Doutorado em Enfermagem e Saúde (FEN)
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Item Pesquisa participante baseada na comunidade: estratégias de formação de redes na proteção ao uso abusivo de drogas(Universidade Federal de Goiás, 2019-12-20) Dias , Paula Cândida da Silva; Munari, Denize Bouttelet; http://lattes.cnpq.br/8409035360598716; Munari, Denize Bouttelet; Staciarrini , Jeanne Marie Rodrigues; Souza, Adenicia Custodia Silvia e; Caixeta, Camila Cardoso; Medeiros , MarceloThe abusive use of psychoactive substances is no longer just a public health problem but became a complex issue, which involves the social, economic and political context. For this reason, when thinking about health promotion and prevention of problems related to drug abuse, it is essential to develop actions including the community, the space where people live. Strengthening community resources and expanding public policies and interventions based not only on moral control for drug use can reduce risk. This study aimed to describe the construction of strategies for the formation of protection networks against the abuse of alcohol and other drugs in a community. This is a Community-Based Participant Survey (CBPR), conducted in a neighborhood in the municipality of Aparecida de Goiânia, State of Goiás, Brazil, and participants were community members interested in discussing the problem of alcohol and other drugs abuse and seeking means to reduce risks to this situation. Community leaders of the neighborhood, workers from various areas and residents who joined a Community Advisory Committee (CBPR) participated. Data were collected between June 2017 and July 2018 and followed the steps provided in the assumptions of CBPR, which establish the conduct of the research in an interactive and cyclical way. Data were recorded, transcribed and discussed along with CAC in terms of content, results and developments that were necessary. In addition, the team of researchers performed descriptive and analytical analysis of the data, and the results were organized around a central theme: Strategies for the formation of networks of protection against drug abuse in the context of CBPR. Four topics were identified: The approach for community partnership training; Formation of the Community Advisory Committee; Identification and prioritization of problems related to protective and risk factors for drug use in the community; and Planning and implementation of actions in the community, results achieved and contributions to sustainability. The results of the actions undertaken in and with the community demonstrate the construction of a network in the community context, which organized strategies to deal with the issue studied in a systemic way, whose sustainability indicators allow to affirm that CBPR is an important strategy of cultural intervention that values people in its territory as an important dimension of psychosocial care. The study presents an example of how to build strategies for the formation network for drug abuse prevention in the community context from the perspective of CBPR, pointing out contributions to the community, science, the training of professionals and researchers. The results of this study broaden our view on the production of health care, with a close relationship between researcher, community and students, and draw attention to the fine line between protecting the other and living collectively.Item Concentração de melatonina no leite humano, qualidade do sono e saúde mental materna: estudo transversal(Universidade Federal de Goiás, 2024-03-05) Oliveira, Flávia Silva e; Guimarães, Janaína Valadares; http://lattes.cnpq.br/0986934969522024; Mota, Dalete Delalibera Faria de Correa; http://lattes.cnpq.br/1684517331855276; Vieira, Flaviana Vely Mendonça; http://lattes.cnpq.br/5199507174724803; Vieira, Flaviana Vely Mendonça; Amaral, Fernanda Gaspar do; Ruiz, Mariana Torreglosa; Gomes, Patrícia Rogrigues Lourenço; Arrais, Alessandra da RochaOliveira FS. Melatonin Concentration in Human Milk, Sleep Quality, and Maternal Mental Health: Cross-Sectional Study [thesis]. Goiânia: Faculdade de Enfermagem/UFG; 2023. p. 196. INTRODUCTION: Melatonin is an endogenous hormone present in human milk and plays a crucial role in regulating the circadian rhythm. Its association with mood disorders and sleep disturbances during the postpartum period is still underexplored. OBJECTIVE: To investigate the association between melatonin concentration in human milk and the quality of sleep, presence of depressive symptoms, anxiety, and maternal stress in the postpartum period. METHODOLOGY: A cross-sectional study was conducted with 84 women in the postpartum period in the public healthcare system. Data collection took place between June 2021 and December 2022, with participants approached in the postpartum ward of the maternity unit. Human milk samples were collected through manual expression between 6 a.m. and 9 a.m. on day 14 postpartum. The samples were stored at -80°C and analyzed using an enzymelinked immunosorbent assay (ELISA). Sociodemographic, obstetric, and neonatal data were collected, and questionnaires on postpartum depression (Edinburgh Postnatal Depression Scale, EPDS), anxiety, stress (Depression, Anxiety, and Stress Scale, DASS-21), and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were administered. Statistical analysis included measures of central tendency and dispersion, bivariate Poisson regression, and multivariate modeling, with p < 0.05 considered statistically significant. RESULTS: The median melatonin concentration was 4.90 pg/ml (Q1: 2.78; Q3: 13.61). Depressive symptoms were reported by 22.6% of the women, anxiety symptoms by 39.3%, stress symptoms by 38.1%, and sleep disturbances by 63.1%. In the multivariate analysis, associations were found between melatonin concentration ≤ 4.90 pg/ml, planned pregnancy (RP: 1.21; 95% CI: 1.04 - 1.42; p = 0.015), and anxiety symptoms (RP: 1.18; 95% CI: 1.02 - 1.37; p = 0.030). Postpartum depressive symptoms were associated with paid employment (RP: 2.58; 95% CI: 1.20 - 5.52; p = 0.015), stress symptoms (RP: 3.84; 95% CI: 1.04 - 14.21; p = 0.044), and sleep disturbances (RP: 3.07; 95% CI: 1.13 - 8.33; p = 0.027). Significant associations were also observed between stress symptoms and unplanned pregnancy (RP: 3.06; 95% CI: 1.16 - 8.12; p = 0.024), anxiety symptoms (RP: 3.06; 95% CI: 2.06 19 - 7.80; p < 0.001), and postpartum depressive symptoms (RP: 1.93; 95% CI: 1.12 - 3.33; p = 0.017). For anxiety symptoms, an association was found with stress symptoms (RP: 1.19; 95% CI: 1.53 - 7.26; p = 0.002) and newborn weight (RP: 1.00; 95% CI: 1.00 - 1.01; p = 0.004). The presence of sleep disturbances was associated with the number of people in the household (RP: 0.71; 95% CI: 0.54 - 0.94; p = 0.015). CONCLUSION: Melatonin concentration in human milk was higher than the daytime levels reported in the literature. The association between melatonin and anxiety symptoms emphasizes the importance of identifying modifiable factors during the perinatal period. The relationship between mood disorders and sleep disturbances suggests a simultaneous or precedence interaction between these conditions.Item Estratégias de avaliação do letramento em saúde na América latina e Caribe: revisão de escopo(Universidade Federal de Goiás, 2024-03-05) Lima, Edmila Lucas de; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Paula, Cristiane Cardoso de; Rocha, Priscilla Roberta Silva; Cardozo , Roxana IsabelCultural and linguistic diversity, socioeconomic inequalities, health organization and systems in Latin America and the Caribbean interact and influence people's health literacy. Knowing how the population's health literacy (HL) of this region has been assessed can contribute to adapting the conduct of health professionals. Objective: to map the strategies used to assess health literacy in the Latin American and Caribbean population. Method: this scoping review adopted the methodological assumptions of the JBI and as eligibility criteria the primary studies in full that used strategies to evaluate the population HL of Latin America and the Caribbean, without time limitation and with restriction of the Latin-Roman alphabet. In July 2023 the sources MEDLINE, CINAHL, SCOPUS, Web of Science, EMBASE, SCIELO, LILACS, BDENF, IBECS, among others from the BVS Portal and gray literature (Google Scholar) were accessed. Results: 228 articles were included, the majority of which (82.4%) came from studies carried out in Brazil, Mexico, Chile and Peru. Observational and methodological studies predominated. The majority was conducted in hospitals and outpatient settings, in adults, adolescents, the elderly and children, especially those with chronic diseases. The temporal distribution was between 2009 and 2023, with an exponential rise from 2019 onwards. Most studies evaluated general HL and among those with specific content, oral/oral HL stood out. 110 LS assessment strategies were identified, and the most used were translated, culturally adapted and/or validated tools (S-TOFHLA; SAHL-S/SAHLPA-18; SAHLSA-50 and the NVS) who evaluated HL functional aspects, were applied in person, without time and application restrictions. Most studies adopted a broad and general concept of LS and Brazil has used five terms to identify HL in the country. Conclusion: HL evaluation in Latin America and the Caribbean has been carried out with varied strategies, which differ in the methodological approaches adopted. The evidence presented can collaborate and offer guidance for the development of reliable and effective tools that respond to Latin American and Caribbean population needs. Efforts and investments must be made in the development of national tools, which guarantee adequacy, cultural competence and meet the specificities of the region. Reliable results can produce effective interventions in promoting health and sustainable development.Item Infecção pelo vírus da hepatite A em mulheres transgêneras: prevalência e fatores associados(Universidade Federal de Goiás, 2022-02-07) Almeida, Mayara Maria Souza de; Souza, Márcia Maria de; http://lattes.cnpq.br/6954087338926237; Souza, Márcia Maria de; Guimarães, Rafael Alves; Caetano, Karlla Antonieta Amorim; Galvão, Marli Teresinha Gimeniz; Vieira, Maria Aparecida da SilvaHepatitis A virus (HAV) infection is a serious public health problem, and transgender women constitute a group that is still stigmatized and quite vulnerable to communicable infections. This study aimed to investigate the epidemiological profile of hepatitis A virus infection in transgender women in Goiás. Cross-sectional, analytical study, carried out between March 2018 and August 2019, with 440 trans women being recruited, in which the sampling technique was used Respondent Driven Samplin. All women participated in data collection through a structured questionnaire and were tested using serological markers for anti-HAV (IgG-IgM) by enzyme immunoassay (ELISA). Bivariate and multivariate analyzes were performed using logistic regression in order to identify factors associated with HAV. More than half self-declared transsexual (66.3%), with a positive marker for anti HAV-IgG (75.6%), single (82.7%), aged between 22 and 30 years, self-declared black/ brown (71.6%), educational level between 10 and 12 years of study (61.3%) and monthly income between R$ 1,000.00 and R$ 3,000.00. Women aged between 20 and 30 years were 6.37 times more likely to have had previous contact with the virus. Those who had less than 10 years of formal education were 5.81 times more likely to be positive for anti-HAV IgG compared to other ages. Although there was no statistically significant association for anti-HAV positivity, some risky sexual and non-sexual behaviors deserve attention, such as sex work, oral and oroanal sex, non-use of condoms, considerable number of weekly sexual partners and group sex, in addition to the use of illicit drugs and prior arrest. The results showed that very young people may be more likely to be exposed to the infection and the shorter the time of schooling, the less knowledge and information about protection and prevention measures for HAV. And there is a need for prevention programs for communicable infections in this population, such as guaranteeing and facilitating access to the hepatitis A vaccine and health education actions regarding preventive and behavioral measures.Item Letramento em saúde de profissionais do Serviço de Atenção Domiciliar(Universidade Federal de Goiás, 2021-09-30) Santos, Laidilce Teles Zatta; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Cordeiro, Jacqueline Andréia Bernardes Leão; Butrico, Gabriela Ferreira de Oliveira; Borges Junior, Laerte HonoratoIntroduction: Home Care has become an important possibility for the Brazilian Unified Health System to respond to the population's health needs, as it includes actions in health promotion, diseases prevention and treatment, rehabilitation, and palliative care, that occur at home, aiming the continuation of care and integration with the Health Care Networks. This covers the way in which services make information, resources, support and health environments available and accessible to different people, that is, it is the responsibility of the services to meet health literacy (HL) demands of people, including users and healthcare professionals in this process. All people have some type of difficulty in accessing health services, as well as in understanding the information they receive. Professionals must develop clear and easy-to-understand communication skills using the HL principles, both in their own health care and to provide adequate assistance in the Home Care Service. Objective: To evaluate health literacy conditions among professionals enrolled in a Home Care Service. Method: Analytical cross-sectional study, conducted with professionals at Home Care Service in Goiânia / GO. Data collection was accomplished, using a sociodemographic questionnaire and the Brazilian version of the Health Literacy Questionnaire (HLQ-Br). Simple descriptive analysis was performed for sociodemographic variables, mean calculation of scores and reliability of the HLQ-Br, Mann Whitney; Kruskal-Wallis; Cohen's d and Spearman's correlation. Results: Twenty-nine home care service professionals participated in the study; the majority were female; with a mean age of 39.9 ± 8.5 years; there was a predominance of the nursing team; most participants have other jobs and work approximately 12 hours / day; parents with education at or above high school; personal and family income greater than six minimum wages (Brazilian currency); and have been working at the Home Care Service for approximately six years. The lowest scores obtained were in Scale 2 “Enough information for health care”, Scale 4 “Social support to health care” and Scale 3 “Active management of health” (Part 1); and in Scale 7 “Navigating the healthcare system” and Scale 6 “Ability to actively engage with healthcare providers” (Part 2). The highest scores obtained were Scale 5 “Assessment of health information” (Part 1) and Scale 9 “Understanding health information well enough to know what to do” (Part 2). Conclusions: This study is a pioneer in evaluating the HL of professionals linked to SAD in Brazil and can collaborate to strengthen this service at the national level and indirectly contribute to the quality of life of patients, in the proposal that it is “Better at Home”. It allowed for reflection on the HL assumptions with professionals working in the SAD and will collaborate with the dissemination of the theme of health literacy among the group, as a tool in assertive communication and in the care of one's own health. The dissemination of these results can contribute to the performance of interventions in the service following the HL assumptions, as well as encouraging the inclusion of HL in undergraduate and graduate health curricula.Item Modelo andragógico de formação para o cuidado centrado na pessoa na atenção psicossocial(Universidade Federal de Goiás, 2024-02-19) Sousa, Johnatan Martins; Nunes, Fernanda Costa; http://lattes.cnpq.br/1676457578129598; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Lucchese, Roselma; Paranaguá, Thatianny Tanferri de Brito ; Farinha, Marciana GonçalvesINTRODUCTION:In the Brazilian scenario, in relation to community psychosocial care service teams, there is still criticism of the hegemony of the biomedical model leading their practices. One possibility of breaking this hegemonic power is the adoption of the Person-Centered Clinical Method, which aims to promote the protagonism and activation of health service users in the care process to reverse this situation through the application of four related components: a) Exploring health, illness and the experience of illness; b) Understanding the person as a whole; c) Drawing up a joint problem management plan; d) Strengthening the relationship between the person and the doctor/health professional, as evidence indicates that in the mental health scenario it is still necessary to increase the participation of users in the decision-making process about their care. OBJECTIVE: Understand the health team's training process on person-centered care in psychosocial care. METHODOLOGY: Intervention research with a qualitative approach carried out in two stages. In the first, 17 professionals from two Psychosocial Care Centers in a municipality in the central region of Brazil participated between the months of June and August 2021, using a sociodemographic and professional profile questionnaire, in addition to a semi-structured script for an individual online interview and notes. in a field diary to survey situational diagnosis on person-centered care. The second phase of data collection consisted of a training intervention guided by the Experiential Learning Cycle on person-centered care, carried out in four meetings to equip multidisciplinary teams and took place between the months of October and December 2022 with the participation of 30 professionals of the services included in the first stage of the study. The emerging data was organized with the help of the ATLAS.ti software and subjected to content analysis, thematic modality. RESULTS: From the analytical process of the situational diagnosis on person-centered care in psychosocial care, 7 thematic categories emerged: 1. Health/illness process in the light of person-centered care; 2. Practice of welcoming for person-centered care; 3. Assistance planning; 4. Enhancer aspects of the therapeutic relationship; 5. Repercussions of the therapeutic relationship; 6. Challenges for the therapeutic relationship; 7. Training process. The results highlighted potential related to person-centered care in the context of psychosocial care, however, it also highlighted some challenges that need to be overcome for the full implementation of the Person-Centered Clinical Method, especially issues related to interpersonal and relational competence. These findings made it possible to construct the second phase of the research to qualify the teams' professional practice in relation to person -centered care. FINAL CONSIDERATIONS: The investigation showed that even in a non systematized way, the teams at the Psychosocial Care Centers put into practice some aspects of the Person-Centered Clinical Method and demonstrate the importance of training processes for combining practice with the theoretical foundation for the strengthening the psychosocial care modelItem Qualidade da assistência especializada a pessoas com diabetes mellitus e hipertensão arterial segundo o Chronic Care Model(Universidade Federal de Goiás, 2022-04-27) Borges, Dalma Alves Pereira; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Vitorino, Priscila Valverde de Oliveira; Zanini, Claudia Regina de Oliveira; Rezende, Marina Aleixo DinizINTRODUCTION: Support for self-management of chronic conditions and health literacy are essential elements in the development of person-centered services. The use of integrated care models that focus on the person, and not just on the specific disease, represent a viable solution for effective care. The Chronic Care Model is a model that is based on the relationship between motivated and informed users and the proactive and prepared health team. However, there is evidence of gaps in the attention and care that should be provided in the care of chronic conditions, especially in hypertension and diabetes. OBJECTIVE: To characterize the quality of care provided and the health literacy conditions reported by people with arterial hypertension and diabetes mellitus in a secondary care service. METHODS: Crosssectional study, carried out in an outpatient clinic that is a reference in the care of arterial hypertension, in a large Brazilian center, where diabetes is prevalent morbidity. Eighty-two people with diabetes mellitus and arterial hypertension were evaluated, with a follow-up of at least five years and ten consultations. Sociodemographic and clinical data were obtained through a nursing consultation. The Patient Assessment of Care for Chronic Conditions - PACIC questionnaire was applied, with 20 questions and five scales. Higher scores (> 3.0) indicate a perception of greater involvement in self-management and support. Three scales from the Brazilian version of the Health Literacy Questionnaire - HLQ-Br were also used. The score of each scale indicates the person's strengths and weaknesses in relation to their health literacy. Internal consistency was evaluated; Mann-Whitney test, Spearman test and significance of 5% were applied. RESULTS: The mean age of the participants was 68.98±8.79 years, female (82.93%), with a median of 4 years of study (IQR 3 - 8). Most parents (70.73%) did not study. Less than half of the users had controlled values of glycated hemoglobin - HbA1c (34.15%) and blood pressure (36.59%). The Cronbach alpha of PACIC was 0.85 and that of HLQ-Br was 0.75. There was a positive correlation between the time of diagnosis of diabetes and HbA1c. The overall PACIC score was 3.4 (IQR 2.8-3.8) out of a high of 5.0. The highest score was evidenced on the scale of care/decision-making model (4.3) and the lowest on the scale of coordination of care/follow-up (2.8). Support for selfmanagement is assessed by the treatment adherence scores (3.0), problem-solving / follow-up contextualization (3.0), and goal setting (3.8). Those with ≥ 4 years of schooling had higher scores for Attention Coordination / Follow-up (p=0.039). Participants whose parents had some schooling had higher scores for Adherence to treatment (p=0.038), Coordination of care / Follow-up (p=0.042) and general PACIC (p=0.026). Lower scores were identified among participants who did not have HbA1c control, on the Goal Setting scale (p=0.003). Health literacy showed mean scores of 4.07 ± 0.87 on the Ability to interact with the team scale; 3.02±1.31 in Understanding the information and 2.84±1.25 in Finding good information. Male users had higher scores for interacting with professionals, finding information and understanding information (p=0.039, p=0.00 and p=0.003). Those with ≥ to 4 years of schooling had higher scores for Finding and Understanding information (p=0.002 and p< 0.001), as well as those whose parents had some schooling (p=0.036 and p=0.037). Those who were overweight had a higher score for Understanding the information (p= 0.040). There was a positive correlation between the time of diagnosis of diabetes and HbA1c and no correlation was identified between the general value of PACIC and the HLQ-Br scales. CONCLUSIONS: The quality of care was considered high according to the general PACIC, and moderate in terms of the person's participation in decision-making and the contextualization of the treatment plan. Weakness was identified in the dependence on other people to be able to access and understand written information, but the ease of involvement with professionals can favor the use of communication strategies to improve health self-management.Item Gestão autônoma da medicação para promoção do cuidado seguro em atenção psicossocial(Universidade Federal de Goiás, 2023-06-06) Pinho, Eurides Santos; Silva, Nathália dos Santos; http://lattes.cnpq.br/9837208542154956; Bezerra, Ana Lúcia Queiroz Bezerra; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Caixeta, Camila Cardoso; Sousa, Girliani Silva de; Cardozo, Elizabeth Esperidião; Nunes, Fernanda CostaINTRODUCTION: Autonomous Medication Management (GAM) enables the co-management of drug treatment by users of mental health services and influences quality and safe care. In Psychosocial Care, the prescription of psychotropic drugs is a care action that focuses on the biological, on the biochemical alterations of psychiatric illnesses without considering the biopsychosocial context of the users. The consumption of psychotropic drugs sometimes disregards the user's participation in conducting the treatment itself. There is evidence of improvements in the context of psychosocial care through investment in the co-management of drug therapy with user involvement in decision-making processes. OBJECTIVE: To analyze, from the perspective of mental health team professionals, the practices of Autonomous Medication Management to promote user involvement in safe care, in psychosocial care. METHOD: This is an intervention-research with a qualitative approach, conducted in four Psychosocial Care Centers in a municipality in the central west region of Brazil, which had the participation of 56 professionals from the teams and health. Data were collected in two stages, the first between May and June 2021 through a questionnaire and semi-structured interview, and the second in August 2022 from the offer of a training process on the autonomous management of medication associated with the perspective of promoting user involvement in safe care. The emerging data were organized using the ATLAS.ti.6.0 software and submitted to content analysis, thematic modality. RESULTS: The GAM is an educational process that encompasses users and professionals. The results of this research were summarized in three categories: Perceptions of professionals about the co-management of drug therapy; Harmless medication in the context of mental health care; Autonomous Medication Management: perspectives for safe care. It was evidenced that the professionals' perception of the demand to involve the user in the decision of drug therapy transits between views based on the hegemony of the biomedical model, which reinforces adherence to the use of psychotropic drugs, between the challenges and existing actions for user involvement and the reformist ideals based on the model of psychosocial care. As actions and challenges to promote co-management, the indiscriminate and inappropriate use of psychotropic drugs and access to information about medications were perceived as intervening in harmless medication and safe care. Autonomous Medication Management was pointed out by professionals with the potential to provide safe care, given the possibilities of carrying out psychoeducational approaches on psychotropic drugs, valuing the participation of family members/caregivers and overcoming obstacles to the involvement of users in medication co-management. FINAL CONSIDERATIONS: The GAM is based on the psychosocial care model, encourages the development of actions that promote co-management through the user's involvement in their treatment and, consequently, provides reflection on their autonomy and protagonism in the face of drug therapy to achieve safe care , in the context of psychosocial care and, more broadly, in mental health.Item Cobertura vacinal em crianças assentadas, quilombolas e ribeirinhas do estado de Goiás, nascidas entre 2010 e 2017(Universidade Federal de Goiás, 2021-08-05) Lima, Juliana de Oliveira Roque e; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Caetano, Karlla Antonieta Amorim; http://lattes.cnpq.br/0112036159794570; Caetano, Karlla Antonieta Amorim; Pagotto, Valéria; Minamisava, Ruth; Pessoni, Grécia Carolina; Junqueira, Ana Luiza NetoVaccination is considered one of the most cost-effective and most effective measures in healthcare services. On the other hand, some population groups that live in geographic and cultural isolation have been showing low rates of vaccination. In Brazil, there are no data evaluating adherence to vaccines recommended by the National Program for the Immunization of Unified Health System, better known by the acronym SUS considering children from rural and traditional communities. Therefore, this study aimed to evaluate vaccination coverage according to the national calendar of vaccination of children for the first year of life, and their distributions in space and trends in time in children living in rural settlements, communities of quilombolas, and riverside dwellers in the state of Goiás, born from 2010 to 2017. This is an epidemiological, retrospective cohort study, carried out in 40 municipalities of Goiás, followed by an ecological study. The sample consisted of 616 children born between 2010 and 2017, residents of a settled, quilombolas or riverside dwellers community in Goiás. To calculate the vaccination coverage, the percentage of children with a complete general vaccination schedule or by the vaccine was considered, with a 95% confidence interval. In the time-series, trend analysis was estimated for communities according to mesoregions of Goiás, and for this purpose, the Prais-Winsten linear regression was used, with robust variance. Trends were classified as increasing, decreasing, or stationary, according to the p-value and regression coefficient. The spatial distribution of vaccination coverage, according to the mesoregions of Goiás, was carried out along the time-series. In total, 616 children had their vaccine data evaluated, most were male (53.7%) and belonging to the quilombolas community (54.7%). The overall vaccination coverage for the recommended vaccines during the first year of life at 12 months and at 18 months was 52.4% (CI95%: 48.5% - 56.3%) and 57.8% (CI95%: 53.9% - 61.6%), respectively. For children born in 2017, just the yellow fever vaccine and measles/mumps/rubella vaccine had vaccination coverage > 90%. According to the birth cohort from 2010 to 2017, in Goiás, of the ten vaccines evaluated, six showed an increasing trend in vaccination coverage (POLIO, 10-valent pneumococcal, human rotavirus, meningococcal, yellow fever, and measles/mumps/rubella). Considering the spatial and temporal distribution, according to the mesoregions where the communities are located, a decreasing trend for vaccination coverage was only observed in the Center Goiano mesoregion for the hepatitis B vaccine. In the North Goiano mesoregion, increasing temporal trends were observed for most vaccine coverage, the exception was for BCG and measles/mumps/rubella vaccines. Despite this, the North Goiano mesoregion was the only one in which no vaccine achieved 90% coverage in the period of birth cohort 2016/2017. The results present an unequal scenario in the access to vaccination services for rural populations and traditional Brazilians and point to the need for urgent strategies to achieve and ensure equity in health for a group with distinct traditions and characteristics of the urban population of Brazil.Item Violência contra o docente na prática pedagógica em saúde: uma abordagem intercultural(Universidade Federal de Goiás, 2021-09-17) Alves, Angela Gilda; Rodriguéz Martín, Dolores Dolores; http://lattes.cnpq.br/6242953215193998; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Guix Comelles, Eva Maria; Pereira, Edna Regina Silva; Santos, José Luis Guedes dos; Martins, Cleusa AlvesIntroduction. Operationalizing the concept of violence, especially against higher education teachers, is difficult. In addition to the various concepts, the violence is presented in expressions of hatred, anger, revenge, acts contrary to social norms of coexistence, prejudice against those that are different, and mistreatment directed toward the teachers, which can lead to consequences and cause harm even in the pedagogical sphere. Intercultural differences enable different spaces, which represent hermeneutical, epistemological and methodological resources. All of this contributes to a dialogic process with other contexts and thoughts that range from the acquisition of information to the emergence of new theories capable of rethinking and transforming learning. Objective. To analyze violence against teachers in the Health pedagogical practice through an intercultural approach. Methodology. This was a multimethod study developed at a University in the Central Region of Brazil, in which the phenomenon of violence was analyzed from different angles, supported by literature reviews (integrative and scoping), the Delphi method, and a qualitative study with the analysis partially using the Constructivist Grounded Theory (CGT). The target population consisted of all teachers at the Faculty of Nursing of the Federal University of Goiás. Data collection took place through recorded and transcribed interviews and, with the use of the NVivo software, analysis categories were created. The analysis used a step of the Grounded Theory. Results. The theoretical contributions of the study were presented, including the concepts of violence and its relationship with the teaching practice in health education. The discussion of knowledge in Higher Education in Health considering Vygotskian theory evidenced convergent terminologies. Violence against teachers can be defined as a set of actions and situations provoked by students in an insidious or chronic way in the workplace and/or through digital media, mediated by the perception of violence, the teacher's coping mechanism and the organizational management of violence. Indicators of violence against the teacher were defined as any threat, attempt, or actual aggressive act, as well as ignoring or disrespecting the teacher through speech, engaging in sexual harassment, homophobia, receiving coercion from the student's family, as well as using information and communication technologies to perform such acts. The factors that lead teachers to suffer violence in Higher Education in Brazil are characterized by the institutional culture, gender, the perception of violence by the teacher and the triggers that lead students to practice violence. Conclusion. Violence by students against teachers deserves pedagogically important reflections. Social origin converted into inequalities triggers positions of domination and, consequently, creates a fertile ground for violence. Teachers will be able to develop actions that blossom into the construction of skills and attitudes for coping with violence, recognize it and intervening in order to prevent aggressive behavior from spreading, causing mutual illness and weakening interpersonal relationships.Item Adaptação transcultural e validação do instrumento Patient Engagement in Patient Safety within Canadian Healthcare Organizations para uso no Brasil(Universidade Federal de Goiás, 2022-05-25) Sousa, Maiana Regina Gomes de; Pomey, Marie-Pascale; Silva, Ana Elisa Bauer de Camargo; http://lattes.cnpq.br/8388407861788466; Silva, Ana Elisa Bauer de Camargo; Bezerra, Ana Lúcia Queiroz; Sousa, Fernanda Raphael Escobar Gimenes de; Vila, Vanessa da Silva Carvalho; Freitas, Juliana Santana deINTRODUCTION: for more than two decades, patient safety has been highlighted as a global health challenge, requiring changes and implementation of initiatives to minimize risks, prevent care failures and prevent harm to patients. Patient engagement in patient safety has been one of the strategies used in the main international recommendations to improve the quality and safety of care, making relevant the existence of instruments to evaluate this practice. OBJECTIVE: to produce the Brazilian version of the instrument Patient Engagement in Patient Safety within Canadian Healthcare Organizations. METHOD: methodological study involving cross-cultural adaptation and validation of the instrument Patient Engagement in Patient Safety within Canadian Healthcare Organizations for use in Brazil, developed in two phases. The first phase, held between January 2020 and June 2021, consisted of the cross-cultural adaptation of the instrument for the Portuguese Brazilian and followed six steps: preparation, translation, back translation, pretest with nine health organizations, review, and documentation. The second phase, held between August and November 2021, was to validate of the content of the instrument using the Delphi technique, through the evaluation of a committee of experts in two sequential rounds. The semantic, conceptual, and normative equivalence of the items of the instrument were analyzed using the Coefficient of Agreement between evaluators, being considered satisfactory values greater than or equal to 90.0%. To analyze the content validity was used the Content Validity Index (CVI) and Inter-Rater Agreement (IRA), being considered approved values greater than 0.8, for both CVI and IRA. The analyses were performed using the Software R version 4.1.2. RESULTS: in cross-cultural adaptation, 97.9% of the items of the instrument were considered equivalent by 100% of the evaluators. For the items that presented agreement less than 90%, the best solutions were discussed, until a consensus was reached. The modifications made were approved by the authors of the original instrument. In content validation, most items had CVI approved in all three aspects, with 99.3% for coverage, 95.8% for clarity and 96.1% for relevance. About the IRA, 99.0% of the items presented satisfactory values for coverage, clarity, and relevance. Items with unsatisfactory values were changed and evaluated again by the expert committee and after approval by all the instrument was concluded, available for use in Brazil with the title “Engajamento do Pacientes na Segurança do Paciente em Organizações de Saúde”. CONCLUSION: the instrument is a reliable and valid tool to investigate patient engagement strategies in patient safety implemented in Brazilian health organizations, at different levels of governance.Item A efetividade de escovas descartáveis e submetidas à desinfecção para a higiene bucal em pacientes ventilados mecanicamente: ensaio clínico(Universidade Federal de Goiás, 2019-04-30) Gonçalves, Fernanda Alves Ferreira; Torres, Ieda Maria Sapateiro; http://lattes.cnpq.br/0836649494981715; Campos, Cerise de Castro; http://lattes.cnpq.br/9109822142576433; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Souza, Adenícia Custódia Silva e; Roriz, Virgílio Moreira; Melo, Dulcelene de Sousa; Tipple, Anaclara Ferreira VeigaINTRODUCTION: Invasive ventilatory and intubated patients are dependent on the nursing team. The mechanical removal of the biofilm with toothbrush is the first option, but after single use it can be contaminated by microorganisms from the oral cavity, as well as from the external environment. The use of the brush should be associated with chemical control of chlorhexidine digluconate, which is semi-critical and requires high level disinfection or be discarded. Peracetic acid is a high-level disinfectant, but has not been tested for use on toothbrushes. AIM: To compare the effectiveness of the use of disposable toothbrushes and disinfection with peracetic acid used for oral hygiene (OH) of patients under mechanical ventilation. MATERIALS AND METHODS: Randomized-controlled clinical trial performed at an intensive care unit of a public hospital in Goiânia / GO. Data were collected from 31 patients, intubated and under mechanical ventilation, between June 2017 and August 2018. The patients were divided into Control Group (OH with disinfected brushes) and Intervention Group (HB with brushes discarded). A dental evaluation was performed on day 1. Saliva collection was performed on day 1, day 3 and day 5 for counting of colony forming units (CFU). HB was performed twice a day, for up to five days, with 0.12% CHX gel and disinfected or discarded brushes. RESULTS: At admission, patients presented poor oral hygiene, periodontal disease, periodontitis and gingivitis. Most of the participants were male, with a mean age of 59.0 ± 14.4 years and mean of 19 teeth. Throughout the days of HB there was a decreasing tendency of buccal and lingual biofilms, however, there was no significant reduction of UFC, with no difference between the groups that used disposable brushes and disinfected brushes. In relation to the bacteria isolated on the fifth day, there was homogeneity in both groups, with predominance of Pseudomonas aeruginosa, Enterococcus faecium, Klebsiella pneumoniae and Staphylococcus haemolyticus. CONCLUSIONS: There was no difference in tooth and tongue brushing, performed with single use brushes, discarded or disinfected at each use. The important thing is to brush properly, following established protocols.Item Gravidez na adolescência e sua prevenção: sentidos atribuídos por um grupo de adolescentes escolares de Porto Velho – Rondônia(Universidade Federal de Goiás, 2019-12-11) Fernandes, Daiana Evangelista Rodrigues; Medeiros, Marcelo; http://lattes.cnpq.br/3009722217245952; Medeiros, Marcelo; Silva, Joana Aparecida Fernandes da; Reis, Mary Lopes; Santos, Walterlânia Silva; Barbosa, Maria AlvesRecent World Health Organization data show that approximately 16 million girls aged 15-19 each year and 1 million girls under 15 annually become mothers worldwide. Teenage pregnancy is an important public health problem that can affect the mother-child binomial in social, biological and psychological aspects. The aim of this study is to identify and analyze the meanings attributed by school adolescents to teenage pregnancy and its prevention. Qualitative study, approaching the principles of ethnography, conducted in a public school in the city of Porto Velho - RO, from October 2017 to November 2018. Participants were 20 adolescents of both sexes, aged 16 or 17 years. who had sexually active lives or not and were in the first or second year of high school. Data were obtained during the fieldwork, through participant observation and individual interviews, following a semi-structured script. The interviews were analyzed by the meanings interpretation method. From the process of analysis of the qualitative material obtained two themes emerged. The first, “Information for the prevention of teenage pregnancy”, shows that mothers are the people who talk and report the most about aspects related to their children's sexual health. Participants also reported as sources of information, leaflets, lectures, classes at school, advertisements and television programs. Regarding contraceptive methods, they reported mainly condom use and oral contraception. The theme “Repercussions of teenage pregnancy” shows that, in general, adolescents consider pregnancy at this stage of life something wrong, which undermines their studies and imposes the need to work. In addition, they evidenced the desire to complete their studies and develop in various professions in order to obtain financial stability and material goods so that only then can they have children. The study showed that participants referred more about their plans and dreams for development as people and future professionals than the desire for a teenage pregnancy. In contrast, the process of sexual and reproductive health education for these adolescents was weakened. Information is fragmented and there is no necessary dialogue between family, school and health service, and others who could participate in this continuum of actions for health promotion. Similarly, the use of contraceptive methods was not stable. However, participants demonstrated the use of the information to which they had access and adopted contraceptive measures motivated by future desires and dreams.Item Adaptação transcultural e validação para uso no Brasil do instrumento Quality and Safety Education for Nurses Student Evaluation Survey(Universidade Federal de Goiás, 2019-05-22) Freitas, Juliana Santana de; Dolansky, Mary; Silva, Ana Elisa Bauer de Camargo; http://lattes.cnpq.br/8388407861788466; Silva, Ana Elisa Bauer de Camargo; Bezerra, Ana Lucia Queiroz; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Alves, Sergiane BisinotoINTRODUCTION: The development of quality and patient safety competencies in health education has been the object of study and focus of recommendations built and published in recent decades in several countries. The evaluation of the achievement of these competencies by the students is necessary, however, in Brazil there are no tools published for this purpose. The Quality and Safety Education for Nurses Student Evaluation Survey (QSEN SES) evaluates, through three scales, the knowledge, skills and attitudes of Nursing students related to the following competencies: Patient-centered care; Evidence-based practice; Teamwork and collaboration; Quality Improvement; Safety and Informatics. OBJECTIVES: To perform the cross-cultural adaptation of the QSEN SES for use in Brazil and to evaluate its initial psychometric properties. METHOD: Methodological study, developed in two phases. The first consisted of the cross-cultural adaptation of the QSEN SES instrument into Brazilian Portuguese and followed six stages: translation, synthesis, back translation, expert committee review, pre-test with 30 undergraduate Nursing students from a public university and validation by the author of the original instrument. In the second phase, the Brazilian version of the QSEN SES was applied to 130 undergraduate Nursing students from three public universities, who had already completed at least 50% of the total course workload. The construct validity and reliability of the instrument were analyzed through confirmatory factor analysis and internal consistency. The Mann-Whitney and Kruskall-Wallis tests were used to verify the possible relationship between the sociodemographic variables and the quality and safety skills and attitudes. RESULTS: The QSEN SES was cross-culturally adapted for use in Brazil, presenting good reliability (Skills scale: 0,70≥ α ≤0,94; Attitudes sale: 0,86≥ α ≤0,97). The confirmatory analysis had insufficient adjustment indices for the skills model (χ2 = 352.46, SRMR = 0.075, RMSEA = 0.084, CFI = 0.868) and for the attitudes model (χ2 = 981.02, SRMR = 0.112, RMSEA = 0.193, CFI = 0.608). There was evidence of association between skills and university and sex variables. The results of the application of the QSEN SES Br in Nursing undergraduate courses in Brazil pointed out that, in a general way, the students reported the exposure to the contents related to the quality and safety in their formation, they recognize the actions as very important, however, feel unprepared to execute them. CONCLUSION: The Brazilian version of the QSEN SES is equivalent to the original version, it is reliable, however, it is suggested new studies with a larger population sample, to confirm the validity of the construct. The application of QSEN SES in Nursing schools will allow a situational analysis of education, producing information that is fundamental for educators and managers to plan curricular reforms, innovations and changes, aligned with identified needs, sustainable, with greater potential for success and longevity.Item Adesão e imunogenicidade aos esquemas ultra-acelerado e acelerado de vacinação contra hepatite B entre homens em situação de rua(Universidade Federal de Goiás, 2019-08-29) Souza, Christiane Moreira; Souza, Sandra Maria Brunini de; http://lattes.cnpq.br/6928658354895859; Souza, Sandra Maria Brunini de; Souza, Márcia Maria de; Teles, Sheila Araújo; Oliveira, Adriana Cristina de; Minamisava, RuthConsidering the long duration of the classic hepatitis B virus (HBV) vaccination schedule, with the common loss of vaccine follow-up, alternative schemes have been proposed for vulnerable populations. The aim of this study was to evaluate the adhesion and immunogenicity of HBV vaccine in homeless men (HSR) under the accelerated (E-UA) and accelerated (E-A) vaccination regimens. Randomized, two-arm, controlled, non-inferiority trial was performed by identifying HBV-susceptible HSR, which were allocated at a 1:1 ratio for E-UA (doses at 0, 7, and 21 days) and E-A (doses at 0, 1 and 2 months). For those who completed the proposed regimen, immunogenicity assessment was performed at 30, 60 and 90 days after the last dose of each regimen. Study approved by the Research Ethics Committee and registered in the Brazilian Clinical Trials Registry (ReBEC) platform. Of the 156 screened HSR, 67 were excluded; 35 (22.4%; 95% CI: 16.6-29.6%) for having some marker of HBV exposure (2 HBsAg/positive total anti-HBc; 15 positive isolated total anti-HBc and 18 anti-HBc/anti-HBs positive) and 32 (20.5%; 95% CI: 14.9-27.5%) for isolated immunity. Of the 89 susceptible identified, 18 (20.2%) were absent at the start of the intervention and the 71 eligible were randomized and allocated to E-UA (n= 35) and E-A (n= 36). The E-UA adherence rate was 94.3% (95% CI: 81.4 -98.4%) and the E-A rate was 63.9% (95% CI: 47.6-77.5%), and E-UA was associated with higher vaccine adherence rate (RR: 1.3; 95% CI: 1.1-1.7). In the analysis of the geometric mean titre (MGT) of anti-HBs, 30 days after the last dose of the vaccine, the group submitted to E-UA had a MGT of 147.6 mIU/mL versus 224.8 mIU/mL of those submitted to the vaccine. E-A (p-value= 0.985). After 60 days, the MGT for E-UA patients was 231.7 mIU/mL versus 211.2 mIU/mL for E-A (p-value= 0.572). After 90 days, the MGT between E-UA and E-A was 259.6 mIU/mL versus 233.1 mIU/mL (p-value= 0.548). In the analysis of adequate immune response (anti-HBs titers ≥10 mIU/mL), after 30 days, 88.0% of E-UA individuals and 94.7% of E-A individuals responded to the vaccine (p-value = 0.622). After 60 days, the response to the vaccine was similar between the E-UA and E-A groups (95.5% versus 92.9%; p-value = 1,000). After 90 days, this rate was 94.7% for the E-UA group and 100.0% for the E-A group (p-value = 1,000). The use of E-UA and E-A was effective with regard to early immunogenicity. Regarding adherence, E-UA was statistically identified as the best vaccination schedule option in this study.Item Efeito da lanolina anidra comparado ao leite materno combinado à concha de proteção para tratamento da dor e do trauma mamilar em lactantes: ensaio clínico randomizado(Universidade Federal de Goiás, 2013-04-30) Vieira, Flaviana Vely Mendonça; Mota, Dálete Delalibera Correa de Faria; http://lattes.cnpq.br/1684517331855276; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Abrão, Ana Cristina Freitas Vilhena; Almeida, Ana Maria de; Costa, Paulo Sérgio Sucasas da; Guimarães, Janaína ValadaresINTRODUCTION: Women often experience nipple trauma when they start breastfeeding, and this is one of the predictive factors of early weaning. There is no sufficient evidence to date supporting one best treatment for nipple trauma. OBJECTIVE: Assess the effect of lanolin anhydrous in the treatment of nipple pain, compared to mother’s breast milk combined with nipple protection shells during breastfeeding. METHOD: Randomized clinical trial, controlled with 100 puerperal women with nipple trauma, who had delivered at a public maternity hospital of Goiânia, Goiás, Brazil. Fifty women were randomized to group 1 and 50 to group 2. In group 1, a total of 97 breasts with nipple trauma were treated with lanolin anhydrous, and in group 2, 95 breasts with nipple trauma were treated with breast milk combined with nipple protection shells, and followed for up to 10 days. Both groups received educational instructions regarding breastfeeding. The outcome variables were: nipple trauma healing – determined by the Nipple Trauma Score (NTS) and pain in the nipple-areolar region – determined by a numerical pain scale. The research proposal was approved by the Research Ethics Committee of the University Hospital at Federal University of Goiás, and was recorded on the Brazilian Record System of Clinical Trials. Data analysis was performed using chi-square test, Fisher’s Exact Test and ANOVA MR, with significance at p<0.05. RESULTS: In the baseline assessment, the groups were homogenous in terms of sociodemographic, obstetrical and neonatal characteristics. The onset of nipple trauma was on the 2nd day postpartum, in average. Intervention was initiated on the 2nd day of nipple trauma. There was a variation of traumas, with the crust being the most frequent. Nipple depigmentation improved with time, with a difference between the groups on day 7 (p=0.013) and 10 (p=0.001). There was no difference between groups for the NTS before the intervention (p=0.642). The analysis of variance over time (ANOVA MR) indicated lower NTS in group 2 with a difference between the groups on days 3 (p=0.026), 5 (p=0.004), 7 (p<0.001) and 10 (p<0.001) of follow-up. Regarding the intensity of pain in the nipple-areolar region, a 5.5 mean was found for group 1 and 5.8 for group 2, on day 1, with no difference between the groups. The intensity of pain was smaller in group 2 compared to group 1 on days 5 (p=0.001), 7 (p<0.001) and 10 (p<0.001). CONCLUSION: Compared to lanolin anhydrous, breast milk combined with nipple protection shells proved more effective in reducing pain and healing nipple trauma in breastfeeding puerperal women.Item Incidentes com pacientes atendidos nos centros de atenção psicossociais: vivências da equipe de saúde(Universidade Federal de Goiás, 2019-04-29) Souza, Adrielle Cristina Silva; Caixeta, Camila Cardoso; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4282188T6; Bezerra, Ana Lúcia Queiroz; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4767942Z2; Bezerra, Ana Lúcia Queiroz; Lucchese, Roselma; Alves, Sergiane Bisinoto; Cardoso, Elizabeth Esperidião; Medeiros, MarceloOBJECTIVE: To analyze the security context of the users served at the Psychosocial Care Centers, based on the experiences of the multiprofessional team. METHODOLOGY: Qualitative study, intervention, mediated by the Cycle of Experiential Learning. 31 professionals from two service units - Psychosocial Care Center - Adult CAPS III from the metropolitan region of Goiânia participated. The data collection took place through group meetings, in which the professionals developed activities proposed by the researcher that led to reflection and learning about patient safety. The data were submitted to content analysis, using qualitative analysis software. RESULTS: The thematic content analysis was performed with the data obtained through participants' experiential techniques. The thematic categories that emerged from the content analysis were: 1 - Knowledge of professionals about patient safety; 2 - Incidents and situations of risks experienced by professionals of the multiprofessional team 3 - Strategies and evaluation of the educational process to promote safety in care. The data revealed low knowledge in the area of patient safety, which further heightened the interest of the team's professionals in understanding the issue. Understanding that the theory is currently more focused on the hospital environment, its focus on psychosocial care is something innovative. Incidents and situations of risks to the patient's safety were revealed in the physical aspects of the unit; in the work process in the services and low communication of the service network; in the lack and professional qualification; inadequate care; low family involvement; deficiency of records and mechanism from prescription to drug administration. The Permanent Health Education strategy in a problematic and participatory manner developed the team's understanding of safe care, which enabled professionals to outline strategies for incident prevention and promotion of safe care in CAPS. The process was evaluated as positive because it allows rethinking and instigating better attitudes in the work, in a dynamic and involving way, being possible to align theory and practice, besides being able to demystify that the clinic does not fit in the unit of mental health respecting the psychosocial attention. FINAL CONSIDERATIONS: Continuous efforts are required in practice, from senior management to direct assistance professionals, with the aim of promoting physical, human and organizational structure that guarantees the promotion of the safety culture in the CAPS. The experiential method favored the reflection of the service dynamics revealing the risk situations in the assistance to the users. The legitimacy of EPS as spaces for the exchange of practices and knowledge in the reflexion-action-reflection process, for the production of knowledge that improves patient safety in mental health is perceived, which will help both the improvement of the quality of services and in the training of professionals.Item Epidemiologia da Sífilis e HIV em cortadores manuais de cana-de-açúcar: bases para ações de promoção da saúde(Universidade Federal de Goiás, 2019-04-15) Rocha, Déborah Ferreira Noronha de Castro; Teles, Sheila Araújo; http://lattes.cnpq.br/4975298732179917; Teles, Sheila Araújo; Pinheiro, Raquel Silva; Carneiro, Megmar Aparecida dos Santos; Souza, Marcia Maria de; Souza, Sandra Maria Brunini deIn Brazil, manual cane harvesting is still common in less developed regions and is predominantly carried out by migrant seasonal workers, mainly from the Northeast of Brazil. Migration results in family isolation, remaining far from their sexual partners. This situation may favor unprotected sex and thus make them vulnerable to sexually transmitted infections (STIs), including syphilis and Human Immunodeficiency Virus (HIV). The objective of this study was to investigate the epidemiology of syphilis and HIV in cane cutters in Goiás and Paraíba. It is a cross-sectional and analytical study carried out from February to September 2016, in the states of Goiás and Paraíba, in five sugar-alcohol plants. A total of 937 cane cutters participated in the study. All were interviewed and tested for serological markers of HIV (anti-HIV 1 and 2) and syphilis (anti-T.pallidum) by the rapid test (TR). The samples were positive for anti-T. pallidum (syphilis in life) were retested by VDRL (active syphilis). All of them were male, ranging in age from 18 to 67 years and almost half (47.4%) had up to four years of study. The majority were married or had a stable union (77.5%), had no prison history (90.4%) and reported an occupational accident (53.4%). A state analysis showed a higher proportion of sugarcane cutters in Goiás that reported multiple sexual partners, which consistently used condoms during sexual intercourse, consumed alcoholic beverages and cocaine (p <0.05). On the other hand, the frequency of homosexual relationships was higher in Paraiba cutters (p <0.05). A global prevalence of anti-HIV-1 of 0.3% (95% CI: 0.1-1.0), syphilis in life of 2.4% (95% CI: 1.6-3.6) and active syphilis of 1.2% (95% CI: 0.6-2.1). The variables religion and marijuana consumption were independently associated with syphilis in life. However, the first variable was shown as a protective factor (adjusted OR: 0.3, 95% CI: 0.1-0.8), and the second was risk-adjusted (adjusted OR: 2.94, 95% CI: 1,1-7,7). The results of this study show sociodemographic and behavioral differences between Goiás and Paraíba sugarcane cutters and the circulation of syphilis and HIV-1 in this impoverished population that has the potential for viral dissemination. The agreement of the public health services with sugar and alcohol industries to carry out prevention and health promotion actions in sugarcane cutters' workplaces would be an important strategy directed at this population of male rural workers.Item Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém(Universidade Federal de Goiás, 2019-03-11) Bastos, Luzia Beatriz Rodrigues; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Duarte, Célia Scapin; Nogueira, Douglas José; Ferreira, Ilma Pastana; Vila, Vanessa da Silva CarvalhoINTRODUCTION. Regulatory structures can become determinants in the organizational process of health management, since it has the possibility of giving more effective responses to the requesting units and, above all, to the user. It would be up to the establishment of flows for the intended service not only implying optimization of expenses. Objective. To analyze the regulation of health services, in the Metropolitan Region I of the state of Pará, in view of complex and regulatory centers, recommended by the Brazilian Unified Health System (SUS). METHODOLOGY. An exploratory descriptive study with a mixed focus developed in the complexes and central regulators of the municipalities of Belém, Ananindeua, Marituba and Benevides, whose sample was composed of eighteen managers and seventy regulators, from September / 2017 to January 2018. It was applied the questionnaire in the first phase of the research and after that 40 semi-structured interviews were carried out. RESULTS. In the process of calculating the quantitative data it was found that the officials of the regulation, are female, with average age of 39 years; salary range of 2 minimum wages; majority of administrative assistants with effective ties. As limiting factors were found: great demand; lack of indication of priority cases and failure to refer to regulatory criteria; unavailability of beds, systemic difficulties in relation to the agreed services and the SISREG; difficult scheduling and execution procedures; increased demand for repressed elective procedures; problems in the flow of information between primary care and regulation, among others. As main potentialities in health regulation, the following stand out: increase of financial resources to health; reorganization of internal regulatory procedures; meeting the needs of users; health training for regulatory professionals, and strengthening of primary health care. CONCLUSION. The study showed that it is difficult to concentrate higher level professionals to perform the tasks of regulators of medium and high complexity procedures of SUS; there are obstacles in operationalizing the regulatory process, because the regulatory structures created coexist with insufficient resources, unconditional agreements with the reality of the municipalities of the north of the country; there is recognition of the need for a strong regulatory component by the State in guaranteeing qualified health access to the population, one of the greatest challenges being to understand the multiplicity of scenarios, subjects and interests, and to implement strategies focused on the user that needs health services.Item Avaliação da funcionalidade familiar por idosos(Universidade Federal de Goiás, 2013-03-11) Vera, Ivana; Lucchese, Roselma; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4769849E6; Nakatani, Adélia Yaeko Kyosen; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4794709T6; Nakatani, Adélia Yaeko Kyosen; Alvarenga, Márcia Regina; Vila, Vanessa da Silva Carvalho; Munari, Denize Bouttelet; Sadoyama, GeraldoDemographic and epidemiologic transitions influence the Family arrangements, making the course of life of the families dynamic and leading to intergenerationality. These factors influence several aspects of the life of the elderly, especially their family relations. To assess the family dynamic of the elderly is associated to the lack of studies on the family function in this context. Thus, the objective was to assess the family relationship of the elderly using the family APGAR and the associated factors in a capital city in the Brazilian Mid-West region. This is a cross-sectional, populationbased, epidemiological study which is part of the matrix study carried out by the Rede de Vigilância a Saúde do Idoso (REVISI -Network for Elderly Health Surveillance). The probability sample was formed by 934 elderly living in the urban area of Goiânia, Goiás, Brazil. Data were collected from November 2009 to April 2010. A standardized questionnaire was applied including socioeconomic and demographic variables, self-referred health conditions, pain, falls, and access to health services. Scales to measure functional and cognitive capacities were applied. Family APGAR index assessed the family dynamics. Scores 7 refer to Good Family Function (GFF) and scores <7 refer to Family Dysfunction (FD). The outcome variables considered were the family relations and all the other relations considered as predictor variables in the instrument. For univariate association analysis, Chisquare (c)2, or Fischer’s Exact test was used at a 5% significance level. The association magnitude was expressed by Prevalence Ratio (PR) and their respective confidence intervals (CI95%). Multiple logistic regressions were used to identify factors associated to the outcome by building the model with the predictor variables whose p values were 0.20 in the univariate analysis. When we inquired the total sample that answered the index, GFF was associated to age, education, having an income, self-refer health as bad /terrible, pain complaint osteoporosis and cancer. As for the elderly who referred family dysfunction, high dysfunction was associated to falls, and a previous episode of AMI. When the population aged 80 was assessed, GFF was associated to variables of referring bad /terrible health, osteoporosis and falls. These results characterize the family dynamics of non-institutionalized elderly regarding GFF prevalence and they point to the need to adjust the current State policies to focus on the real needs of this population stratum so that professionals understand and can help balance the family dynamics and that it can strengthen the health team that works on strategies for Family health.
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