base da prótese e a técnica. Não existiu diferença estatisticamente significativa entre os dois grupos, quanto à técnica de moldagem em relação ao número de unidades oclusais, a integridade da fibromucosa e a extensão da base da prótese. A técnica de moldagem funcional do modelo alterado não oferece vantagens significativas quando comparada a técnica do modelo direto, em relação à quantidade de número de unidades oclusais, a integridade da fibromucosa e extensão da base da prótese.

3
  • JANMILLE VALDIVINO DA SILVA
  • Associação das condições socioeconômicas e de serviços de saúde com as condições de saúde bucal das capitais brasileiras.

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • PAULO FRAZÃO
  • Data: 7 déc. 2012


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  • As iniquidades em saúde entre grupos e indivíduos, ou seja, aquelas desigualdades de saúde que além de sistemáticas e relevantes são também evitáveis, injustas e desnecessárias, são um dos traços mais marcantes da situação de saúde do Brasil. Modificações de indicadores da população brasileira nas últimas décadas expressam melhorias nas condições de vida do nosso país. No entanto, tamanha melhoria parece ainda polarizada entre aqueles grupos de melhor posição social. Não distante, a saúde bucal brasileira também sofre do mesmo fenômeno, onde encontramos maiores agravos à saúde bucal entre as classes socialmente desprivilegiadas. O presente estudo trata de um estudo ecológico que visa avaliar a relação das condições socioeconômicas, bem como de indicadores de serviços de saúde com as condições de saúde bucal nas capitais brasileiras, além de agrupá-las quanto a estas mesmas condições. Indicadores de saúde bucal foram coletados do Projeto SB Brasil 2010, enquanto que as variáveis socioeconômicas foram obtidas do Censo Brasileiro 2010. Análise de correlação de Person foi realizada entre os indicadores de saúde bucal e condições socioeconômicas e de serviços de saúde; análise de regressão linear múltipla foi realizada para a média CPO-D aos 12 anos e média de dentes perdidos das capitais brasileiras; análise de regressão logística foi feita com a população livres de cárie; e análise de agrupamento com as capitais finalizou o estudo. A muito se busca modelos explicativos das iniquidades em saúde bucal embasados nas condições de socioeconômicas e de serviços de saúde. No entanto tal tarefa é árdua, visto a complexidade da determinação do processo saúde-doença bucal.

4
  • POLIANA MEDEIROS CUNHA DANTAS
  • AVALIAÇÃO CLÍNICA E RADIOGRÁFICA DAS COMPLICAÇÕES TÉCNICAS EM PRÓTESES SOBRE IMPLANTE.

  • Leader : PATRICIA DOS SANTOS CALDERON
  • MEMBRES DE LA BANQUE :
  • PATRICIA DOS SANTOS CALDERON
  • ADRIANA DA FONTE PORTO CARREIRO
  • ANDRE ULISSES DANTAS BATISTA
  • Data: 13 déc. 2012


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  • Os critérios de avaliação dos casos tratados com implantes osseointegrados são baseados em testes clínicos e exames radiográficos. Nesse contexto, é importante a realização de pesquisas na determinação do prognóstico dos diferentes tipos de reabilitações protéticas e na determinação dos principais problemas que atingem este tipo de tratamento. Desta forma, o objetivo deste trabalho foi avaliar as condições protéticas de indivíduos reabilitados com implantes osseointegrados e próteses sobre implantes. Neste estudo transversal foram atendidos 153 pacientes, contabilizando uma amostra de 509 implantes. As falhas foram observadas através do exame clínico e radiográfico. Os resultados demonstraram que a fratura (0,2%), a perda (0,4%) e o afrouxamento dos parafusos (3,3%) foram as falhas menos frequentes. A fratura das estruturas como a resina (12,4%), porcelana (5,5%) e metálica (1,5%), a perda da resina que recobre o parafuso de fixação (23,8%) e a perda de retenção nas próteses overdentures (18,6%), tiveram uma ocorrência maior. A falha de adaptação, entre o pilar e o implante (6,9%) e principalmente entre a prótese e o pilar (25,4%) teve uma alta prevalência e, quando relacionada com outros parâmetros, demonstrou uma associação significativa, principalmente com a fixação do tipo cimentada (OR= 6,79). Pode-se concluir que para minimizar o aparecimento de falhas, protocolos devem ser observados desde o diagnóstico até o assentamento e controle das próteses sobre implantes, principalmente com relação aos passos técnicos da confecção da prótese e com o cuidado em avaliar radiograficamente a adaptação entre seus componentes.

5
  • GENYKLEA SILVA DE OLIVEIRA
  • DESIGUALDADE ESPACIAL DA MORTALIDADE NEONATAL NO BRASIL: 2006 a 2010.

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • RAFAEL DA SILVEIRA MOREIRA
  • Data: 17 déc. 2012


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  • Realizou-se um estudo de agregados espaciais com o objetivo de analisar a distribuição espacial da mortalidade neonatal e sua correlação com os fatores biológicos, socioeconômicos e de atenção à saúde materno-infantil nos estados brasileiros, no período de 2006 a 2010.  Foram construídos mapas temáticos e de correlação (LISA) para verificação de dependência espacial, assim como, modelos de regressão linear múltipla a fim de analisar a correlação da mortalidade neonatal e fatores relacionados. Verificou-se que não há autocorrelação espacial para mortalidade neonatal nos estados brasileiros (I = 0,002; p= 0,48). Na análise espacial bivariada a maioria das variáveis biológicas, socioeconômicas e de assistência à saúde materno-infantil esteve correlacionada (r >0,3, p<0,05) com a mortalidade neonatal – a taxa de mães com 35 anos ou mais, mães adolescentes, recém, nascidos com baixo peso ao nascer, leitos de UTI neonatal por nascidos vivos, mães com sete ou mais consultas de pré-natal, recém-nascidos de parto Cesário, renda domiciliar per capta, taxa de cobertura do PBF e escolaridade materna. Foi observada a formação de aglomerados com maiores taxas de mortalidade neonatal em estados do Norte e Nordeste, regiões com maiores números de mães adolescentes, taxas de renda domiciliar per capta baixa, menor realização de consultas de pré-natal e menor número de leitos de UTI Neonatal. O número de leitos de UTI Neonatal por nascido vivo foi à única variável que manteve efeito independente sobre a mortalidade neonatal após a regressão. Conclui-se que as desigualdades regionais das condições de vida e principalmente do acesso aos serviços de saúde à população materno-infantil contribuem para a distribuição desigual da mortalidade neonatal no território brasileiro.

6
  • MARINA CLARISSA BARROS DE MELO LIMA
  • A desigualdade espacial do Baixo Peso ao Nascer no Brasil

  • Leader : MARIA ANGELA FERNANDES FERREIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • RAFAEL DA SILVEIRA MOREIRA
  • Data: 17 déc. 2012


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  • Baixo peso ao nascer (menos de 2500g) é considerado fator de risco para a morbidade e mortalidade neonatal e infantil. No Brasil o fenômeno denominado paradoxo do baixo peso ao nascer, mostra os maiores percentuais de baixo peso nas regiões com melhor situação sócio-econômica. Entre as regiões brasileiras, mães de grupos socialmente desfavorecidos recebem assistência pré-natal de menor qualidade. Há uma contradição, existindo direitos universais a saúde aliados ao não acesso/utilização de serviços. Buscou-se conhecer a distribuição espacial das taxas de baixo peso ao nascer e sua correlação com os indicadores sociais e de serviços nos Estados brasileiros. Estudo ecológico, considerando os estados brasileiros, como unidades de análise de área. Utilizaram-se técnicas de análise espacial, com dados do SINASC (2009), IPEA e IBGE. Baixo peso ao nascer (BPN), variável dependente e as independentes: fatores relacionados à mãe, a assistência médico hospitalar e socioeconômicos. Construiu-se um mapa com as taxas de BPN por estado, para avaliar a dependência espacial utilizou-se o coeficiente de autocorrelação global de Moran. O índice de Moran local (LISA) permitiu identificar padrões a ocorrência de agrupamentos entre os polígonos. A análise bivariada LISA mostrou a correlação entre variável desfecho e demais variáveis. As maiores taxas de BPN se concentraram nos estados da região sul/sudeste, com autocorrelação espacial positiva e coeficiente global de Moran de 0,267, p= 0,02. A formação de clusters mostrou aglomerado do tipo alto-alto na região Sudeste e baixo-baixo para estados da região denominada Amazônia Legal.

7
  • SHEYLA CHRISTINNE LIRA MONTENEGRO
  • Condição Peri-implantar de pacientes reabilitados no serviço odontológico da Faculdade de Odontologia da UFRN

  • Leader : BRUNO CESAR DE VASCONCELOS GURGEL
  • MEMBRES DE LA BANQUE :
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • EULER MACIEL DANTAS
  • RENATO VASCONCELOS ALVES
  • Data: 18 déc. 2012


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  • A introdução dos implantes dentários osseointegrados como uma ferramenta na reabilitação oral de pacientes edêntulos e parcialmente edêntulos é uma realidade no cotidiano do cirurgião-dentista. Estudos reportam uma alta taxa de sucesso da utilização de implantes no tratamento reabilitador. Entretanto, outras investigações têm mostrado a perda desses implantes devido a infecções peri-implantares, como a mucosite e a peri-implantite. O objetivo deste trabalho foi avaliar a frequência da mucosite e peri-implantite bem como a frequência da doença periodontal em pacientes com implantes dentais em função. Foram examinados 155 indivíduos portadores de 525 implantes. Dentes e implantes foram avaliados por meio de sondagem periodontal, observando-se a profundidade de sondagem, retração gengival e nível de inserção clínica, bem como índices de placa visível (IPV) e sangramento gengival (ISG), grau de mobilidade e presença de supuração. Os dados foram armazenados em fichas clínicas e avaliados na estatística descritiva e inferencial. A idade média dos pacientes foi de 53,95 (±12,40) anos, sendo 80% do sexo feminino. As frequências da mucosite, peri-implantite e periodontite em indivíduos foram 54%, 28% e 60%, respectivamente. Dos 525 implantes avaliados, 39% tinham Mucosite, 15% peri-implantite e 46% saúde peri-implantar. Os testes Qui-quadrado de Pearson e Exato de Fischer mostraram que pacientes com doenças peri-implantares estão associadas com as doenças periodontais, uso de medicação, número de implantes, IPV, ISG e com o tempo em que a prótese está em função (p<0,05). Foram propostos dois modelos explicativos para a as doenças peri-implantares atráves da regressão binária logística. O primeiro modelo (saúde x doenças peri-implantares) mostrou que pacientes com doença periodontal, que usavam medicação, com próteses em função por mais de 3 anos e com mais que 2 implantes tem mais peri-implantite, sendo o modelo ajustado pela idade dos pacientes e o IPV. O segundo modelo (saúde/mucosite x peri-implantite) demonstrou que indivíduos com doença periodontal, mais de 15 dentes e mais de 2 implantes apresentavam mais doença peri-implantar. Os resultados sugerem que pacientes com doença periodontal, piores IPV e IS, maior número de implantes e dentes e um tempo de reabilitação prótetica maior que 3 anos tem mais doenças peri-implantares.

8
  • ANGÉLICA OLIVEIRA DE ASSIS
  • Avaliação Clínica da resposta do tratamento periodontal não cirúrgico (Full mouth Scalling and Root Planing) em pacientes diabéticos e não diabéticos

  • Leader : BRUNO CESAR DE VASCONCELOS GURGEL
  • MEMBRES DE LA BANQUE :
  • BRUNO CESAR DE VASCONCELOS GURGEL
  • DELANE MARIA REGO
  • RENATO VASCONCELOS ALVES
  • Data: 18 déc. 2012


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  • Tem sido demonstrado que o diabetes influencia no desenvolvimento e progressão da doença periodontal. Acredita-se ainda que há uma relação bi-direcional entre o Diabetes Mellito e a Doença Periodontal. Por isso, o tratamento periodontal pode responder de forma diferente em pacientes com e sem o quadro de diabetes. O objetivo desse estudo foi avaliar clinicamente o efeito da terapia periodontal não cirúrgica em pacientes com periodontite e diabetes mellito (grupo teste) e sem o quadro de diabetes (grupo controle). Para isso, realizou-se o tratamento periodontal não-cirúrgico FMSRP (Full mouth Scalling and Root Planing) e verificou-se os parâmetro clínicos periodontais (profundidade de sondagem, nível clínico de inserção, mobilidade, índice gengival e índice de placa) no início do estudo e após 3 meses. Na análise estatística, o paciente foi considerado como unidade de análise (p<0,05). Para as variáveis categóricas utilizou-se o teste de Fisher. Nas comparações inter-grupo, foi utilizado o Mann-Whitney Test e para comparações intra-grupo (baseline e três meses) utilizou-se o Teste de Wilcoxon. Participaram 26 pacientes no grupo controle e 14 no grupo teste. O índice de placa era 71,20% no início do estudo para o grupo teste e ficou 47,12% no fim; já no controle, os valores eram de 48,52% passando para 37,50%. E o índice gengival no grupo teste no baseline era 42,67 diminuindo para 26,81 e no grupo controle diminuiu de 41,36 para 30,62.  A profundidade de sondagem foi no grupo teste 2,71mm passando para 2,40mm; já no controle, os valores foram de 2,84mm diminuindo para 2,55mm. O grupo controle ganhou 0,34 mm de inserção e o grupo teste perdeu 0,44mm de inserção. A recessão gengival aumentou 0,33mm no grupo teste e 0,04mm no grupo controle após os 3 meses.  Houve diferença significativa inter-grupo para o índice de placa e gengival no baseline, também foi encontrado na recessão após 3 meses; já intra-grupo verificou-se diferença significativa para todas as variáveis, exceto para o nível clinico de inserção e mobilidade. Quando se categorizou a profundidade de sondagem em ≤3mm, >3 e≤6mm e >6mm, não foi encontrado diferença entre os grupos, mas verificou-se diferença significativa entre os períodos tanto para o grupo teste como para o controle. A hemoglobina glicada no grupo controle foi de 5,90% e no teste aumentou de 7,79% para 8,10%. Portanto, verifica-se que há uma melhora dos parâmetros clínicos periodontais em ambos os grupos, contudo não se verificou uma diferença significativa entre eles. Não obstante, o FMSRP promove um efeito benéfico em relação à condição de saúde periodontal, melhora dos parâmetros clínicos periodontais, em curto prazo (3 meses) tanto em indivíduos diabéticos como em não diabéticos, não sendo possível observar um melhor quadro glicêmico nos diabéticos. 

9
  • KERLISON PAULINO DE OLIVEIRA
  • Avaliação mecânica in vitro utilizando miniplacas quadradas e retangulares do sistema 2.0 mm em fraturas da região anterior de mandíbula

  • Leader : ADRIANO ROCHA GERMANO
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • JOSE SANDRO PEREIRA DA SILVA
  • SANDRA DE CÁSSIA SANTANA SARDINHA
  • Data: 18 déc. 2012


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  • O propósito deste estudo foi avaliar comparativamente a resistência mecânica de miniplacas quadradas e retangulares do sistema 2.0 mm, comparando-as à configuração padrão, com 2 miniplacas retas, na estabilização de fraturas na região anterior de mandíbula. Noventa réplicas de mandíbulas de poliuretano foram utilizadas no ensaio mecânico. As amostras foram divididas em 6 grupos com 3 métodos de fixação do sistema 2.0 mm. Os grupos 1, 2 e 3 apresentavam fraturas sinfisárias completas, caracterizadas pela separação linear entre os incisivos mediais, e os grupos 4, 5 e 6 apresentavam fraturas parassinfisárias completas com desenho oblíquo. Os grupos 1 e 4 foram representados  pelo método padrão, com 2 miniplacas retas, dispostas paralelamente entre si. Os grupos 2 e 5 tiveram as mandíbulas estabilizadas por meio de miniplacas quadradas e os grupos 3 e 6, pelas retangulares. Cada grupo foi submetido a um teste mecânico realizado por meio de uma máquina de ensaio universal, na velocidade de 10mm/minuto, recebendo carga vertical linear na região de primeiro molar esquerdo. Os valores da carga máxima e da carga com deslocamento pré-estabelecido em 5 mm foram obtidos e submetidos à análise estatística a partir do cálculo do intervalo de confiança de 95%. Os sistemas de fixação utilizando miniplacas quadradas (G2) e retangulares (G3) obtiveram resultados similares, sem diferenças estatisticamente significativas em relação à carga máxima e à carga no deslocamento de 5 mm, quando comparada à configuração padrão (G1), nas fraturas sinfisárias da mandíbula. Nas fraturas parassinfisárias, o método de fixação utilizando miniplacas quadradas (G5) obteve resultados sem diferenças estatisticamente significativas no que se refere à carga máxima e à carga no deslocamento de 5 mm, quando comparadas à configuração padrão (G4). O método de fixação utilizando as miniplacas retangulares (G6) obteve resultados inferiores, estatisticamente significantes, quando comparado à configuração padrão (G4) nas fraturas parassinfisárias. O comportamento mecânico dos métodos de fixação estudados foi similar, exceto nas fraturas parassinfisárias, quando se utilizaram as miniplacas com a configuração retangular. Os métodos de fixação utilizados apresentaram melhores resultados, com significância estatística, nas fraturas sinfisárias.

10
  • GLAUDÊNIA ALVES DE MOURA
  • Impacto do Trabalho entre Profissionais de Saúde Mental

  • Leader : LUIZ ROBERTO AUGUSTO NORO
  • MEMBRES DE LA BANQUE :
  • FERNANDO MUSSA ABUJAMRA AITH
  • LUIZ ROBERTO AUGUSTO NORO
  • MARIA ANGELA FERNANDES FERREIRA
  • Data: 19 déc. 2012


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  • A Reforma Psiquiátrica trouxe profundas modificações na assistência às pessoas acometidas por transtornos mentais e de comportamento. No Brasil, esse movimento transformador ficou conhecido como Luta Antimanicomial ou Movimento da Saúde Mental Coletiva. Nesse contexto, os trabalhadores de saúde mental desempenharam papéis decisivos de grande repercussão, atuando de forma impulsionadora do processo. Como serviços substitutivos aos hospitais psiquiátricos, foram criados os Centro de Atenção Psicossocial-CAPS. Essas instituições destinam-se ao acolhimento de pessoas com transtornos mentais, buscando integrá-las a um ambiente social, cultural e familiar; apoiando-as nas suas iniciativas e autonomias. Essa nova forma de cuidar exige dos profissionais um maior envolvimento com a clientela assistida. Sendo assim, é um fator considerável de influência na qualidade dos serviços, já que, a baixa satisfação com o trabalho e a sobrecarga sentida podem afetar o bem estar e a saúde dos profissionais interferindo na qualidade dos atendimentos prestados. Objetivo: Avaliar o impacto laboral sentido pelos profissionais de saúde, em virtude do trabalho diário com pessoas que apresentam distúrbios psiquiátricos.  Trata-se de uma pesquisa de campo, numa abordagem quantitativa, seccional, descritiva e aplicada. A coleta de dados ocorreu por meio da Escala de Avaliação do Impacto do Trabalho em Serviços de Saúde Mental (IMPACTO-BR) aplicada entre os profissionais de saúde Mental da cidade de Mossoró - RN. Participaram desse estudo 87 profissionais, maioria composta pelo sexo feminino, casado (a), assumiam cargo de nível superior, trabalhando em um único serviço, atuando na área a mais de seis anos, com idade entre 25 e 64 anos. Foi observado um baixo efeito de sobrecarga entre os profissionais pesquisados. O presente estudo apresentou resultados semelhantes a outros estudos realizados anteriormente em diferentes regiões do país, indicando baixo impacto do trabalho na saúde dos profissionais de saúde mental.

11
  • CLAUDIA CHRISTIANNE BARROS DE MELO MEDEIROS
  • Projeto pedagógico: abordagens  e  implicações  no âmbito da formação do Cirurgião Dentista

  • Leader : MARIA DO SOCORRO COSTA FEITOSA ALVES
  • MEMBRES DE LA BANQUE :
  • JOÃO BOSCO FILHO
  • LUIZ GONZAGA PONTES PESSOA
  • MARIA DO SOCORRO COSTA FEITOSA ALVES
  • Data: 19 déc. 2012


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  • Propostas de reorientação ao modelo de atenção à saúde no Brasil são indispensáveis diante da atual necessidade sanitária e dos desafios impostos pela sociedade.  Temas como estes surgem dentro das Instituições de Ensino Superior, na tentativa de delinear caminhos para enfrentamento destas demandas. O objetivo desse trabalho é analisar o Projeto Pedagógico (PP) do curso de Graduação em Odontologia da UFRN, em consonância com as Diretrizes Curriculares Nacionais (DCN), considerando a inserção do sujeito reflexivo, e a percepção dos alunos acerca das competências gerais estabelecidas no PP. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa da UFRN sob o nº 285/201. Trata-se de um estudo descritivo, realizado com 30 estudantes do curso de graduação em odontologia mediante a entrevista com situação problema, além do estudo dos planos de ensino das disciplinas. Os dados foram processados mediante o auxílio do software ALCESTE 4.9, por meio da classificação hierárquica descendente.   Diante dos resultados, concluímos que apesar do uso de metodologias ativas e tendências inovadoras, conforme registros obtidos, o curso de odontologia da UFRN, continua centrado no modelo flexneriano, enquanto que as DCN apontam  para  ampliação dos aspectos éticos e humanísticos formativos, indispensáveis  ao enfrentamento dos graves problemas de saúde contemporâneos.

12
  • ANTONIO WELHINGTON DA SILVA
  • AVALIAÇÃO DO PROGRAMA DE ATENÇÃO A SAÚDE DO TRABALHADOR: uma abordagem da atenção primaria

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • FERNANDO MUSSA ABUJAMRA AITH
  • LUIZ ROBERTO AUGUSTO NORO
  • Data: 19 déc. 2012


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  • A industrialização acelerada, vinda com a revolução industrial, provocou mudanças profundas no mundo do trabalho. Essas mudanças levaram para o meio das famílias os riscos do ambiente do trabalho, em um processo de domicilização do risco. Na busca de atender de forma integral a saúde dos trabalhadores o Brasil integra a Atenção à Saúde dos Trabalhadores à Atenção Básica, tendo a Estratégia de Saúde da Família como porta de entrada deste sistema. O estudo busca avaliar se as ações de atenção à saúde do trabalhador têm sido desenvolvidas na atenção básica, via Estratégia Saúde da Família. Trata-se de um estudo quantitativo, com uma abordagem metodológica avaliativa, privilegiando a avaliação normativa. Como público alvo, estão os profissionais da Equipe de Estratégia de Saúde da Família, nos municípios de Paus dos Ferros, Caicó, Mossoró e Natal, no estado do Rio Grande do Norte. A amostra é composta de 405 Profissionais (Médicos, Enfermeiros, Auxiliar/Técnico de Enfermagem e Agentes Comunitários de Saúde) em 87 Unidades de Saúde da Família dos 4 municípios. O instrumento de coleta utilizado é constituído de uma Lista de Verificação, a partir do Caderno de Atenção Básica nº 5 – Saúde da Família – Saúde do Trabalhador, do Ministério da Saúde. Analisaram-se os dados a partir de uma descrição das variáveis na forma de frequência percentual. Observou-se que os profissionais da Saúde da Família conhecem o programa de atenção à saúde do trabalhador, no entanto não conhecem o Caderno de Atenção Básica nº 5, que é um instrumento de orientação. Em consequência da não apropriação dos profissionais da ESF com a saúde do trabalhador estas ações não são realizadas, principalmente as ações de Vigilância em Saúde do Trabalhador e Educação em Saúde do Trabalhador.

13
  • PRYSCYLA PASCALLY TARGINO ARAUJO
  • Avaliação Clínica De Pacientes Submetidos À Colocação De Implantes Zigomáticos Pela Técnica De Stella & Warner.

  • Leader : ADRIANO ROCHA GERMANO
  • MEMBRES DE LA BANQUE :
  • ADRIANO ROCHA GERMANO
  • JOSE SANDRO PEREIRA DA SILVA
  • SANDRA DE CÁSSIA SANTANA SARDINHA
  • Data: 19 déc. 2012


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  • Este trabalho se propôs a avaliar pacientes submetidos à colocação de implantes zigomáticos pela técnica de Stella & Warner, considerando a sobrevivência dos implantes convencionais e zigomáticos, a saúde do seio maxilar e o nível de satisfação dos pacientes em relação à reabilitação oral. Foram avaliados 28 pacientes, onde 14 haviam recebido implantes zigomáticos e convencionais, encontrando-se reabilitados com próteses totais fixas implantossuportadas (grupo 1)  e 14 foram reabilitados somente com implantes convencionais e próteses totais fixas implantossuportadas (grupo 2). O estudo teve quatro fases, representadas pela avaliação radiográfica dos implantes (fase I), avaliação clínica (fase II), avaliação da saúde do seio maxilar (fase III) e aplicação de um questionário para mensurar a satisfação da reabilitação com prótese fixa total implanto-suportada (fase IV). O grupo 2 só foi submetido a fase IV, enquanto o grupo 1 participou de todas as etapas. Foram realizadas análises descritivas e estatísticas, tendo, esta última, utilizado o test t para amostras independentes na avaliação da fase IV. Os resultados demonstraram que a técnica de Stella & Warner mostrou-se efetiva, permitindo um elevado índice de sobrevivência dos implantes convencionais e zigomáticos (100%), considerando um período mínimo de acompanhamento de 15 meses e máximo de 53 meses após reabilitação protética. Não foram encontradas alterações patológicas nos tecidos periimplantares dos implantes convencionais e zigomáticos analisados. Os achados radiográficos mostraram níveis ósseos satisfatórios nos implantes convencionais das reabilitações orais com fixações zigomáticas e um bom posicionamento do ápice dos implantes zigomáticos em relação ao osso zigomático. A presença do implante zigomático não provocou sinusopatias e o teste t demonstrou um índice de satisfação inferior no grupo 1 quando comparado ao grupo 2. A colocação de implantes zigomáticos pela técnica de Stella & Warner mostrou ser uma técnica previsível, com alto índice de sobrevivência em pacientes com maxilas atróficas, sendo necessário um acompanhamento por longo prazo para confirmar os achados iniciais desse estudo.

14
  • ANDRÉ LUIZ BARBOSA DE LIMA
  • ATITUDES E CONHECIMENTO DOS CONSUMIDORES SOBRE OS ALIMENTOS IRRADIADOS: UM INQUÉRITO CONDUZIDO EM NATAL, BRASIL.

  • Leader : ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MEMBRES DE LA BANQUE :
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • MARIA ANGELA FERNANDES FERREIRA
  • FERNANDO MUSSA ABUJAMRA AITH
  • Data: 20 déc. 2012


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  • A confiança interpessoal entre o consumidor e os defensores de uma nova tecnologia como a irradiação de alimentos apresenta diversas interfaces nas ciências sociais e nas ciências da saúde. No Brasil, a tecnologia de irradiação de alimentos ainda é desconhecida da maioria da população e, portanto, suas atitudes são nulas uma vez que os sujeitos devem encontrar o objeto de atitude e responder de maneira avaliativa a ele com base afetiva, cognitiva ou comportamental. Assim, este trabalho abrange a avaliação das atitudes e conhecimento dos consumidores em relação aos alimentos irradiados em Natal, Brasil, utilizando-se de um questionário semiestruturado dimensionado em 16 solicitações de respostas de opiniões e conhecimentos. É uma pesquisa com delineamento seccional, cujo cálculo do tamanho da amostra foi considerado um grau de precisão , nível de significância de 5% e intervalo de confiança de 95%, com prevalência de  de consumidores que não conheciam ou não ouviram falar sobre alimentos irradiados, conforme estudo piloto ( ), determinando um total de 203 consumidores. Foram sorteados aleatoriamente 21 supermercados distribuídos espacialmente em todas as regiões administrativas da cidade de Natal. Na coleta de dados foram realizadas entrevistas e observação direta extensiva pelo entrevistador-pesquisador. O tratamento dos dados foram realizados a partir da sistematização dos dados obtidos a partir do instrumento de coleta que foram digitados e arquivados utilizando-se o Epi InfoTM 7 (versão 7.0.9.34), enquanto que o processamento e a análise estatística foram realizadas no Statistical Package for Social Sciences – SPSS, versão 20.0.0. A análise estatística incluiu a caracterização de sujeitos da pesquisa, utilizando-se o estudo das frequências das variáveis estudadas através do teste binomial para duas proporções e teste t de Student para igualdade das médias. O teste do Qui-quadrado ( ) de Pearson foi utilizado para testar a associação entre a variável “Você conhece ou ouviu falar sobre alimento irradiado?” e as variáveis sociodemográficas dos respondentes. Considerou-se um nível de significância . Nos resultados, do total de 203 respondentes acima de 20 anos de idade que participaram deste inquérito, 34,5% foram homens e 65,5% mulheres, de diferentes bairros e níveis sociais. Daqueles que costumam consultar os rótulos dos alimentos embalados (75,9%), 92,0% declararam que consultam a lista de ingredientes, mas apenas 13,4% destes disseram já ter detectado a frase “ALIMENTO TRATADO POR PROCESSO DE IRRADIAÇÃO” na lista de ingredientes. Apenas 23,2% dos respondentes conhecem ou ouviram falar sobre alimentos irradiados. Além disso, 94,6% disseram não saber qual era o símbolo utilizado no alimento irradiado e 89,7% não conheceram o símbolo Radura apresentado. A falta de conhecimento sobre alimentos irradiados pode interferir negativamente nas atitudes dos consumidores e as informações contidas nos rótulos parecem não ser suficientes para informar sobre os alimentos irradiados.

15
  • MATHEUS DE SOUSA MATA
  • Os investimentos em saúde, os fatores socioeconômicos e a Taxa de Mortalidade Infantil nos municípios brasileiros.

  • Leader : IRIS DO CEU CLARA COSTA
  • MEMBRES DE LA BANQUE :
  • IRIS DO CEU CLARA COSTA
  • ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
  • DAMIAO ERNANE DE SOUZA
  • Data: 21 déc. 2012


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  • A Mortalidade Infantil é um dos principais indicadores de saúde de um país, sendo utilizada também na comparação dos níveis de saúde entre diferentes países.    Este indicador está relacionado ao acesso aos serviços de saúde e às condições de vida da população.

          Este estudo tem por objetivo avaliar os fatores que influenciam as Taxas de Mortalidade Infantil (TMI), principalmente se os investimentos públicos em saúde se correlacionam com essa taxa.

          Trata-se de um estudo ecológico, de base de dados secundários, envolvendo os municípios brasileiros com mais de 80 mil habitantes, gerando um N=355. Inicialmente foi realizada uma análise de correlação entre as variáveis para a seleção daquelas que entrariam no modelo de Regressão Linear Múltipla.

          Dentre as variáveis do estudo, aquelas que apresentaram correlação estatística significativa com a TMI foram a assistência pré-natal, o rendimento mediano dos domicílios, a razão de renda entre os 10% mais ricos e os 40% mais pobres, a porcentagem de domicílios com saneamento e a participação dos investimentos em saúde no PIB dos municípios. Esta variável apresentou comportamento contrário ao esperado, pois quanto maior o investimento em saúde maior foi a TMI. Porém, não obteve relevância estatística no modelo de regressão proposto.

          Os demais indicadores de investimentos em saúde (percentual recursos próprios dos municípios aplicados em saúde e investimentos em saúde per capita) não apresentaram correlação significativa com as taxas de mortalidade infantil, sugerindo que os fatores socioeconômicos e a assistência pré-natal são fatores mais relevantes a serem considerados nas políticas voltadas à redução da TMI.

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