Dissertações/Teses

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2022
Descrição
  • TÁRCIO SADRAQUE GOMES AMORAS
  • SOBREVIDA, MORTALIDADE E PREDITORES DE DOENÇAS CARDIOVASCULARES E SUAS COMPLICAÇÕES RENAIS: ESTUDO RETROSPECTIVO EM UM CENTRO DE REFERÊNCIA NA AMAZÔNIA ORIENTAL

  • Orientador : JOAO SIMAO DE MELO NETO
  • Data: 05/10/2022
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  • Objetivo: Avaliar a sobrevida, preditores e mortalidade em indivíduos com Infarto Agudo do Miocárdio com Supradesnivelamento do Seguimento ST (IAMCSST) e Síndrome Cardiorrenal Tipo 1 (SCR1) de acordo com fatores sociodemográficos e clínicos na Amazônia Oriental. Método: Este é um estudo observacional, retrospectivo, de caso controle, com análises descritivas e inferenciais. Foram avaliadas duas populações de pacientes com IAMCSST (n = 683) e com Insufucuência Cardíaca Aguda (ICA) (n = 183) com idade> 18 anos internados no período de janeiro de 2017 a maio de 2021 em um hospital público referência em nefrologia e cardiologia. Os pacientes foram categorizados em dois grupos, na população com IAMCSST: os que sobreviveram (n = 646) e os que foram a óbito (n = 37); na população com ICA os com SCR1(n = 72) e os sem SCR1 (n = 111). Resultados: Os pacientes com IAMCSST que tiveram maior chance de mortalidade foram frequentemente os mais velhos (G1: 61,58 ± 10,74 anos; G2: 69,57 ± 9,02 anos; t = -4,492; P = 0,001), com classificações Killip III-IV (OR = 0,13; IC 95% = 0,02–0,71; P = 0,03) e com doenças como insuficiência cardíaca (OR = 0,07; IC 95% = 0,004–1,50; P = 0,168) ou insuficiência renal (OR = 0,03; IC 95% = 0,006– 0,16; P = 0,0001). Além disso, sexo feminino (taxa de risco = 2.073; IC 95% = 1.413–5.170), classificações Killip III-IV (taxa de risco = 4.041; IC 95% = 1.703–18.883) e a presença de insuficiência cardíaca (taxa de risco = 34,10; IC 95% = 4,41–263,68) ou insuficiência renal (hazard ratio = 14,27; IC 95% = 3,27–62,25) influenciaram na redução da sobrevida hospitalar. Já dos pacientes com ICA, 72 (39,3%) deles apresentaram SCR1, e 33 (16,6%) evoluíram com Insuficiência Renal Aguda (IRA) dialítica. Identificou-se prevalência da Insuficiência Renal Crônica (IRC) (p = 0,003), hipertensão não controlada (p = 0,005), não adesão alimentar/hídrica (p = 0,043), idade avançada (p = 0,004) e elevação da PA sistólica (p= 0,021) no grupo com SCR1. Dos fatores de descompensação que contribuíram para o agravamento da ICA, apenas a não adesão alimentar/hídrica foi considerada preditora para SCR1 (p = 0,003; OR = 81.45; IC95%: 4,38 – 1513,13). Estes fatores não foram considerados preditores de letalidade intra-hospitalar, sendo apenas identificado como fator a IRA dialítica nestes pacientes (p = 0,010; OR = 15,5; IC95%: 1,93 – 124,35). Conclusões: As análises feitas com indivíduos diagnosticados com as doenças cardiovasculares estudadas (IAMCST e ICA/SCR1), e fatores sociodemográficos e clínicos, forneceram resultados relevantes para a compreensão epidemiológica do comportamento das doenças no segmento populacional da Amazônia Orinetal. O que pode contribuir para gerar evidências, basear e fortalecer políticas públicas, reestruturar estratégias para a execução de serviços de saúde e promover assistência cardiológica de qualidade.

  • MARCIO VINICIUS DE GOUVEIA AFFONSO
  • CÂNCER DE BOCA E OROFARINGE: FATORES SOCIODEMOGRÁFICOS E
    ORGANIZACIONAIS DOS SERVIÇOS DE SAÚDE BUCAL ASSOCIADOS AO
    TEMPO PARA O INÍCIO DO TRATAMENTO E À MORTALIDADE

  • Data: 04/06/2022
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  • Objective: First, to investigate the association between sociodemographic and organizational
    factors of oral health services and mortality from oral and oropharyngeal cancer. Then, analyze
    the evolution of time to treatment initiation of these neoplasms, according to sociodemographic,
    socioeconomic, clinical and therapeutic factors. Method: Initially, an ecological study was
    designed that investigated deaths caused by oral and oropharyngeal cancer, from 2000 to 2019.
    Mortality rates were standardized and compared between age groups, sex and regions. The
    association between variables related to oral health services and mortality was analyzed with
    correlation tests. The survival analysis considered the race/ethnicity variable and included
    Kaplan-Meier estimates, Log Rank tests and Cox regression. Then, another ecological study
    was carried out with the time to treatment initiation as the study’ object, based on secondary
    data from the Hospital Cancer Records. To identify the association between time and the
    variables evaluated, Kruskal-Wallis and Wilcoxon tests were used. To assess the temporal
    trend, the Spearman correlation test was used. Results: As for mortality, rates increased with
    age and were higher in men. The South and Southeast regions had the highest rates for men,
    and the Northeast and Southeast regions for women. Men, black individuals and residents of
    the South Region were more associated with death. The correlation of oral health teams
    coverage was high and negative, while for the number of dental specialty centers and soft tissue
    biopsies, the correlation was high and positive. Regarding the time to start treatment, in both
    cancers there was a tendency to increase, longer intervals in individuals over 39 years of age,
    in individuals considered black, brown and indigenous, in those with a level of education < 8
    years, in residents of the North, Southeast and Northeast regions, in those in staging III and IV
    and in those submitted to radiotherapy first. Conclusions: Mortality and survival patterns of
    individuals with oral and oropharyngeal cancer are associated with sociodemographic factors
    such as sex, age, geographic region and race/ethnicity. Furthermore, preventive procedures
    have not been widely performed. Likewise, the time to treatment initiation is associated with
    sociodemographic, socioeconomic and clinical factors, it is suggested that due to technological
    advances in diagnosis and treatment, the organization of cancer network points and
    socioeconomic and geographic barriers, reflexes of the Social Determinants of Health.

  • RENANDA GISELLE SILVA BEZERRA
  • IMIGRAÇÃO E VULNERABILIDADES: PERSPECTIVA DA SITUAÇÃO DE SAÚDE E NUTRIÇÃO DOS INDÍGENAS VENEZUELANOS WARAO EM BELÉM/PARÁ/BRASIL

  • Orientador : HILTON PEREIRA DA SILVA
  • Data: 03/06/2022
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  • Impulsionados por múltiplos fatores (econômicos, políticos e ambientais), os processos migratórios têm marcado a história de diversos países. A crise na Venezuela vem impactando de forma significativa na subsistência de sua população, entre estes os indígenas da etnia Warao, que diante deste cenário de instabilidade, tem intensificado o deslocamento para os países fronteiriços, especialmente o Brasil, e se abrigando nas cidades locais como Belém-Pará. As repercussões desta transição refletem negativamente sobre a saúde desses indivíduos em situação de vulnerabilidade, inclusive, as relacionadas à alimentação e nutrição. Em uma revisão narrativa de literatura, este trabalho discute sobre a situação da migração e os determinantes de saúde dos imigrantes Warao e complementa, em um estudo de caso, a descrição da situação de saúde e nutrição de uma amostra dos indígenas Warao de um abrigo em Belém-Pará, a partir das informações obtidas em um relatório proveniente de uma ação estratégica de saúde da FUNPAPA. Os resultados mostram que os Warao apresentam diversos níveis de insegurança alimentar e risco nutricional, onde foi apontado que 83,3% dos homens e 60% das mulheres estavam com sobrepeso ou obesidade, e cerca de 50% das crianças de 0 a 9 anos de idade assim como jovens apresentaram atraso de crescimento. Este levantamento reforça o contexto de vulnerabilidade nesta área urbana, havendo, portanto, a necessidade de construção de políticas públicas e oferta de serviços mais adequados à essa população.

  • ARIANA SANTANA DA SILVA
  • EPIDEMIOLOGICAL PROFILE OF VISCERAL LEISHMANIOSIS IN THE STATE OF PARÁ

  • Data: 20/05/2022
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  • Visceral leishmaniasis is an emerging zoonosis with wide distribution in countries with tropical and subtropical climate. It is considered a disease neglected by the WHO and has a worldwide distribution, reaching about 50 to 90 thousand individuals per year. It has expanded and urbanized, and its transmission and expansion are associated with several factors. In Brazil, it has great relevance in public health, with high rates of incidence and lethality. Therefore, this study aims to describe the epidemiological profile of patients with Visceral Leishmaniasis in the state of Pará in the period from 2010 to 2019. It will be a described and retrospective study. The study will be developed from information contained in the database on the Diseases and Diseases Notification System (SINAN) provided by the Pará State Department of Public Health (SESPA) and by the Epidemiological Surveillance Center of the João de Barros Barreto Hospital. The inclusion criteria will be: all cases of VL notified with an Individual Notification Form (FNI) confirmed and closed at SINAN in the state of Pará in the period 2015-2019. And as an exclusion criterion: cases with incomplete Individual Notification Form for Visceral Leishmaniasis or with inconsistent data. This study will make it possible to add new knowledge about this pathology, analyze the triggering factors, the evolution, as well as generate results that can subsidize effective actions in public health to control and prevent the disea

  • BRENDA RAMOS SANTOS
  •  

    Factors Associated with Self-Reported Arterial Hypertension in Blacks in
    Brazil: Data from Vigitel 2018.

  • Orientador : NAIZA NAYLA BANDEIRA DE SA
  • Data: 09/05/2022
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  • Ethnic-racial inequalities have gained even greater space and importance in the development of
    different disease profiles as a result of current and sudden global episodes, so skin color or race
    has become a symbol of precarious health conditions, a situation portrayed as a problem of
    public health and high social inequalities in several countries. In view of this, the World Health
    Organization estimates that approximately 600 million individuals have systemic arterial
    hypertension and that 7.1 million deaths occur annually as a result of it. Therefore, when it
    comes to the black population, there is a higher prevalence of arterial hypertension in black
    individuals when compared to whites. The objective of the study was to identify the factors
    associated with arterial hypertension in black adults in Brazil, based on data from VIGITEL
    2018. This is a cross-sectional study, carried out using secondary data obtained from the Vigitel
    Brasil database. 2018: Black Population. The variables analyzed in the study were: age,
    schooling, marital status, family allowance, health status, possession of health insurance,
    alcohol abuse, smoking, physical inactivity, body mass index, hypertension, diabetes, drug
    treatment for hypertension, drug treatment for diabetes, recommended consumption of fruits
    and vegetables. The percentage of the total population and by sex was calculated. Subsequently,
    the prevalence of arterial hypertension was calculated for all variables, according to sex, using
    a significance level of 5% (p < 0.05), through the application of Pearson's chi-square test.
    Finally, Logistic Regression was applied using the Minitab program in version 21. The
    prevalence of arterial hypertension found in the black population studied was 24.13% (with a
    self-reported medical diagnosis). Person's chi-square test showed that the prevalence of arterial
    hypertension in the total population studied was higher in the age group from 18 to 29 years
    (61.2%), non-diabetics (69.3%) and people who undergo the drug treatment for diabetes
    (71.5%). In men, the prevalence of hypertension was higher in the age group of 60 years or
    older (58.9%) and with a self-reported diagnosis of diabetes (66.2%). In women, the prevalence

    of arterial hypertension was higher in the age group of 60 years or older (63.2%), with a self-
    reported diagnosis of diabetes (72%) and who undergo drug treatment for diabetes (75%).

    Through Logistic Regression, the variables associated with a protective factor for arterial
    hypertension were: female sex (12%), former smoker (44%), fruit consumption (26%) and
    having a health insurance plan (7.0%). As a risk factor for arterial hypertension, the associated
    variables were: alcohol consumption, physical inactivity, age group from 18 to 29 years
    (18.51%), education of 12 years or more of studies (1.47%), state single marital status (1.14%),
    very good health status (3.27%), low weight (5.53%), diabetes (6.70%) and no treatment for
    diabetes (1.65%). From this, it is noted that the black population needs policies and support to
    reduce social differences and for that it is necessary policies and affirmative actions, which
    make visible and respond to their needs. And make the single health system capable of assisting
    this population segment.

  • IVANA MARVAO MONTEIRO
  • FACTORS ASSOCIATED WITH MORTALITY OF PREGNANT WOMEN AND PUERPERA HOSPITALIZED BY COVID-19 IN BRAZIL
  • Orientador : NAIZA NAYLA BANDEIRA DE SA
  • Data: 04/05/2022
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  • In Brazil, the pandemic of COVID-19 has presented high incidence and mortality rates,
    placing the country in the first places in number of cases and deaths in the world. In the
    population of pregnant and postpartum women, mortality is possibly affected by
    characteristics inherent to physiological adaptations in the maternal organism, by the presence
    of comorbidities, and by delays in receiving adequate health care. The study aimed to analyze
    which are the risk factors associated with mortality by COVID-19 in women in the gravidic-
    puerperal cycle, compare the results between survivors and non-survivors, distributed
    between the years 2020 and 2021, and evaluate the spatial distribution of the number of
    deaths. Secondary analysis of the Influenza Epidemiological Surveillance Information System
    - SIVEP-Gripe database was performed. Pregnant and postpartum women hospitalized with a
    diagnosis of Severe Acute Respiratory Syndrome caused by COVID-19 and notified in the
    period from February 26, 2020 to July 25, 2021 were included. Demographic data, clinical
    characteristics, intensive care resource use, and and case outcomes (cure and death) were
    collected. Statistical analysis was performed using the Statistical Package for Social Science,
    version 21 software and the Whitney-Mann, Fisher, and Chi-square tests. A total of 1. 685
    deaths and multivariate logistic regression showed that for the obstetric population in Brazil
    the main risk factors for death caused by COVID-19 were (OR/ 95% CI) being young under
    the age of 35 years (1.03/ 0.98-1.05), being postpartum at the time of notification (2.46/ 1, 84-
    2.60), have obesity (1.42/ 1.11-1.83) as comorbidity, followed by cardiovascular disease
    (1.12/ 0.76-1.65) and diabetes (1.03/ 0.94-1.05), have been admitted to intensive care unit
    (2.13/ 1.56-2.90) with non-invasive (8.82/ 5.32 -14.61) and invasive (2.90/ 1.82-4.63)
    ventilation support. Being of the race/color white was shown to be a protective factor (0.58/
    0.34-0.99). The spatial distribution of deaths was concentrated in municipalities within 100
    km of the notifying unit (85.40%) and in the south-central region of Brazil (43.67%). Covid-
    19 mortality in the Brazilian obstetric population is affected by clinical characteristics, but
    social determinants and barriers to health care access also appear to play a role. There is an
    urgent need to strengthen containment measures targeting the obstetric population and ensure
    quality care throughout pregnancy and the puerperium.

  • PETTRA BLANCO LIRA MATOS
  • Condição socioeconômica e saúde bucal na Amazônia Legal

  • Data: 14/04/2022
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  • O objetivo do estudo foi descrever a relação de aspectos socioeconômicos e os
    indicadores de saúde bucal na Amazônia Legal. Trata-se de um estudo ecológico com
    dados secundários e variáveis correspondendo aos indicadores de saúde bucal do Pacto
    de Indicadores da Atenção Básica, Pacto pela Saúde, transição Pacto pela Saúde/COAP,
    Rol de Diretrizes, Objetivos, Metas e Indicadores e PMAQ-AB/3° ciclo, além do IDHM
    dos estados da Amazônia Legal. Foi utilizado o software SPSS versão 26.0 para análise
    das médias, valores mínimos e máximos e desvio padrão; ademais os indicadores foram
    analisados conforme as faixas de IDHM encontradas na região. Os resultados
    demonstraram que o desenvolvimento humano variou de muito baixo a alto entre os
    estados da região e com a maioria dos indicadores de saúde bucal não obtendo alcance de
    metas ou parâmetros estabelecidos pelo Ministério da Saúde. Conclui-se que os estados
    com menor desenvolvimento humano, apresentaram melhores desempenho; assim como
    há carência desses estudos na região da Amazônia Legal.

  • REGIANE PADILHA DOS SANTOS
  • KATUANA NA AMAZÔNIA: INSEGURANÇA ALIMENTAR EM QUILOMBOLAS MARAJOARAS

  • Orientador : MARIA DO SOCORRO CASTELO BRANCO DE OLIVEIRA BASTOS
  • Data: 01/04/2022
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  • Objetivo: Determinar a prevalência de (in)segurança alimentar e nutricional de comunidades quilombolas
    marajoaras no período anterior ao início da imunização para COVID- 19. Método: Trata-se de estudo
    transversal de base comunitária com abordagem familiar com amostra composta por 434 famílias,
    desenvolvido em 15 comunidades remanescentes de quilombos, localizadas no município de Salvaterra,
    ilha do Marajó-Pará. Foi realizado inquérito domiciliar para aplicação do questionário padronizado sobre
    dados sociodemográficos e o questionário da Escala Brasileira de Insegurança Alimentar (EBIA). Foi
    realizada a classificação em categorias segurança (S), insegurança leve (L), moderada (M) e grave (G), as
    categorias leve e moderada foram associadas, resultando em 3 categorias. Para verificar a associação entre
    as variáveis foi utilizado o teste de Qui-Quadrado de Pearson e teste Kruskal-Wallis. Resultados: Dentre
    as 434 famílias entrevistadas, 88,9% estavam em insegurança alimentar e nutricional. Foram associadas a
    insegurança alimentar de qualquer intensidade, o maior número de moradores na casa (S=3,0; L-M=4,0;
    G=4,0), presença membros com idade ≤ 18 anos (S=;43,8% L-M=72,3%; G=72,2%) , baixa renda familiar
    per capita (S=10,4%; L-M=23,1%; G=38,9%), estar no estrato econômico D/E (S=77,1%; L-M=93,4%;
    G=96,5%) , além de receber bolsa família (S=68,3%; L-M=68,6%; G=79,9%) ou auxílio COVID-19
    durante a pandemia (S=60,4%; L-M=67,8%; G=81,3%). O recebimento de aposentadoria foi associado
    com segurança alimentar (S=56,3%; L-M=24,8%; G=20,8%) e Conclusão: A prevalência de insegurança
    alimentar nas comunidades foi elevada, grave em 33,2%, moderada em 21,4% e leve 34,3%. Segurança
    ocorreu apenas para 11,1%.

2021
Descrição
  • LINDA CAROLINA FIMA DE MIRANDA
  • ENTRE REDES E NÓS: ANÁLISE DA OFERTA E ACESSO NO CAMPO DA SAÚDE MENTAL EM DOIS MUNICÍPIOS DO MARA

  • Orientador : PEDRO PAULO FREIRE PIANI
  • Data: 29/12/2021
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  • A pesquisa visa investigar a oferta e o acesso da Rede de Atenção Psicossocial (RAPS) no Arquipélago do Marajó a partir do CNES e seus desdobramentos nos processos de produção de saúde, a partir dos discursos de profissionais que atuam na Rede, nas cidades de Soure e Salvaterra, com destaque para a rede de saúde mental disponível na atualidade. Para a realização da pesquisa, foram empreendidas as seguintes etapas: identificar a oferta e o acesso à rede de Atenção Psicossocial (RAPS) nos municípios de Salvaterra e Soure, na Ilha do Marajó, a partir do Cadastro Nacional de Estabelecimentos de Saúde (CNES) ; e caracterizar os aspectos da Rede de Atenção em Saúde Mental na Ilha do Marajó, especificamente nas cidades de Soure e Salvaterra, a partir dos serviços ofertados, equipes disponíveis e fluxos de produção de saúde. A pesquisa baseou-se em metodologia documental a partir da base de dados secundária - DATASUS e IBGE , documentos oficiais e entrevistas com três profissionais que atuam no campo da saúde mental na rede local.


  • ADRIANNE PUREZA MACIEL
  • OVERWHEIGHT AND OBESITY PREVALENCE ASSESSMENT AND ITS ASSOCIATED FACTOS IN BRAZIL BASED ON DATA FROM DE 2019 NATIONAL HEALTH SURVEY.

  • Data: 21/12/2021
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  • Excess weight has increased, especially among people from developing countries, at a very fast pace, a worrying situation due to its direct and consolidated relationship with chronic non-communicable diseases (NCDs), which are responsible for the increase in morbidity rates and mortality around the world. Given this scenario, it is evident the need at a global level to create, implement and monitor public policies for the prevention and combat of what is already considered an epidemic. The objective of this study is to assess the prevalence of overweight and obesity and associated factors in Brazil based on data from the 2019 National Health Survey. This is an observational cross-sectional study with secondary data and a population composed of residents in private households surveyed, aged 18 or over, from all over Brazil. Socio-demographic data such as gender, age, census status and income will be used, as well as nutritional status, based on the calculation of the Body Mass Index (BMI) and information about the presence of NCDs such as hypertension, Diabetes Mellitus, hypercholesterolemia and Cardiovascular Diseases.

     

     

    Key-words:  Health Surveys; Overweight; Obesity; Noncommunicable Diseases.

  • THIANA PINHO ARAUJO
  • PRÓ-BREASTFEEDING ACTIONS WITHIN THE FRAMEWORK OF PRIMARY
    HEALTH CARE: DATA OF 2ND AND 3RD CICLOS OF PMAQ-AB

  • Data: 20/12/2021
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  • Primary health care (PHC) corresponds to a space favorable to the
    strengthening of breastfeeding and the health team should be able to recognize the
    multiple dimensions that permeate breastfeeding adherence and maintenance, which are
    biological, psychological, sociocultural and, even, political, appropriating the knowledge
    of the legislation to protect the practice, respecting it, monitoring its compliance and
    reporting possible irregularities. Thus, this research will aim to identify the prevalence of
    pro-breastfeeding actions among PHC teams, according to data from cycles 2 and 3 of 

    the Program for Improvement of Access and Quality of Primary Care (PIAQ-PC). With
    an evaluative nature and a quantitative approach, this work used public data from the
    evaluations of the PIAQ-PC, whose sample was constituted by the PHC teams
    throughout the national territory that joined the program in its 2nd and 3rd cycles and
    who participated in the external evaluation, more specifically in Module II, totaling
    29,778 and 37,350 groups, respectively. The variables of interest for this research were
    selected from the PIAQ-PC external evaluation instrument and are included in the sub-
    dimensions “Care for children from birth to 2 years of age” and “Health promotion”. For
    the descriptive analysis of relative and absolute frequencies, the Microsoft Excel® 2016
    program was used; the statistics were done through the application of the chi-square test
    in the SPSS version 21.0 program. The level of significance adopted was 5% and the
    Confidence Interval (CI) 95%.

  • AMANDA MENEZES MEDEIROS
  • ANALYSIS OF ACCESS TO ORAL HEALTH IN PRIMARY CARE IN BRAZIL

  • Orientador : NAIZA NAYLA BANDEIRA DE SA
  • Data: 10/12/2021
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  • With the many problems of oral health in the Brazilian population, it is necessary
    to understand the conditions of access to dental services in order to analyze the dynamics
    between the population and the oral health teams present in these services. The aim of this study was to identify access to oral health through data from the 3rd cycle of the PMAQ-AB. From the data obtained with the PMAQ-AB, in which an important indicator of dental access was monitored, the coverage of the first programmatic dental appointment was carried out, and data was collected regarding the service actions of the oral health teams working in the care primary health care, the population's main gateway to these services.

    The variables related to Module VI ± Interview with the professional of the Oral Health
    Team were used for the research. All external evaluation variables were stratified by the
    adequate and inadequate access indicator. Subsequently, regression analysis was
    performed using binomial logistic regression on the variables of each subdimension,
    defining a 95% confidence interval (CI) in all analyses, where the odds ratios were
    calculated in the crude and adjusted form, using a significance level of 5% (p < 0.05). The
    greatest chance of access is with teams that are well integrated with the primary care team
    to which they are linked and carry out planning, monitoring and evaluation actions, in
    addition to offering scheduled clinical care and spontaneous demand, demonstrating the
    coordination of care in the host and organized flow of users. Greater chances of access are
    found in the teams that provide emergency clinical care and prescribe medication
    prescriptions. Regarding the form of scheduling the first appointment, making
    appointments through the reception of the UBS and the ACS increase the chance of access.
    On the main flow to the host, the chance of access is reduced for users who arrive early
    and queue up. By identifying factors associated with access to dental services in PHC, it
    is possible to understand the need to implement and implement public policies aimed at
    improving the work processes of teams to ensure access for all to oral health services.

  • DELBANOR DE SOUZA CAMPOS
  • PREVALENCE OF REFRACTIVE ERRORS IN INDIGENOUS STUDENTS OF THE

    FEDERAL UNIVERVITY OF PARÁ (UFPA)

  • Data: 06/12/2021
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  • Objective: Indigenous eye health has not yet been studied systematically,
    implying a scarcity of data on refractive errors and their impact on the quality of life of
    these people. This study aims to identify the prevalence of refractive errors in indigenous
    students at UFPA, a disorder that would directly impact the performance of these
    individuals during the course, if not properly corrected. Method: This is a quantitative,
    cross-sectional and descriptive study, to be carried out in a private eye clinic, accredited
    by SUS, in Belém, Pará, in the Brazilian Amazon region. Indigenous students regularly
    enrolled in courses at UFPA, will be submitted to an ophthalmological examination, with
    visual acuity assessment with and without optical correction. Results: The 48 indigenous
    students had had the right and left eeyes evaluated. Emmetropia was present in the 7
    (14,6%) right eyes, 7 (14,6%) and in the 8(16,6%) left eyes. In this way, 41 (85,4%)
    right eyes and 40 (83,3%) left eyes had some refractive error. The refractive errors more
    prevalent in the right eyes were low with-the-rule astigmatism (34,3%), low myopia
    (28,3%) and oblique astigmatism (14,9%). In the left eyes, th more prevalent were low
    myopia (36,6%) and low with-the-rule astigmatism (35%). Conclusions: Predisposing
    factors for the higher prevalence of refractive errors in indigenous students, as well as
    for non-indigenous students and other population groups, are: higher educational level or
    years of study, living in urban areas, performing near work excessively, such read, using
    computers and smartphones; reduced time from outdoor activity.

  • LUCAS OLIVEIRA DA SILVA
  • Processo de Trabalho dos Núcleos Ampliados de Saúde da Família e Atenção Básica no Brasil

  • Data: 12/11/2021
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  • Este estudo teve como objetivo analisar o potencial preditor de determinados
    aspectos do processo de trabalho de equipes de NASF-AB sobre o desempenho destas.
    Tratou-se de um estudo transversal de abordagem quantitativa, utilizando dados
    secundários públicos, provenientes das respostas do módulo IV do 3º ciclo de avaliações
    externas do Programa de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ-
    AB) no Brasil. Em primeiro momento, foram calculadas frequências absolutas e relativas
    dos dados referentes às variáveis selecionadas para representar o processo de trabalho
    dos NASF-AB respondentes. Em seguida, as certificações recebidas pelas equipes foram
    divididas em dois grupos: Melhor desempenho (Ótimo, Muito bom e Bom) e Pior
    desempenho (Regular e Ruim). Por fim, foi realizada análise de regressão logística
    bivariada para verificar o potencial preditor de cada aspecto do processo de trabalho e
    atividades selecionadas em alcançar os melhores desempenhos. De 3960 equipes
    participantes do estudo, 71,3% alcançaram certificações classificadas como “Melhor
    Desempenho”. Equipes que refletiam sobre o próprio processo de trabalho, promoviam
    atividades de educação em saúde, educação permanente e vigilância em saúde, atendiam
    demanda espontânea, realizavam grupos terapêuticos e construíam projetos terapêuticos
    singulares apresentaram maiores chances de ter um melhor desempenho. Os mecanismos
    que levam ao aumento das chances precisam ser elucidados por meio de mais estudos.

  • LUCRECIA ALINE CABRAL FORMIGOSA
  • AVALIAÇÃO DAS AÇÕES DE CONTROLE DO CÂNCER DE COLO DE ÚTERO NO MUNICIPIO DE BELÉM

  • Data: 13/10/2021
  • Mostrar Resumo
  • O câncer de colo de útero (CCU) é considerado como problema de saúde pública por sua magnitude epidemiológica, especialmente na região norte do Brasil. Nesta perspectiva, o trabalho objetivou analisar as ações de rastreamento para controle ao câncer de colo de útero desenvolvidas no município de Belém. A pesquisa foi conduzida em duas fases: a primeira na qual foi realizada revisão integrativa sobre as políticas públicas voltadas para a promoção e prevenção do CCU, que incluiu a literatura publicada desde 2000, indexada nas bases de dados PUBMED, SciELO e BVS. A segunda fase contou com dois estudos de séries temporais que analisaram os indicadores de qualidade do rastreamento e o impacto das ações de rastreamento sobre as taxas de incidência e mortalidade do CCU em mulheres residentes no município de Belém, utilizando dados do Sistema de Informação do Câncer, Registro de Câncer de Base Populacional de Belém e do Sistema de Informações sobre Mortalidade. Os resultados revelaram que o programa de rastreamento na região apresenta elevado percentual de repetição anual do exame e baixos percentuais de captação de mulheres que nunca realizaram o exame, índice de positividade e representatividade da zona de transformação. A taxa de incidência ajustada para idade diminuiu de 18.65/100.000 em 1998, para 11.79/100.000 em 2017, enquanto que houve estabilidade das taxas de mortalidade no mesmo lapso temporal. O efeito dos esforços governamentais durante o período analisado pode ser visto no impacto positivo na incidência da doença, especialmente em mulheres mais jovens. A tendência da doença depende de estratégias abrangentes de prevenção e controle referentes à situação local e grupos de idade, com ênfase na organização do programa de rastreamento e na vacinação contra o HPV.

  • ATILA AUGUSTO CORDEIRO PEREIRA
  • WORK LINKS OF PRIMARY HEALTH CARE NURSES IN BRAZIL

  • Data: 06/10/2021
  • Mostrar Resumo
  • Introduction: The ultra-neoliberal agenda present in Brazil from the 1990s onwards posed great difficulties for municipal managers in hiring health professionals for PHC, forcing them to increasingly opt for large-scale outsourcing in the SUS. The variety of precarious links offered by outsourcing produces work overload, high turnover, impacts on the health of the worker and reduces the resolution of PHC. This study started from this problem and compared the data found by nurses interviewed in the 3rd cycle of the PMAQ-AB with the theoretical support of the labor sociologist Ricardo Antunes to obtain a more translucent analysis of the work of nursing in PHC in Brazil. Method: This is an evaluative, exploratory, descriptive research with a quantitative approach. Secondary microdata referring to the unfolding of the external evaluation research of the 3rd cycle of the PMAQ-AB were used. The survey was conducted in 2017 and 2018 and has national coverage. Data from teams interviewed only by nurses as key informants in the external evaluation were analyzed, Module II – Interview with the health professional, distributed by region as follows: North Region (2,846), Northeast (13,389), Midwest ( 2,508), Southeast (11,516) and South (5,112). Teams where the questionnaire was not applied and where the nurse was not the key respondent were excluded. Data debugging was performed using Microsoft Office Excel 2016 Software and then transported to SPSS Statistics software (v.20, IBM SPSS, Chicado IL). Results: With the exception of the North Region (33.70%), all other regions had the statutory civil servant as the main respondent: South (66.20%), Midwest (56.50%), Northeast (40.33 %), Southeast (36.69). Temporary contract for the public administration and temporary contract for service provision had important participation in the Northeast (29.51% and 19.33%) and Midwest (16.03% and 17.86%). CLT contract and CLT employee in the APS had more expression in the Southeast (23.54% and 8.27%) and the South (5.93% and 19.31%). There was a predominance of direct administration as a contracting agent of nurses in PHC, therefore, in the Southeast, the participation of workers hired by OSS and other types of links in PHC was expressive. Only 48.7% of the nurses in the survey entered via public examination. The lowest percentages were observed in the North Region (34.36%), Northeast (40.94%) and Southeast (44.88%). Only 26.3% of nurses interviewed in PHC have a career plan, the lowest percentages were in the Northeast (17.2%), North (18.6%) and Southeast (27.3%). Final Considerations: The data reveal a trend of retraction of stable bonds for nurses in Primary Health Care in Brazil and the rise of temporary bonds for commissioned positions, via the Consolidation of Labor Laws, among others that suggest a scenario of informality in these services. The new flexible relationships of work, working hours and remuneration, established by temporary contracts, without stability, without registration, in jobs inside or outside a physical space, announce what Ricardo Antunes calls the new morphology of work. This social phenomenon harmful to the SUS and to the nursing worker, produced in this phase of financialized capital, fulfills the role of self-worth of capital through the exploitation of a surplus workforce, not only in the private sector, but also in the state sphere. Breaking this logic requires a new morphology of forms of organization of nursing workers capable of stopping the ultra-neoliberal offensive and guaranteeing advances such as the regulation of the minimum wage and working hours for the category, social justice and democracy.

  • ROSILENE CUNHA DE OLIVEIRA
  • UMA ETNOGRAFIA NA REPÚBLICA TERAPÊUTICA DE
    PASSAGEM: A ressignificação de vivências de pessoas com transtornos
    mentais que tiveram um conflito com a lei.

  • Data: 31/08/2021
  • Mostrar Resumo
  • AS PESSOAS DIAGNOSTICADAS COM TRANSTORNOS MENTAIS SÃO
    ESTIGMATIZADAS PELAS MARCAS DA DISCRIMINAÇÃO, DA SEGREGAÇÃO E DO
    PRECONCEITO. ESSE CENÁRIO É INTENSIFICADO QUANDO ESSES INDIVÍDUOS
    ENTRAM EM CONFLITO COM A LEI. NESSE CONTEXTO, ESTA PESQUISA TEVE COMO
    OBJETIVO CONHECER COMO AS PESSOAS DIAGNOSTICADAS COM UM
    TRANSTORNO MENTAL RESSIGNIFICAM SUAS VIDAS APÓS O CUMPRIMENTO DE
    UMA MEDIDA DE SEGURANÇA, POR MEIO DA REINSERÇÃO SOCIAL, A PARTIR DE
    UMA ANÁLISE CRÍTICO-REFLEXIVA. NESTA PESQUISA FOI REALIZADA UMA
    ETNOGRAFIA NA REPÚBLICA TERAPÊUTICA DE PASSAGEM POR MEIO DE
    ENTREVISTAS COM QUATRO RESIDENTES E TRÊS PROFISSIONAIS, ALÉM DA
    OBSERVAÇÃO PARTICIPANTE NESSA INSTITUIÇÃO NO PERÍODO DE 28 DE AGOSTO
    DE 2018 A 13 DE DEZEMBRO DE 2019. A PESQUISA REVELOU QUE A MEDIDA DE
    SEGURANÇA É UM DISPOSITIVO DE SEGREGAÇÃO, ROMPIMENTO COM A
    REALIDADE E PERDA DE VÍNCULOS, IMPONDO A DESPERSONALIZAÇÃO DESSES
    INDIVÍDUOS, AOS QUAIS É NEGADO O DIREITO A EXPRESSAR-SE, O LIVRE-
    ARBÍTRIO, A DIGNIDADE, REAFIRMANDO O ESTIGMA QUE RECAI SOBRE ESSA
    POPULAÇÃO MARGINALIZADA.

  • ROSIANY AMARAL DA SILVA
  • PRÁTICA BIBLIOTERÁPICA NO AMBIENTE HOSPITALAR: contribuição para o cuidado humanizado em saúde

  • Orientador : PEDRO PAULO FREIRE PIANI
  • Data: 30/08/2021
  • Mostrar Resumo
  • Uma vez hospitalizado, o paciente passa por momentos de tensão emocional, os quais
    dificultam a sua recuperação. Trata-se de uma mudança na rotina, no ambiente físico e social,
    que afeta os seus afazeres diários. Inserida no contexto da humanização hospitalar, a terapia
    por meio da leitura tem por objetivos diminuir a sensação de isolamento, aliviar o estresse e as
    tensões diárias, ajudar a lidar com sentimentos de raiva, frustração e angústia, facilitar a
    socialização, estimular a criatividade e a imaginação, incentivar o hábito da leitura e
    proporcionar momentos de alegria, lazer e bem-estar. A biblioterapia é especialmente
    indicada para indivíduos de qualquer idade, que permanecerão hospitalizados por longo
    período de tempo, afastados de seu ambiente familiar. O objetivo desse estudo foi identificar e
    analisar as produções científicas publicadas e indexadas sobre a prática biblioterápica no
    ambiente hospitalar. Trata-se de uma revisão integrativa da literatura, com abordagem
    qualitativa, na qual delimitou-se a seguinte pergunta: quais as evidências científicas sobre a
    contribuição da biblioterapia para o cuidado humanizado em saúde? A busca dos dados foi
    feita nas bases BVS, Portal de Periódicos da Capes, SciELO e BRAPCI, valendo-se dos
    descritores: biblioterapia, pacientes internados, unidades hospitalares, humanização da
    assistência. Foram considerados os artigos publicados no período de 2005 a 2021. Após
    análise, as publicações selecionadas foram discutidas de acordo com quatro categorias: fonte
    de lazer, aprendizagem e informação; bem-estar físico, mental e emocional; melhora na
    comunicação e no relacionamento entre o paciente e a equipe multiprofissional e
    humanização do cuidado ao paciente. Os resultados evidenciaram os benefícios e a
    importância da prática biblioterapêutica desenvolvida com pacientes hospitalizados e seus
    acompanhantes. A biblioterapia funciona como atividade recreativa para esses sujeitos, mas
    também demonstrou ser fonte de conhecimento e aprendizagem. A contação de histórias é
    capaz de educar crianças, ensinar-lhes valores humanos, bem como promover a ampliação do
    universo cultural. Quando a biblioterapia se utiliza de jornais e revistas, permite a atualização
    do indivíduo acerca dos acontecimentos do mundo. A biblioterapia incentiva a leitura, prática
    que está diretamente ligada ao conhecimento, uma necessidade indispensável para
    humanização e o equilíbrio social. Foi observado que a biblioterapia proporciona bem-estar,
    uma vez que durante as sessões as pessoas deixam de lado suas preocupações, tiram o foco da
    doença e dos problemas que estão passando, compartilham seus sentimentos, passam a se
    socializar e se relacionar melhor com as pessoas e, principalmente, com a equipe
    multiprofissional. De modo geral, observa-se que a leitura auxilia positivamente na
    recuperação da saúde. Diante disso, fica a reflexão acerca da relevância da prática
    biblioterapêutica nos hospitais públicos, a qual deve ser vista como um complemento a outras
    terapias, que além de trabalhar a promoção à saúde de forma integral, também promove a
    humanização no ambiente hospitalar.

  • TAMARA FURTADO DA SILVA
  • DESAFIOS DAS DOENÇAS RARAS NO CONTEXTO AMAZÔNICO: itinerários
    terapêuticos de pacientes atendidos no Hospital Universitário Bettina Ferro de Souza

  • Data: 27/08/2021
  • Mostrar Resumo
  • Introdução: As doenças neuromusculares (DNM) são todas aquelas que afetam alguns
    dos componentes da unidade motora, ou seja, as células do corno anterior da medula

    espinhal, o nervo periférico, junção neuromuscular ou músculo. São considerados
    distúrbios complexos que podem ocorrer desde a infância até idade adulta, muitas vezes
    progressiva e multissistêmica, principalmente de origem genética, mas também
    adquirida. DNMs são considerados doenças raras, uma vez que não afetam mais de 1 em
    2.000 pessoas, embora sejam raras individualmente, quando englobadas, com mais de
    150 entidades diferentes, representam uma porcentagem significativa com o crescimento
    de doenças crônicas que afetam o ser humano. Objetivo: Descrever os principais
    desafios enfrentados no itinerário terapêutico percorrido por pacientes com doenças
    neuromusculares atendidos pelo Hospital Universitário Bettina Ferro de Souza (HUBFS)
    no percurso da rede de serviços de saúde. Metodologia: Trata-se de um estudo quanti-
    qualitativo realizado em duas etapas. A primeira consistiu em um estudo quantitativo-
    descritivo, retrospectivo, com a coleta dos dados por meio da busca ativa dos prontuários
    dos pacientes atendidos no Ambulatório de Doenças Neuromusculares localizado na
    UASCA/HUBFS/PA a fim de identificar o perfil sociodemográfico e clínico dos
    pacientes com doenças neuromusculares atendidos no hospital. Para essa etapa foram
    triados 47 prontuários. Os dados coletados foram transcritos para um banco de dados no
    programa Excel® e a análise de dados foi realizada por meio do programa Epi Info®. No
    intuito de descrever os achados, foi utilizada a estatística descritiva. Na segunda etapa
    desenvolveu-se um estudo do tipo qualitativo, de natureza exploratória, baseada na
    obtenção e análise de depoimentos. Foram realizadas 11 entrevistas semiestruturadas
    utilizando-se ferramentas digitais de comunicação (Google Meet) e, quando não foi
    possível devido à falta de acesso à rede de dados, a entrevista foi realizada via contato
    telefônico. A análise dos dados iniciou com a transcrição das entrevistas e,
    posteriormente, foi realizada a Análise Temática com uso do software NVivo 11.
    Resultados: No estudo 1 foi identificado o perfil dos pacientes com doenças
    neuromusculares no qual indicaram o predomínio do sexo masculino, maior frequência
    do diagnóstico clínico de Distrofia Muscular de Duchenne, faixa etária entre 10-14 anos,
    em sua maioria procedentes da Região Metropolitana de Belém, apresentando algum tipo
    de deformidade musculoesquelética. A maioria dos pacientes teve média de idade dos
    primeiros sinais e sintomas com 2,8 anos e idade média do diagnóstico com 7,6 anos. No

    estudo 2 foram entrevistadas 11 cuidadoras principais de crianças ou adolescentes com
    doença neuromuscular. Os resultados apontam as principais dificuldades encontradas
    durante o itinerário terapêutico na busca do diagnóstico e tratamento de condições
    consideradas raras. Dentre os desafios enfrentados foram relatados: dificuldade nas
    questões financeiras; necessidade de judicialização para acesso a exames e transporte;
    falta de articulação em diferentes pontos na rede de saúde; capacitação de profissionais
    de saúde para diagnóstico precoce ou encaminhamento precoce ao profissional
    especializado.

  • LEONARDO KEPLER DE OLIVEIRA LUCIO
  • ACE, CASP 8, CIRROSE, INFLAMAÇÃO, POLIMORFISMOS GENÉTICOS, HEPATITES VIRAIS CRÔNICAS.

  • Data: 27/08/2021
  • Mostrar Resumo
  • INTRODUCTION: In the development process of chronic liver diseases, regardless of the causative agent, there is a break in the balance between immune response and cell regeneration, characterized by aggression and necrosis. The condition of chronic hepatitis is characterized by liver inflammation for more than six months. Hepatitis B and C viruses are important etiological agents of chronic viral hepatitis, with unfavorable clinical-pathological evolution to cirrhosis and hepatocellular carcinoma. Genomic alterations in the patient are factors that can contribute to this worsening or unfavorable outcome. OBJECTIVE: To investigate the role of Insertion/Deletion-type (INDEL) functional variants in the CASP8 (rs3834129) and ACE (rs4646994) genes in the prediction of liver cirrhosis in patients with chronic hepatitis caused by viruses B and C. METHODOLOGY: Cross-sectional, retrospective study, observational and descriptive, carried out in patients from two reference hospitals for liver diseases. The studied sample consisted of 76 patients with chronic hepatitis, characterized by clinical alterations and liver function tests, divided into subgroups with and without liver cirrhosis, and submitted to detection of infection by virus B and virus C. Genotyping of genetic variants was performed by Polymerase Chain Reaction (PCR) Multiplex in an ABI Verity thermocycler (Applied Biosystems, Foster City, CA, USA). DNA amplification products were separated using the ABI PRISM 3130 Genetic Analyzer (Life Technologies). Ancestry analysis in the studied sample was performed with 48 informative ancestry markers (AIMs). Statistical analyzes were performed using the SPSS Program, v.25.0 (SPSS, Chicago, IL. USA). Group comparisons for categorical variables were tested two by two using Pearson's chi-square test, and Student's t test was applied for the analysis of continuous variables. The Mann-Whitney test was used to compare the ancestry index between samples. The effect of genetic variants on the risk of developing liver cirrhosis was assessed by logistic regression, controlled for age and smoking. All statistical tests were based on a two-tailed probability and a p-value ≤0.05 was considered. RESULTS. No association was observed between genotypic frequencies and markers of inflammation or degree of liver fibrosis in the studied sample. There was also no statistically significant difference between genotypes and advanced degrees of liver fibrosis in patients with chronic hepatitis. CONCLUSIONS: The results suggest that the Ace and Casp-8 SNPs evaluated in the study are not direct genetic markers of liver fibrosis in patients with HCV and HBV.

  • CARLA SUELLEN LISBOA CARNEIRO SEIFFERT
  • CONHECIMENTO DE MULHERES SOBRE O EXAME COLPOCITOLÓGICO PARA PREVENÇÃO DO CÂNCER DO COLO DO ÚTERO

  • Data: 23/08/2021
  • Mostrar Resumo
  • Introdução: O presente trabalho aborda a temática conhecimento de mulheres sobre o
    exame colpocitológico para prevenção do câncer do colo de útero, haja vista que esta
    temática apresenta alta incidência de casos no contexto paraense, sendo uma patologia
    passível de prevenção por meio do aprimoramento o conhecimento de mulheres no
    processo de autocuidado e adesão ao exame. Objetivo: apresenta-se como objetivo geral
    da pesquisa a análise das produções científicas disponíveis na literatura sobre o
    conhecimento das mulheres acerca do exame colpocitológico para prevenção do câncer
    do colo do útero. Tendo como objetivos específicos desvelar por meio da literatura o
    conhecimento das mulheres sobre o exame colpocitológico para prevenção do câncer do
    colo do útero; sintetizar as informações disponíveis na literatura que exponham o
    conhecimento das mulheres sobre o exame colpocitológico para prevenção do câncer do
    colo do útero. Método: Trata-se de um estudo exploratório e descritivo, de abordagem
    qualitativa do tipo Revisão Integrativa (RIL) que é composta por seis etapas: elaboração
    da pergunta de pesquisa; estabelecimentos das bases de dados, critérios para inclusão e
    exclusão de estudos, seleção dos dados, ou seja, definições das informações a serem
    extraídas dos artigos selecionados, avaliação dos estudos incluídos na revisão integrativa,
    interpretação dos resultados e síntese do conhecimento. Análise dos artigos que
    compõem a RIL se deu pela utilização do software IRAMUTEQ o qual por meio da
    análise de Similitude (Método de Reinert) resultando no perfil dos eixos temáticos a
    partir do resultado das frequências F das palavras e do Qui-quadrado x2, agrupando-os
    em um dendrograma de classificação hierárquica descendente. Resultados: foram
    selecionados 6 artigos após a aplicação dos filtros de busca de dados os quais fora artigos
    disponíveis gratuitamente e na integra, artigos nos idiomas português e inglês,
    publicados no período de 2018 – 2019, ou seja, artigos atualizados sobre o conhecimento
    de mulheres sobre o exame colpocitológico para prevenção do câncer do colo do útero,
    os quais se adequassem a temática da pesquisa, após a formulação do corpus dos artigos
    selecionados e a avaliação pelo IRAMUTEQ fora elencadas 5 classes discursivas as
    quais são, Educação em saúde na prevenção do câncer do colo do útero,
    desconhecimento da mulher sobre câncer do colo do útero e HPV, ampliação do acesso
    ao exame colpocitológico na prevenção do câncer do colo do útero, conhecimento e
    estímulo ao autocuidado feminino na prevenção do câncer do colo do útero, quais os
    principais fatores para não adesão ao exame colpocitológico pelas mulheres?
    Considerações finais: Conclui-se por meio dos dados identificados que é muito
    importante que as mulheres compreendam a importância da realização periódica do
    exame preventivo, pois por meio deste é possível identificar além de alterações
    inflamatórias da flora vaginal, lesões precursoras do câncer do colo do útero, sendo
    importante para aumentar o rastreamento de mulheres e atuar na prevenção, fortalecendo
    a atenção primária em saúde.

  • VALERIA NUNES DO AMARAL BARROS
  • FATORES SOCIODEMOGRÁFICOS E CLÍNICOS ASSOCIADOS AO
    ESTADO NUTRICIONAL DE PACIENTES COM FIBROSE CÍSTICA.

  • Data: 05/08/2021
  • Mostrar Resumo
  • A fibrose cística é uma doença genética autossômica recessiva caracterizada pela
    disfunção do gene Cystic Fibrosis Transmembrane Condutance Regulator, que codifica
    uma proteína reguladora de condutância transmembrana de cloro. A manutenção de um
    estado nutricional adequado é fundamental para o prognóstico e a qualidade de vida dos
    fibrocísticos, assim como melhores condições neonatais e sociodemográficas
    favoráveis. Por ser uma doença multissistêmica e de alto custo para o SUS, é
    imprescindível que haja políticas públicas para o controle da doença, aumentando o
    número de centros especializados em tratar desta doença. O objetivo de estudo foi
    verificar a associação entre o estado nutricional e os fatores sociodemográficos e
    clínicos dos pacientes com fibrose cística. Tratou-se de um estudo epidemiológico,
    observacional, transversal e analítico, realizado no ambulatório de fibrose cística do
    Hospital Universitário João de Barros Barreto, no período de outubro de 2019 a abril de
    2020. Foram coletados dados antropométricos, sociodemográficos e clínicos. Foram
    incluídos os pacientes com diagnóstico confirmado de FC. A estatística descritiva
    compreendeu a frequência das variáveis em valores absolutos e proporção. Comparou-
    se as frequências por meio teste qui-quadrado ou teste G. Aplicou-se o teste de
    regressão logística múltipla para analisar associação dos fatores clínicos com o estado
    nutricional. O tratamento estatístico foi realizado no Bioestat versão 5.1, adotando-se o
    nível de significância de 5%. Foram avaliados 105 pacientes, agrupados em quatro
    categorias: crianças (25,7%), adolescentes (40,9%), adultos (29,5%) e idosos (3,8%).
    Na amostra do estudo, a frequência de homens (59,0%) foi superior à de mulheres
    (40,9%), a maioria procedeu da região metropolitana de Belém (54,3%), prevaleceram
    significativamente a moradia com três a cinco residentes (76,2%), um a dois salários-
    mínimos de renda familiar mensal (76,2%), mais de oito anos de educação formal
    (78,1%) e ocupação do lar (42,8%). Sintoma respiratório (84,7%) foi a manifestação
    clínica presente de maneira significativa ao diagnóstico e 82,8% dos pacientes não
    apresentaram colonização pulmonar. O tipo de mutação mais prevalente foi a F508del
    (39,0%). A maioria usava terapia enzimática (72,4%). O uso de suplemento alimentar
    foi relatado por 51,4% e 73% apresentaram grau bom a excelente segundo o escore de
    Shwachman. Do total, 48,7% dos pacientes encontravam-se eutróficos e 35,2%
    apresentaram risco nutricional significativo em relação aos desnutridos, entretanto não
    houve diferença significativa entre pacientes com nutrição adequada e risco nutricional.
    A partir da análise de regressão logística múltipla, observou-se dois fatores associados
    ao estado nutricional, o escore de Shwachman-kulczycki (OR: 2,97; p = 0,0218) e o
    tratamento enzimático (OR: 0,28; p = 0,0238). Houve prevalência de eutrofia e risco
    nutricional entre os pacientes avaliados, o uso de terapia de reposição enzimática
    reduziu a chance de os pacientes apresentarem desnutrição e os pacientes com escore de
    shwachman- kulczycki mais baixo, tinham chance três vezes maior de estarem
    desnutridos.

  • LORENA DE OLIVEIRA GONÇALVES
  • The change in the perspective of the client/companion's view in relation to the quality of
    services provided at admission versus hospital discharge.

  • Data: 02/08/2021
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  • The quality in hospital health is in a constant process of improvement, being essential to qualify the management and efficiency of the services provided. Thus, the idea of improving the quality of the service in order to meet the expectations of customers and satisfy them has become a challenge for service providers. The study aims to evaluate the quality of services provided in a university hospital from the perspective of clients and/or companions. Observational, cross-sectional study of descriptive and inferential character, carried out through the use of the SERVICE QUALITY - SERVQUAL scale, widely tested, validated in Brazil and adapted to the health area, has five quality dimensions evaluated through a questionnaire. The data sample consisted of 50 questionnaires answered by clients and/or companions hospitalized in the surgical ward, performed in two stages: perspective (hospital admission) and perception (hospital discharge), in the period of approximately 3 months. The data were tabulated and submitted to statistical analysis. The results obtained show the change in the concept of  quality that occurred in the evaluation of the services provided in relation to admissionand hospital discharge. Some reported deficits, such as the need for the addition and training of health professionals, improvement of hospital structure, implementation and implementation of protocols.

  • NERYAM SILVA DOS SANTOS SERRA
  • SEGURANÇA DO PACIENTE: EVIDÊNCIAS DE ESTRATÉGIAS DE BOAS
    PRÁTICAS NO PREPARO E ADMINISTRAÇÃO DE MEDICAMENTOS

  • Data: 02/08/2021
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  • A partir da relevância social da temática “segurança medicamentosa” surge questões como o uso seguro
    de medicamentos, e o conhecimento dos profissionais envolvidos na terapia medicamentosa para evitar
    erros. A equipe de enfermagem é importante para segurança medicamentosa do paciente, já que está
    diretamente envolvida em todas as fases do processo medicamentoso, mais especificamente no preparo
    e administração de medicamentos. E por ser essa, uma atividade complexa, pode estar sujeita a erros
    no desenrolar das respectivas ações. Tais erros podem assumir dimensões significantes e impor custos
    relevantes ao sistema de saúde, pois podem causar efeitos deletérios como reações adversas, lesões
    temporárias e permanentes e até morte. Assim sendo, é importante que essa práxis seja abordada,
    observada e discutida, o que viabiliza a identificação dos possíveis erros, fatores relacionados, bem
    como a obtenção de subsídios para adoção de medidas de prevenção e controle, visando a excelência na
    assistência medicamentosa e a segurança do paciente. Trata-se de estudo de revisão integrativa, cujo
    buscou responder a seguinte questão norteadora: Quais são as evidências disponíveis na literatura sobre
    as estratégias de Enfermeiros para a promoção de boas práticas no preparo e administração de
    medicamentos? Dentre os nove estudos selecionados, a maioria das publicações utilizadas neste estudo
    foram publicadas em português e tiveram sua origem no Brasil, o que pode ser consequência das
    políticas públicas de saúde inclusas no Sistema Único de Saúde (SUS), dentre elas o Programa
    Nacional de Segurança do Paciente, cujo vem sendo intensamente institucionalizado, como ferramenta
    de gestão da qualidade, nos serviços de saúde mediante as metas de segurança do paciente . Quanto aos
    níveis de evidência verificou-se a predominância de estudos de nível VI com enfoque em estudos
    descritivos não experimentais diante da temática. No entanto, apesar disto pôde-se identificar dois
    estudos internacionais com nível de evidência III. Os principais resultados dos estudos selecionados
    nesta revisão foram organizados segundo similaridade semântica e deram origem a duas categorias
    temáticas: Estratégias voltadas para a promoção das boas práticas no preparo e administração de
    medicamentos; Experiências exitosas da utilização de tecnologias para mediar as boas práticas no
    preparo e administração de medicamentos. Evidenciamos que apesar de poucas produções
    identificadas, estratégias educativas e tecnologias em saúde estão sendo utilizadas e tendo significância
    para a promoção da meta de segurança do paciente, espera-se que esta revisão possa fomentar o
    desenvolvimento de novos estudos acerca da temática.

  • NATHERCIA DE FREITAS MEIRELLES
  • AUTISMO NO PARÁ: rede atual, situação e desafios

  • Data: 28/07/2021
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  • O direito à saúde foi garantido pela Constituição Federal de 1988 e materializado pela
    instituição do SUS, por meio da Lei Orgânica nº 8.080 de 1990. Em paralelo ao movimento da
    Constituinte tivemos o processo social complexo da Reforma Psiquiátrica, propondo mudanças
    na assistência mediante novos pressupostos técnicos e éticos, tendo validação jurídica e legal
    da nova ordem. O autismo ou TEA – Transtorno do Espectro do Autismo - como hoje é descrito,
    é caracterizado por uma tríade de comprometimentos em três áreas do desenvolvimento:
    interação social, comunicação e comportamentos restritos e estereotipados. Sua etiologia é
    multifatorial e muitos avanços já foram alcançados a partir de pesquisas, assim como, no
    aspecto das legislações. As conquistas foram importantes para o diagnóstico e tratamento
    precoce. O SUS com pouco mais de trinta anos também avançou para atender ao cuidado
    quanto ao que é proposto por diretrizes e princípios fundamentais da universalidade,
    integralidade e equidade, quando estabelece pela Portaria nº 4.279/2010 a organização de
    Redes de Atenção às Saúde. O objetivo desse estudo foi desenvolver uma pesquisa
    documental sobre organização da Rede de Atenção Psicossocial- RAPS e Rede de Cuidado à
    Pessoa com Deficiência no Estado do Pará, que atendem o público infanto-juvenil com TEA,
    utilizando-se como unidades de análise as Regiões de Saúde propostas pela SESPA, no Plano
    Estadual de Saúde. Foram analisadas legislações federal, estadual e municipal, dados
    disponíveis nos Planos Estadual e Municipal de Saúde e informações recebidas por e-mail do
    Ministério da Saúde. Foram realizadas análises descritivas dos pontos de atenção especializada
    e o georreferenciamento desses pontos. Os resultados levantados foram: a rede de cuidados a
    saúde no Pará está composta de 82 pontos de atenção especializada: 72 CAPS, 06 CER e 06
    Serviços de Reabilitação distribuídos nas 13 regiões de saúde do Estado. Dentre os CAPS , 03
    são CAPS Infanto-juvenil, dentre aos centro de Reabilitação 06 atendem na categoria de CER II
    nas modalidades física e intelectual, 02 na categoria de CER III nas modalidades física,
    intelectual e auditiva, 02 na categoria CER IV nas modalidades física, intelectual, visual e
    auditiva, 01 Serviço de reabilitação com a modalidade intelectual e 01 serviço de reabilitação
    com modalidade neurológica. Observou-se maior concentração dos serviços nas regiões mais
    populosas. Concluindo-se que os pontos de atenção especializada para a população infanto-
    juvenil têm distribuição não equânime, que reflete em vazios assistenciais.

  • MARIA LUIZA RODRIGUES DOS SANTOS
  • A Comunicação Interprofissional e sua Contribuição para Notificação de Eventos Adversos na Terapia Intensiva

  • Data: 28/07/2021
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  • A comunicação efetiva nas instituições de saúde é, atualmente, considerada
    uma importante ferramenta utilizada no cuidado e segurança do paciente. Devido a sua
    importância, é uma das ações dispostas dentro das competências do Comitê de
    Implementação do Programa Nacional de Segurança do Paciente, cuja criação surgiu em
    decorrência de estudos que evidenciaram elevada ocorrência de Eventos Adversos como
    consequência do cuidado ao paciente. O CTI é o local onde os riscos e danos acabam
    sendo mais graves pelas suas características próprias. É dentro do CTI que estão os
    pacientes mais críticos, e onde se utilizam equipamentos e tecnologias mais específicas,
    de monitoramento e de diagnóstico. Procedimentos invasivos são realizados,
    medicamentos específicos são mais utilizados. É, também, onde a equipe é mais
    diversificada nos seus saberes, experiências e competências, o que pode criar algumas
    dificuldades de comunicação entre os profissionais e, portanto, levar a equipe a não
    convergir para a segurança do paciente. Portanto, o objetivo desta pesquisa é avaliar a
    comunicação interprofissional e a notificação de eventos adversos como estratégia de
    promoção do cuidado e segurança do paciente. Consiste em um estudo descritivo
    exploratório, com abordagem qualitativa e quantitativa. A pesquisa foi segmentada em
    dois artigos que estão expostos ao decorrer do trabalho.

  • TAYANA CAROLINA SANTOS SILVA
  • PREVALENCE AND FACTORS ASSOCIATED WITH SARCOPENIA AND UNDERNUTRITION IN ELDERLY OUTPATIENTS

  • Data: 26/07/2021
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  • Sarcopenia is a progressive and generalised skeletal muscle disorder involving loss of muscle mass and strength. 
    It may affect individuals throughout aging and is associated with increased adverse health outcomes including 
    functional decline, frailty, poor quality of life and death. In this perspective, sarcopenia represents a major public
     health problem that can lead to high personal, social and financial burdens. This study aims to identify the main 
    factors associated to sarcopenia in the elderly attended at a teaching hospital. This is a case-control study with the 
    inclusion of 285 elderly patients, of both sexes, attended at the clinical nutrition ambulatory of the Hospital 
    Universitário João de Barros Barreto, in Belém, Pará. The case group will be composed of elderly with sarcopenia 
    (n = 95) and the control group by those without sarcopenia (n = 190). 
    Considering two controls for each case, which will be matched for age and gender. 
    The dependent variable will be sarcopenia, determined according to the criteria of the European Working Group 
    on Elderly Sarcopenia, which includes three parameters: muscle strength, assessed by hand grip strength <27 kg 
    for men and <16 kg for women; muscle mass, assessed by skeletal muscle mass index <7.0 kg / m² for men and <5.5 kg / m² for women; and physical performance, assessed by gait speed ≤ 0.8 m / s. And the independent variables will be represented by sociodemographic, behavioral, health and nutritional characteristics. Data will be recorded in a previously prepared data collection form. It is hoped that a study can contribute to broaden the knowledge on the subject and to serve to subsidize the implementation 
    of public policies aimed at health promotion for the elderly.
  • CHRISTINE ELIZABETH LOBATO BEMERGUY
  • Avaliação da Regulação de Acesso por Profissionais do Setor da Urgência e Emergência em Oftalmologia em um Hospital Universitário em Belém, PA

  • Data: 16/07/2021
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  • As urgências oftalmológicas são uma das principais causas de morbidade e
    cegueiras preveníveis, sendo um dos grandes problemas de saúde pública, devido a
    pouca oferta de serviço especializado. A regulação de acesso nos serviços
    oftalmológicos, quando estruturada com processos, protocolos e fluxos bem
    estabelecidos garante a organização do acesso, da oferta e da demanda dos serviços,
    oferecendo qualidade e resolutividade na assistência em tempo hábil a população. Para
    isso, buscou-se identificar a Regulação do acesso à assistência das Urgências e
    Emergências Oftalmológicas sob a ótica dos profissionais do setor em um Hospital
    Universitário em Belém, PA. Foi realizado um estudo quali-quantitativo e descritivo no
    setor de Oftalmologia do Hospital Universitário Bettina Ferro de Souza (HUBFS). Para
    coleta de dados, utilizou-se um questionário próprio com 15 perguntas abertas e fechadas
    aplicado com 29 profissionais atuantes no setor de Oftalmologia. A análise quantitativa
    foi realizada com base na estatística descritiva, cujos dados numéricos captados serão
    armazenados em bancos de dados numéricos do Microsoft Excel 2007. A maioria dos
    entrevistados tinha como tempo de atuação de 1 a 5 anos na Oftalmologia do HUBFS
    (75%). Segundo os entrevistados, 58,6% acredita que exista um espaço adequado para o
    atendimento do paciente em situação de U/E no HUBFS, 61,5% disseram desconhecer
    protocolo assistencial para o atendimento de um paciente em situação de U/E no
    HUBFS. Quanto a priorização do atendimento de U/E em relação aos pacientes
    ambulatoriais, 82,7% afirmou acontecer. E 71,4% afirmaram que o serviço de
    Oftalmologia tem acesso imediato ao Centro Cirúrgico em situações que necessitam de
    intervenção cirúrgica de U/E. A U/E Oftalmológicas atendidas no HUBFS, houve uma
    frequência de 30% com relatos de trauma. Quanto ao conhecimento dos profissionais
    sobre U/E Oftalmológicas no HUBFS, 68,9% acreditam que o HUBFS tem capacidade
    de atender U/E nas 24 horas, 82,7% desconhecem o número de U/E em Oftalmologia
    atendidos mensalmente no HUBFS e 51,7% tem conhecimento do fluxo externo de
    demanda do atendimento U/E Oftalmologia. Para os profissionais, as mudanças para a
    melhoria do atendimento da U/E Oftalmológicas devem ser nos aspectos de estrutura

    Pessoal e Física. Conclui-se que a maioria dos profissionais do setor reconhecem a
    importância das U/E Oftalmológicas para comunidade, desconhecem os protocolos,
    porém destacam a necessidade de melhorias nos processos de trabalho.

  • LUCIANA MARIA FURTADO FERNANDES
  • KNOWLEDGE OF HEALTH PROFESSIONALS AND ITS INFLUENCE PATIENT SAFETY: A SYSTEMATIC REVIEW
  • Data: 15/07/2021
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  • The World Health Organization (WHO) defines patient safety as reducing the risk and  unnecessary harm associated with health care to an acceptable minimum. Assess, using a  systematic review model, whether strategies for training health professionals have an impact  on patient safety. A systematic review study was carried out, without meta-analysis,  registered in PROSPERO under protocol number: CDR 42021258660. Data were collected  together in the databases, MEDLINE, LILACS, COCHRANE, EMBASE and CAPES  Periodicals. Upon selection of descriptors: health professionals, patient safety, knowledge.  4265 articles were identified, the final sample resulted in 05 articles written in English. 982  health professionals participated. This study presents a high risk of bias and a high level of  evidence, for this analysis we used the tools, Risk of Bias in Systematic Reviews (ROBIS  2.0) and the Grading System of Recommendations Assessment, Development and  Evaluation (GRADE), respectively. It demonstrates that in-service qualifications, training  and education have a positive impact on the knowledge of physicians, physiotherapists,  nurses and nursing technicians about patient safety. The limitation found was the lack of  RCTs and national studies. Finally, it appears that the investment in knowledge about patient  safety, for multidisciplinary health professionals, reflects on gains in safe acts for the health  institution, professionals and, above all, the population's health. 


  • MARLY DE SOUZA CAMPOS
  • PESQUISA DESCRITIVA-DIAGNÓSTICA DA INCORPORAÇÃO DE APARELHO DE RADIOGRAFIA EM HOSPITAL UNIVERSITÁRIO NO NORTE DO BRASIL COM RECURSO DE CAPITAL/INVESTIMENTO DO REHUF

  • Data: 05/07/2021
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  • A incorporação de tecnologia em saúde busca solucionar muitos problemas que
    se avolumam diariamente na gestão de hospitais universitários, entre os quais
    estruturas insuficientes no atendimento de média e alta complexidade, além de
    problemas de gestão, segurança estrutural (do paciente) e central de energia.
    Assim, o objetivo geral desta pesquisa foi descrever a incorporação de
    tecnologia em saúde no Programa Nacional de Reestruturação desenvolvido em
    Hospital Universitário no Norte do Brasil, no período de 2011 a 2018. De modo
    específico se buscou analisar a matriz da distribuição de recursos financeiros de
    capital do REHUF ao HU, e ainda avaliar o alcance das metas e os critérios de
    compra de equipamentos médico-hospitalares, os impactos da incorporação do
    aparelho de radiografia Axion Iconos MD 07721819º, a partir de preceitos da
    economia em saúde. Foi feita uma pesquisa bibliográfica, documental,
    descritiva, com abordagem quantitativa, focada na incorporação de tecnologia
    em saúde e na avaliação custo-efetividade. Os resultados apontaram, após
    analisar os valores da produção aprovada de média e alta complexidade, que no
    3º ano de uso do equipamento, o retorno do investimento foi efetivo,
    confirmando o impacto financeiro, social e ambiental positivo na receita do HU.

  • SHIRLEY VANIA BONFIM DOS SANTOS
  • Estratégias de promoção à saúde para trabalhadores de enfermagem durante a pandemia do COVID-19

  • Data: 05/07/2021
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  • A Covid-19 é uma doença de caráter global, uma pandemia, que para os profissionais de saúde, em especial enfermeiros, que lidam de forma intimista com pacientes, gerou uma série de problemas físicos e psicológicos, ao qual, inviabilizaram uma parte destes profissionais de efetuarem suas tarefas da forma a qual gostariam, o estudo desta problemáticas é de suma importância para gerar conteúdos que visem ajudar a conhecer os efeitos e minimizá-los mediante a estes profissionais. Com a sobrecarga de trabalho acometida pela equipe de saúde, em destaque a equipe de enfermagem e o triste cenário que aflige as unidades de saúde o qual esses profissionais estão presente diariamente com grande número de sofrimentos e demasiada de perdas de paciente por conta da pandemia do coronavírus, muitos tendo que isolar-se da própria família para não correr o risco de contamina-las, pois sabem que estão em contato direto com o vírus, sendo esse de fácil contagio, vem afetando a rotina e a vida dos mesmos. Trata-se de estudo de revisão integrativa que tem por escopo caracterizar as evidências disponíveis na literatura sobre as estratégias de contenção do acometimento da saúde dos trabalhadores de Enfermagem durante a pandemia do Covid-19, para tanto seguiram-se as fases seleção da pergunta de pesquisa; definição dos critérios de inclusão e exclusão de estudos e seleção da amostra; estudos selecionados; considerando as características; análise crítica dos achados; interpretação dos resultados e reportar, de forma clara, a evidência identificada. Foram selecionados seis (n=6) estudos, dentre os quais cinco foram produzidos no Brasil e publicados em periódicos nacionais, apenas um artigo encontrado foi de origem internacional, quanto aos níveis de evidência, todos os artigos inclusos nesta revisão foram classificados com nível de evidencia V, por possuírem a abordagem descritiva como método. Para a discussão dos resultados foram criadas as categorias de análise de conteúdo: Estratégias utilizadas para garantir a seguridade física de trabalhadores de enfermagem durante a pandemia do COVID-19; Estratégias utilizadas para garantir a seguridade psicológica de trabalhadores de enfermagem durante a pandemia do COVID19. Os estudos incluídos nessa revisão vêm a caracterizar as dificuldades encontradas por enfermeiros no cenário da pandemia, bem como as estratégias adotas por organizações (a exemplo de sindicatos), das instituições hospitalares, ou até mesmo da sensibilidade de outros profissionais integrantes da equipe multiprofissional, para o cuidado físico e psicológico da equipe de enfermagem. Espera-se que os resultados deste estudo venham a contribuir com a reflexão, reprodução e com o estímulo destas estratégias e de novos estudos que abordem a cultura da saúde do trabalhador.

  • RUTH HELENA LOPES RODRIGUES
  • INTERVENÇÕES EDUCATIVAS DESENVOLVIDAS POR ENFERMEIROS PARA PESSOAS COM DIABETES MELLITUS

  • Data: 05/07/2021
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  • O diabetes é uma condição clínica definida como um grupo de doenças metabólicas caracterizadas por hiperglicemia resultante de defeitos na secreção ou na ação da insulina. A nível mundial o diabetes tem prevalência entre 8,8% e 14,2%, com expectativa de aumento nos próximos anos, enquanto no Brasil apresentou aumento na prevalência, que passou de 5,5% para 7,4%, especialmente entre mulheres e pessoas adultas com 65 anos ou mais. Os pacientes com diabetes Mellitus necessitam de cuidados de saúde especializados por se tratar de doentes crônicos, com propensão a desenvolvimento de complicações da doença, a baixa escolaridade, a prevalência desta doença em pessoas com idade maior que 40 anos, bem como a associação do diabetes com outras comorbidades, são fatores primordiais para o desenvolvimento de complicações do diabetes, por conta das dificuldades que este público apresenta em realizar e compreender as ações de autocuidado em relação ao controle do diabetes. Nesse sentido é de fundamental importância a atuação do profissional de Enfermagem para o empoderamento dessas pessoas no diz respeito ao desenvolvimento de práticas de promoção e prevenção de complicações para a melhoria da qualidade de vida, e principalmente para a adaptação, reabilitação e enfrentamento destes pacientes diante da doença e das novas condições de vida mediante ao desenvolvimento de complicações. Trata-se de estudo de revisão integrativa que tem por escopo resumir as pesquisas já realizadas sobre as intervenções e tecnologias educativas desenvolvidas por enfermeiros para pessoas com diabetes Mellitus, para tanto buscou-se utilizar a estratégia PICO, dessa maneira, esse estudo buscou responder a seguinte questão norteadora: Quais são as evidências disponíveis na literatura sobre as intervenções e tecnologias educativas desenvolvidas por enfermeiros para a pessoa com diabetes Mellitus? Para a busca das evidências científicas utilizou-se os descritores: “Diabetes Mellitus” (em inglês: “Diabetes Mellitus”; em espanhol: “Diabetes Mellitus”); “Cuidados de Enfermagem” (em inglês: “Nursing Care”, em espanhol: “Atención de Enfermería”), “Educação de Pacientes como assunto” (em inglês: “Patient Education as Topic”, “em espanhol: “Educación del Paciente como Asunto”). O período temporal de busca definido foi de artigos publicados no período de 2017 a 2020. As buscas ocorreram nas seguintes bases de dados que são Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS); Medical Literature Analysis and Retrieval Sisten On-line (MedLine)/ PubMed (via National Library of Medicine); SCielo e BDENF. Dez estudos foram incluídos nesta revisão, estes foram compreendidos no período de 2016 a 2020, a maioria das publicações utilizadas neste estudo (n=6) foi publicado em português e teve sua origem no Brasil, o que demonstra certa fragilidade e lacuna na publicação internacional em relação à temática. Quanto aos níveis de evidência verificou-se a predominância de estudos de nível V com enfoque em estudos descritivos não experimentais diante da temática. No entanto, apesar disto pôde-se identificar um estudo nacional com nível de evidência III. Os principais resultados dos estudos selecionados nesta revisão foram organizados segundo similaridade semântica e derem origem a duas categorias temáticas: Experiências educativas exitosas voltadas a pessoas com diabetes; Recursos tecnológicos utilizados para mediar o processo educativo de pessoas com diabetes. A revisão das produções acerca da temática evidenciou que os estudos desenvolvidos por enfermeiros sobre a educação do paciente diabético como tema de pesquisa, ainda é pouco explorada em níveis de maior evidência científica. Necessitando de aprofundamento nos métodos de pesquisa para as produções desenvolvidas com esta temática. Um dos pontos positivos encontrados nesta revisão, é o fato de que as produções nacionais foram predominantesneste estudo, o que pode ser justificado pelo cuidado dessas pessoas ser instituído pelas políticas públicas de atenção à saúde do idoso e pela instituição do programa HIPERDIA no âmbito da Atenção Primária do Sistema Único de Saúde (SUS) brasileiro. Como contribuições para a pesquisa em enfermagem e em saúde pública espera-se que esta revisão integrativa, venha a embasar futuros estudos que abordem a proposição de atividades e de tecnologias educativas voltas para o cuidado de pessoas com diabetes Mellitus e principalmente para fundamentação da prática educativa e clínica de enfermeiros para a realização de ações de promoção, prevenção e da instituição de políticas públicas para a minimização das complicações advindas do diabetes Mellitus.

  • GEISA FERNANDA MELO PIMENTEL
  • Ações educativas e preventivas de enfermeiros à pessoa submetida ao exame de colonoscopia

  • Data: 05/07/2021
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  • As doenças gastrointestinais se desenvolvem como resultado de anormalidades dentro ou fora do intestino, cuja gravidade pode variar de distúrbios que causam sintomas leves e nenhuma morbidade de longa duração, até transtornos com sintomas incontroláveis e/ou prognósticos desfavoráveis. Para o diagnóstico das patologias do aparelho digestivo, utilizam-se diversos tipos de exames, entre eles, a colonoscopia. A colonoscopia na prática clínica reformulou a abordagem diagnóstica para as patologias colorretais, assim como possibilitou procedimentos terapêuticos endoscópicos. Os profissionais de enfermagem são atores de fundamentais para o exame de colonoscopia, uma vez que deve-se garantir um preparo de cólon numa condição ótima, a fim de que haja agilidade no diagnóstico de doenças do sistema digestório identificáveis através do exame. Por outro lado, para a saúde coletiva, esse papel se torna relevante ao ponto que possibilita, o diagnóstico precoce, tratamento e acompanhamento de doenças graves como o câncer colorretal, por meio de ações preventivas e educativas em saúde, além de cuidados de enfermagem nos exames de colonoscopia. Trata-se de estudo de revisão integrativa, o qual buscou responder à questão norteadora: Quais são as evidências disponíveis na literatura sobre as ações educativas e preventivas de enfermagem ao paciente submetido a colonoscopia? Foram selecionados sete estudos para compor a revisão, dos quais cinco (n=5) foram publicados na língua inglesa, o que demonstra certa fragilidade e lacuna na publicação nacional em relação à temática. Quanto aos níveis de evidência verificou-se uma disparidade entre os estudos desenvolvidos por enfermeiros estrangeiros e enfermeiros brasileiros, onde a produção nacional acerca do tema ainda está centrada na realização de estudos com evidências mais baixas (estudos de nível VI) com enfoque em estudos descritivos não experimentais diante da temática. Já quanto aos estudos internacionais conseguimos identificar a predominância de estudos com maiores níveis de evidência (um estudo com nível I e quatro estudos com nível II). os principais resultados dos estudos selecionados nesta revisão foram organizados segundo similaridade semântica e derem origem a três categorias temáticas, apresentadas a seguir: Fatores a serem considerados para o Planejamento da Assistência de Enfermagem à Pessoa Submetida ao Exame de Colonoscopia; Ações Educativas de Enfermeiros à Pessoa Submetida ao Exame de Colonoscopia; Atuação de Enfermeiros em Programas de Rastreio de Câncer Colorretal. Espera-se que os resultados desta revisão venham a contribuir com a reflexão da atuação de enfermeiros nos setores de diagnóstico por imagem, principalmente daqueles que lidam com a vídeo colonoscopia, a fim de que incorporem, reproduzam e/ou desenvolvam ações educativas, as tecnologias, novas abordagens ao usuário, e principalmente, venha a pôr em evidência a necessidade de discussão científica sobre a ampliação do papel de Enfermeiros na prevenção do CCR.

  • RAISSA TEREZA CASSEB OLIVEIRA
  • Influência de fatores sociais, demográficos e clínicos em nascidos vivos com espinha bífida no Brasil: um estudo ecológico de 21 anos

  • Data: 21/06/2021
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  • Introdução: A espinha bífida é um defeito congênito que ocorre quando os ossos da coluna não se formam completamente, resultando em uma abertura na região posterior da coluna, geralmente no final da coluna (região sacral). No Brasil, não existem estudos abrangentes que descrevam a associação de características sociais, demográficas e clínicas em relação à espinha bífida.
    Objetivos: Este estudo visa verificar possíveis associações de fatores sociodemográficos e clínicos em nascidos vivos com espinha bífida.
    Delineamento e Métodos: Foi realizado um estudo analítico (descritivo e inferencial), ecológico e retrospectivo com base em dados secundários de 11.308 nascidos vivos com espinha bífida registrados no Sistema de Informação de Nascidos Vivos (SINASC) no Brasil de 1999 a 2019. Dados sócio-demográficos os fatores analisados foram a idade, escolaridade, estado civil das mães e a região geográfica. Os fatores clínicos analisados foram a duração, o tempo de gestação, o peso ao nascer e o número de atendimentos pré-natais.
    Resultados: Há um aumento no número de casos de espinha bífida nos últimos anos no Brasil com variação percentual anual de 3,52%. Porém, no período de 2005: 2009 apresentou redução de nascidos vivos com espinha bífida. Os estados com maior incidência foram: Rondônia, Rio Grande do Norte, Pernambuco, Sergipe, São Paulo, Rio Grande do Sul e Mato Grosso. Porém, nas unidades da federação a maior incidência foi nas regiões Sul (São Paulo) e Sudeste (Rio Grande do Sul). O risco aumentou em mães nascidas após 1980, com idade superior a 30 anos e alto nível de escolaridade. O risco aumentou em nascidos vivos: brancos e negros, gravidez dupla e peso corporal inferior a 3.000 gramas. A ausência do pré-natal resultou em maior incidência.
    Conclusão: Assim, os fatores sociodemográficos e clínicos apresentam características específicas que podem predizer Espinha bífida em recém-nascidos no Brasil.

  • SÂMELA STEFANE CORREA GALVÃO
  • ACCESS TO PRIMARY HEALTH CARE UNDER THE PERCEPTION OF USER RIBEIRINHO OF THE AMAZON

  • Data: 15/06/2021
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  • The study aimed to understand the perception of the riverside user who lives on the banks of rivers in a municipality in the state of Pará, regarding access to services offered in Primary Health Care - Family Health Strategy of the Riverside. A descriptive study was carried out, with a qualitative approach, in a riverside family health unit located on the banks of the Arumanduba river, in the municipality of Abaetetuba (PA), 30 individual semi-structured interviews were conducted with users who were looking for some service in the unit on the day of the interview. For data analysis, content analysis was used. Participants understand the ESFR as the first health service to look for in case of need, which is directly related to the fact that the health unit is located in their community and the bond created with health professionals, which is important for the promotion of care and effective access as the essential attribute of PHC. However, there are organizational and structural barriers that need to be overcome to guarantee comprehensive care, such as reduced hours, lack of electricity, absence of services such as immunization, absence of medical professionals, lack of medication. It was evident in the study the need to strengthen the capillarity of PHC through the Family Health Strategy in the liquid territories of the Amazon and the importance of this in the impact of access to health for the riverside population.

  • JUCILENE MAGALHAES ALVES SOUSA
  •  

     
  • Data: 14/06/2021
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  • Em decorrência do processo de descentralização da gestão das políticas
    públicas, fez-se necessário a participação da sociedade civil nas tomadas de decisões e na
    fiscalização da utilização de recursos públicos, resultando, no âmbito do Programa
    Nacional de Alimentação Escolar (PNAE), na exigência da composição do Conselho de
    Alimentação Escolar (CAE). Assim, esse estudo objetivou caracterizar a atuação, os
    desafios e potencialidades dos conselheiros de alimentação escolar, por meio de
    indicadores de controle social e análise de conteúdo de conselheiros atuantes em 04
    municípios paraenses. Estudo documental, descritivo de delineamento transversal, a
    partir da análise documental de Relatórios Técnicos referentes às atividades de assessoria
    e monitoramento executados pelo CECANE/UFPA, no ano de 2019, adotando uma
    abordagem quali-quantitativa. As informações qualitativas foram obtidas a partir da
    análise das entrevistas com os conselheiros, sobre os possíveis obstáculos e/ou
    potencialidades vivenciados por eles. Os dados quantitativos foram tabulados e
    analisados no Programa Microsoft Excel versão 2016 e Epi Info versão 7.2.4. Foi
    utilizada a estatística descritiva, a partir da elaboração de gráficos e tabelas com
    frequências absolutas e relativas. No que se refere à análise das entrevistas, foram
    utilizados os preceitos da Análise de Conteúdo clássica, proposto por Bardin. A partir
    dos resultados, observou-se que a maioria era mulheres, estavam na faixa etária de 40 a
    49 anos, média de 42,2 (±7,8), tinham mais de 12 anos de estudo e representavam o
    segmento de pais de alunos, seguido de representantes de entidades de trabalhadores da
    educação e discentes. Os conselhos estão funcionando conforme determina as legislações
    vigentes, assim como, os conselheiros estavam desempenhando suas atribuições dentro
    do esperado e possuem conhecimento sobre o papel fundamental que desenvolvem na
    execução dessa política promotora da SAN no Brasil. Entretanto, identificou-se alguns
    entraves para o desenvolvimento e articulação de algumas atividades que competem aos
    conselheiros de alimentação escolar, principalmente no que se refere ao processo de
    composição, funcionamento e infraestrutura do CAE. Dessa forma, evidencia-se a
    importância de participação dos conselheiros em ações estratégicas de formações e
    capacitações continuadas sobre aspectos gerais de execução do PNAE e suas atribuições.

  • MARCELA DO SOCORRO TAVARES DE MELO
  • FAMILY DEVELOPMENT OF QUILOMBALL COMMUNITIES IN THE STATE OF PARÁ

  • Data: 29/05/2021
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  • FAMILY DEVELOPMENT OF QUILOMBALL COMMUNITIES IN THE STATE OF PARÁ

  • DANIELLE DO SOCORRO PINTO DA SILVA
  • ALTERAÇÕES NUTRICIONAIS E RISCO PARA DOENÇAS CRÔNICAS NÃO
    TRANSMISSÍVEIS (DCNT's) EM INDÍGENAS ADULTOS DAS ETNIAS
    SURUÍ/AIKEWARA, TUPAIU E TEMBÉ, PARÁ-BRASIL.

  • Data: 14/05/2021
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  • ESTE ESTUDO SE DIRECIONA PELAS TEMÁTICAS DA ALIMENTAÇÃO, DA SAÚDE E DA CULTURA. TEM COMO PROPOSTA DE ESTUDO A COMPREENSÃO DAS PRÁTICAS ALIMENTARES EM UMA COMUNIDADE INDÍGENA NO SUDESTE PARAENSE. AS PRÁTICAS ALIMENTARES REPRESENTAM UMA AÇÃO CONCRETA DE INCORPORAÇÃO TANTO DAS CATEGORIAS PARA OS DIFERENTES ALIMENTOS COMO DO ESTABELECIMENTOS DE SEUS SIGNIFICADOS, PERMEADA POR TROCAS SIMBÓLICAS, ENVOLVENDO UMA INFINIDADE DE ELEMENTOS E DE ASSOCIAÇÕES CAPAZES DE EXPRESSAR E CONSOLIDAR A POSIÇÃO DO SUJEITO SOCIAL EM SUAS RELAÇÕES COTIDIANAS. O OBJETIVO DA PESQUISA É COMPREENDER COMO SE CONFIGURAM AS PRÁTICAS ALIMENTARES E DE QUE FORMA ELAS SE RELACIONAM COM A SAÚDE E A CULTURA DOS SUJEITOS ENVOLVIDOS NO CONTEXTO DA COMUNIDADE INDÍGENA SURUÍ/AIKEWARA; CARACTERIZAR O CONTEXTO SOCIODEMOGRÁFICO E AMBIENTAL DESSA ALDEIA, CONSIDERANDO SEU PROCESSO HISTÓRICO DE FORMAÇÃO; CONHECER AS MEMÓRIAS FAMILIAR E COMUNITÁRIA DAS PRÁTICAS ALIMENTARES, OBSERVANDO AS MUDANÇAS E PERMANÊNCIAS AO LONGO DE UM DETERMINADO PERÍODO DE TEMPO; OBSERVAR E ANALISAR AS PRÁTICAS ALIMENTARES A PARTIR DAS FALAS DOS PARTICIPANTES ENVOLVIDOS, COMPREENDENDO SUA RELAÇÃO COM A SAÚDE E A CULTURA DESSE GRUPO. TRATA-SE DE UM ESTUDO DE ABORDAGEM QUALITATIVA, DO TIPO DESCRITIVO E EXPLORATÓRIO E A PERSPECTIVA TEÓRICA INTERPRETATIVISTA PARA FUNDAMENTAR A ANÁLISE. A CONSTRUÇÃO DOS DADOS SERÁ POR MEIO DE LEVANTAMENTO BIBLIOGRÁFICO E DOCUMENTAL, BEM COMO ATRAVÉS DE OBSERVAÇÃO E ENTREVISTA DO TIPO SEMIESTRUTURADA E GRAVADAS CONFORME O CONSENTIMENTO DOS ENTREVISTADOS, ESTABELECENDO UMA CONVERSA AMIGÁVEL. A INTERPRETAÇÃO DOS DADOS OBTIDOS POR MEIO DAS INFORMAÇÕES RELATADAS PELOS PARTICIPANTES SERÁ PELA ADAPTAÇÃO DA ANÁLISE DE CONTEÚDO, USADO COM O OBJETIVO DE DESCREVER E INTERPRETAR O CONTEÚDO A PARTIR DAS NARRATIVAS DE MORADORES DA COMUNIDADE. A POPULAÇÃO ESTUDADA SERÁ COMPOSTA POR MORADORES DA COMUNIDADE INDÍGENA SURUÍ AIKEWARA E PETENCENTES A TRÊS DIFERENTES GERAÇÕES, ENCONTRADOS NO MOMENTO DA VISITA, QUE ACEITAREM PARTICIPAR DO ESTUDO MEDIANTE À APRESENTAÇÃO DO TERMO DE CONSENTIMENTO LIVRE E ESCLARECIDO (TCLE).

  • LEILIANE DE CARVALHO CORDEIRO
  • Evaluate the factors associated with compliance with the Brazilian Standard
    for the Marketing of Food for Infants and Early Childhood Children, Nipples, Pacifiers
    and Bottles in Commercial Establishments in Belém - Pará (Multi-Nbcal). Method: This
    is a cross-sectional study that comprises a multi-center epidemiological survey - Multi –
    NBCAL, carried out through triangulation of quantitative and qualitative methods, aimed
    at assessing compliance with NBCAL in all regions of the country. The population
    studied was composed of managers or managers of commercial establishments found in
    the environments at the time of the visit, who agreed to participate in the study and
    answered structured interview questionnaires based on instruments used to monitor
    compliance with NBCAL. Data analysis was performed using absolute and relative
    frequencies, in addition to logistic regression. Results: 197 interviews were conducted
    with professionals from 200 commercial establishments. In 72.50% (n = 145) of
    establishments, infractions were identified. Among the professionals interviewed,
    68.02% (n = 134) said that they advise mothers on breastfeeding and infant feeding;
    37.56% (n = 74) of the professionals stated that they did not know NBCAL; 24.87% (n =
    49) reported that they knew more or less; 57.87% (n = 114) of the interviewees stated that
    they had never received training on breastfeeding and infant feeding; 80.71% (n = 159)
    of the professionals said they had never been trained on NBCAL; 76.14% (n = 150)
    professionals said they received visits from industry representatives / companies of LM
    substitutes and childcare products and of those, 11.68% (n = 23) reported that they
    received gifts, prizes and a free sample from these representatives . Establishments that
    are part of the network (RP = 4.56; 95% CI = 1.94-10.73), classified as large / hyper (RP
    = 1.53; IC95 = 1.07-2.17), which receive visits from industry representatives / companies
    of LM substitutes and childcare (RP = 2.86; CI9% = 1.43- 5.72), where the managers or
    guardians were male (CI95% = 1.06- 5.06) and where the disposition of products in the
    gondolas was defined by the matrix (CI95% = 1.64- 6.34 ), showed a statistically
    significant association with infractions. Conclusions: Most of the professionals
    interviewed did not participate in qualification training on NBCAL and breastfeeding and
    infant feeding and demonstrated that their knowledge about it is insufficient. Industry
    representatives / companies of LM substitutes and childcare products act strongly in
    commerce and their presence may be related to the occurrence of infractions in the
    surveyed establishments.

  • Data: 07/05/2021
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  • Breastfeeding; Infant Food; Commercialization; Standards; Knowledge;
    Professionals

  • FABIO DA COSTA FERREIRA

  • ASSESSMENT OF HYPERTENSION ASSISTANCE AND DIABETES IN PRIMARY HEALTH CARE IN THE PERCEPTION OF USERS

  • Data: 20/04/2021
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  • In recent decades, following a global disposition, there has been an increase in morbidity and mortality and hospitalizations due to chronic non-communicable diseases (CNCD) in Brazil, such as systemic arterial hypertension (AHS) and diabetes mellitus (DM), making it necessary to plan and implement public that lead to lower rates. This study aims to understand the perception of users about assistance to hypertension and diabetes, of the public health service, in the city of Ananindeua, metropolitan region of Belém. In order to achieve the proposed objectives, two studies were carried out: an integrative literature review with 9 articles selected after the data collection stage. And another empirical of the descriptive type and with a qualitative approach, carried out using the focus group technique and systematized data based on content analysis with 12 users of the hypertension and diabetes control and monitoring program. In the review study, difficulties related to consultations, exams, adherence, access, filling in documentation, service management, and non-pharmacological treatment were presented. Empirically, 10 categories were grouped, divided into 4 thematic axes: access to health services; consultation in health units; host; and home visit. Thus, by better understanding the reality of care for hypertension and diabetes, it may be possible to improve quality, both in terms of users' experiences and in terms of public health and the recommendations of the Ministry of Health. Therefore, the effectiveness of access, consultations, reception and visits permeates the ability of management to organize services with a focus on meeting the needs of the population, respecting the geographic and social characteristics of the community. This study reinforces the need for greater attention to public health policies on hypertension and diabetes, in order to make management and care more efficient.

     

  • ANA DE FATIMA MORAES BRITO
  • Analysis of the Contracting Policy by the Ministry of Health in Teaching Hospitals

    in Brazil.

  • Data: 19/04/2021
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  • Analyze the Ministry of Health's Contracting Policy in Teaching Hospitals in Brazil will make it possible to design a bibliographic parameter of the advances, proposals for interventions and perspectives for teaching, research, assistance and management of SUS in these institutional spaces. The experience of contracting with hospitals, at SUS, began in 2004, with the restructuring program of teaching hospitals and philanthropic hospitals. The contracting policy is established by the Ministry of Health as a process where the municipal / state manager of the Unified Health System (SUS) and representative hospital, establishes indicators, quantitative and qualitative targets for health care health and hospital management, formalized through a contractual instrument. It is necessary to reframe the practice of managing, making it imperative to establishment of managerial and technical-scientific instruments to qualify management, with the objective of guaranteeing its sustainability, to meet the needs of health of the referenced population, offer services and streamline assistance to users of the SUS, thus contributing to the organization of the system. For this, it is of great importance to use of mechanism and instrument such as the Document described, the Programming Physical - budgetary (FPO) and service production reports to subsidize the management practice. The Document Described instrument constituted in the process of contractualization (Ministry of Health, 2010).
  • JORGEANE PEDROSA PANTOJA
  • The integrality and autonomy arrangement in the care of people with disabilities in the childhood segment: A documentary analysis

  • Orientador : PEDRO PAULO FREIRE PIANI
  • Data: 15/04/2021
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  • Human development happens in a continuous process, childhood is the period of greatest physical and intellectual development. Phase where there are risks that could compromise the development of the inherent functions. When looking at childhood follow-up, it was found that there were changes in the way of understanding about this phase of life. Theorists like Ariès (1981) in their studies report the lack of feeling towards childhood, realizing that the child was inserted in the context of adult life, being seen by society as a miniature adult. For a long time, the peculiarities of this phase were not taken into account, when going through these studies, questions arose as to how children who were not with their development shared with expected, children with disabilities were treated. In this perspective, the aim is to develop a study to identify and analyze the perspectives in use on integrality and autonomy in public policies for the care of people with disabilities and to see how society has been responding to the diversity of people with disabilities, especially children. Has society prepared children with disabilities  to  promote  their  full  participation?  How  does  the  principle of autonomy articulate with public policies ?. For this, the path designed for the study was qualitativ research,  of  the  documentary  analysis  type,  carried  out  a  survey  and  analysis.

  • JUAN ANDRADE GUEDES
  •  
     
  • Data: 09/04/2021
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  • A malária é uma doença infecciosa, febril aguda, de caráter sistêmico, causada por
    protozoários do gênero Plasmodium, sendo transmitidos ao homem através da picada de
    mosquitos fêmeas do gênero Anopheles. Esta doença é considerada um grave problema de
    saúde pública, sobretudo na Amazônia brasileira, devido sua ampla difusão na região, alta
    incidência e difícil controle. Esse estudo objetivou analisar a produção ambiental da malária
    no município de Cametá, estado do Pará, no período de 2013 a 2019. Os dados
    epidemiológicos foram obtidos junto ao Ministério da Saúde. Os dados cartográficos e
    demográficos foram levantados no Instituto Brasileiro de Geografia e Estatística. Os dados
    ambientais sobre desmatamento e uso e cobertura da terra foram obtidos no Instituto Nacional
    de Pesquisas Espaciais. Já os indicadores de vegetação foram desenvolvidos
    laboratorialmente. Após o processo de depuração dos dados, os mesmos foram analisados
    com técnicas estatísticas descritivas e espaciais. Foram analisados 12.052 casos notificados
    de malária, sendo os indivíduos mais acometidos do sexo masculino, adultos, pardos, baixo
    nível de escolaridade, moradores da zona rural, ocupação extrativista e de agricultura, com
    parasitemia de duas cruzes, espécie Plasmodium vivax, o tipo de exame gota
    espessa/esfregaço e o tipo de detecção passiva. A análise espacial mostrou uma distribuição
    não homogênea da doença associada a uma autocorrelação espacial direta com os diferentes
    níveis de desmatamento e de uso da terra. Além disso, foi verificada uma distribuição
    desigual dos serviços de saúde no município. A malária se constituiu um grande e complexo
    problema de saúde pública em Cametá e sua distribuição está diretamente relacionada à
    fatores de riscos ambientais e a precariedade da política pública de saúde no município.
    Ressaltamos a necessidade de ampliação das ações de vigilância epidemiológica e ambiental
    da doença.

  • MESSIAS LEMOS
  • ANALYSIS OF THE ORGANIZATION OF THE WORK PROCESS OF THE BASIC CARE TEAMS IN BRAZIL

  • Data: 31/03/2021
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  • Introduction: Primary Health Care takes on the challenge of organizing and articulating Health Care Networks. There are distinct differences in the way of organizing and conducting the work process of PHC teams, as well as difficulties in adopting management tools for the conduct of activities in relation to the different realities of performance determined by the location of the teams. Objective: To analyze the work process of primary care teams in Brazilian municipalities. Methodology: Research of an evaluative nature of an exploratory nature with a quantitative approach, using secondary data from the 3rd cycle of the National Program for the Improvement of Access and Quality of Primary Care. The variables related to the External Evaluation, “Module II - Interview with the health professional” and the Rural-Urban Classification of the Brazilian Institute of Geography and Statistics, both open access, were used. The teams that participated in all moments of the external evaluation, corresponding to 37,350 teams, were included in the study. After obtaining the databases on the Ministry of Health website, the information was organized into a data matrix in the Microsoft® Office Excel® 2016 software and a link was made between the IBGE database and the PMAQ database. -AB. Using the SPSS Statistics software (v.20, IBM SPSS, Chicado IL), a descriptive analysis of the variables was carried out according to the rural-urban classification in 3 axes: Territorialization, Action planning and Monitoring and Self-assessment. Then, the relationships between the axes of variables and the rural – urban classification were verified using a Multiple Correspondence Analysis. Results: It was observed that the adjacent rural municipalities have the lowest percentage of teams with an uncovered population in the territory (21.0%), the urban municipalities showed a higher percentage of teams with a reference population above 3,500 people / team (43.0%). Action planning is not carried out by 15.1% of the participating teams, with the highest percentage of achievement observed in the urban stratum (85.7%). Monitoring and analysis of the indicators is carried out by 87.9% of the teams, with approximation of the values between the municipal strata with similar location characteristics, whereas the self-assessment performed had a higher percentage in the adjacent intermediate strata (90.4%). The Multiple Correspondence Analysis made it possible to identify three groups of teams with distinct territorial characteristics and two groups in relation to planning, monitoring and self-assessment. Conclusion: The results presented in this study suggest that there are important differences in the work process of the Primary Health Care teams that vary according to the characteristics of the municipality in which they are located.

     

  • ANA MARIA BAIA CARDOSO
  • PERMANENT HEALTH EDUCATION IN THE WORK PROCESS IN

    AN UNIVERSITY HOSPITAL

  • Data: 05/03/2021
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  • Public policies are sets of measures and procedures that promote and guide State activities according to the needs of the public interest. The field that relates to national health policies has guidelines for improving the conditions of the population, in order to promote protection and recovery of the health of individuals and the collective. With the expansion of the Unified Health System network and new challenges for improving the quality of care, the Ministry of Health instituted the National Policy for Permanent Education in Health (EPS), constituting strategies in order to contribute to qualify the health practices and training processes, from the identification of problems in the reality of work, highlighting the need for change in the training of health professionals, aiming at transforming work processes and the organization of services. Understood as a pedagogical practice that relates teaching, work and teaching, EPS is guided by the actions of professional development of health workers and the transformation of practices at work, geared to the needs of the population, configuring a participatory management methodology. Thus, this research aimed to analyze how EPS happens to health professionals in a University Hospital Complex. This is an exploratory, descriptive study, with qualitative and quantitative approaches, with review of narrative literature, documentary analysis of secondary public data and application of a questionnaire with open and closed questions. As a support tool for data analysis, the software IRAMUTEQ, by Pierre Ratinaud (2009), used the content analysis approach of Bardin (1977) and finally created the pre-design of the Logical Model (ML) (APPENDIX) A), as an intervention proposal. This study took place at the University Hospital Complex (CHU) of the Federal University of Pará (UFPA) which includes two university hospitals, both located in the metropolitan region of Belém, Pará, which are regulated by the Municipal Health Department (SESMA). The study population consisted of CHU health workers, from the administrative and assistance areas. For the documentary analysis stage, the reports of the 1373 CHU health workers were considered, of this total, only 391 accepted to answer the questionnaire, participating freely in the research, signing the Free and Informed Consent Form (ICF). As inclusion criteria, workers who have an employment relationship with the institutions Empresa Brasileira de Serviços Hospitalares (EBSERH) and UFPA participated, as exclusion criteria individuals from other jobs.

    Secondary data were extracted from the training reports carried out by the 1373 health workers of the CHU at UFPA from 2014 to 2019. The quantitative data had descriptive treatment and the qualitative data were subjected to analysis using the IRAMUTEQ software. As a result, the importance of training as strategic actions to improve work practices was highlighted. It was identified that health workers want to improve the communication and dissemination of training courses, as well as the expansion of vacancies to all professional categories. Most respondents consider the practice of EPS to be fundamental to maintaining quality in work processes. Finally, it is concluded that it is important and fundamental that all workers are involved in EPS strategies, including managers and that EPS brings reflection and attitude to each of the actors involved, providing both personal and institutional transformations in their permanent processes capacity building

  • RODRIGO JUNIOR FARIAS DA COSTA
  • SPACE-TEMPORAL DISTRIBUTION OF TUBERCULOSIS AND ITS RELATIONSHIP WITH SOCIOECONOMIC AND DEMOGRAPHIC CHARACTERISTICS IN THE MUNICIPALITY OF ANANINDEUA, PARÁ, BRAZIL

  • Data: 05/02/2021
  • Mostrar Resumo
  • Introduction: Tuberculosis is a highly endemic bacterial disease in Brazil and still remains a major public health problem, especially in the northern region. However, the municipality of Ananindeua has presented disparities in relation to the regional incidence of the disease. Objective: Analyze the spatial and temporal distribution of Tuberculosis and its relationship with socioeconomic characteristics and demographic in the municipality of Ananindeua-PA, from 2010 to 2017. Methods: An ecological and cross-sectional study was carried out based on data from the Information System for Notifiable 

    Diseases (SINAN) of the Ministry of Health and the 2010 Demographic Census of the Brazilian Institute of Geography and Statistics (IBGE). Socioeconomic, demographic and epidemiological variables were analyzed. For the epidemiological profile, the Chi-Square test for adherence was used with the BioEstat 5.3 software. Thematic maps were made to visualize the distribution of the disease in the urban space of the municipality where geoprocessing techniques were used. Results: A decreasing trend was observed in the number of cases of tuberculosis. The profile of the most affected individuals was male (59.41%), adult age group (83.18%), with incomplete fundamental level (36.14%), mixed race (75.06%) and with outcome of cure (64.92%). The analysis also showed that the disease is not evenly distributed in the municipality and shows evidence of an epidemiological silence in certain geographical areas. Conclusion: This study provided a better understanding of the epidemiological profile of tuberculosis cases in the municipality of Ananindeua, in the state of Pará. Furthermore, it was observed that tuberculosis is still a major public health problem and needs more health promotion and prevention programs.

    Keywords: Tuberculosis. Epidemiology. Public Health.

  • RAFAEL ALEIXO COELHO DE OLIVEIRA
  • THE ENVIRONMENTAL PRODUCTION OF TEGUMENTARY LEISHMANIASIS AMERICAN IN TWO MUNICIPALITIES OF THE SOUTHEAST PARAENSE MESOREGION

  • Data: 29/01/2021
  • Mostrar Resumo
  • American Cutaneous Leishmaniasis (ATL) is an anthropozoonosis considered a great public health problem, which is distributed throughout the national territory. In the state of Pará, in the southeast mesoregion, the ATL has great epidemiological relevance due to its endemicity related to the socioeconomic and environmental characteristics of its municipalities, which condition the establishment of the disease. This study aimed to analyze the environmental production of the ATL in the municipalities of Tucuruí and São Félix do Xingu, state of Pará, from 2012 to 2016. Epidemiological data were obtained from the Information System for Notifiable Diseases of the Secretary of Public Health of the Pará. The cartographic, demographic, conservation units and indigenous lands data were collected at the Brazilian Institute of Geography and Statistics. Environmental data of deforestation and land use and cover were obtained from the Amazon Deforestation Program and the TerraClass project, respectively. The municipalities of Tucuruí and São Félix do Xingu had 286 and 183 confirmed cases. The most affected individuals in both municipalities were males, adults, brown skin, elementary level of education and residents in urban area of Tucuruí and in rural areas of São Félix do Xingu. Spatial analysis showed different levels of deforestation in Tucuruí and land use and cover in São Félix do Xingu, with a non-homogeneous distribution of cases, which formed clusters in both municipalities. ATL is a large and complex public health problem in Tucuruí and São Félix do Xingu, related to the observed environmental risk factors, which were conditioned by poverty and lack of public policies in those municipalities. We emphasize the need to expand the actions of epidemiological and environmental surveillance of the disease in the studied municipalities

2020
Descrição
  • SIMONE DORA SILVA DA SILVA
  • NBCAL compliance with the commercialization of infant formulas: A comparative
    study between Belém and São Paulo

  • Data: 30/11/2020
  • Mostrar Resumo
  • Breastfeeding is essential for the child's full development, ensuring that the individual
    reaches its full potential for evolution. Therefore, it is essential to defend breastfeeding
    through legal protection, so that mother and baby have their right to breastfeed. This
    study aimed to assess the most frequent forms of infringement of the Brazilian Standard
    for the Marketing of Food for Infants and Early Childhoods, Nipples, Pacifiers, Bottles
    and Nipple Protectors - NBCAL, regarding the sale of infant formulas whose commercial
    promotion is prohibited. A cross-sectional study was carried out in 2019, in pharmacies
    and supermarkets in the cities of Belém and São Paulo, which market the products
    covered by NBCAL, interviewers trained at NBCAL used a structured electronic form
    for direct observation of establishments, in order to verify the infractions present in these
    establishments. The data description was made by absolute, relative frequency and 95%  CI. 200 establishments in Belém and 199 in São Paulo were evaluated, of which 11% had

    an infraction in the city of Belém and 9.5% violated the Standard in São Paulo. The most
    frequent infractions were: price promotion (52%) in Belém, (46.2%) and São Paulo, and
    special exposure (10%) in belém and (35.9%) in São Paulo, it was also possible to verify
    the simultaneous occurrence of the two infractions in (38%) Belém and (17.9%) in São
    Paulo. Although 32 years have elapsed since the establishment of NBCAL, there are still
    recurring infractions of the Legislation on products whose commercial promotion is
    prohibited, the present study reinforces the need for greater inspection in commercial
    establishments and the Companies that commercialize the products object of the
    NBCAL.

  • ANDRÉA CRISTINA MARASSI LUCAS
  • DENTAL CARE OFFERED BY ORAL HEALTH TEAMS IN PRIMARY CARE IN BRAZIL

  • Data: 03/11/2020
  • Mostrar Resumo
  • In Brazil, despite the gradual expansion of oral health teams and services in SUS from the creation and strengthening of public oral health policies, obstacles can still be observed in relation to dental care, which interferes with oral health and quality of care. population life. In this sense, health assessment is important in identifying problems, monitoring, planning and preparing intervention proposals. The evaluation in oral health is a recent research object, with a considerable increase after the national evaluations of the Program for Improvement of Access and Quality of primary care and of dental specialties centers (PMAQ-AB and PMAQ-CEO) conducted by the Ministry of Health (MS). Thus, the objective of this study was to evaluate how PHC access and assistance flow to specialized services throughout Brazil are carried out, using a descriptive, cross-sectional study, using data from the 3rd cycle PMAQ-AB extracted from the E-manager system, referring to the external evaluation phase of the participating Oral Health teams (ESB). As a result of this research, two scientific articles were prepared, the first comparing dental care between regions in Brazil and the second relating the care practices of ESB (s) in the state of Pará with the performance in the evaluation process. It was identified that despite the increase in the offer of specialized Dentistry services in Brazil, the support provided by the CEO (s) and the improvement of the reception in PHC by the ESB (s), obstacles still persist in the work process, which negatively impacts the team performance. The main results point to flaws in the organization of demand and in the assistance flow of users, mainly due to the lack of protocols and professional training, especially in the North, making access 

    and continuity of care difficult and therefore the completion of dental treatments.In Pará, the ESB (s) that experienced practices of offering specialized consultations and support from the CEO (s) had more than twice the chance of obtaining better certification performance. The construction of the Logical Model (ML) proved to be an important intervention proposal in the reorganization of the referral system for CEOs, through online scheduling for specialized services. Therefore, it is concluded that it is important to incorporate the practice of qualified health assessment with management support, through ML, for decision making and build hierarchical and regulated care flows that allow integration between the levels of care and community participation, considering the specificities and availability of loco-regional health care networks.


  • ÍTALA SUZANE DA SILVA FIGUEIREDO
  • THERAPEUTIC REPUBLIC OF PASSAGE: a device that transforms the exclusion into affections and (re)connections

  • Data: 03/11/2020
  • Mostrar Resumo
  • The Therapeutic Republic of Passage (RTP) is a temporary shelter service that houses people with mental disorders who have had a conflict with the law. The objective of this institution is to resuscitate the graduates of the General Penitentiary Hospital (HGP), which complied with a security measure in the state of Pará. The general objective of this study is to understand the experiences of the graduates of the HGP during the fulfillment of the safety measure in that hospital and comparing them to the experiences in RTP, a substitutive service to prolonged hospitalization. This will be a qualitative ethnographic study to be carried out at RTP from August 2018 to May 2019. The research will be composed of six interlocutors, two managers, two residents and two caregivers. The data will be obtained through participant observation, recorded in field diary, and the UNIVERSIDADE FEDERAL DO PARÁ INSTITUTO DE CIÊNCIAS DA SAÚDE PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE, AMBIENTE EM SOCIEDADE NA AMAZÔNIA. Praça Camilo Salgado, nº 1, Umarizal, Belém, Pará, CEP 66.050-060, Belém, PA. Fone: (91) 3201-6806 application of semistructured interviews, recorded and later submitted to content analysis. The expected results are that this research contributes to the emancipation of new knowledge in the area of mental health and the implementation of new public policies in this context.

  • DIEGO BESSA DANTAS
  • PREDITORES SOCIODEMOGRÁFICOS DE MORTALIDADE POR CÂNCER UTERINO NO BRASIL

  • Data: 28/08/2020
  • Mostrar Resumo
  • O câncer de colo e de corpo de útero são problemas recorrentes no sistema urogenital
    feminino. De acordo com o Sistema de Informação sobre Mortalidade do Ministério da
    Saúde, a incidência deste tipo de câncer é crescente nas últimas décadas no Brasil. Entender
    os fatores que podem estar associados ao óbito por doenças do sistema urogenital pode
    favorecer o desenvolvimento de políticas públicas que proporcionem um melhor acesso e a
    criação de estratégias adequadas para a prevenção, detecção precoce e tratamento, de forma a
    diminuir o número de óbitos no país. Esta pesquisa busca encontrar os fatores
    sociodemográficos que podem estar associados à ocorrência desse desfecho no Brasil, de
    forma a oferecer dados consistentes para a criação e direcionamento de políticas em saúde
    baseadas em evidência. Essa pesquisa é construída em formato de artigos que serão
    apresentados ao longo do trabalho.


  • TAIANA MOITA KOURY ALVES
  • CHALLENGES OF REGULATING ACCESS TO HOSPITAL ASSISTANCE IN THE UNIQUE HEALTH SYSTEM, IN A NORTH 
    BRAZILIAN METROPOLIS: from the perspective of users and managers
  • Data: 13/08/2020
  • Mostrar Resumo
  • One way to critically improve public health management strategies is to study the Brazilian
    Unified Health System (SUS) with emphasis in the Health Assistance Regulation. The general goal of this research
    was to analyze the regulation process of hospital assistance access in SUS, in Belém, state of Pará, by means of a 
    descriptive, case study type investigation with qualitative approach. The evidence sources were documental, consisting
     of normative elements about assistance regulation, scientific articles, books within the subject and semi-structured
     interviews with managers and SUS users. Seven interviews were conducted: four of them with public health 
    managers working with access regulation, and three with SUS users who were hospitalized in the same period. 
    From the interview content analysis, the extracted subcategories for SUS managers were: Necessity of consolidating 
    Assistance Regulation in RAS; Operationalize regulatory flows between health establishments of RAS, based in current 
    contract- and pact-formations and Lack of hospital beds for user needs. From SUS users, the extracted 
    subcategories were: Waiting time for hospital bed and User perception about the received assistance. 
    The results of this study prompted reflections about the necessary changes in public health strategies of the city. 
    Given that the possibilities of overcoming difficulties include the identification of different related aspects, this 
    investigation proposes three suggestions for improving the regulation of hospital assistance access in Belém: consta
    nt education in health offered to the assistance and SUS health management teams about access regulations; 
    stimulation of serial meetings involving the health establishments participating in RAS regulatory flows of SUS in
     order to debate, to dimension, and to qualify them, thus offering more dynamism to the act of regulating; and 
    finally, monitoring and sequential evaluation of offered services from the SUS user perspective, aiming to improve
     these services for fully fulfilling the population needs. 
  • TULIO GONCALVES GOMES
  • Alimentação Infantil. NBCAL. Amamentação

  • Data: 04/03/2020
  • Mostrar Resumo
  • Breastfeeding is the ideal feeding practice, when exclusive up to 6 months of age and associated with adequate complementary feeding for 6 months up to 2 years or more is capable of reducing infant mortality, promoting satisfactory growth and development and guaranteeing several protective factors for mothers and children. However, the trade in breastmilk substitute foods, driven by powerful marketing strategies, since the 1970s has been identified as one of the main factors associated with the low prevalence of breastfeeding in the world. In response, the World Health Organization published in 1981 the International International Code of Marketing of Breast-milk Substitutes. In Brazil, the most important legal framework in defense of breastfeeding is the Norma Brasileira de Comercialização de Alimentos Infantis, Bicos, Chupetas e Mamadeiras (NBCAL – Brazilian Code of Marketing of Infant and Toddlers Food and Childcare-related products), regulated in 2006, which aims to regulate advertising, labeling and marketing of the products in question. The “Multicentric NBCAL Compliance Assessment Study (Multi-NBCAL)” was carried out in commercial establishments and hospitals with maternity hospitals in 7 Brazilian cities in 2017 and 2018. For the present study, only the data referring to the city of Belém ( PA), collected in December 2018, when 145 pharmacies were evaluated in 33 neighborhoods, the locations were mapped over the internet and through the Municipal Health Surveillance. In 72% of the establishments, some type of infraction was evidenced: 74 pharmacies offered discounts, 75 violated the exposure rules and 48 committed both. The high rate of infractions found reinforces that, in Belém (PA), public policies to promote breastfeeding must, mandatorily, include the increase in the inspection of commercial establishments regarding compliance with NBCAL.

  • NALU DE MORAES RIBEIRO
  • FACTORS ASSOCIATED WITH OVERWEIGHT IN BRAZILIAN SCHOOL ADOLESCENTS: NATIONAL SCHOOL HEALTH RESEARCH- PENSE 2015

     

  • Data: 02/03/2020
  • Mostrar Resumo
  • Overweight in adolescence represents one of the most serious health problems public in Brazil and in the world. Adolescents are exposed to various risk situations at this stage, such as the adoption of eating habits and inappropriate eating behavior, physical inactivity and physical inactivity, which can directly affect the development of overweight and comorbidities, which can negatively impact their health conditions. short and long term. Given this scenario, this study aims to identify the prevalence and factors associated with excess weight in school adolescents enrolled in public and private schools in Brazil. This is an analytical, observational, cross-sectional study that will be carried out based on secondary data obtained in the National School Health Survey, 2015, conducted with adolescents from public and private schools in the country. The data were collected through an electronic questionnaire. To check the association between the dependent variable and the explanatory variables, the Chi-square test and Logistic Regression were used, estimating the prevalence ratio with 95% confidence intervals, with the aid of the Stata version 14.0 program. According to Table 2, other significant prevalences occurred with adolescent students who were overweight and did not consume beans regularly (27.15%), who consumed vegetables regularly (27.61%), consumed fruits regularly (26 , 42%), did not consume fried snacks regularly (25.98%), did not consume sweets regularly (27.74%), did not consume soft drinks regularly (25.76%), did not consume ultra-processed foods regularly (26.16%) , and did not consume fast food regularly (25.51%). From the results of the simple logistic regression, it was verified through the gross prevalence ratios that the variables associated with excess weight were: Geographic region; Administrative dependency of the school; Age group (in years); Maternal schooling; Regular consumption of breakfast; Bean consumption; Consumption of vegetables; Consumption of fried snacks and Consumption of sweets.

  • IANE RAQUEL BARATA GUIMARAES
  • Association between body image dissatisfaction and risk behaviors for chronic non-transmissible diseases in Brazilian adolescents: PENSE, 2015.

  • Data: 02/03/2020
  • Mostrar Resumo
  • A body image is the perception that the individual has the same, an image of his body formed in the mind. In adolescence, the look of the other becomes a mirror and the influence of family, the media and even friends can cause teenagers to develop a body image different from their real body, or what is called body image distortion, or a rejection of your body, called dissatisfaction with a body image. Researches associated with dissatisfaction with body image and sex, age, education, nutritional status, physical exercise or not, smoking, elitism, chronic non-communicable diseases, among others. OBJECTIVE: To verify an association between dissatisfaction with body image and to run risks for chronic non-transmissible diseases among Brazilian adolescents. METHODOLOGY: This is a cross-sectional, analytical study, with a population sample and based on secondary data from the 2015 National School Health Survey. Body image was selected as a dependent variable, the independent variables will be sociodemographic information, such as: sex, education, family composition and maternal education; while the variables of risk behaviors for chronic non-transmissible diseases will be: behavior and food consumption, physical inactivity, smoking and the consumption of alcoholic beverages. A descriptive analysis will be performed using relative and absolute frequencies to characterize the subjects. To check the association between the dependent variable and the explanatory variables, the Chi-square test and Logistic Regression will be used, estimating the prevalence ratio with 95% confidence intervals. The level of significance will be 5% and the statistical program used will be Stata, version 14.0. RESULTS AND DISCUSSION: It was found that most adolescents lived in the southeast region; (43.70%) called themselves race / brown color, 40.42% of males and 46.96% of females. Regarding age, most adolescents were in the 13 to 15 age group, with 62.49% and 61.09%, respectively. It was observed through the crude prevalence ratios that among the variables associated with dissatisfaction with body image were the female gender; those who did not consume beans regularly; those who consumed ultra-processed foods on a regular basis; who did not regularly consume breakfast; who did not have the regular habit of having lunch / dinner with a mother / father / guardian; they were physically inactive and overweight. The survey also showed a marked increase in students who consumed alcohol and smoked in the past 30 days.

    CONCLUSION: Thus, according to the analyzes carried out in this study, it was observed that risk and protective factors for chronic non-transmissible diseases are closely related to the risk and protective factors for the satisfaction of body image, leading us to reflect on the importance of having a satisfactory self-perception of body image.

2019
Descrição
  • ROSENDO SOUZA BARATA
  • Keywords: Cryptococcus. Epidemiology. Georeferencing.

  • Data: 16/12/2019
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  • Cryptococcal meningitis has been characterized as one of the emerging invasive fungal diseases that causes an extraordinary burden to public health, having in its causative agent one of the pathogens that most produce infections in humans, due to an increase of susceptible hosts including those with HIV, leading to severe morbidity and high mortality worldwide, and its insurgency with continuous outbreaks in individuals with no apparent immune defects. Some fungal species may compromise human hosts with some immunosuppression, while others may affect immunocompetent patients and in this sphere the genus Cryptococcus sp. Although it is closely linked to the main cause of disease in both populations, and may be triggered by different factors, it is one of those related to the host, having in Cryptococcus gattii and neoformans excellent species of interest to global public health. Due to their chronicity, invasive fungal diseases maintain their morbidity and mortality slower than other infectious agents, being potentially lethal due to greater resistance to treatment, increasing their cost due to the time available for cure ranging from months to years and its form of contagion that has aroused little interest in public health authorities, having a negative or under informed impact on its incidence and prevalence in relation to other conditions in which contagion is much more immediate. The number of deaths caused by this disease when associated mainly with HIV patients is extraordinarily high and even with the use of antiretroviral treatment this condition has shown an unacceptable advance with an estimated 220,000 cases per year worldwide, with 181,000 deaths per year being listed. as one of the most frequent causes of death in adult patients and more recently in pre-pubertal as identified in the state of Pará. Therefore, specific public policies for this fungal disease should be better planned and employed mainly in the paraense region, due to Its vast territory, surrounded by several rivers, which makes its diagnosis and treatment costly for public rulers, however to correct the damage caused by this disease, a change of behavior is required with the participation of health authorities, scientific community and especially the SUS user, which element It will define the necessary changes for the environment where it lives and what actions will be necessary to maintain its health as a citizen.

  • LAIS DO ESPIRITO SANTO LIMA
  • Acessibilidade das mulheres com câncer do colo do útero: Do diagnóstico aos níveis assistenciais

  • Orientador : MARY ELIZABETH DE SANTANA
  • Data: 14/11/2019
  • Mostrar Resumo
  • Considerações iniciais: A acessibilidade aos serviços de saúde para o câncer do colo do útero se
    constitui como um dos principais entraves para o sucesso do controle desta neoplasia. Objetivo:
    Conhecer a acessibilidade das mulheres com câncer do colo do útero aos níveis assistenciais. Método:
    Trata-se de um estudo descritivo com abordagem qualitativa. Resultados: As mulheres do estudo
    encontravam-se na faixa etária de 33 a 49 anos correspondendo a 65% do total, apresentando como
    média 46.75 anos. Quanto religião 50% das mulheres são evangélicas, 35% são solteiras, 30% possuem
    três filhos, 55% com ensino fundamental incompleto, tendo estudado até a quinta série. No tocante a
    ocupação, 35% são “do lar”. A renda familiar 30% das mulheres mantinham sua família com um salário
    mínimo, 45% das mulheres moravam até 100 km de distância do centro de tratamento. O histórico de
    câncer na família representa 70%, sendo que 6 das 14 mulheres especificaram que genitora, irmãs ou
    primas foram acometidas pelo câncer do colo do útero. Discussão: As categorias que emergiram: Acesso
    a baixa e média complexidade no Sistema Único de Saúde: “Eu ia morrer e não ia conseguir”; Acesso a
    alta complexidade e demora diagnóstica: demora demais e o trabalho fora do domicílio só trouxe, O
    Enfermeiro nos níveis assistenciais: me explicou como seria o processo. Considerações finais: A
    realidade verbalizada para a garantia do acesso aos níveis assistenciais de saúde pelas participantes
    deste estudo se assemelha a de tantas outras mulheres que vivem distantes dos grandes centros das
    cidades do Norte do Brasil. A Atenção Primária que deveria ser a coordenadora e ordenadora do cuidado
    não se demonstrou como primeira escolha para a obtenção de cuidados de saúde face aos sinais de
    adoecimento. Na atenção secundária, há uma escassez de unidades com serviços de biópsia, tornando
    as mulheres reféns dos serviços particulares ou do deslocamento do seu município de residência para a
    capital. O acesso ao nível terciário de saúde, além de caracterizado pela migração para a capital em
    busca de recursos de alta complexidade, desvelou-se na análise do discurso das participantes como um
    campo de batalhas seja na busca do auxílio do tratamento fora do domicílio e as casas de apoio, mais do
    que um local para hospedaria, são referências de unidade de cuidado e suporte em meio a tanta
    desatenção do poder público nas minúcias que é estar longe do seu lugar de origem. A Enfermeira, nesta
    conjuntura, embora tenha sido pouco mencionada nos níveis primário e secundário de saúde, é
    fundamental para assistir, guiar o percurso assistencial no atendimento dos princípios e diretrizes
    inerentes do Sistema Único de Saúde. Cabe ao Enfermeiro assistir, guiar o percurso assistencial e
    sensibilizar as mulheres sobre seus direitos, e garantir o atendimento no Sistema Único de Saúde.

  • ANA CARLA PINTO DA SILVA
  • STUDY ON SOCIO-BEHAVIORAL AND DEMOGRAPHIC PROFILE AS A RISK FACTOR FOR GASTRIC ADENOCARCINOMA IN PATIENTS AT A REFERENCE HOSPITAL IN BELÉM-PA
  • Data: 05/11/2019
  • Mostrar Resumo
  • A nível mundial, o câncer ainda é um problema de saúde pública presente em países desenvolvidos e em desenvolvimento. O (CG) Câncer Gástrico é considerado o quinto tipo mais frequente e a terceira causa de morte por câncer no mundo. A frequência de casos de CG é elevada no país, na região norte este tipo de câncer ocupa a segunda posição, excluindo-se os tumores de pele não-melanomas. OBJETIVO: Caracterizar o padrão sociodemográfico e o perfil de consumo alimentar em pacientes com adenocarcinoma gástrico (ADNG) atendidos em um hospital de referência em oncologia. METODOLOGIA: Participaram do estudo 110 pacientes atendidos no Hospital Ophir Loyola em Belém/Pará no período de novembro de 2017 a abril de 2019. Foram aplicados três questionários, um sobre frequência alimentar, um sobre dados sociodemográficos (sexo, idade, etnia, escolaridade, profissão, saneamento básico) e outro sobre dados sociocomportamentais (histórico médico pessoal e familiar, consumo de álcool e tabaco). RESULTADOS: A análise descritiva demonstrou que a maioria dos pacientes eram do sexo masculino, de cor parda, com nível fundamental incompleto e trabalhadores rurais. Observou-se também que a conservação dos alimentos sob refrigeração foi um hábito recente, há aproximadamente vinte anos. A maioria dos pacientes relatou ter tido algum parente de 1º grau com neoplasia. A aplicação da análise por correspondência, possibilitou a confirmação de associações entre os tipos de ADNG e as variáveis sociodemográficas, sociocomportamentais e o consumo alimentar dos pacientes. Dessa forma, pode-se afirmar que o ADNG tipo intestinal associa-se mais com o tabagismo, 89,65%, e o tipo difuso com o etilismo, de 94,24%.  O ADNG do tipo difuso apresentou maior associação com idades menos avançadas, 99,51%. Além disso, o tipo intestinal, mostrou estar mais associado com o sexo masculino, 98,37%. Quanto ao consumo médio de alimentos considerados de risco para o ADNG, estes estão associados aos dois tipos histológicos, no entanto com o tipo intestinal apresentou uma maior significância estatística, 84,38%. Com relação aos alimentos considerados de proteção, o baixo consumo também apresentou associação aos dois tipos de ADNG, porém o tipo intestinal destacou-se, com confiança de 79,46%. CONCLUSÃO: As taxas de incidência do CG vêm reduzindo, no entanto, suas taxas de mortalidade são elevadas. O CG é uma doença altamente incapacitante em anos de vida perdidos e necessita de ações permanentes que auxiliem no declínio de sua incidência, visando a difusão de informações sobre seus principais fatores de risco.

  • SANDRA MARIA DA CONCEICAO MOURA ALVES
  • Institutional violence in the classroom: repercussions on the lives of university students

  • Data: 02/10/2019
  • Mostrar Resumo
  •  

    This study discusses the possible occurrences of violent practices manifested in the relational space of classroom whose objective is to know the institutional violence presented in the classroom environment and the repercussions in university students’ lives. It was also studied the influence of violence phenomenon in classroom, identifying the most frequent manifestations of violence, trying also to generate subsidies for the realization of promotion and prevention sizes, capable to promote an study environment and professional preparation most welcoming and healthy. This is a mixed-basis research (quantitative and qualitative), in which a questionnaire and interview were used as the forms of data collection. The data analysis was performed by the descriptive statistics means, represented by graphs and tables, and content analysis, according to Bardin (2011), based on the categories emerged from the information provided by the research participants. The results found that the university classroom showed being experiencing violence, and despite being considered a little violent place, violence is present and latent in this environment and in the interpersonal relationships, whether through witnessing, own experience or practice by their students. In this study, verbal violence was too striking and expressive, although other forms of manifestation were also presented. The student-student relationship was most affected by attitudes / acts of violence, followed by the student-professor relationship, and these violent manifestations are capable to impact by negatively ways in the students’ lives, as well as in their studies and in family and friends’ relationships. Therefore, the classroom, at the university institutional level, configures itself as an environment that can trigger violence and may lead to harmful consequences to human nature. Thus, preventive actions can help to minimize the effects originated by this phenomenon.

  • RODRIGO ALEXANDRE DA CUNHA RODRIGUES
  • Salt consumption in the north coast of Brazil and associations with social determinants, eating habits, body mass index and 24-hour ambulatory blood pressure monitor

  • Data: 13/09/2019
  • Mostrar Resumo
  • Excessive salt intake is a major risk factor for high blood pressure. The World Health Organization recommends consuming less than 5g of salt per day, but, in most countries, it is consumed more than twice the recommended. In Brazil, the average salt intake is 12g per day and around a quarter of the adult population is hypertensive. Bragança is a Brazilian city with about 120,000 inhabitants, located in the northeast of the State of Pará, which has social, economic and cultural peculiarities due to its coastal characteristics. Due to intense maritime fishing activity, it is expected that its population has a high level of salt consumption and, consequently, a high prevalence of hypertension. The objective of the research was to measure salt consumption in Bragança-PA, to investigate the influence of social determinants and eating habits, and to evaluate the association with body mass index and blood pressure. Therefore, a crosssectional study was conducted through a household survey, whose sampling was random and stratified by census sector, gender and age group. From March to August 2018, 393 individuals from all 108 census sectors, men and women, aged between 30 and 59 years were surveyed. Salt intake and blood pressure were assessed by urinary sodium excretion in 12-hour night urine and 24-hour ambulatory blood pressure monitoring, respectively. Most of the study population had low education and poor socioeconomic status, especially among rural participants. Men had significantly higher income and occupancy 

  • RONDINEI SILVA LIMA
  • MIBARAIÓ IN AMAZON: A case-control study on the association between diabetes mellitus and mild cognitive impairment in the elderly.

  • Data: 05/09/2019
  • Mostrar Resumo
  • To verify the association between diabetes mellitus and mild cognitive impairment in the elderly. Method: Observational, case-control study, conducted with people aged 60 years or older from an outpatient service in the city of Belém do Pará, with data collection of participants from 2014 to 2017. This is an analysis of secondary database, with a population of 1,569 elderly. A total of 1,185 patients were considered eligible for the study. The analysis included 302 cases with mild cognitive impairment, and 883 controls without this diagnosis. Data were collected and analyzed using the IBM SPSS Statistics 20 statistical software. The Kolmogorov-Smirnov test was performed to assess the normality of distribution for the age variable. Then, the Mann Whitney test was used for the nonparametric distribution of continuous variables. For the analysis of categorical variables, the corrected Chi-square test was performed. Values with a probability of significance (p-value) less than 0.05 were considered statistically significant. After univariate analysis, logistic regression was performed with the variables with statistical significance. The significance level for regression was considered lower than 0.05. Results: There was no association between diabetes mellitus and mild cognitive impairment (p = 0.307) in the univariate analysis. In the regression analysis, there was a significant association between CCL and age (p = 0.0001), calf circumference (p = 0.002), handgrip strength (p = 0.025) and physical activity (p = 0.005). Conclusion: There was an association between CCL and risk factors related to the diagnosis of Sarcopenia, raising the possibility of a relationship between the two diseases. In addition, the results indicate that these variables may be part of objective criteria in the diagnosis of CCL.

  • TAMILIS FEITOSA LEAL
  • OS SENTIDOS DE FAZER EDUCAÇÃO PERMANENTE EM UMA UNIDADE BÁSICA DE SAÚDE  NO MUNICIPIO DE BELÉM - PA

  • Data: 23/08/2019
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  • xxxxx

  • PAULO ALTEMAR M DO NASCIMENTO
  • HEALTH IMPACTS IN THE SPACE OF THE DAMAGE OF REJECTION OF A MINING MACHINE IN BARCARENA / PA.

  • Data: 30/07/2019
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  • The present study aims to analyze the health impacts of environmental pollution in the Bom Futuro community, located near the industrial waste dam area of a mining company in Barcarena, State of Pará. For each environmental accident, the health impacts of these populations are aggravated, provoking also contingency actions to serve the affected communities. In the research, the health impacts will be identified and analyzed from a collective health perspective, using semi-structured interview and participant observation techniques, as well as the analysis of environmental surveillance reports and institutes that carried out on-site health actions. Six key informants were interviewed, who are health workers who worked directly in the period after the extravasation of the tailings dam and who could provide relevant information for the survey. The treatment of the collected data followed the steps of description, analysis and qualitative interpretation, using the content analysis approach, based on the categorization of the answers and analysis based on theoretical reference related to the theme. In the analysis of the results it was possible to conclude that there were several signs and symptoms prevalent such as abdominal pain, headache, skin alterations, diarrhea, nausea and vomiting, among others. However, the emergency health care and preventive environmental health actions carried out in the area contributed to the situation not becoming more serious, but the community still awaits answers regarding the specialized examinations and referrals.

  • ILA IANDARA ARAÚJO DE SOUZA
  • SOCIO-DEMOGRAPHIC FACTORS, LIFESTYLE AND CHRONIC NON-COMMUNICABLE DISEASES ASSOCIATED WITH PHYSICAL DISABILITY IN THE BRAZILIAN ELDERLY: ANALYSIS OF THE NATIONAL HEALTH SURVEY.

  • Data: 26/04/2019
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  • SOUZA, I. I. A. Socio-demographic factors, lifestyle and chronic non-communicable diseases associated with physical disability in the Brazilian elderly: Analysis of the National Health Survey. 88p. Thesis (Master’s degree) – Federal University of Pará, Postgraduate Program in Health, Environment and Society in the Amazon, Belém, 2019.

    Introduction: With increasing age, several health-related risk factors are impacted and changed. In addition to the natural decline of the body's organic functions, there is also an increase in non-transmissible chronic diseases, factors that can generate important functional deficits and subsequent physical deficiencies. Studies suggest that aging has enormous influence on propensities concerning physical disabilities. Objective: To identify sociodemographic factors, lifestyle and self-reported diagnosis of chronic non-communicable diseases associated with the presence of physical disability and the absence of disability in the elderly in Brazil, through the PNS data. Methodology: Cross-sectional, population-based study, conducted using secondary data from the National Health Survey (PNS) for the year 2013. A reduced sample of n = 11,177 individuals (60+ years old) and a sample of n = 382 individuals (60+ years old) who presented physical deficiency. 21 of whom had congenital physical disabilities were excluded, totaling n = 361 elderly people with physical disabilities were used to analyse the modules G (People with disabilities), P (Lifestyles ) and Q (Chronic Noncommunicable Diseases). The following variables were analyzed: age, sex, color or race, marital status, schooling; abusive use of alcoholic beverages, smoking and physical activity; in addition to self-referenced diagnosis for hypertension, diabetes, stroke, infarct and chronic respiratory diseases. The elderly with physical disability were considered the outcome variable. The percentage distribution of the associated factors in Brazilian elderly was calculated with a 95% confidence interval (CI). Subsequently, the prevalence of the elderly with and without physical disability was verified, according to the studied variables, with 95% CI. Results: The variables: sex, regular physical activity and NCDs: Diabetes Mellitus and Stroke were associated factors for both the physically disabled and the non physically disabled. On the other hand, the variables schooling and infarct NCD were associated only to the elderly with disability, which did not occur with any variable in relation to the elderly without disability. Conclusion: The present study found that age, sex, schooling, regular physical activity, and Diabetes Mellitus, Stroke and Infarct, were associated with the elderly with physical disability. Comparing the prevalence between the two groups, there is a direct association between males and physical disabilities. The data also indicate that elderly people with physical disabilities are more inactive than those without disabilities. Comparing NCDs, it was observed that only Diabetes Mellitus and Stroke presented significant differences in prevalence between the groups with and without disability, these variables being therefore associated with physical disabilities. Cerebral Vascular Accident, in turn, is highlighted by presenting in this study a 3 times greater frequency in the elderly with physical disability than in the elderly without disability.

  • FABRICIO MORAES PEREIRA
  • PERCEPTION OF THE SCHOOL HEALTH PROGRAM BY TEACHERS OF THE MUNICIPAL PUBLIC NETWORK OF BELÉM, PA

  • Data: 25/04/2019
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  • This work aims to understand the functioning of the School Health Program and the progress of school health in municipal public schools in Belém, PA, based on the perception of its teachers. For that, a theoretical reference was made to the project, proportional draw of the agreed schools, by administrative district, submission to the Research Ethics Committee of the Health Sciences Institute of the Federal University of Pará and qualitative research, using a questionnaire and an interview as tools of analysis. Previously to the research subjects, a pilot study was conducted with similar subjects, to adjust the interview script. Subsequently, the incursions were made in the schools, totaling 22 interviewees participating in the research. The profile of the interviewees consisted of a majority of women, with different educational backgrounds and postgraduate studies at the specialization level, with a mean of 43.4 years of age, 19.9 years of total service time, 239.3 hours of monthly work. The interviews will be analyzed using the content analysis method

  • DEISIANE AMORIM DA SILVA
  • INTERFACE BETWEEN PUBLIC HEALTH AND MENTAL HEALTH  FOCUSING WOMEN AFFECTED BY THE ZIKA VIRUS.

  • Data: 02/04/2019
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  • The present work reflects about the outbreak caused by Zika virus that affected Brazilian population and has ended up generating not only physical but also emotional consequences for all involved. There is a particular group who daily has to deal with the difficulties of this new imposed reality: women. The approach to the subject of this dissertation presupposes the necessity to know, understand and apprehend psychosocial issues in a broader context. Thus, it is necessary to go into a relatively new context which has affected black, poor and low-educated women, in order to offer assistance, especially for those whom have had her mental health affected as a result of this new reality. In addition, it will be known the reality of women who have had children with a microcephaly diagnosis attributed to Zika virus. This research is a qualitative study in which an ethnographic method was adopted, and the place where the study was developed is the institution of “Fundação Santa Casa de Misericórdia do Pará (FSCMPA)”. The research analyzed that the women in this situation were not heard or cared for, besides the normalized care for a postpartum period. It was concluded that, despite this lack, the mental health of these women is affected since the beginning of the pregnancy. Therefore, the family and social context becomes important to foster discussions about health practices and the representations that Zika brings to women who have had their lives changed by the situation that has caused a great alarm throughout society

  • ADRIANO AUGUSTO REIS SOUZA
  • KATUANA OF AMAZÔNIA: Food consumption and association with the cardiovascular risk in urban population

  • Data: 28/03/2019
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  • Objective general: To evaluate the dietary intake pattern and its association with the risk of coronary artery disease in urban population over 30 years old. Specific: to describe the cardiovascular risk profile by the Framingham score; verify the food and food groups consumed in the study population; to analyze the association between dietary intake and the high and low risk groups by the Framingham score. Methodology: A cross-sectional study involving 267 individuals from the periphery of the city of Belém do Pará. A questionnaire on socioeconomic characteristics at home and a food frequency questionnaire (FFQ) was carried out. Biological samples were collected for biochemical tests and.  measures of weight, height and blood pressure were taken. Cardiovascular risk was calculated from clinical and biochemical data and using the Framingham cardiovascular risk scale, classifying subjects into two groups of high and low cardiovascular risk. Food consumption was measured by means of a food frequency questionnaire (FFQ) and the consumption of food analyzed in daily and non-daily. Results: 22.5% of the group had a high risk of developing coronary artery disease and 77.5% were low risk according to the Framingham score. Of the population that presented high risk, 65% were women, 91.7% had the predominant brown or black color; 68.3% belonged to classes B and C; the median per capita income was R$ 300,70; the median age was 47 years; the median number of years of study was 8 years; 65.9% had a marital relationship; 76.7% were overweight and 41.7% had increased waist circumference. Concerning daily food consumption of the studied population, 62.9% consumed whole milk, 13.9% red meat, 50.2% margarine, 65.5% cassava flour, 8.6% soda, 10.5% skimmed milk, 38, 6% beans and 15.7% consumed fruit and vegetables five times a day. Conclusion: The present study observed that the population studied presented a fairly homogeneous diet, probably due to the similarities of purchasing power and eating habits. Thus, this study did not find statistical association between cardiovascular risk and food consumption in this population group

  • VICTOR VIEIRA DE OLIVEIRA
  • XXXXX

    Rural Adolescents: Risk Behaviors for Noncommunicable Chronic Diseases in a Town of the State of Pará

  • Data: 15/03/2019
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  • OLIVEIRA, V. V. Rural Adolescents: Risk Behaviors for Noncommunicable Chronic
    Diseases in a Town of the State of Pará. 2019. 110f. Thesis (Master’s degree) - Universidade
    Federal do Pará, Programa de Pós-Graduação em Saúde, Ambiente e Sociedade na Amazônia,
    Belém, 2019.
    Recent studies have demonstrated the epidemiological transition and the increased occurrence
    of Noncommunicable Chronic Diseases (NCD), especially among adolescents in less
    developed countries, and in those who live in poor areas. Although it is recognized that these
    diseases are more commonly perceived in adults, their manifestations are the result of the
    interaction of risk factors acquired at an early age. Therefore, the objective of this research
    was to identify the risk factors for NCDs in adolescents from the rural area of a town in the
    northeast of the state of Pará, Brazil, as well as to present the risk factors for NCDs through
    the following variables: physical activity, tobacco use, alcohol consumption, Body Mass
    Index, waist circumference and blood pressure, identifying the possible associations between
    these variables with the socio-demographic, socioeconomic conditions and with the
    behavioral and alimentary markers. An observational, cross-sectional epidemiological study
    was carried out on a representative sample of students of both sexes, aged between 15 and 19
    years, enrolled in the regular high school of six public schools in the rural area of the
    municipality of Ipixuna-PA. The data were obtained through a questionnaire and clinical
    evaluation, being analyzed by means of explanatory analysis and univariate and multiple
    logistic regression, considering a significance level of 5% (p < 0 ,05) and a 95% confidence
    interval (CI). The sample consisted mostly of female individuals, with an average age of 17
    years, who were insufficiently active, who had already experienced alcohol and tobacco,
    belonging to the most socially vulnerable strata and who had a poor -fiber diet, but rich in fats
    and sugar. The sedentary lifestyle was significantly related to the female sex, while the risk of
    altered blood pressure and tobacco experimentation were significantly related to the male sex.
    Socioeconomic conditions have been shown to influence mainly blood pressure increase,
    tobacco experimentation, and waist circumf erence, while older age has been shown to be a
    protective factor for abdominal obesity. Likewise, the consumption and experimentation of
    alcohol and tobacco showed to have their use combined, as well as the presence of abdominal
    obesity and overweight. Inadequate feeding, in turn, was associated with the greater risk of
    the adolescent being insufficiently active. This study makes clear the need for more effective
    public policies aimed at raising awareness of the need for a healthier lifestyle among
    adolescents in rural areas.

  • CAMILA AGUIAR DA FONSECA
  • The worldwide prevalence of obesity more than doubled between 1980 and 2014. Increasing metabolic changes that include overweight and obesity, associated with inadequate eating behavior, physical inactivity and excessive time spent in front of screens, generated interest in investigating these variables related to adolescents from public and private schools in the municipality of Belém / Pa. Methodology: It is a subproject of the Cardiovascular Risk Study in Adolescents (ERICA), a cross-sectional multicenter national study with adolescents aged 12 to 17 who attend public and private schools in Brazilian cities with more than 100 thousand inhabitants. The variables used for this subproject were on sociodemographic aspects, physical activity evaluation and food behavior. Results: In the universe of 1.259 adolescents, there is higher prevalence of students aged 15 to 17 years. About 25% of the overweight / obese male were found in the private school, and in the female sex about 17%, higher values than in the public school, which presented as the most recurrent low weight. There was a higher prevalence in female students with inactive physical activity (67.22%) and in active males (52.30%). A higher prevalence was found in students (both sexes) of private school who do not usually eat lunch; and dinner with those responsible; Regarding TV viewing / playing video games / computer use eating snacks, there was a higher prevalence among male students of public schools with 30.47%, a very close figure among female students (29.39%) of the same type school. Adolescents are no longer eating breakfast and are more physically inactive than males. There was an excessive time spent in front of the screens, negatively influencing their eating habits and their sedentary lifestyle. The adolescents with lower BMI are predominantly of the predominant B / C classes - in detriment of those of private school, who presented higher BMI - obesity, being of class and A / B.

  • Orientador : MARILIA DE SOUZA ARAUJO
  • Data: 27/02/2019
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  • Adolescent; food behavior; physical inactivity; obesity

  • MAURICIO SOARES CARNEIRO
  • Epidemiological Profile of Patients with Heart Failure Attended at a Reference Hospital in Belém-PA

  • Data: 04/02/2019
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  • Heart failure (HF) remains a growing epidemic. In Brazil, there are few studies that evaluate
    demographic, clinical and prognostic characteristics of patients admitted with a clinical
    diagnosis of HF. This study aims to describe the demographic and clinical characteristics of
    HF patients admitted in a public referral hospital in Belém, Pará. The study is observational
    and descriptive, the population is part of the I Brazilian Registry of Heart Failure. The patients
    in this study were admitted through the emergency department of the State Public Foundation
    Hospital das Clínicas Gaspar Vianna with clinical diagnosis of decompensated heart failure
    (DHF), from January to December 2017. Patients older than 18 years were included, reaching
    more than 7 points in the Boston criteria for diagnosis of HF and that completed at least 24
    hours of hospitalization. To compare the causes of decompensation, the Chi-square test in the
    qualitative variables and the Kruskal-Wallis test, with Dunn&#39;s post-test, to compare the
    quantitative variables. Statistical processing was performed in the BioEstat version 5.3
    program and data analysis planning was performed using the Statistical Analysis Model
    technology. Sixty-five patients were included, with a median age of 64 years, 56.9% men. The
    main risk factors for HF were arterial hypertension (66.2% of patients), smoking (70.8%) and
    sedentary lifestyle (63.1%). The main etiologies were hypertensive heart disease (23% of
    cases), ischemic heart disease, idiopathic cardiomyopathy and valve disease (18.5% each).
    The main causes of decompensation observed were valve dysfunction (26.1%) and infection
    (15.3%). Half of the patients used beta-blocker at the time of hospital admission, 49% took
    ACE inhibitors or ARBs, and 35.4% used Spironolactone. After 24 hours of admission the
    prescription of medicines recommended by the guidelines was below desirable. Measures
    should be taken to encourage the prescription and use of drugs recommended by scientific
    evidence that have been shown to reduce the morbidity and mortality of HF. Further studies
    should be conducted for a better understanding of the epidemiology, diagnosis and treatment
    of HF in the northern Brazil.

  • ADAIR DA SILVA ELLERES
  • Underdiagnosis of Chronic Obstructive Pulmonary Disease in a Cardiology Ambulatory from a Reference Hospital in Belém, Pará, Brazil.

  • Data: 31/01/2019
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  • Chronic Obstructive Pulmonary Disease (COPD) is an important public health issue, with high morbimortality and causing a huge economic and social impact, representing a loss in quality of life for the disease carriers. Subdiagnosis of COPD constitutes one of the worse aggravations of the disease. The development of a simple risk model to stratify and predict the respiratory comorbidity would help prevent Subdiagnosis and progression of the disease. Objective: Identifying prevalence of COPD, identifying non-pulmonary comorbidities related to the prevalence of this disease in the attended patients in an ambulatory of cardiovascular diseases, developing a tool to predict risk factors for COPD in patients carrying cardiovascular diseases. Methods: Explanatory, transversal and prospective study of carrier patients for vascular cardiopathies in the cardiology ambulatory of a reference hospital in Belém, Pará, Brazil, from July/2018 to September/2018. Patients with respiratory symptoms were selected, from both sexes, aging 40 years or more, history of being exposed to risk factors for COPD and those with a previous diagnosis for COPD. We excluded patients with a previous diagnosis for other chronic respiratory diseases, allergic diseases and patients that were unable to perform spirometry. COPD diagnosis was given after spirometry, obeying the criteria established by GOLD, where the FEV1/FVC ratio < 0.70 or by the FEV1/FVC ratio under the limit inferior of normality. Statistical analysis was conducted using the chi-square test. Results: Amongst the assessed patients, 76 fulfilled the criteria for COPD; out of these, 2 were previously diagnosed with COPD and 35 were only diagnosed with COPD starting from this study. COPD prevalence was of 48.68% and underdiagnosis was of 46.05% among patients with risk factors for the disease. We compared the group With a diagnosis for COPD with the group Without a diagnosis for COPD according to sociodemographic variables, respiratory symptoms and comorbidities. Sex ratio (p = 0.1159, not significant) has shown that in the group With COPD there were 78.4% patients from the male sex, and in the group Without COPD they were 41%. Distribution of patients with a smoking track (p = 0.1642, not significant) has shown that in the group With CPOD there were 78.4% former smokers, while in the group Without COPD there were 59%. Age comparison has not shown any real distinction between groups: With COPD (67.1± 8.6 years) and Without COPD (63.3 ± 10 years). Comparison of BMI also did not present any difference between groups: With COPD (28.6 ± 5.3 kg/m2 ) and Without COPD (29.50 ± 5.0 kg/m2 ). Comparison of Smoking history did not present any distinction between the group With COPD (44.4 ± 50.5) and the group Without COPD (49.6 ± 51.2). Comparison of Oxygen Saturation also did not present distinctions between the groups: With COPD (97.5 ± 1.6) and Without COPD (97.3 ± 1.7). When comparing the dyspnea scale we observed that, in the group With COPD the category Grade 3 was more frequent (43%), and in the group Without COPD the category Grade 1 prevailed (48.1%); however, statistical analysis has shown that there is no significant difference between groups (p = 0.0827). When we assessed the severity of COPD based on spirometry values, most were on the GOLD Stage 1 – mild (p-value = 0.0365). The most common comorbidities in patients with COPD were SAH (89.2%), Dyslipidemias (67.6%), Ischemic Cardiopathy (64.9%) and Diabetes Mellitus (29.7%). Due to the high prevalence of underdiagnosis of COPD and its association with non-pulmonary comorbidities, it was necessary to develop a predictor UNIVERSIDADE FEDERAL DO PARÁ INSTITUTO DE CIÊNCIAS DA SAÚDE PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE, AMBIENTE EM SOCIEDADE NA AMAZÔNIA. Praça Camilo Salgado, nº 1, Umarizal, Belém, Pará, CEP 66.050-060, Belém, PA. Fone: (91) 3201-6806 score to predict respiratory comorbidity. Conclusion: Our study has shown a high prevalence of COPD underdiagnosis among patients carrying cardiovascular diseases, raising awareness to the importance of early diagnosis and adequate treatment. Keywords: Chronic obstructive pulmonary disease (COPD), COPD Underdiagnosis, Cardiovascular Diseases, Spirometry

  • LUIZ ALBERTO ROLLA MANESCHY
  • Coronary Artery Disease: Is there a gender difference in the mortality of patients submitted to angioplasty at a public hospital in the state of Pará? 2018

  • Data: 31/01/2019
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  • Coronary Artery Disease; Angioplasty; Women.

  • ALEXSANDRO SILVA DE ARAUJO
  • FATORES DE RISCO SOCIODEMOGRÁFICO, COMPORTAMENTAIS E DE SAÚDE ASSOCIADOS À SÍNDROME METABÓLICA EM ADOLESCENTES DE ESCOLAS PÚBLICAS E PRIVADAS EM UM MUNÍCIPIOS DO ESTADO DO PARÁ. BRASIL, 2013

  • Data: 14/01/2019
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  • A síndrome metabólica (SM) é definida como o conjunto de alterações metabólicas inter-relacionadas presente no organismo que incluem resistência à insulina, resistência à glicose, dislipidemia, gordura abdominal aumentada e hipertensão arterial sistêmica. Visto que a adolescência é um período muito especial no desenvolvimento humano, considerada a transição entre a infância e a idade adulta, caracterizada por intenso crescimento e desenvolvimento que se manifesta por marcantes transformações anatômicas, fisiológicas, psicológicas e sociais.  Hábitos alimentares inadequados na adolescência podem ser fatores de risco para a presença de doenças crônicas não transmissíveis, tanto na vida atual como na futura. A presença de alterações metabólicas na infância e adolescência pode contribuir para o desenvolvimento deste processo, já que estudos longitudinais clássicos mostram uma forte associação entre o excesso de peso nas primeiras décadas de vida e a alta taxa de morbimortalidade na vida adulta por doenças cardiovasculares. Assim, torna-se necessário, a partir da proposta de estudo, o conhecimento da prevalência da SM em nossa população de adolescentes, que frequentam escolas pública e privada pertencentes no município de Belém do estado Pará a partir dos fatores sociodemográficos, comportamentais e de saúde associados à SM em escolares, com idade entre 12 e 17. Os dados foram coletados por meio de três questionários: um destinado aos alunos, um para os responsáveis e outro referente à escola. Trata-se de um estudo transversal, realizado a partir de dados secundários obtidos no Estudo de Riscos Cardiovasculares em Adolescentes – ERICA, realizado junto a adolescentes em escolas públicas e privadas, no município de Belém do Pará

2018
Descrição
  • SILVIO SILVA DE OLIVEIRA
  • EPIDEMIOLOGICAL AND SPATIAL PROFILE OF LEPROSY IN CHILDREN UNDER 15 YEARS OF AGE, IN THE METROPOLITAN REGION OF BELÉM, STATE OF PARÁ

  • Data: 18/12/2018
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  • Leprosy is an infectious, curable disease, however, with great potential for generating physical incapacity. Knowing the impact of leprosy in children under 15 allows estimating the level of transmission, the intensity of the endemic disease and evaluating the effectiveness of health services in combating this disease, which is more prevalent in poor populations and represents a growing health problem in the this study analyzed the epidemiological profile of leprosy in children under 15 years of age and the population coverage of the Family Health Strategy in the Metropolitan Region of Belém, state of Pará, from 2006 to 2015. Quantitative study with an ecological study design in a historical series of leprosy cases reported in the years 2006 to 2015, using secondary data from the Ministry of Health's Notifiable Diseases and Basic Attention Database State of Pará, Brazil. Of the 675 cases, the majority (58.96%) were detected by referral, predominantly male (55.70%), black + brown (81.63%) and incomplete elementary school (77.48 %). The most frequent age group (65.09%) was children aged 10 to 14 years, with a predominance of paucibacillary forms and a higher frequency of dimorphic clinical form. The evolution of the standardized rate of detection of leprosy in less than 15 years, presented geographically, showed a high level of hyperendemicity in the municipalities of Castanhal, which had population coverage of the Consolidated Family Health Strategy and Marituba with intermediate coverage. It was presented with hyperendemicity in the municipality of Santa Bárbara do Pará also as a consolidated coverage and very high endemicity in the municipalities of Ananindeua with intermediate coverage, Belém with incipient coverage, Benevides and Santa Izabel do Pará with consolidated coverage. The areas of spatial autocorrelation for the transmission of the disease appeared to form two clusters, the first one involving the municipalities of Ananindeua, Belém and Benevides and the second one formed by the municipality of Castanhal located opposite to the first one. The highest densities of mean detection rates were observed in the municipalities of Marituba that spread to the municipalities of Ananindeua and Benevides and also in the municipality of Castanhal, representing to some extent the areas of greatest risk for the transmission of the disease. In the city of Belém, the capital of the State of Pará, the population coverage of the Family Health Strategy was incipient in most of the neighborhoods, although in some of the Mosqueiro Island it was consolidated, contradictorily putting those areas with the highest densities of average detection rates. The magnitude of the endemic disease, the strength of the morbidity and the tendency of the disease, indicated by the indicators of epidemiological follow-up remained high and the coverage of the Family Health Strategy, although consolidated in most municipalities, was not homogeneously distributed to guarantee universal coverage to the territories , implying in some way with this epidemiological situation, to affirm that leprosy is a serious public health problem in the Metropolitan Region of Belem.

    .

  • ROMENIA VIDAL DE FREITAS ESTRELA
  • ASSOCIATION BETWEEN OVERWEIGHT AND SMOKING STATUS IN THE ADULT POPULATION OF BRAZIL: VIGITEL 2016.

  • Data: 17/12/2018
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  • Noncommunicable Diseases are on the global agenda as one of the greatest health and challenge problems of the 21st century, and several modifiable factors are associated with them, such as: smoking, inadequate nutrition, physical inactivity and alcohol. Poor diet and lifestyle changes have contributed to the increased prevalence of obesity. Studies suggest that there is an association between obesity and smoking, which is often used as an alternative in weight control, believing that smoking influences weight. Objective: To verify the association between overweight and smoking, considering sociodemographic and behavioral factors, in the adult population of Brazil, based on data from VIGITEL 2016. Methods: Cross-sectional, population-based study, based on data from 2016, of the Surveillance System for Risk Factors and Protection for Chronic Diseases by Telephone Inquiry (VIGITEL) with adults (≥ 18 years of age), living in the capitals of the 26 in the Brazilian states and in the Federal District. The total sample consisted of 53,210 people interviewed, but for this study only data from people aged ≥ 20 years and ≤ 59 years old will be used, and pregnant women will be excluded at the time of the interview, people who did not know their weight and / or their current height, as well as people who declare themselves indigenous and / or yellow. The variables used will be: overweight, smoking, age, schooling, marital union, consumption of alcoholic beverages, physical activity, sedentary behavior, food consumption and hypertension, diabetes, cholesterol or high triglycerides. Overweight will be considered as the outcome variable (dependent), classified as BMI ≥ 25 Kg/m2, derived from self-reported weight and height. The smoking behavior will be the explanatory variable (independent), in which it will be considered: current smoker, ex-smoker and never smoker. The variables will be stratified by sex, and the population distribution (total and by sex), considering all variables studied, both considering the 95% confidence interval (CI). The Chi-square test will be applied to all variables and the variables with p <0.02 will be selected for the multivariate analysis using Poisson Regression. STATA version 12.0 software will be used for data analysis. VIGITEL has the approval of the National Commission for Ethics in Research for Human Beings of the Ministry of Health, and free and informed consent was obtained verbally at the moment of telephone contact with the people interviewed (BRAZIL, 2016; 2017)

  • SILVIA HELENA SILVA DO NASCIMENTO
  • Segurança do Paciente. Eventos adversos. Gestão de Riscos. Insuficiência Renal Crônica. Hemodiálise.

  • Data: 07/12/2018
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  • The dialectic therapy in the course of history has undergone several changes both in technological advances and in the legislations that regulate the services making the modality much safer, however we still cannot guarantee to be a free treatment of Risks for patients who depend on this treatment. In hemodialysis units There are numerous risk factors that increase the probability of occurrence of these events, the risks need to be identified and managed by the team in order to avoid adverse events, the processes of continuous improvement should Be part of the day in order to ensure patient safety and provide quality care. This study aimed to analyze the patient's safety by identifying the risks on hemodialysis. This is a descriptive study with a qualitative approach, developed with the method of convergent care research (PCA). We analyzed 57 interviews conducted with the professionals working in the dialysis services of the srts and Chml linked to the Fundação Hospital de clinicas Gaspar Vianna in Belém-Pará. The project was approved by the Ethics Committee on Human Research (CEP) of the ICS/UFPA, under the opinion consubstantiated N º 3,004,759, CAAE: 95992718.5.0000.0018. The results were organized into two categories, and Category 1 generated two subcategories: 1. The team's knowledge of the risks that permeate hemodialysis (subcategory 1: Exposure of patients to health care risks; Subcategory 2: Occupational risk exposure among hemodialysis professionals); 2. Relationship between patient safety goals and health care risks.

  • PAULO ROBERTO SANTOS WANDERLEY
  • The qualification process of services in general hospitals of the Metropolitan area of the State of Pará to the SUS: Contextualization under the opticians of managers

  • Data: 06/12/2018
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  • The process of habilitation of health services is the act of the Federal Manager that ratifies the accreditation of the Full Manager of the Municipal or State System of SUS, duly referred to the Ministry of Health by the respective State Manager. The present study is focused on the verification of supposed difficulties to enable medium and high complexity services in hospitals in the Metropolitan Area I of the State of Pará, which function as referenced services in public health, and it is important to understand and carry out an integrative approach to the variables that intervene in the habilitation, in the implantation or in the expansion of services to be financed by the state. In this way a systematic bibliographic survey on the subject was made and later a field research through semi-structured interviews in 4 hospitals, being 2 public and 2 private, using a descriptive and analytical methodology, on the qualitative data collected in the field research. It was observed that there are services operating without financing coverage and that they are the direct and concrete consequence of the practical rupture of the habilitation process, causing consequently other secondary problems of the most diverse orders, and no less serious than the first. The difficulty in qualifying the services with the SUS should be considered a major problem, especially because it still keeps a model of organization and self-centered functioning, based on the control of the means and without the proper monitoring of the ends. Such mismatch between the declared national ideals and objectives, at least nominally, incite the evaluation of the way the public machine operates, not infrequently marked by regulatory fragility of the State and Municipal Health Secretariats, low technological incorporation, and consequent corrosion of the capacity to offer quality services and integral, inclusive and transversal, to the Brazilian population.

  • EMANUELE DE JESUS SILVA DE LIMA
  • KATUANA QUILOMBOLA: AÇAÍ CONSUPTION AND CARDIOVASCULAR RISK IN AMAZON QUILOMBOLA POPULATIONS.

  • Data: 31/10/2018
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  • The association between diet and cardiovascular disease has been widely investigated worldwide for years. Nevertheless, little research has been conducted in the Amazon region, particularly in traditional populations such as the quilombolas. Similarly, the literature presents only few investigations on the impact of açaí consumption on these peoples’ health. Within this context, the present work aims to evaluate the consumption of açaí and verify its association with cardiovascular risk factors in people of both genders with ages from 30 years in the remaining quilombo communities in Salvaterra, Marajó Island, Pará. For that purpose, a cross-sectional study will be carried out on a population of 312 individuals, distributed in 8 quilombola communities. Home visits will be perfomed, in order to georeference participants and to apply standardized socioeconomic and daily açaí consumption questionnaires. Moreover, biological material will be collected for measurement of serum levels of fasting glucose, triglycerides, total cholesterol and HDL, as well as anthropometric and blood pressure measurements. As partial results, the complete data of 216 individuals was already obtained. Among them, 62.5% are women, 25.5% reported to have finished elementary school and 36.1% were participants of the Bolsa Família program. Regarding diseases, 25.5% informed to have hypertension and 8.3%, DM2; however, only 17.6% and 6.0% reported to use any medication due to these diseases, respectively. Participants were categorized in three groups, according to daily açaí intake: 1) no consumption of açaí, 2) consumption of up to 100g of açaí per day and 3) above that value. There was no statistically significant difference between the variables, daily açaí consumption, age, systolic and diastolic blood pressure, BMI, waist circumference and capillary glycemia. The next step of this study will be to analyze the association between açaí intake and plasma glucose and lipid levels.

  • CLAUDIA DZIMIDAS HABER
  • EVALUATION OF THE QUALITY OF LIFE OF PATIENTS CARRIED OUT OF CARDIOVASCULAR DISEASES IN A STATE PUBLIC HOSPITAL

  • Data: 30/10/2018
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  • Patients with cardiovascular diseases may have altered quality of life as a consequence of their health, either because of their physical or psychological deficiencies. OBJECTIVE: To evaluate the Quality of Life of patients with cardiovascular diseases admitted to a referral hospital in cardiology. METHOD: Prospective cross-sectional study conducted from April to May 2018 through the application of the SF-36 Sociodemographic and Clinical Profile and Medical Outcomes Short-form Health Survey questionnaires. The SF-36 Scale is a generic instrument consisting of 36 questions covering eight domains or dimensions with scores ranging from 0 (poorer health status) to 100 (better health status) and which measure Quality of Life. The domains are identified by: Functional capacity, Physical aspects, Pain, General state of health, Vitality, Social aspects, Emotional aspects and Mental health. The sample corresponded to 70 patients randomly and voluntarily interviewed, admitted to the Cardiology Clinic. RESULTS: Of the 70 patients interviewed, 70% (49/70) of the individuals were male, 32.8% (23/70) aged over 70 years, 44.3% (31/70) married and 35, 7% (25/70) with study through incomplete primary education. Although 62.9% (44/70) had a previous diagnosis of heart disease, only 40% (28/70) underwent some drug treatment. Acute infarction was diagnosed in 54.3% (38/70) of the patients and heart failure in 12.9% (9/70), and the other patients had different diagnoses for cardiovascular diseases. Risk factors such as smoking (55.7%), hypertension (47.1%) and diabetes (31.4%) were reported. The mean values for SF-36 domains that measure Quality of Life ranged from 40 to 50. Mental health received the highest mean (62.6) and the lowest was for Physical aspects limitation (23.6) and emotional aspects (23,6). Previous diagnosis of the disease was reported by 36 individuals, 9 of whom had less than two years of disease and presented better Quality of Life. Compared a year ago, 24 patients rated their health as almost the same as a year. CONCLUSION: The study allowed to characterize the sociodemographic profile of hospitalized patients and to identify clinical variables. The evaluation of the Quality of Life of the patients verified that the domains Limitation by emotional aspects and limitations by physical aspects were the most compromised, followed by the Social aspects. The General and Vitality domains were more preserved. Individuals with less than two years of diagnosis of cardiovascular disease presented better quality of life than patients diagnosed for more than three years. When compared to current health and a year ago, most said it is almost identical a year ago

  • ELIZABETH DAS DORES SILVA
  • THE FUNCTIONING OF THE PSYCHOSOCIAL ATTENTION NETWORK AS GUARANTEE OF THE MENTAL HEALTH POLICY IN THE MUNICIPALITY OF BELÉM-PA

  • Data: 18/10/2018
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  • This study aims to evaluate the functioning of the Psychosocial Attention Network of the city of Belém-Pa to stablish if this policy is an effective way of guarantee the Psychiatric Reform Policy in Brazil. The type of this study was the qualitative type, according to the propositions made by Minayo (2006) in the field of health. The field research was carried out at the Gaspar Viana Clinic Hospital Foundation’s Psychiatric Emergency, General Hospital of State Reference in Urgency and Psychiatric Emergency. Participated in the survey 5 family users of patients who had more than 3 hospitalizations in a period of 1 year in this Psychiatric Emergency. Throughout the entire research, the collection of data was made by the following instruments: documentary and bibliographical research, as well as semi-structured interviews that were recorded and transcribed. With the deepening of the reading and reflection about the condition of the discourse production, the categories of the analyzes were defined. The results of the research shows that the Psychosocial Care Network of the Municipality of Belém is incipient, requiring individual, social and institutional changes to comply with the Mental Health Policy, and a new, more humanized and community service model must be adopted, among the territorialisation of the services. The results of this study can contribute to a more effective guarantee of the rights brought with the Psychiatric Reform to the person who is in psychic suffering.

  • VITOR NINA DE LIMA
  • OUTRAS NISES: MULHERES EM CLÍNICAS, ARTES E PEDAGOGIAS INSURGENTES ÀS POLÍTICAS DA MORTE EM BELÉM, ENTRE 2014 E 2018

  • Data: 08/10/2018
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  • Comover Cuidado: amor, arte e indisciplina para a saúde das comunidades

  • SILVANA RODRIGUES GOUVEIA
  • FOOD DETERMINATION IN A CABOCLO COMMUNITY OF AMAZONIA IN A SPACE-TIME PERSPECTIVE

  • Data: 01/10/2018
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  • This work aimed to study determinants and conditioning factors in the construction of the food history of a Caboclo community called Nova Vida in Barcarena / PA, which suffered socio-environmental impacts: two compulsory displacements and exposure to mining pollutants, which provoked ruptures and adaptations in the strategies of access to food, marking the specificity of the food history of the community. The qualitative approach and the semi-structured interview with community residents who experienced the displacement processes were essential for obtaining the food experiences. From the reports it was evidenced that the strategies of access to food in Ponta da Montanha and Curuperé are well delimited. All families practiced subsistence agriculture, vegetable extractivism in the forest, collection of fish on the beach, cultivation of fruit plants in backyards. On the other hand, the hunting in the forest, the raising of domestic animals for food consumption, fishing 'outside', were strategies restricted to some residents. However, in Nova Vida, the third place of occupation of this community, the acquisition of food takes place, for the most part, monetary way. The form of geopolitical and economic organization in Barcarena, Amazonian ecosystem, individual and family choices are determining factors of the community's food history. This community is a reference that demonstrates processes of changes and permanences, loco-regional specificities and similarities, where in the socio-spatial scenario the local and global coexist because there is a permanence of the food culture of the Amazonian caboclo and a process of change, although late, in other parts of the country, for a more industrialized, globalized food. In this context, food is a marker that indicates the political macro-structuring and socio-spatial transformations in Barcarena, but above all, the adaptations developed and the re-significances of the individual and collective life history

  • VÂNIA MARIA SEGURADO PIMENTEL
  • Avaliação do Risco Cardiovascular em Médicos de um Hospital Público de Referência em
    Cardiologia

  • Data: 26/09/2018
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  • As doenças cardiovasculares são responsáveis por altas taxas de
    morbimortalidade em todo mundo e os médicos vêm se tornando vítimas frequentes
    desses agravos. Foi realizado um estudo transversal, analítico, exploratório, com
    objetivo de identificar os fatores de risco cardiovasculares em médicos do quadro de
    profissionais da Fundação Pública Estadual Hospital de Clínicas Gaspar Vianna -
    FPEHCGV, referência em Cardiologia, no Estado do Pará. Participaram da pesquisa
    148 profissionais médicos efetivos e contratados, em atividade na FPEHCGV,
    localizado em Belém/PA, com idade média de 45±10 anos (28 a 72 anos), com
    predomínio do sexo feminino (60.8%) e mais de 20 anos de formado (47,3%) com
    boa auto avaliação da saúde (62.8%). Observou-se alta prevalência de sobrepeso e
    obesos, bem como de pré diabéticos. Após análise estatística por regressão
    univariada e múltipla que as medidas antropométricas (IMC, CC e RCE) tiveram
    correlação positiva com a maioria das variáveis, sendo bons preditores de risco
    cardiovascular. A proteína C reativa de alta sensibilidade apesar de alterada em
    grande parte (62,1%) dos médicos mostrou pouca correlação com as variáveis
    clinicas e metabólicas estudadas. Médicos pré-hipertensos e hipertensos
    apresentaram maior risco de obesidade e hiperglicemia. Neste estudo, portanto,
    ficou bem demonstrado a alta prevalência de fatores de risco modificáveis para
    doenças cardiovasculares entre os profissionais médicos da Fundação Pública
    Estadual Hospital das clinicas Gaspar Vianna (FPPEHCGV) com destaque para
    obesidade, sobrepeso, sedentarismo hipertensão arterial e risco aumentado de
    desenvolver DM. Os médicos como profissionais de saúde esclarecidos devem estar
    mais atentos as suas condições de saúde e conscientes de que a alteração do estilo
    de vida trará resultados efetivos no risco de desenvolvimento de doenças
    cardiovasculares.

  • JULIANA DE FREITAS MAGNO PANTOJA
  • Work process of oral health team in Health Family Program in Belém municipality.

  • Data: 11/09/2018
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  •  

    The way of producing care by the oral health team in Health Family Program seem to be different from the one played in the tradicional assistance which understantands sickness and helthness as a result from unique biological reasons. However, source of factors difficult the new way working process. The National Oral Health Policy (NOPH) serves as guideline to this new way of intervention on oral care. The aim of study was to analyse work process of the oral health teams participated in Health Family Program in Belém municipality. Methods: Work process was evaluated  based on the data from the  second cicle Program of Improving Acess and Quality of Primary Care, ocurred on 2013. Questions mentioned were about planning actions, management, institucional support , matricial support, integration with the existent health net, profissional qualification, resolution and home visit. Results: The results shown tha 60% of the Professionals acted over Five years in primary care and 20 % had contuined education in social issues. There was no carrer plan and the teams were not participant caracterizing a weak relationship with the rest Family Health Program team. Management support could be better standing the oral team actions that represented the majority of curative care. Related to home visit and planning actions it was found that 100% of the teams perfomed these

    movements. The reference and counter-reference system was realized by 80% of the teams with no garanty of multidisciplinary attendance. Conclusion: In spite of  Health Family Program  discerns a new way of taking care; in Belém it was observed that work process realized by the oral health teams were different from the one predictted on NOPH. Cultural factors, management and public policies can be atributted to this disagreement. Thus, looking out for principal difficulties in work process it’s essencial for transforming the practice dentistry – consolidating oral health as an unbroken part of health

  • KELLY LENE LOPES CALDERARO EUCLIDES
  • THE IMPLEMENTATION OF THE NATIONAL POLICY OF HEALTH PROMOTION IN PRIMARY ATTENTION UNDER THE PERSPECTIVE OF HEALTH PROFESSIONALS

  • Data: 04/09/2018
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  • The health promotion provides for the involvement of all the actors of doing and being health, in order to be protagonists and active participants in its implementation and continuity in care. Health promotion brings a new perspective that involves political, social, ethical, cultural, spiritual aspects to ensure health in a universal, equitable and integral way. The effective and efficient implementation of its policy in primary care focuses on changes of conduct in the treatment of users, through actions that tend to reach the individual's complete health, considering the determinants of health that make up this universe. In primary care, collective action is essential, where all are protagonists for health production. For this action to become concrete health professionals need to be aware of the process of health promotion to users, producing their actions with conscience, actually promote health and non-compliance with agenda and / or assitentialism, as deigned with this study. There is an urgent need for a real change in the praxis and paradigms of health care models, emphasizing the importance of intersectoriality and multiprofessional work in the logic of total health promotion, its concepts and functioning should be capillary to the professionals and doers of SUS in all its activities and levels of performance and / or management

  • CLEYBISMAR BEGOT DA RESSURREIÇÃO
  • Urinary tract infections (UTIs) are an important cause of morbidity and mortality in hospitalized patients, and most cases are caused by Enterobacteriaceae, especially Escherichia coli and Klebsiella pneumoniae. These bacteria have developed and disseminated mechanisms of antimicrobial resistance, especially extended spectrum betalactamases enzymes (ESBL), which makes them resistant to broad-spectrum and monobacchaic cephalosporins. The use of bladder catheters is one of the major risk factors for UTI related to health care, increasing morbidity and treatment costs. Microbiological, clinical, molecular and health aspects of the growing threat of antimicrobial resistance will be addressed. This paper intends to describe the ITU casuistry in adult patients hospitalized in a public hospital in Belém, northern Brazil, from January 2011 to December 2016, as well as their variables gender, age, presence and indication of bladder catheterization , Associated signs and symptoms, death during hospitalization, presence of comorbidities, isolated microorganism in the culture and antimicrobial susceptibility profile in current use, and from May to October 2017 isolated from strains of E. coli and K. pneumoniae obtained from urine of over 18 years and phenotypically evaluated for ESBL characterization. Characterization will be performed by Polymerase Chain Reaction (PCR) technique to determine whether the blaTEM, blaSHV and blaCTX-M1 genes were present in the microorganisms. 

  • Data: 28/08/2018
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  • Urinary Tract Infection, Health Care Related Infection, Urinary Catheter, EBSL, blaTEM, blaSHV and blaCTX-M.

  • WADIH BRAZÃO E SILVA
  • ANALYSIS OF THE NORMATIVE INSTRUMENTS GOVERNING THE PURCHASEOF FOOD INTENDEDFOR SCHOOL LUNCH HALL BELENENSE AFTER THE CONSTITUCIONAL AMENDMENT Nº 64/10: comparison between the practice and the guarantee established by the “Citizen Constitucio

  • Data: 28/08/2018
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  • Abstract- Taking as a reference the scientific evidence that inadequate food results in a variety of health problems, as well as the fact that, from 2010, food has been elevated to the category of social law set forth in the Federal Constitution through Constitutional Amendment number 64, the present study is directed to the research about the effective observation of this right in relation to the student population that receives school meals in the city of Belém from the year of validity of said Amendment, delimiting the period from February 2010 to February 2018. Therefore, it assumed as a premise that the full realization of the social right to food only occurs if the food has nutritional value and that this condition is in the drafting of normative instruments (Bidding Documents and Public Call Records) governing the acquisition of food intended for school lunches in the municipality. The study focused on the poor quality of school meals in some schools in Belém, analyzing the normative instruments of municipal public acquisition of food for school meals in the light of the quality criteria recommended by the National School Feeding Program (PNAE) and of the dispositions of the current legislation, and proposes alternatives for the mitigation of the mentioned problem.

     

     

  • JULIANE COSTA LEITE
  • INSEGURANÇA ALIMENTAR EM FAMÍLIAS DE CRIANÇAS MATRICULADAS NA REDE MUNICIPAL DE EDUCAÇÃO INFANTIL, BELÉM-PA.

  • Data: 20/08/2018
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  • Estudo analítico, observacional de delineamento transversal que objetivou estimar a
    prevalência de Insegurança Alimentar e Nutricional (IAN) entre as famílias de crianças
    matriculadas na rede municipal de educação infantil, Belém-Pa. Como instrumentos para
    essa mensuração foi utilizada a Escala Brasileira de medida de Insegurança Alimentar
    (EBIA), e, para avaliar o perfil familiar, utilizou-se formulário sócio demográfico.
    Procedeu-se também à avaliação antropométrica das crianças para análise do estado
    nutricional. Foram pesquisadas 368 famílias do município de Belém-Pa, distribuídas
    proporcionalmente entre seis distritos administrativos. A técnica de amostragem
    considerou um erro de 5% e foi do tipo aleatória estratificada proporcional. Na análise
    estatística da associação entre indicadores sócio demográficos e insegurança alimentar,
    utilizou-se os testes Qui-quadrado e teste G. Para estimar os valores de razões de chance
    (Odds ratio) e respectivos intervalos de confiança (IC 95%), usou-se a regressão logística
    múltipla considerando a categoria de desfecho insegurança alimentar de acordo com a
    EBIA. Em todos os testes foi adotado o nível de significância (α) igual a 5%. O programa
    estatístico usado nas análises foi BioEstat 5.3. Como resultado, encontrou-se prevalência
    de IAN de 85,6%, que se distribuiu, de acordo com o gradiente de severidade, em 36,4%
    de IAN leve, 28,8% moderada e 20,4% grave. Verificou-se associação estatisticamente
    significativa entre insegurança alimentar e renda familiar per capita (p = 0,0001), 

    escolaridade do chefe da família (p=0,0040), recebimento do Bolsa Família (p=0,0540) e
    tipo de material empregado na construção do domicílio (p=0,0370). No modelo de
    regressão logística múltipla, observou-se que a renda familiar per capita menor que meio
    salário mínimo e a condição de não possuir trabalho remunerado pelo entrevistado,
    associou-se, respectivamente, a chances 6 e 2 vezes maiores de a família apresentar
    insegurança alimentar. O estudo se apresenta como um instrumento importante na
    identificação do público pesquisado como um grupo de risco, no que se refere a IAN,
    para o qual estratégias de intervenção e enfrentamento devem ser prioritárias e, também,
    favorece a criação e a análise de políticas públicas municipais de promoção de segurança
    alimentar e nutricional, além de permitir o reconhecimento das causas contemporâneas
    do problema investigado.

  • SANDRA REGINA MONTEIRO FERREIRA
  • The needs of caring for the stomized child: From the perspective of Communicative Theory

  • Data: 14/08/2018
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  • The children can get urinary or gastrointestinal stomas for a variety of causes, right
    after birth or at any time in their life. The most common causes are congenital
    anomalies and traumas that occur during development and are mostly temporary
    anomalies. It is estimated that one in each 33 babies, born with congenital problems
    in the world. Objective: know the challenges faced by the mothers with the care of
    their stomized son. Method: It is a descriptive study with qualitative approach having
    as theoretical support the communicative action of Habermas. The scenario of the
    study was Serviço de Atenção à Pessoa com Estomia, localized at Unidade de
    Referência Especializada Presidente Vargas in Belém of Pará. It was performed the
    collections of data through semi-structured interviews with mothers of stomized
    children properly registered at the service of attention for stomized people. It was
    performed the data’s analysis using the Bardin content technique. Results: It was
    been interviewed 12 mothers, whom two mothers live in Belém count and the
    remaining in countryside of the state. The age group of children was between 8
    months’ to 8 years old, considering congenital disease the main diagnosis for ostomy
    production and the ostomy type more incident was colonoscopy, in relation to
    gender, six are male and six female, time of ostomy ranged between one month of
    life to two years old. The mothers’ age ranged from 18 to 46 years old, related to
    level of education, two mothers had full high school, one had unfinished h igh school,
    five had full middle school and four had unfinished middle school. Discussion: The
    results of the study indicated that mothers are not adequately oriented regarding their
    child's stomized care, revealing fear and anguish as the biggest challenges to
    changing and handling collecting equipment. The stomized child needs specialized
    care by the multi-professional team, and especially the nurse who is the professional
    responsible for health education, with guidance on care and education for parents
    regarding the exchange of equipment and the necessary care with the peristomal
    skin to preparing them to the returns home time with minimal conditions to care your
    child. Final considerations: the mothers experience the flaws in care provision for
    your stomized child and they reveal the fear as the main challenge in provision of
    healthcare. It was verified as inadequate The educational actions provided by nurses
    for the mothers when it comes to guide the care of stomized children, causing the
    unpreparedness of mothers and contributing to the inability to perform the expected
    assistance at home. It was expected that the construction of an educational material
    target for the care of stomized child could contribute with both mothers and nursing
    professionals in order to provide assistance with the view to quality of life and
    rehabilitation of the stomized child.

  • THIAGO HELENO RODRIGUES FERREIRA
  • COMPARATIVE STUDY BETWEEN MODELS OF HOSPITAL MANAGEMENT BY SOCIAL ORGANIZATION OF HEALTH AND THE HELD BY A PUBLIC FOUNDATION IN THE STATE OF PARÁ.

  • Data: 27/04/2018
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  • Due the economic crises occurred in Brazil, in the 1980s and 1990s, international development institutions, FMI and the World Bank, proposed a model of public management characterized by privatizations, public-private partnerships and management outsourcing of public services, including the SUS, alleging add quality to the activities of the State. In this context, emerged the OSS, private law entities, that currently in the Pará State, are in charge of the management of several hospitals in the state public health network, but there are still hospitals managed by the indirect public administration, that is by public foundations or autarchies, which are references in their specialties of attention. Beyond the legal question that covers the discussion about the outsourcing of management in the SUS, this research project objective to investigate if, in the Pará State, the OSS provide health services with higher quality, in relation to a public foundation of the state health network, corroborating the justification of the adoption of this management model or denying it, showing that the State is able to provide good health services

  • ANA LYDIA LÉDO DE CASTRO RIBEIRO CABEÇA
  • SPACE AND EPIDEMIOLOGICAL DISTRIBUTION OF END STAGE RENAL DISEASE IN DIALYTHIC THERAPY IN THE STATE OF PARÁ, BRAZIL

  • Data: 11/04/2018
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  • Kidney disease is thought to be a public health problem in the world. Little is known
    about the frequency between renal dialysis therapy and geographic aspects of patients
    in renal replacement therapy (RRT) in Brazil and correlations between epidemiology
    and end stage renal disease (ESRD) spacial distribution, especially in the North region.
    A prospective, descriptive, cross-sectional, quantitative study was carried out to
    analyze the spatial and epidemiological distribution of patients with ESRD in dialysis
    therapy in the state of Pará. The research was carried out in patients from the state of
    Pará, in November 2017, attending the Unified Health System in three RRT services
    located in the city of Belém-PA, through the application of a semi-structured
    questionnaire and analysis of medical records. Demographic, cartographic and public
    health policy variables were obtained, respectively, from CENSO 2010, the
    Milionésimo Digital System of IBGE and the National Registry System of Health
    Establishments. Geographic database was developed through the geo-referencing of
    data from 329 patients included in the study, based on the interrelationship of
    epidemiological, socioeconomic, clinical, demographic, cartographic and public policy
    data, indexed by geographic coordinates obtained through LAT / LONG Projection
    System with DATUM WGS84, using ArcGis 10.2 and TerraView 4.0 softwares, using
    Kernel, Buffer, flow analysis and algebra maps Geoprocessing techniques. Individuals
    aged between 50 and 59 years (29.2%), brown people (63.5%), with primary level
    education (56.2%) and family income of up to 1 minimum wage (59.6%) prevailed. The
    main causes of ESRD were hypertension (78.6%) and diabetes mellitus (43.2%).The
    patients came from 59 (41%) counties of the state; 82% from the metropolitan area of
    Belém, 81% from the Marajó mesoregion and 67% from the Northeast of Pará. The
    counties with the greatest access to RRT services were located in the short (20.69%)
    and medium (62.07%) distances, and 41.03% of the patients lived more than 50 Km
    from the place of care. A cluster of cases was found in the Metropolitan Region of
    Belém, with many counties of origin for few places of service delivery. The
    mesoregions with the highest percentages of cases attended were the Metropolitan of
    Belém (63.22%), the Northeast of Pará (27.36%) and the Marajó (7.90%), respectively.
    Epidemiological silence in terms of services of high complexity in nephrology was
    evidenced in most of the counties of the state and so as non-homogeneous spatial
    distribution of cases in relation to the counties of origin, with the formation of a
    transversality of flow of repressed demand for the metropolitan region. The study
    concluded that georeferencing may allow better planning for the implementation of
    RRT services, increasing access to treatment. Further studies are necessary to the
    knowledge about the social and geographical determinants and the existence of
    dialysis networks in the state, in order to contribute to the formulation and
    implementation of public policies in the area of nephrology.

  • RENATA MARIA COUTINHO ALVES
  • DISTRIBUIÇÃO ESPACIAL E EPIDEMIOLÓGICA DA CARDIOPATIA CONGÊNITA NO ESTADO DO PARÁ, BRASIL

  • Data: 11/04/2018
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  • Congenital heart diseases are the most frequent among congenital malformations and present high mortality in the first year of life, being an important global health problem. This ecological, descriptive, retrospective, population - based study aimed to describe the clinical - epidemiological profile and the spatial distribution pattern of cases of congenital heart disease treated at a referral hospital in the state of Pará - Brazil. Data from the census of the patients served between January 2012 and December 2016 were used, and for the decoding of information from the cities of origin, a database of the 2010 Census and the millionth system of the IBGE were used. All patients had a diagnosis confirmed by at least one echocardiogram. The variables observed were: gender, age, type of cardiopathy, treatment performed, waiting time and spatial distribution. Of the 905 cases observed, 52% were older than 1 year at diagnosis, 75.1% had acyanotic heart disease, and ventricular septal defect was the most frequent (21%). Among the cyanotic heart diseases, Tetralogy of Fallot was the most frequent (12%). There was no predominance of gender. At the time of the evaluation, 55.7% of the patients were awaiting treatment, 33.8% had undergone surgery, 5.3% had undergone surgery and underwent hemodynamic treatment, and 5.2% had undergone treatment alone hemodynamic. The lethality during the study period was 9.61%, of which 83.9% had undergone surgical treatment. The spatial distribution of the cases was not homogeneous, with the formation of clusters in the areas closest to the referal hospital, implying different types of flows, and allowing the conclusion that there are difficulties in accessing diagnosis and treatment, particularly at the cities farther from the state capital

  • AURICELI DA SILVA SOUZA
  • ANÁLISE DA DISTRIBUÍÇÃO ESPACIAL DA DOENÇA RENAL CRÔNICA PRÉ DIALÍTICA E SEUS FATORES DE RISCO NO ESTADO DO PARÁ 

  • Data: 11/04/2018
  • Mostrar Resumo
  • DRC in its early stages is insidious and silent progression; in addition, the health services that offer this care are not yet totally structured based on the determinants and health determinants of this population, being the disease under-diagnosed and consequently attenuated its the possibility of preventive interventions generating an inadequacy of the health care provided to patients with CKD at this stage. The geoprocessing techniques in health enabled a spatial analysis of pre-dialytic renal disease in the municipalities of Paraense, bringing greater visibility to the creation of a network of attention in nephrology. This work aimed at the spatial analysis of the pre-dialysis CKD and its risk factors in the state of Pará. This is a cross-sectional, descriptive epidemiological study using GIS with support of the Arcgis 10.2 and TerraView 4.0 softwares. A total of 221 patients with CKD in stages 1 to 5 ND under conservative management were analyzed at the Hospital de Clínicas Gaspar Vianna, in Belém - Pará, Brazil, performed between the years of 2012 and 2016. There was a predominance of males older than 60 years old and of brown color 51.1%, 50.2% and 58.8%, respectively. The main causes of the disease were hypertension with (85) 38.4% and (73) 33% for diabetes mellitus. Stages 2 were the most present with 24.4% (54) followed by 44 (19.9%) in stage 3B. Of these, 73 (33%)% were normal weight and 71 (32.1%) were pre-obese. Of the patients studied, 185 (83.7%) did not smoke. With 137 (83.7% proteinuria) above 150mg / dl and 127 (72%) of patients with blood pressure equal to or above 130x80 mmHg. The analysis of the spatial distribution of the cases was heterogeneous, evidencing the kernel technique agglomerated in the metropolitan mesoregion of Belém. The great distances and difficulty of access and displacement seem to be obstacles in the provision of health care for the studied population. The municipalities of the state of Pará with little coverage of PHC far from centers of reference specialized in nephrology are more vulnerable and exposed to risk factors for renal disease, which generates greater difficulty in reaching the control of the disease in its early stages. Therefore, it was observed the need to implement a nephrology care network in the state of Pará based on regionalization and with strategies that guarantee access to health and integral care to all regions and microregions, based on regional characteristics, besides strengthening investment in programs in health services aimed at the management and tracking of renal disease in primary care, through hiring and training of the multiprofessional team and conducting matriciation

  • ALISSON BRUNO LEITE LIMA
  • Perspectives of the Health Professionals and Managers of the More Doctors Program in the State of Pará

  • Orientador : HILTON PEREIRA DA SILVA
  • Data: 03/04/2018
  • Mostrar Resumo
  • The Mais Médicos Program was established in October 2013 in Brazil, one of the propuses was to strengthen the Primary Health and decrease the inqueties on the acess to health services, for this one of the measures was the increase of human resources. After the low adherence of Brazilian physicians, vacancies were made available to foreign physicians, among them Cuban exchange doctors. On the last years have been performed many researches about pmm, but are few the studies about the perception of the other health professionals and managers about the cooperated physicians. Therefore, the objective of this study was to analyze the perception of health professionals and managers about to cooperative doctors in the state of Pará. In this study, was made a content analysis of the interviews conducted with 32 health professionals and 16 managers was carried out in two stages, in 2015 and 2016, as part of subproject 5 "case study in 32 municipalities enrolled" that is included in the national multicenter project "Analysis of the Effectiveness of the More Medical Initiative in the Realization of the Universal Right to Health and in the Consolidation of Health Services Networks". The results of this analysis are presented in the form of two scientific articles, the first is about the managers' perceptions, in which the results highlight that there was an improvement in access, the resolution of PHC, and the provision of doctors in an exclusive dedication to municipalities. It can be affirm that the interviewed managers are satisfied with the Mais Médicos Program and with the cooperated doctors, and that it is possible to perform a Primary Health Care with quality in Brazil. And the second one was about the perception of other health professionals, where it was found that there is a good inter-professional relationship between the cooperative doctors and the health professionals, the perception of a more humanized care by the cooperative doctors, improvements such as the presence of the doctor in the community, the attempt to solve health problems in the basic units, forwarding only when necessary and the accuracy of the diagnoses. From these results, it can be said that the professionals and managers perceptions regarding the cooperative doctors are good and that the Mais Médicos Program provided very good results for PHC in Brazil.

  • ROSEANE BITTENCOURT TAVARES
  • Analysis Of The Professional Qualification And Experience Of The Cooperated Doctors Of The More Physicians Program In Brazil

  • Data: 03/04/2018
  • Mostrar Resumo
  •  

    The More Physicians Program (PMM) was established in 2013 due to various social pressures and one of its objectives is to attract physicians to areas of difficult access to work in Primary Care considering the insufficiency of these professionals in the Unified Health System (SUS). However, in the first calls for participation in the program, the Brazilian physicians did register for the program. One of the solutions was the implementation of a cooperation agreement between Brazil and Cuba through the Pan American Health Organization. Thus, thousands of Cuban doctors came to Brazil to work in the program. However, the coming of these was criticized by the medical associations, affirming that the Cuban professionals did not possess the necessary formation to act as physicians in Brazil. Therefore, the objective of this study is to analyze the professional qualification and previous experience of the cooperated physicians participating in the PMM. For this purpose, data from the multicentric survey "Evaluation of the implementation of the More Physicians Project for Brazil (Subproject: Analysis of the effectiveness of the More Physicians initiative in the realization of the universal right to health and in the consolidation of Health Services Networks)”, organized by the University of Brasília were used. The data collection was done through interviews with the cooperated physicians in the different regions of Brazil. The content analysis of these interviews was carried out, and, in addition, a comparison was made of the curricula of Cuban and Brazilian medical schools, observing their similarities and differences. From these data, it was concluded that Cuban physicians have adequate training to practice medicine in the country, they have experience in other countries due to their internationalist perspective, most have some postgraduate degrees and, in addition, the academic curricula of Cuba are similar to those of Brazil. Thus, there is no reason to criticize these professionals, coming from a country well known for its medicine and the way they practice work. It is necessary to learn from them, with their humane treatment, not only for the Cuban population, but also for people from all over the world.

  • BRUNO SOUZA BRABO
  • Mental Health in the Amazon: Mortality for Suicide and Coverage of Psychosocial Care Centers in the state of Pará 2006 to 2015

  • Data: 28/03/2018
  • Mostrar Resumo
  • In order to identify characteristics of suicide in the state of Pará, as well as to study the
    correlation of cases with the Psychosocial Attention Centers (CAPS), data obtained from
    the Mortality Information System (SIM), the National Registr y of Health Establishments
    (CNES) and the Brazilian Institute of Geography and Statistics (IBGE) were used to
    calculate suicide rates and CAPS coverage between the years 2006 to 2015. It was
    observed that suicide occurs in a 4:1 ratio between the sexes male and female, one-third
    of the deaths are concentrated in the age group of young adults, aged 20 to 29, most of
    them of brown race/color and single marital status. Hanging was the most commonly used
    method of suicide (65%) in both sexes, followed by firearm shooting (16.7%) among men
    and exogenous intoxication (24.3%) among women. State suicide rates as a whole rose
    44%, from 2.25 (deaths/100,000 inhabitants) in 2006 to 3.24 (deaths/100,000 inhabitants)
    in 2015, more than doubling the national increase in the same period. This occurred
    despite the significant improvement in CAPS coverage in the state, which was 0.48
    (CAPS/100 thousand inhabitants) in 2006, considered as a regular/low level, and
    increased to 1.06 (CAPS/100 thousand inhabitants) in 2015, a better level of coverage
    according to the Ministry of Health (MS) criteria. The cartographic distribution, however,
    revealed that the phenomenon is not homogeneous within the state. Some municipalities
    presented growth or maintained high rates of suicide despite the improvement in CAPS
    coverage; while others, even with high suicide death rates, did not receive any investment
    in CAPS coverage during the study period. The claim that suicides rates in the state of
    Pará have increased can’t be generalized even with the significant improvement in the
    coverage of mental health services.

  • IÊ REGINA BENTES FERNANDEZ
  • EVALUATION OF THE RATIONAL USE OF BLOOD COMPONENTS IN PUBLIC HOSPITALS OF HIGH COMPLEXITY IN THE METROPOLITAN AREA OF BELÉM-PA

  • Data: 27/03/2018
  • Mostrar Resumo
  • FERNANDEZ, Iê Regina Bentes. Evaluation of the rational use of blood components in public hospitals of high complexity in the metropolitan area of Belém-PA. 2018. Dissertation (Master in Health, Environment and Society in the Amazon) - Federal University of Pará.

     

    INTRODUCTION. The transfusion process has been continuously modified under the aegis of current legislation, based on the safety and quality of these practices. The transfusion is triggered by the prescriber after laboratory and clinical analysis of the patient and should be adequate for the rational use of blood components, as well as, the blood request form must be correctly filled, respecting the character of the care, and well justified for analysis and release of the product for hemotherapy service. OBJECTIVES. To evaluate the adequacy of requests for blood components regarding the rational use of blood and the character of care. Verify if the transfusion records were being full filled and if the justification used to indicate the transfusion contained sufficient data for analysis in the hemotherapy service. MATERIAL AND METHODS A total of 636 records of transfused blood components were analyzed in two public hospitals in the metropolitan area of Belém from January 2015 to December 2016. The protocol form was applied, and statistical analysis was performed using descriptive and inferential statistical methods. RESULTS.  As for the filling, 79.5% of incomplete chips were obtained. There was a tendency for the inappropriate use of the service character in 49.2%, the main representative of this group being the requests characterized as urgency (79.9%). Regarding rational use, the study showed that prescribers did not follow restricted use in their requests for transfusion of packed red blood cells (73.3%), platelet concentrate (72.2%) and fresh frozen plasma (81.6%). The justifications contained data for analysis and were adequate in: 62.7% of the indications for packed red blood cells, 59.7% for platelet concentrate and 68.4% for fresh frozen plasma. CONCLUSION. Although there are legislations that guide the complete filling of the request forms for blood components and guidelines that guide the rational use of blood, the results presented showed a high percentage of prescriber failure in these practices. Therefore, it is necessary to plan actions and develop tools to improve the transfusion process from the point of view of quality and patient safety.

  • MARIZETE SANTOS ARAUJO
  • EPIDEMIOLOGICAL CLINICAL PROFILE OF PATIENTS WITH ENDOCARDITIS MET IN HOSPITAL OF REFERENCE: NURSING STRATEGIES FOR SELF-CARE.

  • Data: 06/03/2018
  • Mostrar Resumo
  • ARAÚJO, Marizete Santos. Epidemiological clinical Profile of patients with endocarditis met in hospital of reference: nursing strategies for self-care.Dissertation (master's thesis)-Universidade Federal do Pará, Institute of Health Sciences, graduate program in health, environment and society in the Amazon, Belem, 2018.

    Infective endocarditis (EI), still stands with significant morbidity and mortality, although the available technologies in healthcare exhibiting high resolution, helping to the diagnosis I need. Consequently has contributed to a more effective action in order to provide efficient care for patients in the various segments of society. However, some factors tend to complicate the definition of the diagnosis, that more effective action, as in the case of difficult access and the precariousness of health services. Endocarditis is still a challenge to what has been keeping the morbidity and mortality rates still quite high. In the present research sought to characterize the profile of inpatients, whereas the clinical epidemiological profile plotting strategies for technical monitoring and self-care of patients with endocarditis, listing possible demographic and clinical variables, describing the clinical epidemiological profile and proposing technical note with high recommendations and outpatient follow-up, as well as indicate a protocol recommendations for self-carein a referral hospital in the cardiac area over a period of seven years. Material and methods: data Were carried out based on the International statistical classification of diseases and Related Health Problems- ICD-10chapter IX, diseases of the appliance circulatory system (I00-I99) taking into consideration the following grouping (I30-I52) other forms of heart diseaseamong these only were included, I33 acute and subacute Endocarditis; I38 unspecified valve endocarditis, part. Results: the age group studied runs from ≤19 to <,60 years, male, 53 (61.63%) and female (38.37%) 33. Marital status: single (as), 40 (46.61%), married (as), 25 (29.07%), 13 (15.12%) had stable and separated and widowed (the) 4 (4.65%). origin: 49 (56.96%), Immediate geographic region Belem, statement: essential incomplete, 51 (59.31%). Middle complete, 17 (19.77%) medium incomplete, 8 (9.30%) 5 (5.81%). Religion: Catholic, 41 (47.67%), higher than incomplete, 2 (2.33%) complete 3 (2.33%) fundamental illiterate, and without information 1 (1.16%), Tan color, 68 (79.07%), white, 13 (15.12%) black evangelicals, 38 (44.19%), no religion (8.14%) 7. Comorbidities other CVD, 27 (31.40%), no Comorbidities, 22 (25.58%), other diseases, 9 (10.47%), it HAS/DM/IRC, 8 (9.30%), HAS 4 (4.65%),, IRC, 4 (4.65%), and other CVD, 3 (3.49%), it HAS/IRC, 3 (3.49%), it HAS/DM, 2 (2.33%), rheumatic heart disease, 1 (1.16%), DM/ IRC), 1 (1.16%), rheumatic disease, 1 (1.16%), IRC and Other CVD 1 (1.16%). Blood culture: 49 (56.98%), unpaid, 31 (36.05%) negative, 2 (2.33%) Acinetobacter, 1 (1.16%),K. pneumonie, P. auereginosa, Streptococcus. sanguinis and Streptococcus bovis, high, 59 (68.61%) improved, 23 (26.74%) death, 3 (3.49%), at the request and 1 (1.16%). aortic vegetation, 32 (37.21%), 19 (22.09%) No, 14 (16.28%) mitral vegetation, 11 (12.79%) 7 (8.14%) tricuspid and mitral and aortic 3 (3.49 %). Conclusions: the clinical epidemiological profile can be observed and mapped out in the present study, which studied population allowed to view what is being treated, and that the hospital does not meet exclusively to cardiology area, but also the areas of Nephrology, psychiatry and obstetrics, which may be related to cardiology. The presence of specific Comorbidities leading to a more serious picture of infective endocarditis, emphasizing the care that can be applied by the nurse, since the primary, always obeying the criteria of health prevention.

  • MARLUCE ROCHA BEZERRA
  • TRADIONALTI HAEALTH PRACTIS IN RIBEIRINHO COMMUNITIES OF ABAETETUBA PARA MUNICIPALITY

  • Data: 23/02/2018
  • Mostrar Resumo
  • This present work aims at knowing, describing and analyzing the main practices of care, maintenance and health restoration. How these practive are be delimited through the interaction between the environment, the culture and the access to information. And describe the perception of local caregivers on the health situation in riverside communities of Abaetetuba city, Pará state, Brazil. It is a descriptive and exploratory study, based on qualitative research, accomplished through the on interview script (With topics and guiding questions) and a the field diary. In all, 12 traditional caregivers were interviewed in this study, with specialties and experience in diverse popular practices of care and cure for various health and illness frameworks, between them, handlers, midwives, shamans, shamans, and the use of medicinal plants. The results demonstrate the importance and the wealth of knowledge that these practices have, consisting of the reapplication of knowledge and techniques learned, in the exchange of experiences and in the rationality about certain beliefs or superstitions. The results demonstrate the importance and the wealth of knowledge that these practices have, consisting of the reapplication of knowledge and techniques learned, in the exchange of experiences and in the rationality about certain beliefs or superstitions. It is believed that such knowledge is not sufficient to remedy the diseases and harms faced by communities, but they are of immeasurable value in solving everyday situations, in addition to being used in an isolated or complementary way simultaneously with biomedicine. There was also a great difficulty in accessing health services in these communities. And the need for a greater understanding, adequacy and application of health strategies and mechanisms capable of promoting the integration of actions pertinent to the reality of these peoples. Therefore it is necessary to develop studies and means that collaborate with the process of inclusion and social insertion in health, and, in numerous other areas with similar profile in the Amazon. Respecting social, cultural and economic the of practices of these communities, allowing the coexistence or integration of different knowledge and practices

  • BIANCA DA CONCEIÇÃO CABRAL
  • ASSOCIAÇÃO ENTRE ASPECTOS NUTRICIONAIS E ANEMIA EM CRIANÇAS E ADOLESCENTES COM MALARIA VIVAX NA AMAZÔNIA BRASILEIRA.

  • Data: 20/02/2018
  • Mostrar Resumo
  • Malaria is one of the major infectious diseases that can lead to death, affecting mainly children under five years of age. Older children and adolescents in endemic areas may also present complications that merit attention from the health system. Nutrition, in addition to physiological function, plays an important role in the recovery of the individual infected with malaria. The objective of this study was to study the nutritional and hematological characteristics of children and adolescents diagnosed with malaria for Plasmodium vivax in the city of Anajás, State of Pará. Methodology: A cross-sectional epidemiological study occurred during the period from January 2014 to December 2016, with children and adolescents, divided into two groups: group 1 "with malaria" and group 2 "without malaria". Sociodemographic and epidemiological data were recorded in the semistructured research protocol. Data were collected from anthropometry, weight in kg and height in m, and consumption by means of the Food Frequency Questionnaire (FFQ), a blood collection in a fasting period of 12 hours. Data were analyzed in programs WHO AnthroPlus, version 1.0.3, Epi Info 3.5.1. and Bio Estat 5.0. The accepted level of significance was p <0.05. Results: A total of 144 individuals participated in the study, of which 66.67% were children and 33.33% were adolescents. Overall, 69 patients were diagnosed with malaria and 75 were in group 2. Those responsible for the participants were mothers (87.50%) with a mean age of 31.16 y (±7.62). A high percentage of illiterate mothers (17.39%) was found among infected patients, with p <0.0001 between the two groups. There was also a statistical difference (p <0.0001) between the employment situation, although the majority of those in group 1 and 2 declared themselves "at home", 81.16% and 42.67%, respectively. A percentage of 41.33% of employees/retirees for group 2, noting that 72.46% of group 1 had Family Income less than a minimum wage, and 88.41% received the “Bolsa Família” benefit. More than half of the patients with malaria had already had four or more malaria episodes (p <0.0001), and the parasitemia level was between 501-10,000 mm3. Regarding the nutritional status, it was verified that 17.71% of the total children were stunting for age, being 18.60% of group 1 and 16,98% of group 2 and for adolescents stunting for age was present in 19.23% and 4.55%, respectively for groups 1 and 2. Body mass index for age showed a high frequency of overweight for group 2, for children (20.75%) and adolescents (22.73%), without statistical difference. The mean hemoglobin level was 11.37 (±1.63) g/dL for the "group malaria" and 12.20 (± 1.30) g/dL for the second group (p = 0.0011), also with significant statistical difference children (p = 0.0116) and adolescents (p = 0.0028) of both groups. In "group malaria", 50.72% had anemia, beging 74.29% were of the moderate type and the "without malaria" group was 20.00%, of these 60.00% of the mild type (p = 0.0002).

2017
Descrição
  • ANA CRISTINA ÁLVARES GUZZO
  • VIOLÊNCIA OBSTÉTRICfgSGGA PERINATAL NA PERSPECTIVA DOS/DAS PROFISSIONAIS DE SAÚDE

  • Data: 04/12/2017
  • Mostrar Resumo
  • Assistence during birth determines the many forms of birth, and temporal, cultural, economic, and social factors contribute to the quality of this care, whose experiences have repercussions for the rest of the life of the woman and the child. In Brazil, during the last forty years, obstetric and neonatal care has undergone important interventions from the technological evolution, following the worldwide trend, however, the avoidable morbidity and mortality of women and babies are still unacceptably high, reflecting the great disconnection identified between the available scientific knowledge and clinical practice, constituting what the scholars of the subject have named the Brazilian Perinatal Paradox (LANSKY, 2014). Obstetric violence, which also includes institutional violence against infants, although this is not very evident in most of the work and concepts of this phenomenon, has also been part of the birth and birth scenario in Brazil and in the world, and is considered serious disrespect to the human rights of women and children, contributing to the worsening of the risks to morbidity and mortality of both. In this context, a qualitative research was sought to understand the perception of health professionals working in maternity hospitals in the Metropolitan Region of Belém-Pará, on violence against babies during obstetric and neonatal care. It was considered a sample composed of 11 professionals with training in medicine and nursing, who work in obstetrics and neonatology and develop assistence activities at birth and to the newborn in these maternities. It is hoped that this study will contribute to cognize the perception of the professionals about the practices adopted in childbirth and birth that constitute perinatal obstetric violence to which the babies are or may be submitted during the stages of labor, at the delivery and through the first days of life. And also to characterize the main types of perinatal violence. It is also hoped to be able to contribute to the implementation of the policies aimed at the more humanized conditions of care for childbirth and birth, since the study will allow the dissemination of the assistence professionals voices about the multiple factors associated with perinatal obstetric violence

  • MARIA DE NAZARE BARBOSA TEIXEIRA
  • THE VOICE OF THE PUBLIC SERVANT OF UFPA: A STUDY OF THE PRODUCTION OF SENSES ABOUT THE PROMOTION OF HEALTH AT THE WORKPLACE

  • Data: 21/09/2017
  • Mostrar Resumo
  • The National Policy for Civil Servant’s Health and Work Security (Política Nacional de Atenção à Saúde e Segurança do Trabalho do Servidor Público Federal – PASS) is an established state policy, and is used as a legal tool for promoting and surveilling health among the public organs of the Federal Public Administration in the executive. PASS leads three principles: health assistance for civil servants; health and vigilance expertise; and health promotion. The latter recommends that changing actions must be developed in the workplace in order to reflect health gain for the servants. Methodology: Descriptive and exploratory study; qualitative research approach with a theoretical and methodological support based on the discursive practices by Spink (2010). The research consisted of a semi-structured interview, and aimed at investigating civil servants’ production of meanings on health promotion in the workplace. 17 (seventeen) federal civil servants from UFPA’s personnel took part in the interview. Result and discussion: The interviews were analyzed through two distinct processes: servants’ knowledge on “health” and “health promotion” – which was highlighted by terms/words – and the elaboration of four categories that appeared a posteriori about participants’ speech, considering: 1- the meanings about health promotion in the workplace; 2- health gain in the workplace due to health promotion; 3- health promotion, vigilance and intervention; and 4- information as a support for health gain. The categories were interpreted based on the narratives in light of the five main fields of health promotion proposed by the Ottawa charter, the guidelines that comprise the set of actions from PASS, and the theoretical background. The research result indicated the need of improving the theoretical discussions on health, risks, vulnerability, territory, intersectorality, critical autonomy, empowerment, and social participation as a way to face situations that prevent health gain. The interlocutors aim at gaining health from new social and environmental attitudes, social interactions, and health service reorientations. From the narratives, there was the need for an institutional planning that prioritizes programs and projects with the purpose of: improving UFPA’s campus infrastructure in Belém; promoting life quality in the workplace; and qualifying the servants about the policy for civil servants’ health and work security (PASS), which includes vigilance to environment and work process, and health promotion to servants. Conclusion: In the civil service, outside the healthcare sector, actions for health promotion aim at improving environment, organization, and work process in order to promote a health valuation culture through changing habits and behavioral attitudes individually and collectively, and to reduce morbimortality in the workplace. However, it can only happen through changes in social and environmental attitudes, social interactions, and health service reorientations. Furthermore, the institutional planning must have programs and projects to enhance life quality promotion in the workplace, and qualify the servants to develop their personal skills suitable for health gain.

  • PAULA VALENTE LEAO
  • AVALIAÇÃO DA ATUAÇÃO DO NUTRICIONISTA NA EFETIVIDADE DO PNAE NA REGIÃO NORDESTE PARAENSE
  • Data: 06/09/2017
  • Mostrar Resumo
  • The National School Feeding Program (PNAE) aims to contribute to the
    growthandbiopsychosocialdevelopmentandimprovementofstudents'performanceduring
    theclassperiod,forthisitisnecessaryahealthydietthatrespectstheeatinghabitsand
    actions that allow articulation Amongallthe PNAE actors,as well as activities that contribute
    to thegood performance of students in schools. Methodology:Thisdissertationincludestwo
    importantanalyzes toensure that the PNAE is adequately adheredto. This is across-
    sectional,descriptiveandquantitativestudy thatanalyzedthefulfillmentof theattributionsby
    nutritionistsinfivemunicipalitiesintheNortheastofParaense,thenumberofprofessionals
    presentinMoju/PAandthemenus offered toElementarySchoolI(6to10years)andII(11
    to 15 years) in theyear 2015 in this municipality. Results and Discussion: Two research
    lineswereevaluated:Evaluationofthe nutritionistperformance intheNationalSchool
    FeedingProgramintheNortheastRegionofParaenseandAnalysis ofthemenuspreparedin
    amunicipalityintheNortheastofParaense.Thefirstconcernsthenutritionist,whoplaysa
    fundamentalroleintheprogram.Thus,thisstudyaimstoanalyzesociodemographic,
    economicand professional data andthe executionof the 13compulsoryattributionsof
    practicingnutritionistsinthePNAEinfivemunicipalitiesoftheNortheastofParaenseby
    meansofaquestionnaireappliedinloco.Itwasverifiedthatallprofessionalswerefemale
    andthattherewasnoncomplianceinmostoftheattributions,suchasabsenceofNutrition
    DiagnosisandManualofGoodPractices,absenceofTechnicalDataSheetandAnnualPlan
    bymostnutritionists,besidesinsufficienttechnicalstaffinallThemunicipalities,among
    otherinadequacies.Inrelationtothesecondaxis,theobjectivewastoevaluatetheadequacy
    ofnutritionists,accordingtothenumberofstudentsandthemenusofferedforElementary
    SchoolinthemunicipalityofMoju/PA.Itisacross-sectional,descriptiveandquantitative
    study thatanalyzed the number ofnutritionistspresentin Moju/PA and themenusofferedto
    ElementarySchoolI(6to10years)andII(11to15years)intheyear2015.ForToevaluate
    theadequate numberof nutritionists, Resolution 465/2010 wasobtainedas areference.
    Regarding thenutritionalcomposition ofthe menus,offerof fruits and vegetables, sweetsand
    sweetpreparationsandrestrictedfoods,Resolution26/2013.ThesoftwareusedwasExcel
    withdatabaseofTACOandIBGE.Oneactivenutritionistwasidentifiedinthemunicipality
    and38menus,being23forurbanareaand15forruralarea.Regardingnutritional
    composition,all the menus wereinadequate, withvaluesbelowfor macro andmicronutrients,
    exceptforsodium, whosevalues werehigher than recommended.Itwas observedlow
    consumptionoffruitsinElementarySchoolUrbanandabsenceofthesefoodsintheRura
     
    area.Thesupplyofvegetablesreachedtheminimumrecommendationonlyinthemonthof
    Marchintheurbanarea.Asforsweetsandsweetpreparations,adequateconsumptiontook
    placeinMarchfortheruralandurbanarea(1,5portionintheweek)andinAprilfor
    Elementary School (2 portions in the week). Conclusion: We believe that this work will bring
    positivecontributionsintheareaofschoolfeeding,consideringthatitseekstoevaluatethe
    formofplanning,managementandexecutionofthenutritionistprofessional,animportant
    actorsothatthecurrentPNAElegislationsarefulfilled,togetherwiththeparticipationofthe
    other actors Involved in the program
  • ISAMERILIAM ROSAULEM PEREIRA DA SILVA
  • PNAE: PROGRAMA DO ABASTECIMENTO DE GÊNEROS ALIMENTICIOS DA AGRICULTURA FAMILIAR EM MUNICIPIOS DO NORDENTE PARAENSE

  • Data: 05/09/2017
  • Mostrar Resumo
  • With the creation of Law No. 11,947 / 09, it became compulsory to purchase products from family agriculture for the National School Feeding Program (PNAE), in at least 30% of the total resource passed on for school feeding. Thus, the present study sought to report from the perspective of family farmers, in two municipalities located in the Northeast region of the State of Pará, the difficulties and opportunities in the supply process for PNAE. Interviews and application of instruments were carried out with family farmers who were already accessing the PNAE. To obtain data on the purchase of PNAE, we analyzed the public call process provided by the Executing Entities (EEx) of the municipalities studied. According to the results, it was observed that in one of them the process of acquiring family farming still occurred in disagreement with the law. In addition, it was found that the difficulties were mainly related to the supply logistics issues and articulation among the actors involved in the execution of the program. In addition, the opportunities stand out mainly in what concerns the strengthening of family farming and the guarantee of healthy eating in schools. With this, there is a need for greater visibility in this scenario so that the policy is executed in order to achieve its objectives. 

  • ANDREA DOS SANTOS MENDES
  • Knowledge of carers about the prevention of gastric

  • Data: 05/09/2017
  • Mostrar Resumo
  • Gastric cancer comprises one of the leading causes of death in the world, occupying prominent positions between men and women. This is an important public health problem, since the disease is closely linked to the acquired lifestyle, which, when not done adequately, contributes to the acquisition of the disease. Health action measures should be implemented in order to promote the dissemination of knowledge about the disease and ways of preventing it. This study aims to analyze the knowledge of caregivers of patients with gastric cancer, identify the main associated factors for the development of gastric cancer in caregivers of institutionalized patients and propose actions of health education with family caregivers on gastric cancer. This is a descriptive study, with a qualitative approach, carried out in a public reference hospital in oncology that attends patients diagnosed with gastric cancer, the research happened with the caregivers of patients with gastric cancer. The data collection was performed through the semi-structured interview, since it can provide a good level of information. The analysis of the data was based on the analysis of content based on the proposal of Bardin, which consists of three fundamental phases: pre-analysis, material exploration and treatment of results.  Prior authorization was requested from the coordination of the research institution in order to meet all the ethical and legal criteria inherent in scientific research. The study was attended by 30 caregivers, the majority of whom were female, daughters of the patients, Catholics, aged between 18 and 30 years, married, with full secondary education, from the metropolitan region of Belém and with a predominant family income of 1-2 wages minimum. The caregivers' knowledge about the prevention of gastric cancer was grouped in four thematic units: "The positive perception of caregivers on the prevention of gastric cancer", "The lack of knowledge about the prevention of gastric cancer", " of risk for the onset of gastric cancer in caregivers "and" Actions to promote health for the prevention of gastric cancer in caregivers ". It was possible to observe that the interviewees had insufficient knowledge about the prevention of gastric cancer, leading to the acquisition of unhealthy habits, which compromise health. It was observed that it is necessary to implement educational actions at all levels of health care and it is up to professionals to inform the population about the ways of preventing gastric cancer, improving their understanding of the disease. On the other hand, it is up to users to make decisions about changing behaviors that generate health, abandoning habits that contribute to the acquisition of diseases, in this way, it will be possible in the long term to change the panorama of the northern region in a positive way, through reduction in the incidence of gastric cancer

  • EVERSON VANDO MELO MATOS
  • TECOBÉ NO MARAJÓ - TEMPORARY TREND OF HANSENÍASE AND THE PROGRAM OF TRANSFER OF INCOME - BOLSA FAMÍLIA

  • Data: 30/08/2017
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  • Currently, efforts to eliminate leprosy have been intensified at a global and local level, causing a considerable reduction of the disease, but there are some clusters of the endemic, the Region of Health of Marajó presents with a high number of cases. Objective: To analyze the spatial and temporal distribution of leprosy and its relation with the Municipal Human Development Index, from 2010 to 2014 in the Marajó health region. Method: The study was ecological, composed of all cases of leprosy reported in the Information System and Notification Diseases (SINAN), from 2004 to 2014, in the 16 municipalities of the Marajó Health Region, software used: Excell 2010, for table production and ArcGIS 10.2. For the production of maps. Partial results: In the first phase of the study, the incidence rates of leprosy were calculated and presented on maps per year as partial results. In 2010, the rate was 31.62 per 100 thousand inhabitants, in 2012, it was 32.91. In 2012, of 32.78. In 2013, from 38.10 and 2014 from 33.5. All rates considered with very high parameter. Partial conclusions: It is observed that the incidence of leprosy in the health region of Marajó is a major public health problem, involving all the municipalities in question, most of them with very high and hyperendemic incidence rates

  • WIRLLEY QUARESMA DA CUNHA
  • he fragmentation in health: a study theoretical-reflective under the optic of Theory of Complexity

  • Data: 29/08/2017
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  • In face of SUS challenges mentioned by the academic literature, which make impossible the consolidation of ideals of Sanitary Reform, calls our attention the recurrent author’s reference of the fragmentation in health. In this way, we seek in this study to deepen the reflection on this issue toward understand how and in which Brazilian health system dimension the problem has been identified. To this end, we conduct review of the narrative type from the survey of articles that mention the fragmentation in health in the major databases. From the reading and interpretation of texts was possible to perceive that, despite the diversity of expressions employed to report the problem, there are similarities between what is referred to by the authors, emerging three interpretive categories: work process, care line and assistance network.

  • MARCIA MILENE JACOB CASTELO BRANCO
  • Tecobé no Marajó: Assessment of the Physical Structure and Reception in Primary Care based on the National Program for Improving Access and Quality of Primary Care - PMAQ.

  • Data: 29/08/2017
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  • To evaluate the physical structure and the implantation of the care unit in primary health care units in the municipalities of the Marajó health region, using data from the National Program for Improving Access and Quality of Primary Care (PMAQ). Methodology: This is an evaluative research carried out based on secondary data belonging to the External Evaluation component available in the PMAQ-PA database. For this study, data from the PMAQ First (2012-2013) and Second Cycle (2014) will be used, referring to the evaluations carried out in the Marajó health region, with 16 municipalities in the First Cycle and 9 municipalities in the Second Cycle. In order to evaluate the physical structure of the units, the data of module I of the first and second cycle of the PMAQ will be used with items that correspond to "Identification of the Mode and Professionals of the Health Team", "Unit Infrastructure”, Offices, restrooms, etc.) in 16 units in the period 2012-2013 and 9 units in 2014. In order to evaluate the reception structure in the health units, the data of module II of the first and second cycle of the PMAQ will be used, with items That correspond to "Welcoming the spontaneous demand (if it is implemented, it meets the spontaneous demand, if the professionals are qualified to assess user risks and vulnerabilities) in the period 2012-2013 and 2014, respectively. In the comparative analysis between the first (2012-2013) and second (2014) cycle of the PMAQ will be used the data of only 9 municipalities. Partial Results: In the first cycle, 133 primary care units were included in the National Registry of Health Establishments, where the municipality of the Marajó health region with the largest number of health units was Breves with 22 units. Some of the 133 units are home to 81 Family Health Strategies, where most have oral health care. In most The number of clinics is less than the number of units, indicating that there are units without offices. Dental office does not exist in most units. Concerning the internal physical structure of rooms, reception room, waiting room, curative and vaccine, there are in most units; Room specific to host, procedure, observation, nebulization, sterilization, washing, purging and local to common waste do not exist in most units. Regarding the adequate structure of toilets, these present themselves in less than half of the units, highlighting a very small number of toilets adapted for people with disabilities, observed in only 3 units. Regarding the results for the host, the majority of the units with shelter are in the first cycle and the health needs are met with spontaneous demands; And the minority of the health teams were trained to assess the risks and vulnerabilities of families

  • VICENTE BELISÁRIO DE SOUSA NETO
  • “Avaliação da adesão ao tratamento da Hipertensão no distrito DAGUA, no Município de Belém-PA”

  • Data: 28/08/2017
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  • Cardiovascular diseases are the main cause of morbidity and mortality in the Brazilian population. There is not a single cause for these diseases, but several risk factors that increase the likelihood of their occurrence. The treatment of systemic arterial hypertension (SAH) is long, and requires commitment, responsibility, commitment and active participation of the bearer. With the general objective of studying the adherence to the treatment of hypertension of the residents of the DAGUA district in the city of Belém, and to determine the adherence to the treatment according to the Martín-Bayarre-Grau questionnaire (MBG), as well as to identify relationships between sociodemographic variables With adherence to the treatment and to identify the actions of hypertension control with higher and lower frequencies of achievement, according to the MBG questionnaire. A quantitative cross-sectional study was carried out between April 1 and May 30, 2017, in the administrative district DAGUA, in Belém-PA. 288 hypertensive patients, 62.15% female, 50.35% brown, 39.24% retired, 45.14% unmarried, 33.68% aged 58-68 years, 57 , 9% with incomplete primary schooling and 67, 36% of people with a family income of up to 2 minimum wages. According to the MBG questionnaire, most of the participants in the study were classified as "partial adherents", with scores ranging from 18 to 37 points. The variables, sex, income and schooling when associated with adherence to treatment did not present significant differences. However, differences were observed in the association with color or race, marital status, relation between participants living with a partner or not, alcohol consumption, time of treatment and knowledge about medications of continuous use. Adherence to treatment encompasses several factors that require attention, and it is of great relevance that further studies are developed in order to provide knowledge and new techniques or strategies to cope with non-adherence and stand out as points to be studied, the reasons for Physical activity and the development of coping strategies and techniques or inefficient and distant relationship between professionals and patients are not practiced.

  • MAYARA SABRINA LUZ MIRANDA
  • ANALYSIS OF THE GOVERNANCE OF THE POLICY FLUORIDATION

    THE PUBLIC SUPPLY WATER OF THE CITY OF BELÉM

  • Data: 28/08/2017
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  • The policy of fluoridation of public water supply is considered one of the ten greatest public health achievements of the twentieth century. Its importance as an intervention measure is the prevention of up to 60% of dental caries.
    In addition, it is an inclusive policy, as it also provides access to treated water, which can be considered as one of the most important public health actions. The objective of this study will be to analyze the governance of the fluoridation policy of public water supply in the city of Belém-PA. To analyze the governance of the policy, a qualitative cross-sectional study will be carried out, with semi-structured interviews based on a script with open questions. The sample will be composed of the oral health managers of the state and the municipality of Belém, those responsible for the fluoridation of the water supply in the state and municipal sanitation companies, and the heads of the entities of the dental class. The data processing will be done through the technique of content analysis proposed by Bardin. Through this study it is expected to know the perception of the main actors involved in the process and how governance has been developed in the planning, execution and control of the fluoridation of public water supply in Belém

  • ARTHUR CARNEIRO BERNARDES
  • Spatial and Temporal Distribution of Tuberculosis in the Municipality of Belém – Pará, netween 2009 to 2016.

  • Data: 28/08/2017
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  • The use of geoprocessing techniques and Geographic Information Systems applied to the spatial analysis of diseases and health problems has proved to be a powerful tool, that allows the epidemiological surveillance to monitor the health situation in spaces and times. It contributes to monitorize the way the variables determinants and interveners that constitute the Health and Disease process behaves, facilitating to describe the pathogens behavior and the delimitation of risk areas or influence of these. In this study, the spatial and temporal distribution of tuberculosis (TB) were analyzed in the municipality of Belém - Pará, between 2009 and 2016, based on secondary data from the System of Information about Notifiable Illnesses (SINAN). The purpose of this study was determinate the sociodemographic profile of the population with the disease, analyze the temporal evolution of the cases, identify and characterize factors and possible risk areas of transmission of tuberculosis. For this, a geographic data base (BD_GEO) was builded with sociodemographic and environmental informations. Cartographic bases of census tracts, subnormal clusters, neighborhoods, municipal boundaries and municipal headquarters were used, as well as the alphanumeric data of the Demographic Census Database of 2010, of the Brazilian Institute of Geography and Statistics (IBGE) and the estimates for the subsequent years. After debugging the epidemiological data contained in the SINAN, these were grouped by neighborhoods and were associated to the BD_GEO data, resulting in a georeferenced database of tuberculosis cases in the city of Belém (N = 10,493), which allowed the use of geostatistic algorithms that made possible the observation of the behavior of the variables in the study area. The Global Moran Index was calculated (CI-95% and α = 5%), it showed positive spatial autocorrelation for TB at all years of the study. The Chi-Square test was utilised (CI-95% and α = 5%), and it indicated a probably significant trend in the distribution of sociodemographic variables related to TB. The disease was more important in males, between 20 and 59 years of age, of the breed / brown color, who completed the studies until high school and living in areas with a certain degree of social fragility. Were used two methods to analyze the form and the intensity which TB is expressed in the study area. The Kernel Density Estimation (KDE), that is a statistical method of interpolation who identifies a continuous density surface, forming clusters in the areas with the highest occurrence of TB cases, and the method of Kernel Ratio (KR), which behaves in a similar way, however, it ponders the occurrence of TB cases and the population of the localities in the study area, forming clusters in the areas of higher incidence of illness. The KDE and the KR, resulted in clusters in specific areas throughout the studied period, which allowed analyse the temporal evolution of disease, which presents a standardized way, and also point which areas has the larger probability of TB transmission. Was possible to infer that the disease continues to be resurgent in places of high population densities, with people living in the low income situation and in the identified presence, in most cases under conditions of disadvantage, risk or social vulnerability. Classically, the factors of iniquity that contributes to perpetuate the TB beyond estimates involved and the segregating conditions  that the illnes impose, helps to strength this chain. From this perspective, it is concluded that the studies using the elucidative and guiding power of the techniques of geoprocessing made possible to determinate de sociodemographic profile of the patients affected, analyze the spatial evolution of TB and identify and charachterize factors, delimiting risk areas of transmission.

  • SUELEN TRINDADE CORREA
  • "Amandaba in Caeté: Health Education for the Self-Care of Diabetes Mellitus Carriers based on Paulo Freire's Culture Circles".

  • Data: 28/08/2017
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  • The Primary Health Care should use strategies that overcome the traditional model of health education, which does not consider relevant the knowledge, experience and culture of the user, since it is observed that the practice of health education is still focused on the professional, Which has prescriptive attitudes emphasized in the disease. It identifies the need for a problematizing, user-centered health education, considering its social and cultural aspects and not only the disease, encouraging people with diabetes through dialogue, active listening and reflections, adequate glycemic control and Self-care. Thus, this project aims to evaluate if the health education carried out through the Culture Circles of Paulo Freire improves the knowledge about the self-care of patients with Diabetes Mellitus. This is a randomized clinical trial to be developed with users with diabetes mellitus, 30 to 60 years of age, of both sexes, accompanied at the Family Health Strategies units of the city of Bragança, Pará. Will be advised to carry out the routine consultations, every three months, receiving individual orientations from the professionals working in the Family Health Strategies. Participants in the intervention group will be submitted to health education activities based on the Culture Circles method and will also be directed to continue their individual care in the Family Health Strategies, as routine, every three months. The culture circles will be developed in the phases: a thematic survey conducted by the researcher that will use informal conversations and the analysis of the answers of the questionnaires applied individually to raise and select the generative themes used by the participants regarding diabetes; Choice of generating themes by the group, from the reflection of the question: what are the challenges in having diabetes?; Problematization of the situations lived by the group, through the codification and decoding of the generating themes debated by the participants and to generate the debates will be used photos, drawings on the themes; Critical unveiling, that by taking a critical conscience of the experience in diabetes, transform their reality. An evaluation of the culture circles will be carried out through the dynamic "Tree of Self-Care". A sociodemographic questionnaire and the Diabetes-QAD Self-Care Activity Questionnaire will be applied, and capillary glycemia will be collected, a measure of weight and height for calculation of Body Mass Index, waist circumference and blood pressure. The softwear SPSS 20.0 will be used for the statistical analyzes, in which the values of p <0.05 will be considered statistically significant. The project was submitted to the Ethics and Research Committee of the Health Sciences Institute of the Federal University of Pará and is guided by the ethical principles of Resolution 466/2012, with approval on 05/07/2016 with CAEE 57049416.9.0000.0018. A pilot project was carried out with seven users with diabetes from an Family Health Strategies, six women and one man, with a mean age of 50 years, who participated in four Culture Circles. Firstly, there was a survey of seven generating themes by the researcher. These themes were presented to the group in the 1st circle, which chose three themes: diabetes / complications, feeding and foot care. The subjects were debated and unveiled in the 2nd, 3rd and 4th round, using photos of complications of diabetes, EVA illustrations of the bloodstream, pancreas, insulin and glucose, healthy dish design, food pyramid with food replicas, photos of Feet with complications. The group debated and reflected on the generative themes, problematizing situations experienced in diabetes treatment: "Very expensive integral food"; "There are shoes that give some calluses, but I use them anyway." Critically unveiled the themes and building a different perspective on self-care with diabetes: "If I was already taking care of myself, I will take care of myself even more so I do not have these complications"; "I know I will not take the flour out of it like that, but I'll eat more vegetables and fruit to make up for it." In assessing cultural circles, participants reported on the importance of the user in building knowledge: "I had never participated in a circle; it was good that you asked us to speak our thoughts and to talk with our colleagues." Carrying out the pilot project along the lines of the Culture Circle was extremely important, since it enabled dialogue, listening and interaction between the users and the researcher, contributing to the participants being active subjects in the debates, reflecting on the generated themes chosen and increasing knowledge about self-care related to diabetes.

  • AMANDA DE NAZARE ALVES FRANCO
  • STANDARD OF FOOD CONSUMPTION OF AMAZON COMMUNITY QUILOMBOLAS

  • Data: 22/08/2017
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  • The present study aims to evaluate the dietary intake of a black population and to identify the nutritional aspects and their relationships with the development of chronic noncommunicable diseases in adult individuals living in the remaining community of Quilombo Mangueiras, Salvaterra, Marajó Island , Pará.

    It is an observational, cross-sectional, population-based study. The study population consists of adults and elderly men and women of both sexes, who live in the remaining community of Quilombo Mangueiras located in the municipality of Salvaterra, in the island of Marajó (PA), and was carried out in the months of September and October of the year 2015 , In the remaining quilombo community of Mangueiras. The sample was obtained by non-probabilistic sampling technique for convenience. Data were collected through a research questionnaire. Statistical analysis was done using the Z-test of proportions and the chi-square test. In both tests, the significance level α = 5% was used. With regard to the frequency of food consumption of residents of the quilombola community, the most ingested foods are, as a rule, those that are in the harvest, are more affordable and available on a large scale. There is a large consumption of fresh fish (63.56%), garlic / onion (97.25%), açaí (44.96%), cassava flour (87.17%), rice (85.17%), refrigerant (40.74%) and coffee (94.44%). The study presents a very low frequency without consumption of fruits, vegetables and vegetables and the consumption of regional and typical foods, as for example, maniçoba and tacacá

  • EDER MARTINS DA ROCHA
  • ANALYSIS OF THE SPACE AND TEMPORAL DISTRIBUTION OF HOMICIDES OCCURRING IN THE PERIOD 2005 AND 2013 IN THE MUNICIPALITY OF BELÉM-PARÁ

  • Data: 18/08/2017
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  • Homicide is a harmful phenomenon in any society. Brazil has tragically and precociously lost its young people. This situation makes necessary studies on social violence, especially in a city based on the legal amazona, North region in Brazil. This municipality still lacks statistical data and more efficient public policies regarding local homicides. We aimed to analyze the spatial and temporal distribution of homicides from 2005 to 2013 in Belém City, Para State/Brazil, in order to identify its main socioeconomic determinants and to draw an epidemiological profile. This is a ecological, observational, descriptive / analytical and retrospective study. Data were obtained from the State Department of Public Health / Department of Epidemiology from Pará State, (Secretaria de Estado de Saúde do Pará, SESPA) available in the Mortality Information System – (Sistema de Informação sobre Mortalidade, SIM). Data were later georeferenced for Geostatistics analysis. A total of 5,487 homicides were reported, the predominant gender being male (94%), mean age 22 years, black / brown skin color (77%), primary school (74%). We found a strong correlation between homicide rate and life-condition index (índie de condição de vida, ICV), as showed by the Pearson's correlation of r = 0.93 (p = 0.001), Based on a linear regression model, we also observed significant trends and oscillations of incidence rates per 100 thousand inhabitants. Statistical and Geostatistical techniques revealed that the Guamá and Terra Firme neighborhood (D´ÁGUA) had very high homicide rates and low ICV, while in DAMOS, two out of 19 neighborhoods had a very high homicide rate (Farol and Maraú), both with low ICV. Our time series showed an increasing and alarming average homicide rate in the city of Belém, with higher rates than the average rates of the State of Pará, North Region, Brazil, and values recommended by the WHO. In addition, they demonstrated seasonal changes  associated with festivities and an inverse relationship with the living conditions of the population. The greater predominance of homicides was observed among young men. Thus, we suggest further studies to evaluate different strategies in public safety, aiming to reduce

  • CLAUDIA NAZARÉ DE SOUZA ALMEIDA TITAN MARTINS
  • SPACE AND TEMPORAL DISTRIBUTION OF CERVICAL CANCER ASSOCIATED WITH HPV INFECTION, ATTENDED IN AN ONCOLOGICAL REFERENCE HOSPITAL IN THE METROPOLITAN MESOREGION OF BELÉM

  • Data: 16/08/2017
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  • Epidemiology has been essential for the knowledge of cancer, malignant disease described since antiquity. The control of cervical cancer (CCU) in the last decades has become a priority of public health policies in Brazil, due to its high incidence, morbidity and mortality. Thus, the aim of this work was the analysis of the spatial and temporal distribution on the incidence of CCU cases associated with HPV infection in the Metropolitan Region of Belém, attended at a Center of High Complexity in Oncology. The study was descriptive, Cross-Sectional, retrospective, quantitative, ecologically of population-based study, from the Hospital Registry of Cancer database of the Ophir Loyola Hospital, from 2011 to 2015, of 542 medical records and pathological exams. The spatial analysis showed that in 2011, the municipalities of Castanhal, Belém, Marituba, Santa Izabel, Ananindeua and Benevides were the most incidental. Regarding the socioeconomic characteristics, it was observed that in Belem the most part of cases (52, 96%) were in the age range of 40 to 60 years, (56, 4%) had elementary education complete or incomplete. The skin color most found was brown (81,6%) at Belem, with an exception of municipality of Castanhal where declared themselves black ethnicity (42,3). At Benevides the major women (50%) declared as informal workers. About marital status was observed the most women (51,5%) was declared married or with consensual union. The highest frequency of cases, (62,5%%) reported ex-consuming alcohol, (49,5%) ex-smokers, and (43.36%) had a family history. The main neoplastic alteration was that of squamous cell carcinoma, in its undefined form in all the study years.  showing that diagnosis of the disease was late because of the high incidence of this type of histology, which has a rapid and progressive evolution. There was a percentage increase in the number of cases of squamous cell carcinoma (invasive form) and the carcinoma in situ in Papanicolau`s classification in all the years of the study series, which may be related to the execution of public health  in the cities studied

  • SUELLEM CARLA NUNES NOBRE
  • NASF CHANGES AND PERSPECTIVES: in view of the multiprofessional support team of the district dagua in Belém / Pa.
  • Data: 19/06/2017
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  • Support Center For Family Health (NASF) is a basic care strategy that aims to support, expand and improve health care and management in Basic Health Care (BHC)/Family Health Strategy (FHS). It must also be commited to promoting transformation in attitude and performance of FHS professionals and among its own team members (NASF), including in its performance intersectoral and interdisciplinary actions, promotion, prevention, health rehabilitation and healing, as well as humanization Services, permanent education, promotion of integrality and territorial organization of health services. Thanks to its importance in Primary Care, especially in the studied municipality whose implementation of this service only happened in 2014, it was important to know the vision of the NASF multiprofessional team about the changes that have occurred since its implementation, in order to understand their opinion on the NASF, its activities, process of permanent education in health and relationship between teams. For this, a qualitative approach, case-study-based, was conducted with a semi-structured interview with NASF professionals from the Dagua District in Belém/Pa and participant observation of their practices. The treatment of the results was performed using the content analysis of the answers, in the thematic modality. The results indicated that the professionals understand NASF as an important device for BHC, being able to support actions of prevention and health promotion in the scope territory; they also emphasize that the training process is necessary and it does happen, however the process of permanent education in health left much to be desired as practice and understanding of the team. They emphasize that multiprofissional team work is a daily construction that brings benefits to the work process, but it has many challenges to overcome. The data also indicate that professionals evaluate their actions as positive, showing that the health service users adhere to various activities, actions, attendances and follow-up activities  proposed, especially group visits with objectives of health promotion and quality of life

  • BRUNO VINICIUS DA SILVA PINHEIRO
  • SPACE DISTRIBUTION OF HANSENIASIS AND ITS RELATIONSHIP WITH SOCIO-ECONOMIC VARIABLES AND PUBLIC POLICIES IN THREE MUNICIPALITIES IN THE STATE OF PARÁ.

  • Data: 12/05/2017
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  • Over the last years, the World Health Organization (WHO), the Pan American Health Organization (PAHO) and the Ministry of Health (MS) have been prioritizing geographic areas with high case detection and social determinants that increase the risk of illness of its inhabitants in favor of the geographic policies to combat the endemic leprosy. The current study aims to characterize the disease, its epidemiological, operational and socio-demographic variables and the policies developed for its control and elimination. Thus, there was a transversal, retrospective and descriptive study, on the population basis with a temporal and spatial analysis of new leprosy cases that was associated with the income population condition and the level of health services in three cities in the state of Pará : Ananindeua, Marabá and Xinguara. Using the digital cartographic basis and socioeconomic data of each city, developed by the Brazilian Institute of Geography and Statistics (IBGE) and the morbidity registered in the SINAN, the new cases diagnosed during the period of 2010 to 2015 were characterized, by census sector, aiming to subsidize the analysis, as well as intervention strategies. The Epi Info 7 and Bioestat 5.0 softwares were used for the statistical tests, in which it was hypothesized that there is a positive relationship between the epidemiological variables and the other ones. The cases were geographically referenced on site, using a Global Positioning System receiver (GPS) and theses very cases were specialized using a Geographic Information System (GIS). The Kernel estimation method was applied in order to obtain spatial analysis and aiming to highlight areas of higher case density and also where the best levels of patient care were found. The real risk of occurrence of leprosy in each area was analyzed using the Buffer technique, as from the incidence in children under 15 years old and multibacillary cases. Considering the problem and the use of the aforementioned methods and techniques, a collection of tables and graphs of the main indicators and the magnitude of the hidden prevalence of leprosy was generated, as well as a variety of digital images that express the disease spatial analysis. The results shown in thematic maps reveal an inhomogeneous distribution of leprosy in the territories, highlighting areas of greater and lower risk and allowing to identify those that could be taken as a priority by the Leprosy Control Program

  • LUCIANA MELO DE MELO
  • ESTUDO DA DISTRIBUIÇÃO ESPAÇO-TEMPORAL DA LEISHMANIOSE TEGUMENTAR AMERICANA NO MUNICÍPIO DE BRAGANÇA, PARÁ.

  • Data: 12/05/2017
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  • ESTUDO DA DISTRIBUIÇÃO ESPAÇO-TEMPORAL DA LEISHMANIOSE TEGUMENTAR AMERICANA NO MUNICÍPIO DE BRAGANÇA, PARÁ.

  • RODOLFO MARCONY NOBRE LIRA
  • FACTORS RELATED TO LEPROSY TREATMENT OF ABANDONMENT IN BELÉM CITY
  • Data: 11/05/2017
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  • Leprosy is an infectious disease with great importance to public health. Caused by Mycobacterium leprae – bacillus that primarily affects the skin and peripheral nerves and, in some cases, lymph nodes, eyes and testicles – it is a disease that affects all social classes, but with a higher prevalence in populations socioeconomic vulnerability. The diagnosis and treatment of leprosy are offered by health facilities of the basic network under the Unified Health System (SUS); the time of treatment ranges between six months to one year depending on the operational classification of disease. Early initiation of treatment, established by a combination of antibiotics called multidrug therapy (MDT), is key to the cure of the disease and to prevent the bacillus is transmitted to healthy individuals. The objective of the study is to identify and analyze the factors related by leprosy treatment dropout in the city of Belém/PA. This is a quantitative research documentary and statistical-descriptive character. It Will be addressed users, residents in Belém/PA which are in MDT abandonment situation and were diagnosed between the years 2010 to 2014. The data collection will be done by applying a questionnaire with thirty closed questions multiple choices, through which seek to identify and analyze the profile socio-demographic of the participants, their habits and lifestyle, social stigma caused, quality access to services and health staff, as well as the factor (s) connected (s) to abandon treatment, the patient's perspective. Also the notification forms of the research subjects will be analyzed after returning the completed questionnaire. The purpose of this step is the delimitation of the clinical profile of each subject from related information to the general characteristics of the disease (date of diagnosis, clinical form, operational classification and degree of disability). This step will be developed after the return of the questionnaire completed by the participant.

  • LUCIA DI PAULA MOREIRA DA COSTA
  • Quality evaluation, health services, Diabetes Mellitus, primary health care.

  • Data: 24/04/2017
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  • Diabetes Mellitus (DM) is nowadays a worldwide epidemic, posing a major challenge for health systems around the world. Diabetes management should be done within a hierarchical health system, with its base being the primary level. The strengthening of Primary Health Care (PHC) is identified as a strategic action to confront the crisis that the Health Systems are undergoing. The Ministry of Health (MS) has prioritized the execution of public management based on actions to monitor and evaluate processes and results. The present study focused on the evaluation of the quality of health services provided in primary care for people with diabetes, based on the Donabedian Theory, focusing on structure and process as determinants of quality. It was verified that the Basic Health Units (BHU) and the Family Health Strategies (FHT) of the DAGUA district of the Municipality of Belém, present Intermediate quality of the services provided to Diabetes Mellitus patients, identifying weakness in several analyzed categories that characterized these dimensions. Through the Structure dimension, a weakness in infrastructure and human resources was identified in the two types of services addressed, with a greater commitment to the qualification of FHT. Consequently, through the approach of the Process of Service, a greater commitment was created in the assistance model presented by the PHUs, which reached an incipient classification in most of the indicators evaluated. The findings of the research allow the conclusion, and agreement with Donabedian, that a structure of good quality does not guarantee quality in the service process, but can become influential. In the qualitative approach, the lack of consensus among the professionals in relation to the care line was identified in both the BHU and the FHS, establishing diversity of action plans with impacts that are not always significant to improve the results of health indicators.

  • ROSIANE PINHEIRO RODRIGUES
  • Analysis of actions and services aimed at indigenous health in the regional plans of health care networks in Pará: transversality or equity?
  • Data: 20/04/2017
  • Mostrar Resumo
  • The beginning of the debate about the networks of attention occurs from the need that exists about the non-resoluteness that the current health model does not respond to the demographic transition, which is demonstrated by the triple burden of diseases, consisting of chronic diseases, infectious diseases And diseases caused by external causes. Indigenous peoples are original inhabitants of Pará. And an important group to have access to the actions and services of the SANs are indigenous people, who, since the creation of the Secretariat of Attention to Indigenous Health - SESAI in 2012, has been joining forces with the municipalities and To offer assistance to this population according to the social and ethnic-cultural aspects that permeate this clientele. The objective of this study is to analyze the insertion of actions and services focused on indigenous health care in the SAN plans, which cover the municipalities that compose the DWI GUATOC / Pará. In order to analyze the insertion of these actions and services, a qualitative and descriptive study will be carried out, with documentary analysis. The method for obtaining the data for the research will be divided into two stages: the first will be the analysis of the regional plans of the health care networks (stork network, emergency and emergency, psychosocial, people with disabilities and people with chronic diseases) and Semi-structured interview application to the state network coordinators, DSEI supporter, state coordinator of indigenous health. The data processing will be done through the technique of content analysis proposed by Bardin. Through this study, it is expected to verify which health actions and services of the GUATOC DSEI is a priority in the plans of the SARs and to identify in which Networks of Attention to Health, the indigenous population is contemplated in its ethnic and cultural specificities

  • CAMILA DE VASCONCELLOS ROCHA MAIA
  • The impact of oral health on the quality of life of teenagers and young adults from a riverine population of the Amazon.

     

  • Data: 10/02/2017
  • Mostrar Resumo
  • This current study evaluated the impact of dental caries and periodontal disease on the quality of life of adolescents and young adults from an urban area and from two riverine communities of the Amazon region, located at different distances from downtown. The occurrence of dental caries and periodontal disease was examined through the DMFT / IDC index (Index of the Dental Condition) and CPI (Community Periodontal Index). The impact of oral health conditions on quality of life was examined through a simplified version OHIP-14 (Oral Health Impact Profile) questionnaire. The data collected from 212 individuals (15-25 years old), residents from the urban area of Abaetetuba-Pará, were compared to those from 186 inhabitants of the nearest riverine community (Maracapucu), and from another riverine population (n=166), further located from the city (Tucumanduba River). The quality of life was analyzed as a dependent outcome, while dental caries, bleeding, calculus, periodontal pocket depth, as well as sex and age, were analyzed as independent variables, determined through multilevel and Poisson analysis. The worst indicators of quality of life and the highest DMFT scores were found in the riverine populations. Based on the adjusted multivariate model, variables such as the contextual variable (location), individual demographic variables (sex and age), DMFT and the presence of periodontal pockets were significantly related to OHIP. Women (IRR 1.19, p <0.0001), age (IRR 1.04, p <0.0001), and students from riverine schools reported the poorest qualify of life (IRR 1.33, p <0.0001), especially those students from the riverine community far from de urban center (p <0.001). The results of this study confirms that dental caries and periodontal disease negatively impact the quality of life, however, these diseases seem to impact the individuals of remote communities in a more significant way.

  • CAMILO EDUARDO ALMEIDA PEREIRA
  • O CONHECIMENTO DOS AGENTES COMUNITÁRIOS DE SAÚDE DO MUNICÍPIO DE BELÉM SOBRE A BUSCA ATIVA DO SINTOMÁTICO RESPIRATÓRIO.

  • Data: 02/02/2017
  • Mostrar Resumo
  • s paper is to analyze the knowledge of the community health agents about the active search for respiratory symptomatic. As the 
    professionalis the main social actor responsible for making an active search for respiratory symptomatic during the home visit, thus contributing to an early diagnosis

    Methodology: The research followed the qualitative trajectory with a descriptive approach, with the participation of 12 community health agents of the municipality of Belém, Being three professionals by health strategy of the chosen family, which resulted in 57 home visits. Data collection was through the field diary and semi-structured interview. For data analyses, was used the method proposed by Bardin for content analyses.Results and Discussion: The results were grouped into 3 axes. The 1nd axis was about social determinants of health with tuberculosis correlation, in which was evaluated the relationship between housing conditions, per capita income, basic sanitation and personal habits (Alcohol, smoking and drug addiction). Despite the social determinants identified, it was perceived that the community health agents  did not work with the vulnerability group logic for tuberculosis. In the 2rd axis of approach and knowledge of the  community health agents on the active search of , it can be verified that the domiciliary visit of the  community health agents is focused on the group of elderly people with Chronic Non-communicable Diseases, and that the community health agents doesn’t make a relation between that group and tuberculosis . The active search for  is limited, since only one community health agents performed it, being restricted to only one member of the family. This ineffective search may be a reflection on the knowledge of these professionals on the subject, since although they identify cough as the main symptom of Tuberculosis, there are still professionals who do not know about periodicity and type, besides not knowing conceptually what the active search for the symptomatic is. In the last axis, which is related to the importance of health education in the active search of the , was performed the health education according to the Ploblematization Methodology, using the five stages of the Arch of Maguerez, which made possible a significant learning with community health agents, so that it could glimpse the importance of active search for  in the area, according to the needs of each user/family/community. In front of these 4 axes emerged 3 manuscripts that are: The reflection of the home visit of the community health agents in the active search of the ; The knowledge of the community health agents of a municipality of the Amazon about the active search of the ; and The walk of the nue with the community health agents: active search of the  of tuberculosis .Conclusion: We believe that this study will provide valuable contribution to a dialectical and reflexive analysis on the work process of the community health agents related to the active search of the , also to the importance of this professional for the control of , tuberculosis so that it can be a transforming agent, dialoguing with the social determinants in the community. Therefore, enhancing social participation, fundamental for the effective control of tuberculosis.

2016
Descrição
  • LIDIANE ASSUNCAO DE VASCONCELOS
  • AVALIAÇÃO DO ACESSO E UTILIZAÇÃO DA ATENÇÃO PRIMÁRIA
    NA COMUNIDADE QUILOMBOLA DE ANANINDEUA

  • Data: 22/12/2016
  • Mostrar Resumo
  • The aim of this study was to evaluate the first contact access attribute of primary health care
    in the QuilombolaCommunity of Abacatal in Ananindeua-PA, in order to identify the
    primary care reference service recognized by the community as a care device, assess
    utilization and accessibility of the Family Health Strategy Using PCATool for the adult
    population of said community. The quantitative descriptive cross-sectional study involved
    the participation of 92 residents of the Quilombola Community of Abacatal, over 30 years
    old, who, after consent, answered the Instrument of Assessment of Primary Care (PCATool)
    adult version, which consists of 87 Items divided into ten components related to the
    attributes of Primary Health Care (PHC), three dimensions were used for the study: Degree
    of affiliation (5 items) that sought to assess the degree of affiliation, that is, how much the
    patient feels " Belonging "to the service; Whether there is a health service that is usually
    sought when there is a need; If there is a service that knows the user better and if there is a
    service that is considered responsible for the user's care, first contact - utilization (3 items),
    which sought to evaluate if the doctor or nurse of the FHS indicated in the component
    degree of affiliation Is the first to be sought for a review query; If the referred service is the
    first place that the interviewee would look for if he / she has a health problem that has not
    yet occurred or a new episode of a chronic problem and if the service under evaluation is the
    only means of referral to a specialist or specialized service , And Accessibility (12 items)
    that sought to evaluate if the user gets access on weekends and night to the referred service;
    If the FHS attends its users with agility when they have acute illness or aggravation of a
    chronic or telephone problem in these circumstances or for doubts as to their health situation
    / treatments; If you have a means of communication when this service is closed, not
    including other services that the interviewee can access; If the doctor / nurse or someone in
    the service under evaluation would attend the patient during the weekend or at night;
    Evaluate the time spent in the waiting room, until the patient is seen in consultation by the
    doctor or nurse; If there is difficulty for medical care; If you need to miss work or school on
    the day of the consultation. The results show that most residents turn to the FHS when they
    become ill or need advice on their health; And some have reported using other services,
    negatively evaluating the usage attribute. Regarding the availability of services, care and
    communication with the FHS, the answers had a negative majority. It is concluded that there
    is no recognition of the community about the local FHS as its gateway, because it is not
    considered resolutive, the study contributed to the fact that, when evaluating, it is indicated
    punctually where it is necessary to move towards reaching Comprehensive and quality
    assistance. From these findings, it is also a necessity for policies to be established, to be
    implemented.

  • VANIA CRISTINA CAMPELO BARROSO CARNEIRO
  • TECOBÉ NO MARAJÓ: ESTUDO DA EVOLUÇÃO DO PROGRAMA MAIS MÉDICOS PARA O BRASIL EM UMA REGIÃO DA AMAZÔNIA ORIENTAL, ENTRE 2013 E 2015

  • Data: 31/10/2016
  • Mostrar Resumo
  • ABSTRACT

    This study aimed to evaluate the performance of the Family Health Strategy after implementation of the Program More Doctors (PMMB), in the territory of Marajó-Pa-Brazil, through the historical series of six primary care indicators during 2011-2015: population coverage, proportion of live births to mothers for prenatal consultations (considering seven or more prenatal visits, 4-6 prenatal visits, without any prenatal consultation), hospitalization rates condition sensitive to primary care (ICSAP), hospitalization rates sensitive condition primary care (ICSAP) in children under 5 years, infant mortality rate and mortality rate in children under 5 years. The trend of improvement was evident after implementation of PMMB in 2013, achieving a 42.8% coverage in 12/2015. In 04/2014, all 16 municipalities had established with medical teams. The proportion of live births whose mothers had seven or more prenatal visits showed increasing trend in most municipalities, increasing on average by 97%, predominantly 7 times or more and reducing the proportion of live births mothers without prenatal visit. The results also showed that PMMB was potentially relevant to reducing ICSAP and ICSAP in children under 5 years, especially from infectious gastroenteritis and its complications. The infant mortality rate obtained downward trend from the results of 2014. The expansion and consolidation of the ESF in the Marajó region made possible by PMMB signal improvement of primary care, from the selected indicators.

  • BARBARA GUERREIRO AMÉRICO GOMES
  • RELATIONSHIP BETWEEN PERIODONTAL DISEASE, EDENTULISM AND GENETIC VARIATIONS OF INTERLEUCIN 10 IN THE INDIGENOUS POPULATION XIKRIN DO CATETÉ, PARÁ, BRAZIL.

  • Data: 04/10/2016
  • Mostrar Resumo
  • This study investigated the susceptibility to chronic periodontitis, edentulism and its association between polymorphisms in the IL10 gene in the indigenous population of the Xikrin do Cateté villages. Oral health is an integral and essential part of general health and, as such, is a determining factor for quality of life. Chronic periodontitis has a slow progression, similar to diseases with complex and chronic nature. The environmental factors that most relate to the disease are smoking, alcoholism and stress, and genetic factors. Somehow the genes or group of genes modify the periodontal response to environmental etiological factors and essential for periodontitis. The community is characterized by being a population affected early by tooth loss and edentulism. There is a relation between the increase in age with the presence of periodontal disease and edentulism. The sex issue was decisive for the course of the disease, both male and female presented the disease, however the male presented a majority of individuals with periodontal disease 62.5% and the female with 52.3% Edentulous individuals. Both smoking and diabetes had an impact on the course of periodontal disease, but found that smoking increases the chances of developing periodontal disease (22.4%) and dental loss (24.5%). Diabetes is related to loss of the dental element, raising the risk for edentulism in 43.36%. There is an association of the genetic mutation in IL-819 studied with the presence of periodontal disease in the Xikrin indigenous population of Cateté, where the mutant (risk) genotype is observed in 81% of the sample. That is, IL-819 is a risky SNP for the development of periodontal disease and subsequent dental loss. More studies are needed to verify the action and the relationship of existing genetic polymorphisms with periodontal disease in the indigenous population of the Cateté Xikrin. In indigenous oral health, there is a need to promote research on these peoples, with the intention of generating information for the planning and organization of health services, with the purpose of ensuring the establishment of care in the oral health program, with a non-mutilating character , Universal, integral, and that considers the cultural values related to the hygienic, dietary practices of the Xikrin people of Cateté.

  • HALLESSA DE FATIMA DA SILVA PIMENTEL
  • A INFLUÊNCIA DO AÇAÍ NOS COMPONENTES DA SÍNDROME METABÓLICA EM UMA COMUNIDADE RIBEIRINHA DAS ILHAS DO COMBÚ, PAPAGAIO E MURUTUCUM, BELÉM-PA-BRASIL

  • Data: 30/09/2016
  • Mostrar Resumo
  • Objectives: To investigate the association between the components of the metabolic syndrome (MS) and the consumption of açaí in the riverine population of Combú Islands, Murutucum and Parrot, located in the city of Belém, Pará, Brazil; to identify and to characterize the metabolic syndrome in this population; calculating the frequency components of the metabolic syndrome; evaluate the frequency and consumption of açaí. Methodology: The study is cross-sectional, correlational and is part of the "Katuana the Combu - vulnerability to type 2 diabetes and hypertension in the Archipelago Combú". The study of the target population are individuals from 30 years, both genders, residents in the Archipelago. Combú, located in the Bay of Guajará, in Belém. - Pará, totaling 661 people, whose sample consists of 172 individuals a standardized questionnaire was administered at home, there was a collection of biological material, anthropometric measurements, checking blood pressure and frequency consumption of açaí through a form food frequency. People with MS were classified according to criteria of the National Cholesterol Education Program's Adult Treatment Panel III modified. All continuous variables were tested for normal distribution with the Kolmogorov -Smirnov. The t-test was used to compare means in normal distribution variables, the Mann-Whitney test for nonparametric variables. The difference between the 3 groups with non-parametric distribution was performed by Kruskal-Wallis test if there was a difference multiple comparisons were tested to determine the different groups. For categorical variables we used the chi-square test. The level of significance was set at 5% (p <0.05). Participants were categorized as "carriers" or "no carrier" SM and divided into groups for acai consumption pattern to allow the MS components were compared. IBM SPSS version 20 software was used for data analysis. Results: The prevalence of MS was 41.27% (n = 71), being more prevalent in women (71.8%). Participants with MS had median (47 years) older than those who did not have MS. There was no statistically significant difference in relation to self-reported color, marital status, study time, per capita income and economic status among participants with MS and without MS. All components of MS in this population were statistically significant (p <0.05). Most participants (77.9%) had HDL-c levels reduced both in patients with MS (37.8%) and in noncarriers (40.1%). It was found that 50% of participants had one or more components that characterize the MS. They are still smoking in this population 20.3% and 27.3% stopped smoking, while 52.3% had never smoked. Smoking among participants dind´t have statistically significant association with MS and the consumption of alcohol. The median açaí consumption was 250.0g a day, the majority (84.9%) consumed daily, among these, 57.0% consumed more than once a day. Most (43.0%) reported low consumption of açaí (202.00 g / day), 24.4% average consumption (300.00 g / day) and 32.6% high consumption (500.0 g / day ). The higher consumption of açaí was associated with a lower frequency of MS, and those who had higher consumption had decreased waist circumference. Conclusion: In the population of the islands of Combu, Murutucum and Parrot aged 30 years and older, the prevalence of MS was 41.27% and the highest consumption of açaí was associated with lower prevalence of MS.

  • PAULA SOUSA DA SILVA ROCHA
  • Tuberculose Resistente a Múltiplos Medicamentos, Saúde Coletiva, Pará, Amazônia, Brasil.

  • Data: 28/09/2016
  • Mostrar Resumo
  • This work aimed to evaluate the outcome of patients with resistant tuberculosis

    multidrug (MDR-TB) in the State of Pará from the assessment of disease indicators in

    the State Department data system Para Health (SESPA) and of medical records of

    patients admitted to a reference hospital in the state, the University hospital João de

    Barros Barreto. This research took place in stages: first sought to give reasons in the

    studies on the subject in research, where origin gave to an integrative literature

    review, in the second stage held a historic series of MDR-TB in Pará in 2005 2014

    and there was a reduction in the percentage of high cure and in 2006 was the highest

    rate (92.6%) and in 2014 the lowest (46.7%). There was also an increase in the

    percentage abandonment of treatment in this period. The failure had the highest

    percentage in 2013 (8.8%), followed by the year of 2014 (6.7%). Regarding the

    deaths, the peak occurred in 2008 (18.9%) followed by 2007 (13.6%). The incidence

    rate of the disease was shown to be reduced over the period analyzed, the third

    stage, developed a research on the clinical course of patients with MDR-TB treated

    at a university hospital in the 2010-2014 period from information contained in

    records, predominantly male and the most affected age group was the one in the

    most productive years (18-55 years), the secondary form of the disease was present

    in 94.1% of cases, the diagnostic time and the start of treatment for MDR-TB 1 to 10

    days, the profile of resistance to drugs that prevailed were rifampicin, isoniazid and

    streptomycin and was most associated comorbid diabetes. In the fourth and final

    stage held the lifting of antituberculosis resistance profile of these patients treated at

    the referral center in the period 2010-2014, where most of the samples were from

    men, the age group between 18-55 years, most was not HIV positive, healing

    endpoint was the highest (77.4%), the most resistance pattern introduced drug

    resistance 3 (41.9%) and of these, the pattern that was introduced to rifampicin (R ),

    isoniazid (H) and ethambutol (E) (16.13%), the drug most widely used in treatments

    was E with 28 treatments and the most used scheme was that contains levofloxacin

    (LFX), terizidone (TRZ), and , amikacin (Am) and metronidazole (Mtr) with 22.6% of

    the schemes. With the research it was possible to trace the profile of the disease in

    the state, demonstrating how the disease still affects negatively on the indicators

    which shows the need for more effective public policies to combat and control the

    disease and also more investments in more treatments efficient and of short duration.

  • MARIANA RODRIGUES DA SILVA DE MENEZES
  • FATORES DE RISCO À SAÚDE CARDIOVASCULAR DE RIBEIRINHOS NO ARQUIPELAGO DO COMBÚ

  • Data: 19/09/2016
  • Mostrar Resumo
  • In Brazil, cardiovascular diseases account for the largest number of deaths.
    Within the current concept of cardiovascular prevention, more important than simply
    taxing an individual as having DM, SAH or dyslipidemia, is to characterize him in
    terms of his cardiovascular risk. The Framingham risk score uses variables of age,
    gender, smoking, diabetes, blood pressure levels, total cholesterol, and fractions; The
    risk of myocardial infarction (AMI) or death from coronary disease in 10 years,
    classified as low (risk less than 10%), intermediate (10-20%) or high (risk greater
    than 20%) risk is estimated. Therefore, cardiovascular risk was assessed in the
    riverside communities of the Combú archipelago, according to the Framingham risk
    score. A transversal study with quantitative method was carried out on riverine
    participants aged 30 years or more. The study was part of the project "Katuana do
    Combú - vulnerability to DM2 and HAS in the Combú Archipelago." The Katuana was
    approved by the Ethics and Research Committee of the Institute of Health Sciences /
    UFPA according to opinion CAAE 06029712.3.0000.0018 and meets Resolution
    466/2012 All participants were given a verbal and written explanation and accepted to
    participate in the study by signing the free informed consent form - TCLE To quantify
    the sample, a simple frequency of the risk factors used by the Framingham cohort
    was performed, as well as The Kolmogorov-Smirnov test was used to compare the
    mean values of the two variables (p <0.05) Independent groups with normal
    distribution were analyzed by the Student's t-test and non-parametric by the MannWhitney test. For categorical variables, the chi-square test was used for 2 groups and
    Pearson test for 3 or more groups. IBM SPSS Statistics 20 software was used for
    data analysis. A total of 178 people were analyzed, with a mean age of 47.10 (SD ±
    12.90) years, predominance of women. The mean LDL-c was 110.11 (SD ± 37.770)
    mg / dL, total cholesterol (CT) 173.70 (SD ± 40.397) mg / dL, HDL-c 37.94 (SD ±
    9.591) mg / DL, triglyceride 132.96 (SD ± 63.642) mg / dL, PAS 131.86 (DP ±
    22.144), PAD 76.09 (DP ± 15.536), DM 7 (3.9%), HAS 43 2%). According to the
    Framingham risk score 98 (55.10%) of the participants presented a high risk (10%
    risk or more) for a coronary event in 10 years. In the borderline profile, participants
    with 4 years or more of study time, economic class D and E (n = 75; 60.50%), black
    and brown (n = 79; 57,20), married or with stable union ( N = 69, 54.80%), DM (n = 5,
    71.40%), SAH (n = 30, 60.80%), and alcoholics (n = N = 52, 65%) were classified as
    high risk. Therefore, riverine patients presented a high risk for coronary event in 10
    years and riverside patients with associated comorbidities were shown to be the
    synergistic risk factor for coronary event in 10 years.

  • CAMILA MAISA SANTOS MONTEIRO
  • Health of the black population; nutritional transition; adolescents; Amazon.

  • Data: 19/09/2016
  • Mostrar Resumo
  • NUTRICIONAL SITUATION OF QUILOMBOLA ADOLESCENTS IN
    THE STATE OF PARÁ, AMAZONIA, BRAZIL
    ABSTRACT
    Quilombola (afrodescendant) communities are frequently absent from national research about
    health, resulting in a lack of data about their reality, making it difficult to construct
    epidemiological indicators for them. Historically, these groups have been constantly faced
    with situations of socioecological vulnerability. These difficulties are reflected in the different
    age groups and eventually have negative consequences, particularly in the early stages of life,
    childhood and adolescence, periods that occur the main changes that will project the
    individual's potential in adulthood. It is already recognized in epidemiologic studies
    worldwide that the nutritional transition has reached more traditional populations, increasing
    the rates of overweight. However, there are still few studies investigating the nutritional status
    of quilombola adolescents in Amazonia. Monitoring the nutritional status in this period,
    adapting the study tools already used in other populations to the local reality of the
    quilombola, is a way to understand the possible causes of the development overweight during
    adolescence and its persistence into adulthood besides providing subsidies for public health
    planning. This study has as main objective to analyse the problem of overweight among
    adolescent quilombolas from Pará state, verifying the influence of socio-demographic
    conditions in the nutritional status of this population. A transversal study was made, where
    participated 150 adolescents between 10 and 19 years old, with a mean age of 14,37 (±3,02)
    years old. These belonged to 54 families from nine quilombo communities located in three
    municipalities of Pará- Oriximiná, Cametá and Ananindeua- It was measured, weight, height
    and body composition, besides the application of a socio-economic survey per family.
    Quilombos belonging to the Oriximiná municipality are located at the banks of Trumpets and
    Erepecuru river, being accessible only by river. The communities of Cametá and Ananindeua,
    there is road access, but the roads have no paving, with plenty of slopes, there is no public
    transportation, being motorcycles the primary means of driving used. In all communities,
    subsistence agriculture, based on family labor, with the production of flour, acts as the main
    source of income, supplemented by financial assistance received from government. Only
    9,3% had some kid of sanitation and in relation the householders, most part of then (55,3%)
    had even three years of schooling. Homes with electricity comprised 44.67% of the sample. In
    relation to the nutritional transition, 22% of the population of adolescents are overweight, and
    there are still 16.7% of deficit of stature among young people, suggesting a past of
    malnutrition condition. In relation to body composition of adolescents, it was found that
    83.65% having body fat percentage within the average. The correspondence analysis showed
    that the indicator BMI/I had association with all the surveyed socioeconomic conditions
    (Community, income, education of the householder, household income and sanitation), about
    E / I, this was not influenced by the variable income and sanitation (p= 0,165 and
    p=0,345,respectively). The present study, even not using a methodology that verify the
    clinical situation and integral adolescent health corroborates other studies that point to the
    vulnerability of the quilombo population.

  • JAMILIE SUELEN DOS PRAZERES CAMPOS
  • Qualidade da dieta. Estado nutricional. Síndrome metabólica.

  • Data: 01/09/2016
  • Mostrar Resumo
  • According to the World Health Organization, a significant percentage of healthy individuals living in industrialized societies will develop some chronic disease in the course of their life, with food components making a major contribution to the genesis of these diseases. Considering that the Revised Healthy Eating Index (IQD-R), is a useful tool to measure various dietary risk factors for chronic diseases and that many companies have been affected by the increased costs caused by these diseases, this paper aims to identify The factors associated with the quality of the diet of urban workers in the metropolitan region of Belém-PA. It is a cross-sectional study that used secondary data from 504 adult male and female workers in order to test the association between diet quality and socio-demographic profile, nutritional status and the occurrence of Metabolic Syndrome (SM). From the information of the REC24h, the workers' diet was classified as "poor", "needs modification" and "healthy", according to IQD-R. The nutritional status was obtained from the calculation of the Body Mass Index and for the diagnosis of SM, the criterion established by the International Diabetes Federation was used. A mean IQD-R score of 58.16 points was observed. Lower mean scores were attributed to whole grain and total plant groups, while the total cereal and meat, egg and legume groups had higher averages. Most of the workers are male, aged between 20 and 34 years, studied until high school, had a companion and monthly income between 2 and 5 minimum wages, overweight, without MS and maintained a diet that Changes. There was no significant difference between the IQD-R point means in each category of sociodemographic variables. However, through the multivariate analysis, the IQD-R showed a dependence on income. It is noteworthy that 34% of the obese individuals and 24.1% of the eutrophic maintained a healthy diet, while 87.5% of those with low weight had a diet that needed modifications. However, no significant association was observed between the IQD-R and the nutritional status nor with the occurrence of SM. It was concluded that, despite the majority of workers maintaining a diet that requires modifications and the relevant prevalence of overweight and metabolic syndrome, the quality of the diet was not a determining factor for the sociodemographic profile, for the nutritional diagnosis and nor for the development of SM in this population.

  • ALCIONE FERREIRA PINHEIRO
  • STUDY OF THE DISTRIBUTION TEMPORARY SPACE OF LEISHMANIOSE
    TEGUMENTAR AMERICANA, IN THE MUNICIPALITY OF ULIANÓPOLIS-PA, NO
    PERIOD FROM 2010 TO 2014.

  • Data: 30/08/2016
  • Mostrar Resumo
  • In the state of Pará, the municipality of Ulianópolis, located in the southeastern region has recorded high prevalence of American Cutaneous Leishmaniasis (ACL) cases in recent years. In order to know the distribution of the localities involved in the infection, the aim of this study was to analyze the spatiotemporal form the of American Cutaneous Leishmaniasis (ACL) distribution in the municipality of Ulianópolis, in the period 2010 to 2014. SINAM data were obtained for epidemiological, socioeconomic and environmental analysis; survey of cartographic databases and satellite images geostatistical analysis based on kernel density estimator, interpolation technique and self spatial autocorrelation using the Moran index were performed. The prevalence rate of LTA was higher in males (334/406), aged between 15-45 years with low education (5th to 8th incomplete grade of elementary school) and predominance of cutaneous form (99.26%). The distribution of LTA cases was observed throughout the municipality, with a displacement of the disease over the years. The localities “Assentamento Nova Vida”, “Fazenda São Marcos”, “Colônia Bom Jesus” and “Km 60” had higher expressivity in numbers of cases and in its vicinity were perceived secondary vegetation, forest, shieling and agriculture. Several focus of occurrences and LTA clusters were identified in different areas of the municipality during the study period, suggesting that the ideal conditions for the establishment and maintenance of transmission are found in these places and that the pattern of occurrence of LTA is not static and diseases may occasionally spread to other areas of the county. The use of tools such as geoprocessing technology provides understand the epidemiological dynamics of LTA that is established in Ulianópolis, which will enable the prevention and promotion activities in priority areas.

  • RINALDO ANTONIO ALMEIDA GONÇALVES
  • AVALIAÇÃO DA QUALIDADE EM PRONTUÁRIOS DE PACIENTES E PROCESSOS DE UM HOSPITAL DE ENSINO NO MUNICÍPIO DE BELÉM-PA

  • Data: 26/08/2016
  • Mostrar Resumo
  • ction: Record information in medical records is occupation and duty daily life
    of all health professionals. Objectives: To evaluate and describe the quality practices
    of a sample of records and analyze the information management mechanisms in
    Ophir Loyola Hospital. Methodology: Quantitative and qualitative study with
    analytical and descriptive purposes in information collection, using the quadrupole
    method, which guided the research in the review of baseline study of the medical
    records and interviews with 40 managers to understand the organizational culture
    and information technology and produced communication and exist in this institution
    and compare with a hospital in Portugal. The sample size charts considering the
    significance level of 95%, with a maximum variance and sampling error, calculated,
    amounted to the "n" of ninety-nine (n = 99), stratified by year from 2000 to 2015. the
    statistical analysis techniques were applied Descriptive organized to observe or not
    the predominance of calculated and analyzed variables and Inferencial the
    application of nonparametric chi-square tack considering significance level α = 0.05,
    and Fisher statistics for surveys of managers in the comparative analysis. Results:
    The quality of records was considered regular, detected fragmented notes history
    (80%), vital signs (66.6%); serious absences records and individual records for the
    multidisciplinary teams (82.83%), incompleteness in physiological and
    pathophysiological parameters (80%) and items with correct answers (90%) in the
    records of doctors as: patient identification; diagnostics; pipelines and signatures,
    and even crossed information about the technologies used in the management of
    quality in design based information managers, who understand the importance of
    technology, but with certain doubts and misconceptions. Conclusions: essential
    handwritten information is ceasing to be registered in the records and information
    systems. It emphasizes the importance of developing measures to improve the
    quality of patient records, which will reflect in the quality of patient care in the
    management of clinical and administrative information, legal aspects, teaching and
    research

  • LUÍS HENRIQUE ROCHA GUIMARÃES
  • Leishmaniasis is a disease caused by protozoa of the genus Leishmania parasites with transmission through the bite of sandflies mosquitoes, popularly known as phlebotominae.

    The different clinical aspects of the disease are represented in two forms: cutaneous or cutaneous and visceral or kala azar. According to the World Health Organization, leishmaniasis is part of the group of neglected tropical diseases, ie, associated with poor living conditions and health inequities, which is a reportable disease in Brazil through Diseases Information System Notice that has recorded the last ten years more than 200 thousand cases.

    Leishmaniasis is an endemic disease in the Amazon region and demand for studies that consider environmental variables to raise the research level of ecological analysis. In this context the objective of this study was to analyze the spatial distribution of Leishmaniasis in Barcarena - PA, from 2007 to 2013, considering socioeconomic and environmental variables.

    Barcarena was the scene of installation of large industrial projects and has undergone an intense migratory flow, as well as a great process of environmental degradation. The implementation of this study passed the review of scientific and technical literature;

    acquisition and processing of satellite images, cartographic, environmental and socioeconomic data. Epidemiological data were debugged, confirmed the location field and georeferenced. In the laboratory stage, epidemiological data were tested the spatial distribution pattern, the detection of spatial clusters, the identification of risk areas and the construction of a case of leishmaniasis density map. Later epidemiological data were processed along with environmental data to correlate the occurrence of the disease with the degradation in the study area and were then aggregated by census tracts with socioeconomic variables and tested a method of multivariate multiple regression analysis in the search for evidence interaction with the studied grievance. a geographic database was built and geoprocessing techniques allowed the generation of thematic maps with cartographic, environmental and epidemiological information, it is possible to identify the areas with the highest occurrence of cases and a standard disease distribution cluster in the city. The observed epidemiological profile was predominantly rural (84%), male (71%) and less than a thousand meters in relation to degradation foci (62.4%) of 125 georeferenced cases. The multiple regression tests showed socioeconomic variables related to poverty, sanitation and public infrastructure as three predictor variables with significant correlation to the occurrence of leishmaniasis cases with a model of reliability of 32%, indicating an average correlation.

    The results of this study showed the importance of using inferential statistics and geotechnology in management and analysis of information from diverse backgrounds and areas of knowledge enabling trends IDs for planning, evaluation, and interference located in the most affected areas.

  • Data: 26/08/2016
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  • Leishmaniasis; Epidemiology; Geographic Information System; Spatial analysis; Multiple regression.

  • RITA CRISTINA COTTA ALCÂNTARA
  •  

    ANÁLISE DA DISTRIBUIÇÃO ESPACIAL DA HANSENÍASE NOS TERRITÓRIOS ADSCRITOS PELA ESTRATÉGIA SAÚDE DA FAMÍLIA NO DISTRITO ADMINISTRATIVO DE MOSQUEIRO, BELÉM-PARÁ, NO PERÍODO DE 2007 A 2013.

     

  • Data: 26/08/2016
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  • Leprosy is a infectious disease, which despite reports since Biblical times, persists as a public health problem in many countries, including Brazil, with a high degree of endemicity in territories with poor living conditions and difficult access to health services, characteristic of regions that suffered intense and disordered processes of occupation, very common in the Amazon region. In this sense, this paper analyzes the temporal and spatial distribution of leprosy in the territories ascribed by the family health strategy in the administrative district of Mosqueiro which is part of the municipality of Belem, Pará, between 2007 and 2013. For this we used the database of the Secretariat of health of the municipality of Belém of the reported cases of leprosy which have been notified by the family health teams that operate in the District of Mosqueiro, in the period selected for the study. Socio-demographic variables (gender, age, education, and residence), as well as the clinico-epidemiological variables (operating rank, degree of physical disability, detection mode and input mode) were obtained from the Notifiable Diseases Information System (SINAN). For the calculation of the index that condition of life (ICV), using information from the Brazilian Institute of geography and statistics (IBGE). The selected variables were subjected to statistical analysis and geoestatísticas. Statistical analysis showed that there is a downward trend in the rate of detection of the disease in the territories studied, and this trend is stronger for females. Most of the reported cases was of new cases occurring in men, economically active age, residing in the urban area, with multibacillary classification, zero degree disability, diagnosed through forwarding. The higher prevalence in the territory that had less coverage of health agents. In the analysis of space distribution it was noted that most territories presented very high degree of endemicity, pegged to the index of living conditions too low, with greater density of multibacillary cases

  • MARIA AMELIA DOS SANTOS LEMOS
  • SAÚDE BUCAL E QUALIDADE DE VIDA DE POPULAÇÃO IDOSA RIBEIRINHA DA AMAZÔNIA

  • Data: 23/08/2016
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  • The health and quality of life are dimensions of human life strongly

    influenced by the social context. For populations in vulnerable situations, such

    as riverside communities, it is essential to know how the social determinants are

    expressed in the construction of health perception by the individual in their

    midst. The oral health is part of the overall health of the individual, and the

    elderly, oral conditions influence the physiological and psychosocial function,

    and therefore act to determine the quality of life. This research aims to evaluate

    the impact of tooth loss in quality of life, according to the GOHAI, bordering the

    elderly Combu Island, Belém-PA. This is an observational study with over 65

    elderly enrolled in the Health Strategy Combu family. socioeconomic conditions

    were assessed by socio demographic indicators; quality of life, according to the

    Geriatric Index Determination of Oral Health (GOHAI); and edentulism through

    oral examination for use and need of prosthesis according to the protocol

    adopted by the National Survey of Oral Health, SB 2100. Brazil were evaluated

    53 subjects with a mean age of 71.6 years (± 6.68) to five years of schooling

    and maximum income of two minimum wages. There was a high prevalence of

    edentulism: 58% of the elderly are totaling edentulous and 42% have lost at

    least one tooth. There was a higher proportion of edentulos among the elderly

    aged over 70 years and with less education. Quality of life was considered poor,

    with a mean score of 25.9 GOHAI. The rehabilitated elderly had better quality of

    life compared to non-rehabilitated. Increased life expectancy of Brazilian

    citizens reports a special look to old problems, such as the development of a

    health policy that includes the preservation of tooth and rehabilitation so that

    they can live with quality and better inclusion in society.

  • ANA CRISTINA AGUIAR DE ALENCAR
  • PUBLIC HEALTH INSTITUTIONS IN PARÁ: research, scenarios and actors (1912-1921)

  • Data: 16/08/2016
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  • The study analyzes how was the institutionalization of preventive measures in the first two decades of the twentieth century, among the years 1912-1921, due to diseases affecting the ‘Pará’ State population, more specifically, the diseases treated in health institutions: Institute protection and Care of children of Pará (child mortality), Pasteur Institute (rabies), Belem Hygiene Institute (laboratory tests and production of vaccines), Prophylaxis of Venereal Diseases Institute (syphilis, cancroids, gonorrhea and skin diseases). To compose the work were documents of searches done in several places as: Paraense Belle Letters Academy, Arthur Vianna Public Library, Pará State Faculty of Medicine, Medical-Surgical Pará Society, Ophir Loyola Hospital, which there were reports of readings, statutes, regulations, newspapers, magazines, books, dissertations and theses. In the face of what was found, we discuss about the treatment applied by academic medicine in the first Republic, observing a national sanitation policy of urban space and treatment offered to the patient as individual health education model. The state health authorities have implemented a control, governed by principles and norms, socially intervening in the health and disease. Not all professed measures by government agencies have taken peacefully. By deploying institutes, medical hygienists wrote works related to performance of their profession, published texts in the form of articles and books. Moreover, they presented lectures in order to warn the public about the care they should have about the incidence of diseases of the time, for lack of adequate food and especially hygiene and poor sanitation. Health policies developed in this period in Pará State were interventions that reflected a national policy considering there are few resources and professional available in the region.

  • LEIDIANA DE JESUS SILVA LOPES
  • Network of Attention to the Person with Disabilities. SUS. Health of the person with disability. For
  • Data: 11/08/2016
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  • It talks about the attention network to the health focused to the person with disability that
    aims to analyze the challenges to the process of formation of the care network to the person
    with disability from the health politics to the person with disability in the state of Pará,
    identify the current state of the attention network of care to the person with disability from
    their components: basic attention; specialized attention in auditive rehabilitation, physics,
    intellectual, visual, ostomy and in multiple deficiencies; and hospital attention and of urgency
    and emergency, as well as analyze the processes of implementation, problems and challenges
    related to the care politics recommended by the state from the rights established related to the
    person with disability. This study was based in a qualitative study with a hybrid approach held
    through the analysis of documents, 8 semi-structured interviews with managers of the units of
    health references in attention to the person with disability and contribution of critical literature
    about the theme. The attention network to the person with disability in Pará is unstructured,
    and was identified that it is concentrated in the capital, a fact that undermines the guarantee of
    access to health services and treatments, as well as prejudicing the social inclusion and hinder
    the integral care to the health of people with disabilities. It is a significant network but still
    incipient.

  • MARTA GIANE MACHADO TORRES
  • Master in Health, Environment and Society in the Amazon

  • Data: 09/08/2016
  • Mostrar Resumo
  • The research had as objective to know the perception of users living with HIV / AIDS on the integrality of the assistance in the service of Home Care. Imbued in the media of the then paradigm of health promotion and the constituents of the Unified Health System, data for the study, from a descriptive-qualitative approach, were obtained through a semi-structured interview with questions directed to the research question. Eight people living with HIV and receiving home care participated in the study. All of them are linked to the State of São Paulo Specialized Reference Unit for HIV / AIDS in Belém. The theoretical basis was established based on the conception of health as a universal right and its political and social structuring in the consolidation of the struggle for health public. Counting on the contribution of related areas such as sociology and anthropology. The analysis and interpretation of the data made possible through the Bardin content analysis technique resulted in the construction of a conceptual framework, allowing interaction with the work process and in this scope of its direct connection with the users. Among life history when reached by HIV and its arrival and involvement with Home Care Therapy. The results indicate that the dynamics of the service for integral health care of people living with HIV / AIDS is complex and disjointed. The structure and organization of the specialized care of the service that comes to the home follows the dictates of the state policy established in the Brazilian Magna Carta in consonance with the principles and guidelines of the SUS. They point out satisfaction with the assistance. However, existing problems, which have emerged from the speeches, related to human rights violations, deficiencies in human resources, equipment and transportation, for example, could jeopardize the advances generated by integrality. There is recognition of the fragmentation of networking and the difficulty of making it flow between services. Failures were pointed out to ensure reference flow and counter-reference. From the intersection between their lives and the dynamics of care, services, health practices and social control, pointing out what integrality comes to be, as the central axis of health work, a consequent pillar of the current Health System, by the formulation of general policies and specific attention to users and society.

  • JOSIVALDO SOARES DA SILVA JUNIOR
  • Quilombo, Negro, Anemia, Hemoglobinopatia, Óbidos, Oriximiná, 
    talassemia, anemia Falciforme

  • Data: 24/07/2016
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  • A presente pesquisa retrata a saúde da população quilombola no estado do Pará,
    considerando as diretrizes e princípios estabelecido no SUS. Deste modo, analisa-se que
    são vários os aspectos a serem observados na construção da saúde de populações
    quilombolas, entre esses aspectos observamos a incidência de anemia como um importante
    fator a ser levado em consideração nessas populações, bem como a incidência de
    hemoglobinopatias que podem afetar a qualidade de vida. Portanto, buscou-se analisar a
    classificação dos parâmetros eritrocitários e a prevalência de hemoglobinopatias
    hereditárias em comunidades afrodescendentes de Óbidos e Oriximiná, região do baixoamazonas, Pará. A amostra foi composta de comunidades quilombolas de dois municípios
    do estado do Pará, Óbidos com três comunidades (239 indivíduos) e Oriximiná com nove
    comunidades (368 indivíduos). Elas foram categorizadas de acordo com o sexo e a faixa
    etária para analise e comparação dos dados. O município de Oriximiná teve um total de
    29,9% de sua população com quadro de anemia e Óbidos apresentou 7,5% com anemia,
    observando os valores de hemoglobina, sendo que 46,6% das crianças das comunidades de
    Oriximiná abaixo de 5 anos estavam com anemia e com um percentual maior em
    comparação com Óbidos; 58,1% das crianças entre 6 – 11 anos de Oriximiná e 25% em
    Óbidos apresentaram quadro de anemia. Com relação à distribuição das hemoglobinas
    variantes o maior percentual em Oriximiná foi observado para a HbAS com 5,2% da
    população, seguido de indivíduos com interação Talβ/S com 1,9%, foi observado 1,4% de
    casos sugestivos de Talassemia beta; a distribuição em Óbidos teve sua maior frequência
    também para HbAS com 4,2% da população, seguido de casos sugestivos de Talassemia
    beta e interação Talβ/S, ainda foi observado casos de HbC. Os percentuais observados
    apontam para a necessidade de politicas publicas para reverter esse quadro, contudo a
    saúde da população negra em nosso país perpassa por várias esferas e que estão
    correlacionadas entre si, levando a disparidade no que se diz respeito ao acesso à saúde e
    equidade. Portanto, além dos serviços de saúde a há necessidade de politicas que venham
    empoderar essas populações acerca de seus direitos como indivíduos inclusos na
    sociedade, bem como dos possíveis agravos de saúde que podem ocorrer em decorrência
    da sua origem ou composição genética.

  • CIBELLE CRISTINA OLIVEIRA DOS SANTOS
  • THE IMPACT OF ORAL HEALTH ON THE QUALITY OF LIFE OF TEENAGERS OF RIVERINE AND URBAN COMMUNITIES OF AMAZON AND ASSOCIATION WITH THE PRESENCE OF MALLOCLUSION

  • Data: 30/06/2016
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  • Objective: To assess the impact of oral health, especially malocclusion, the quality of life of adolescents belonging to the riverside and urban communities in the Amazon. Methods: This cross-sectional study involved 266 students, aged 11 to 14 years old, residents of riverside and urban communities in the city of Abaetetuba / PA. Participants completed the questionnaire quality CPQ life, and were clinically evaluated to determine the severity of malocclusion through the DAI index. The Multilevel analysis was used to evaluate the association of quality of life in two areas at the first level (gender and malocclusion) and one on the second level (school). Results: The average value of the DAI index for the adolescents in the region of the islands was 26.31 and the urban region was 23.81, clinically demonstrating the severity of malocclusion ranging from absent and light . The average value of the quality of life index was similar for both regions , equal to 10.68 to the riverine and 11.46 for the urban area . There was no impact of malocclusion (PR = 1 to 1.05) and the gender variable in quality of life of adolescents of both regions. Bad severe occlusion involving cases are expressed preferentially in the riverside area. Teenagers riverine reported better quality of life in relation to the urban area (PR = 0.38). Conclusion: There was no impact of malocclusion in adolescent quality of life of urban and rural area in the city of Abaetetuba / PA. Teenagers riverine reported better quality of life in relation to the urban area. Most cases of severe malocclusion is in the region of islands, which justifies the need for inclusion of the community in public health policies.

  • ROSANA NAZARE LEAO SOUZA
  • Mental Health and Work presents an analysis from the implementation at the Federal University of Pará, Attention Integrated Subsystem Health of Civil Servants - SIASS, responsible for ensuring the axes Assistance Policy Health Federal Public Servants - PASS that is based on the axes: a) monitoring and promotion of health; b) health care and c) health expertise. In the search for a better understanding of the topic, the study was carried out by the documents published on the actions and programs proposed by the Directorate of Health and Quality of the Federal University of Pará Life, for its servers. The overall objective was to describe the implementation of SIASS and their contribution to the organization of health care of the UFPA servers, observing the scope of the proposed actions in the number of servers served by these programs. It is taken up by specific identifying the demand calls for the period 2010 to 2014 offered by DSQV and their coordinators since the implementation of SIASS / UFPA and demonstrate preventive actions and dressing the same period, offered to UFPA servers, the Program Psychosocial assistance Server - PAPS. The research is an exploratory and descriptive study, based on theoretical basis data on the subject and documentary, literature review and the collection and systematization of secondary data and consolidated found in the management reports of the Pro Rector for Development and Personnel Management - PROGEP the period from 2010 to 2014, in SIASS the Federal University of Pará unit. It takes an approach to quantitative and qualitative method. The results point to actions taken by coordinating offices that make up the DSQV, highlighting the programs and health favoring projects and quality of life of the servers; the major causes of absenteeism server through variables external factors osteomusculares diseases and mental and behavioral disorders; and reducing absenteeism.

  • Data: 22/06/2016
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  • Mental health; Attention to workers' health; Labor; Servers public; Federal University of Pará.

  • MARIANA BEZERRA DAS FLORES
  • FATORES DE RISCOS CARDIOVASCULARES DE ADOLESCENTES EM BELÉM E EM SÃO PAULO

  • Data: 09/06/2016
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  • Cardiovascular disease (CVD) is developed since the childhood and adolescence. As well as the globalization process grows in the cities, many behavoir changes and unhealthy diet influence the CVD’s development. Therefore, this study goals compare the cardiovascular risk factors public and private schools' adolescents at Belém (PA) and São Paulo (SP). Data from adolescents aged from 12 to 17years were evaluated in Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional study with representative sample for both cities (Belém n= 1.259 and São Paulo n= 1.920). Physical activity’s level, eating behavior, body mass index, blood pressure, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides and glucose were evaluated. Prevalence and 95% Confidence Intervals were estimated for each variable according to the sex and city. Physical inactivity was presented at more than 50% of adolescents from Belém and São Paulo, especially women; there was a higher prevalence of adolescents who didn’t take breakfast (95% CI= 28,4 – 32,6) and lunch with parents/guardians (95% CI= 18 – 21,6), mainly in women, at São Paulo. This city also presented higher prevalence of eat snacks watching TV (95% CI= 28,5 – 32,7) and eat snacks using videogame or computer (95% CI= 18,2 – 21,9); there was no difference on both cities between the overweight percentage (16,3% and 18,5% at Belém and São Paulo respectively) and obesity (8,3% and 8,2% respectively), with overlapping confidence intervals. There was also no difference at the changed blood pressure percentual on both (10,3% and 8,5% respectively). Higher girls prevalence of total cholesterol and LDL cholesterol abnormal was observed in these cities. More than a half of all the boys had higher low HDL cholesterol prevalence and a higher prevalence of glucose levels changed (95% CI= 3- 4,8) was observed at São Paulo city. Therefore, physical inactivity was present in both capitals teenagers. At São Paulo was observed higher prevalence of teens who didn’t take breakfast and didn’t lunch with the presence of guardians and Belém showed higher prevalence of low HDL cholesterol and less cardiovascular risk factors than São Paulo city

  • ALCINÊS DA SILVA SOUSA JUNIOR
  •  

    ECOEPIDEMIOLOGIA DA DOENÇA DE CHAGAS, NO MUNICÍPIO DE BARCARENA, NO ESTADO DO PARÁ,NO PERÍODO DE 2007 A 2014

     

  • Data: 27/04/2016
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  • Chagas disease is endemic in the Amazon region, but it has always been poorly documented. In the recent decades, Pará State is where most of these cases of this disease were recorded, mainly from the micro-region of Belém. In this context, this study focused to develop the disease scenario, from 2007 to 2014, in order to comprehend the relationships with environmental and socioeconomic variables at Barcarena municipality, which is located in the above-mentioned micro-region. Barcarena was selected because it has been confirmed 83 cases of Chagas in this period, with a prevalence rate of 89.38 cases/100,000 inhabitants. Thus, many scenarios were developed to assess the factors related with the risk of Chagas disease. In this way, the municipality of Barcarena was divided into 5 political and administrative areas because of the different intra-regional characteristics of these areas, which are: Headquarter, Morucupi, Vila do Conde, islands and roads. Furthermore, there were interrelated basis of epidemiological, environmental and socioeconomic data, all debugged and then indexed with geographic coordinates obtained in the study areas. For epidemiological and socioeconomic analysis were used statistical techniques, for environmental analysis were used satellite image classification technique with Artificial Neural Networks, and for the analysis of spatial autocorrelation among the variables mentioned above were used geostatistical techniques. The historical series of the disease has shown an increasing trend of cases, with maximum impact in the years of 2013 and 2014 with 40.9/100,000 inhabitants, also was observed a seasonal pattern with higher notification in the second semester. The epidemiological profile for of Chagas disease was male, adult, mixed race, illiterate, living in urban and rural areas, and the oral transmission was the most responsible for the infection in urban areas, such as in regions Headquarters, Morucupi and Vila do Conde. Also, the vector transmission was higher in rural areas, as in the regions of the Islands and Roads a cluster pattern was observed from this disease in deforested. Finally, the use of techniques Statistical and geostatistical proved satisfactory and allowed us to identify regions with different levels of risk. Considering these results, we could emphasize the importance of using these techniques applying to studies in Public Health, because of that, the use of them in this work contributed to the construction of possible eco-epidemiological scenarios of Chagas, providing important information for health managers and planners in order control and surveillance of this disease

  • CLAUDIA CRUZ BARBOSA
  • AVALIAÇÃO DE PARÂMETROS ANTROPOMÉTRICOS E BIOQUÍMICOS, RELACIONADOS COM O PROCESSO DE TRANSIÇÃO NUTRICIONAL DA POPULAÇÃO INDÍGENA XIKRIN DO KATETÉ.

  • Data: 15/04/2016
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  • A transição epidemiológica está relacionada com a mudanças econômicas e socioculturais que alteram a fecundidade e a morbimortalidade de uma população, modificando a forma de adoecer dessas pessoas, diminuindo os casos de doenças infecciosas e parasitárias e aumentando o número de doenças crônicas não transmissíveis, a transição nutricional faz parte deste processo, estas alterações modificam o padrão alimentar de uma população, contribuindo para o processo de transição epidemiológica. No Brasil apesar do decréscimo global e proporcional das taxas de mortalidade por doenças infecciosas e parasitárias, esta taxa ainda é considerada elevada e encontra-se aliada ao aumento das DCNT’s. Este estudo visa descrever a antropometria (Índice de massa corporal e Circunferência de cintura) e os exames bioquímicos (Glicemia de jejum, Hemoglobina glicada, Triglicerídeos e Colesterol) e a possível relação destas varáveis, participaram 293 indígenas sendo 130 homens e 163 mulheres, adultos Xikrins do Kateté maiores de 18 anos da etnia Kayapó, residentes na região da mata de cipó, no interior da jurisdição do município de Parauapebas, próximo ao núcleo urbano de Carajás, Pará, Brasil. Foram feitos testes para verificar se houve diferença significante nos resultados entre os sexos e a relação entre as variáveis.  Ocorreram resultados significante em relação ao sexo, entre as varáveis antropométricas (IMC e CC), 83,3% das mulheres estavam com excesso de peso, 47,1% estavam obesas e 95,3% estavam com a circunferência de cintura elevada, enquanto 69,6% dos homens estavam com excesso de peso, 24,5% obesos e 46,9% com a circunferência de cintura elevada. Nos resultados bioquímicos houve um grande número de glicemia de jejum alterada, 54,3 % dos indivíduos, havendo associação entre a o IMC e CC e entre glicemia e triglicerídeos. Os resultados sugerem que os Xikrins do Kateté estão passando por um rápido processo de transição nutricional, igual ao exposto em outros estudos com populações indígenas.

  • FABIO GIAN BRAGA PANTOJA
  • AVALIAÇÃO DA SÍNDROME DE BURNOUT EM TRABALHADORES DE UM

    HOSPITAL UNIVERSITÁRIO DO MUNICÍPIO DE BELÉM-PA

  • Data: 08/04/2016
  • Mostrar Resumo
  • Burnout is an occupational disease that is expressed in three dimensions: emotional

    exhaustion (EE), depersonalization (DP) and low personal accomplishment (RP), causing

    damage to worker health. Objectives: To evaluate the characteristics of the disease in workers

    at a university hospital in the city of Belem, State of Para, Brazil. Methods: A descriptive and

    observational study using quantitative approach to cross-sectional design. 2 questionnaires

    were applied, being a socio-occupational characterization protocol and the Maslach Burnout

    Inventory (MBI) with 62 professionals. Data analysis was descriptive and inferential statistics

    used. The presentation of the data was performed using absolute and relative frequency

    distributions. The inferential statistics were performed by Kruskal-Wallis test, since the

    samples were not Gaussian, as the result of the test D'Agostino-Pearson. The chi-square test

    was used to evaluate the qualitative variables. Quantitative variables were compared by

    Kruskal-Wallis ANOVA with Dunn's post-test, since they were not compatible with the

    normal range. significance level were considered (alpha level) of 5%. Overall result: 48.3%

    had medium or high degree in EE; 40.03% medium or high in low PR and 38.7% had medium

    or high degree DP, with 45.16% of the workers had at least one dimension at a critical level

    and 8.06% had all three dimensions criticism. It was found statistically significant

    associations between being single and higher EE levels (p = 0.0285) and RP (p = 0.0082);

    income above 10 minimum wages and high levels of EE (p = 0.0122) and PD (p = 0.0498),

    lack of interest in work and higher levels of RP (p = 0.0011) and PD (p = 0, 0046) and other

    gainful activity and high levels of EE (p = 0.0373). Discussion: Although some results did not

    confirm the literature, it should be noted that most of the professional categories had not been

    investigated by adopting the methodology, which prevented us from establishing more

    consistent comparisons. Final Thoughts: The prevalence rate was found to be high among

    workers. How much of the studied associations did not achieve statistical significance, it is

    possible to suggest that working conditions may be responsible for the symptoms of burnout

    more than isolated features of professional or your workplace.

  • JOANA DULCE CABRAL FORMIGOSA
  • FORMIGOSA, Joana Dulce Cabral. Transfusion Safety: Rational use of blood andimmediate transfusion reactions, the experience of a public hospital in the state ofPará. 2016. Dissertation (Masters inHealth, Environmentand Societyin the Amazon) – Federal University of Pará

  • Data: 08/03/2016
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  • INTRODUCTION.Allblood transfusion must be accurately indicated following the rational useof blood, correct clinical indication and lesspatient exposure to transfusion reactions in order to ensure the safety of transfusion process. OBJECTIVES. Analyze the transfusion safety with regard to the rational use of blood and notification of transfusion reactions in a public hospital in Belém/Pará, from October 2013 to December 2014. MATERIAL AND METHODS. Exploratory research, descriptive, quantitative, with data from blood transfusion requests forwarded to the Agency Transfusion, the Reaction Notification FormsTransfusion, and a questionnaire to the medical and nursing staff of the sectors with the highest number of requests for transfusion Fundação Pública Estadual Hospital de Clinicas Gaspar Vianna (FPEHCGV). RESULTS. The analysis of the requests for transfusion of blood components (590) from the surgical block and intensive care units, 40% on an urgent basis, and only 68 completely filled. Anemia and blood components reserve for surgery were the main indications for transfusion, especially for elderly patients. The notification of transfusion reactions were only 07, and 05 by transfusion of packed red blood cellsin adult patients,for febrile non-hemolytic causes(04), allergic urticaria (02) and volume overload (01). Regarding the knowledge of professionals (93) on blood transfusion and transfusion reaction it was found that 38% said they had learned transfusion notions of daily living; 60% - 70% informed to know exactly the criteria for appointment of a transfusion and for the recognition and registration of the signs/symptoms of a transfusion reaction; 42% stated that in the event of an adverse event discontinued transfusion. All respondents consider necessary to implement training programs in hemotherapy in FPEHCGV. CONCLUSION. Indirect transfusion safety analysis showed that the respondents were flaws in the technical and basic training in hemotherapy, reflecting on errors in the completion of clinical information important plug request transfusion of blood products and possibly reducing the number of notifications of transfusion reactions. Suggesting that these conditions may be unfavorable factors to the rational use of blood and patient safety.

     

    KEYWORDS:Blood Transfusion; Transfusion safety;Transfusion reaction.

  • NADIA BARRETO DOS SANTOS
  • ACOLHIMENTO NA ESTRATÉGIA SAÚDE DA FAMÍLIA DO DISTRITO ADMINISTRATIVO DO GUAMÁ, BELÉM, PARÁ: a visão de usuários idosos

  • Data: 04/03/2016
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  • This study aimed to know the perception of elderly in a Family Health Strategy from the District of Guamá, Belém, Pará (FHS) about the embracement, as well as the difficulties they have faced and their expectations, starting from the knowledge of these users on this topic and observation of the service at FHG. Considering the reality of the growing number of elderly in health services and the need for specific service for these people, the Ministry of Health has appointed as a priority the expansion and the qualification of the basic health care through Family Health Strategy, as well as has invested in the formulation and implementation of policies in this direction. In this context, the embracement has a very important role because, by enabling users the listening to their problems and their resolution in a qualified manner, it is characterized as a technology that contributes to the organization of the service, in order to ensure universal access and efficaciousness. Therefore it is important to identify experiences about the embracement in the brazilian public health system (Sistema Único de Saúde). The design of this study consisted of quantitative and qualitative approaches, conducted in the period from June to August, 2015 in the FHS Parque Amazônia I of ADMINISTRATIVE DISTRICT of Guamá, Belém, Pará. The quantitative data were obtained through a questionnaire concerning to the sociodemographic profile of users, which were analysed in a descriptive way. The qualitative data were gathered by using semi structured interviews and the participant observation technique. 20 elderlies were interviewed. Qualitative analysis was conducted using the Thematic Content Analysis proposed by Bardin. It was observed that most elderlies were female. They aged 60 to 70 years old, with a family income of only a minimum wage. 50% of them were illiterate and most of participants had a spouse. By using qualitative analysis it was obtained 11 categories, which were grouped into four themes: Embracement: the meaning of this word in elderly view; Embracement as technology to the service reorganization; Professional health-user relationship: empathetic attitude that promotes the embracement; Embracement: technology that contributes to the achievement of a health care model based on extended clinic. The embracement concept that emerged from the speaking of the users was translated in the desire to be treated well, to be received with affection, patience, conviviality and respect. These characteristics showed the relational side of the embracement and how important is the relationship between health care professional and user. In the field of practical attitudes, passing beyond the conceptual view, it was reported the long wait for the service and for scheduling clinical appointments and tests, inadequate physical space, lack of some drugs, which results in the need to go to other locations, overcoming geographical and financial barriers, characterized as difficulties to the implementation of the embracement. In addition, unfortunately, the reductionist logic - "curativist" – based on abundance of medicine and doctors, it is installed, however all the efforts for the transformation of this health care model in SUS. Thus, the embracement, if it is carried out effectively, represents an instrument that can contribute significantly to this great revolution in the design of health care, considering that through it, the user is placed in the center, bringing better results to his health. Therefore, the study allowed a reflection on concepts and characteristics related to embracement that are evident in practice, or are yet to improve, bringing new perspectives to the improvement of the health under this guideline.

  • ANA LORENA LIMA FERREIRA
  •  

    AVALIAÇÃO DIAGNÓSTICA DO PROJETO "ACADEMIA AO AR LIVRE" DA PREFEITURA DO MUNICÍPIO DE BELÉM/PA

  • Data: 15/02/2016
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  • As determinações de instituições internacionais e nacionais, como a Organização Mundial de Saúde e o Ministério da Saúde do Brasil, preconizam desde 2006 o desenvolvimento de programas e estratégias que viabilizem a prática de atividade física e alimentação saudável. Contudo, altos níveis de inatividade física são percebidos no Brasil, o que é considerado um grave problema de saúde pública em função da influência que exerce na prevalência das doenças crônicas não transmissíveis. No município de Belém, existe desde o ano de 2009 o projeto de "Academia ao Ar Livre", que tem o objetivo de promover a prática de atividade física visando a melhora da qualidade de vida e da saúde da população. Sabe-se que o processo avaliativo é crucial para a percepção de efetividade de uma ação em saúde. Dados quanto a avaliação desse projeto são limitados ou não existem. Logo, teve-se como objetivo realizar uma avaliação diagnóstica do Projeto "Academia ao Ar livre" da Secretária Municipal de Esporte, Juventude e Lazer da Prefeitura de Belém, a partir da análise da estrutura (implementação, profissionais e equipamentos), do processo (relação entro o usuário e o profissional envolvido) e dos resultados (percepção de saúde dos usuários). Foi feito em estudo de caso e utilizou-se a triangulação dos métodos, com a combinação de abordagens quantitativas e qualitativas. Foram realizadas entrevistas: semiestruturadas com os gestores responsáveis pelo projeto e entrevistas estruturadas com profissionais atuantes nos polos e com os usuários. Percebeu-se que a distribuição das academias no território de Belém, não possibilitou acesso adequado a toda ou pelo menos a maioria da população. De acordo com os gestores o processo de avaliação existe, mas o mesmo não é formalizado e sistematizado e sim baseado no retorno verbal dos usuários e profissionais. Foi colocado pela maioria dos usuários que houve melhora da saúde após o ingresso na academia ao ar livre, com redução de quadros álgicos dentre outros. Porém, mesmo que os gestores tenham relatado que existe o planejamento e a aquisição de materiais para a implementação de 20 novas academias até 2017, e que existe verba voltada especificamente para a manutenção da infraestrutura, grande parte dos usuários apontou que a falta de manutenção dos maquinários era a maior necessidade do projeto. Sobre o ponto de vista dos profissionais, a maior limitação era quanto a inadequação dos espaços das AAL. Assim, apesar dos benefícios relacionados a saúde, referido pelos usuários, limitações relacionadas ao contexto de implementação e sustentabilidade, dentre outros pontos, parecem comprometer a efetividade do programa

  • RAISSA CECILIA ROSALINO GUIMARAES
  • CONDIÇÕES SÓCIO-ECONÔMICAS, DEMOGRÁFICAS E O CRESCIMENTO DE CRIANÇAS QUILOMBOLAS NO PARÁ

     

  • Data: 12/02/2016
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  • To identify sociodemographic and economic determinants of quilombolas populations living in the state of Pará and its potential interference with the growth of children aged 0- 3 years old. Methods: The sample consisted of 120 children under 3 years of age and 87 people over 18 who represented the parents and/or guardians of children, totaling 207 people. The research instrument used for data collection was a home visit questionnaire with qualitative and quantitative questions about socioeconomic, housing data and sewerage, obtained through interviews with each family head and an individual questionnaire in order to get anthropometric measurements of children. Weight for age (W/A), Height for age (H/A) and body mass index (BMI) for age (BMI/A) were descriptors of nutritional status of children and for this study was considered as an outcome, in other words, variable dependent, the score-z values below -2 for these index and demographic and economic determinants are configured as independent variables, which were categorized to the chi-square test, whose correlation is significant to the values that have p ≤ 0,05. Results and Discussion: The quilombos communities of Pará showed very impressive results, highlighting the poor infrastructure that still characterizes them, marked by difficult access to potable water and non-existent sewage system. The nutritional status of children suggests the nutritional transition process, where there is still prevalence of underweight children and stunting, while it realizes the trend of overweight among children under 3 years. Conclusion: This study shows that not only is the population with economically favorable conditions that are going through the process of nutritional transition, but those people in precarious situations may be experiencing this process too, and reinforces the importance of conducting studies of this type of design in vulnerable populations such as the quilombolas, who despite being a significant population in Brazil and especially in the Amazon, are still supporting the scientific research and national and international literature.

  • GILZA BRENA NONATO MIRANDA
  •  

    Integralidade no trabalho em saúde: dificuldades, possibilidades e perspectivas gerais da abordagem multiprofissional na visão dos trabalhadores de uma equipe da Atenção Primária de Belém-Pará

    BELÉM

  • Data: 04/02/2016
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  • MIRANDA, G.B.N. Integralidade no trabalho em saúde: dificuldades, possibilidades e perspectivas gerais da abordagem multiprofissional na visão dos trabalhadores de uma equipe da Atenção Primária de Belém-Pará. Dissertação (Mestrado em Saúde, Ambiente e Sociedade) - Programa de Pós-graduação e Saúde, Ambiente e Sociedade na Amazônia da Universidade Federal do Pará, Belém – Pará, 2016.

    The integrality, one of the principles of the SUS, is widely discussed for its diversity of meanings, in which we highlight the multidisciplinary approach, one of the pillars of the Health Strategy work processes of Family and Support Center for Family Health, while the new model of care restructuring tools to health advocated by the Primary. The objective of this study was to evaluate the routine of a health service, with emphasis on practices and conceptions of a team of ESF and NASF within the multidisciplinary approach in the light of the integrality care. The study was performed using the technique of participant observation associated with the application of semi-structured interviews with subsequent content analysis in the FHS teams Amazon Park I and NASF Mainland, from June to August 2015. The professionals have demonstrated knowledge regarding the integrality and multidisciplinary approach, however present difficulties in practicing them, because related challenges, especially the structural issues of the service, especially the workers of FHS, cited home visits and educational activities as the main practical aspects of the approach multidisciplinary, pointed to the union as a positive aspect of teamwork, and suggested improvements in infrastructure to optimize the workers' actions. We see the need for constant training and updates to the

  • RAPHAELLA SANTOS LOUREIRO
  • LONG-TERM INSTITUTIONS, WAIVER OF THE CONVIVAL FAMILY AND THE PERCEPTION OF HEALTH BETWEEN ELDERLY PEOPLE

  • Data: 02/01/2016
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  • The aging of the world population, including the Amazon, is a phenomenon that causes

    researchers, health managers and policy makers need to look into the specific demands of an

    increasingly long-lived society. This fact, along with the change of the current family

    dynamics, has reflected in an increase in the number of elderly people living in long-stay

    institutions (ILPI's). The transfer of the elderly in your home for ILPI causes it has to adapt to

    a new reality, which includes changes in habits, routines, environments and personal and

    social relationships. This may result in changes in health and quality of life of older people,

    which is an important issue for public health. In Brazil, little has been investigated on the

    impact of family separation on the health of aged people. This study aims to investigate the

    potential relationship between institutionalization, family separation and health perception.

    This is an observational and descriptive study using a qualitative approach linked to the

    phenomenological perspective. Participated 26 seniors, six men and 20 women, aged 62-95

    years, living in two ILPI's, Bethlehem, PA. An elderly characterization questionnaire was

    applied and held a semi-structured interview with each, as well as participant observation

    during everyday activities. Data were analyzed using the technique of content analysis. It was

    observed that 50% of seniors assess their health condition as good, and that men have

    apparent lack of interest in relation to health; that family visits do not occur frequently, even

    among those who have cited family life, and that even when the very elderly

    institutionalization opts for this choice is made due to some external necessity to the subject.

    It was also observed that the removal of family life is understood as contentment agent and /

    or distress, depending on each subject and experienced contexts, which interferes with the

    perception of subjective well-being. The study found that the elderly differentiate health

    condition and well-being, and that the health of institutionalized elderly in addition to being

    influenced by physical and biological factors of their own age is also affected by their

    perception of the separation from family life. Other factors that potentially influence the

    health perceptions are personal and social experiences, expectations, socioeconomic and

    environmental factors that have. It is concluded that the self-perceived health in the elderly

    results from a complex set of factors that must be considered when analyzing the quality of

    life of residents and when planning public policies aimed at this segment of the population.

2015
Descrição
  • MARCELLA KAROLINE TAVARES DOS SANTOS
  •  

    A INFLUÊNCIA DO PLANEJAMENTO REGIONAL INTEGRADO NA

     

    GOVERNANÇA: Um estudo de caso na Comissão Intergestores Regional de Saúde

     

    Metropolitana I

     

  • Data: 16/12/2015
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  • SANTOS, Marcella Karoline Tavares dos. A influência do planejamento regional integrado na governança: Um estudo de caso na Comissão Intergestores Regional de Saúde Metropolitana I. 2015. 147 f. Dissertação de Mestrado (Programa de Pós- Graduação de Mestrado em Saúde, Ambiente e Sociedade na Amazônia) –Universidade Federal do Pará, Belém-PA, 2015.

    O Decreto 7.508/2011 causou mudanças na operação e na gestão do Sistema Único de Saúde. A regionalização da saúde foi enfatizada, trazendo consigo a gestão compartilhada e a articulação interfederativa. Agora, além do planejamento emâmbito individual, os entes federados devem fazê-lo em conjunto, reunidos em Comissão Intergestores Regional (CIR), de forma ascendente e integrada, através de momentos interdependentes e com instrumentos específicos para pactuar responsabilidades em Contrato Organizativo de Ação Pública da Saúde (COAP). Tal situação representa a vivência da governança, pois converge esforços e habilidades dos  overnantes para a implementação das ações e alcance de diretrizes, objetivos e metas regionais de saúde. A análise da influência do processo de planejamento regional integrado na governança vivenciada pela CIR Metropolitana I foi o objetivo geral deste estudo. Para isso, utilizou-se a Triangulação de Métodos, executando-se técnicas quantitativas e qualitativas à consecução de pesquisa avaliativa de análise de implantação e de estudo de caso, obtendo-se como resultado a verificação de CIR parcialmente implantada, ainda não executando todos os passos metodológicos do planejamento regional integrado indicado pelas legislações e sem COAP assinado, o que influenciou negativamente a governança vivenciada, uma vez que a respectiva CIR ainda não pactuou responsabilidades regionais à melhoria da saúde da população abrangida de forma a implementar as devidas políticas regionais de saúde. Apesar disso, apresentou movimentações positivas em prol deste processo, ensejando a continuidade do estudo em pesquisas futuras.

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