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Disertaciones |
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1
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Paulo Eduardo Guedes Sellera
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“WEIGHTED CAPITATION INCENTIVE (PREVINE BRASIL PROGRAM): IMPACTS ON THE EVOLUTION OF THE POPULATION REGISTER IN PRIMARY HEALTH CARE ”
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Líder : MARIA FATIMA DE SOUSA
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MIEMBROS DE LA BANCA :
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ANA VALERIA MACHADO MENDONCA
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MARIA FATIMA DE SOUSA
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PAULO DE TARSO RIBEIRO DE OLIVEIRA
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VERONICA CORTEZ GINANI
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Data: 24-ene-2023
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Resumen Espectáculo
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“Primary Health Care (PHC) is the first level of health care, being considered the main and most adequate form of access for people to health systems. Health systems oriented to primary care have a positive impact on morbidity and mortality indicators, promoting more effective health care and achieving greater effectiveness, efficiency and equity when compared to systems focused on specialized care. In Brazil, PHC plays an important role in the SUS in guaranteeing the citizen's constitutional rights, and should be guided by the principles of universality, integrality and equity, established in the Federal Constitution of 1988. Consistent advances occurred towards universal coverage after the creation of the Family Health Program (FHP), the main strategy for expanding first contact access and changing the care model in Brazil, strengthened from the creation of The Primary Care Floor (PAB), with resources exclusively for Primary Care, transferred to the municipalities on a regular and automatic basis. The registration of the population is one of the fundamentals of work in the Family Health Strategy (ESF), aiming to know the families assigned to the teams, offering information for the realization of the situational diagnosis in health, the development of relationships of bonding and accountability between the teams and the population. According to the National Primary Care Policy, the registration data should be kept updated in the local information system for the analysis of the health situation, considering the social, economic, cultural, demographic and epidemiological characteristics of the territory. The institution of the Previne Brasil Program in November 2019 established a new funding model for aps costing, having as one of its components the weighted capitation, whose remuneration model is calculated based on the number of people registered. The general objective of the study was to analyze the evolution of the population registered in PHC after the creation of the weighted capitation incentive, established by the Prevent Brazil Program. This is a descriptive and quantitative study comparing the 3rd Quarter/2019 and the 3rd Quarter/2021, covering municipalities with Family Health teams (eSF) and Primary Care teams (eAP) approved by the Ministry of Health. The data were obtained through access to the e-Gestor AB and SISAB reports, grouped according to the rural-urban municipal typology and population size, classifications used by IBGE. The study showed that in most municipalities (76.1%) there was an increase in registrations in the period analyzed. In all typologies there was an increase in the proportion of registrations, and in the Remote Intermediate typology and in the Remote Rural, the mean evolution was higher (63.3% and 40%), respectively. There was also an increase in the proportion of registrations in all population sizes, and in small municipalities the proportion of registrations presented a better result than the other ones. The average evolution of the proportion of registrations was higher in the Metropolises with 41.9%. The results indicate that the weighted capitation incentive influenced the increase of the population registered in PHC, regardless of the demographic profile of the municipalities”
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2
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JOSÉ MARIA VIANA DOS SANTOS
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“Inclusion of male health care for truck drivers from the Health Card of the Truck Driver and
Truck Driver (CSCC) in Primary Health Care (PHC)”
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Líder : MUNA MUHAMMAD ODEH
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MIEMBROS DE LA BANCA :
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ERLENE ROBERTA RIBEIRO DOS SANTOS
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MARIA DA GRACA LUDERITZ HOEFEL
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MUNA MUHAMMAD ODEH
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SHEILA RUBIA LINDNER
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Data: 27-ene-2023
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Resumen Espectáculo
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“Truckers are professionals who work in the labor market as general cargo transportation drivers, composed of 99.5% males, with an intense work routine, driving more than 9,000 km per month, adding up to 11.5 hours per day and 5.7 days per week. One of the characteristics of these professionals is to be transient, and therefore health care can be impaired, lacking actions that enable the facilitation and expansion of access to health services regardless of their location. This study aims to identify the progress of the implementation of the Trucker's Health Card (CSCC) in Primary Health Care (PHC) of these professionals. The methodology used in this study belongs to the descriptive exploratory field, using structured interviews. The target audience was the health professionals of the health units located near the Resting and Stopping Points (ROPS) certified by the Ministry of Infrastructure (Minfra) and male truckers present in these same points. This research resulted in a proposal for a Pilot Project to implement the access to Primary Health Care with the practice of the Trucker's Health Card._”
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3
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Laís Bié Pinto Bandeira
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“Minor Ailments Service in Brazil: Characteristics and Impact of a Proposal for Training Pharmacists”
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Líder : RAFAEL SANTOS SANTANA
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MIEMBROS DE LA BANCA :
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DAYDE LANE MENDONCA DA SILVA
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DIVALDO PEREIRA DE LYRA JÚNIOR
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RAFAEL SANTOS SANTANA
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TIAGO MARQUES DOS REIS
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Data: 30-ene-2023
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Resumen Espectáculo
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“Minor Ailments Service is the service in which the pharmacist accepts a patient's demand and prescribes and guidance on non-pharmacological measures or nonprescription drugs and, when it’s necessary, forwards the patient to another health professional. For the qualification of the pharmacist and the standardization of the work process of this service, it is necessary for the pharmacist to be up to date and in constant training and learning. To this end, the use of clinical guides is an essential strategy for pharmaceutical training. The present study aimed to describe the performance of the minor ailments service in Brazil and to evaluate the effectiveness of a training course for pharmacists in the management of self-limiting health problems. The study was carried out in two stages. The pharmacy pharmacists through the application of a questionnaire released to pharmacists in all Brazilian states, in order to analyze how the demand for the minor ailments service, the most prevalent health conditions in community pharmacies, as well as the care steps performed by pharmacists during the exercise of this service. In the second stage, a distance course was developed, based on evidence-based pharmacy clinical guidelines to train pharmacists and pharmacy students to practice managing self-limited health problems, as well as evaluating the effectiveness of this course through the application of questionnaires in two distinct moments – before and after the course – to measure the participants' acquisition of knowledge. The results indicate that 62% of community pharmacists provide the self-limited health problem management service, in which the main health problems addressed daily or weekly in community pharmacies are muscle pain, headache and cold. As for the training course for pharmaceutical professionals and pharmacy students, there was a 64% increase in performance between the first and second questionnaires, indicating that the course was effective in gaining knowledge among the participants.”
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4
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Josélio Emar de Araújo Queiroz
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IMPACTS OF THE COVID-19 PANDEMIC ON THE DONATION AND TRANSPLANT PROCESS - ANALYTICAL ECOLOGICAL STUDY
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Líder : RAFAEL SANTOS SANTANA
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MIEMBROS DE LA BANCA :
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RAFAEL SANTOS SANTANA
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IVAN RICARDO ZIMMERMANN
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NOEMIA URRUTH LEAO TAVARES
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JOSE OSMAR MEDINA DE ABREU PESTANA
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Data: 01-feb-2023
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Resumen Espectáculo
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Organ transplantation is often the only therapeutic option for patients with organ failure and the COVID-19 pandemic has had an impact on these activities. Our objective was to evaluate the impact of the COVID-19 pandemic on the donation and transplant process in the global context and in Brazil. An ecological study was carried out with the numbers of donors and transplants between 2017 and 2021 and cases and deaths of COVID-19. Simple linear regression analysis was used in two blocks — 1: between the years 2017 and 2020, and 2: between 2017 and 2021. Rates per million inhabitants were considered, assessing the impacts. The study included two articles, the first considering 10 countries and the second presenting, by federal unit, the impact of the Covid-19 pandemic on the donation and transplant process. Regarding the first part, Portugal had the greatest impact on the rate of effective donors, with a decrease of 4,463.8 (95%CI: -5103.2; -3824.4), followed by Spain (-3,964.4; 95%CI: - 5850.2; -2078.6), Mexico (-3879.3; 95%CI: -4688.6; - 3069.9) and Australia (-309.0; 95%CI: -565.3; -52.7), unlike the United States, which showed increase. In the rate of transplants, Brazil, Portugal, Spain, France, Iran and Mexico stand out, which also showed a decrease. In the second product, it was verified, similar to the behavior of the analysis of the countries, a variation in the impacts of cases and deaths on the process of donation and transplants by state. The analysis of the effect of Covid-19 deaths on the rate of effective donors showed, in the period 2017 to 2020, the states of Alagoas (-157.6; 95%CI: -241.8; -73.4), Pernambuco (-142 .7;95%CI: -167.3; -118.0) and Mato Grosso do Sul, in the 2017 to 2021 interval, (-472.6;95%CI: -726.9;-218.2) with significant reductions. Regarding the number of organ transplants performed, São Paulo presented significant results in both intervals with a decrease of - 143.6 (95%CI: -229.7; - 57.5) -295.3 (95%CI: -554.1 ;-36.5). The Federal District, on the other hand, showed a significant growth, in the period from 2017 to 2021, of 323.1 (95%CI:10.1;636.0)The COVID-19 pandemic presented a challenging scenario for organ donation and transplant activity, where identifying successful experiences of adapting and sustaining transplant activity and reflecting on opportunities to be employed in supporting the resumption of donation and transplant systems is essential
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5
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Daniela Vaz Ferreira Gómez
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"Advances in the elimination of trachoma as a public health problem in non-indigenous and indigenous areas of the state of Maranhão, Northeastern Brazil, 2019 - 2022"
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Líder : IVAN RICARDO ZIMMERMANN
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MIEMBROS DE LA BANCA :
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IVAN RICARDO ZIMMERMANN
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MARIA PAULA DO AMARAL ZAITUNE
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NOEMIA URRUTH LEAO TAVARES
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RICARDO MÖRSCHBÄCHER
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Data: 15-mar-2023
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Resumen Espectáculo
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“Introduction: The World Health Organization recommends conducting surveys to validate the elimination of trachoma as a public health problem. To verify that the elimination targets have been met, the Ministry of Health conducted a survey in non-indigenous and indigenous areas of the country between 2018 and 2022. The aim of this study was to know the prevalence of the disease in areas of the state of Maranhão and to evaluate possible differences in prevalence between non-indigenous and indigenous populations based on data from this survey. Methods: Population-based cross-sectional observational study with probabilistic sampling. For the selection of the non-indigenous Evaluation Unit (EU), homogeneous mesoregions with at least one municipality at risk to trachoma and indicators of poverty and sanitation were considered. The Special Indigenous Sanitary District of Maranhão (Dsei-MA) was selected to make up the indigenous EU in the state due to the size of the population, and the proximity to the selected non-indigenous EU made it possible to compare. All residents of one year or older were examined for trachoma. Results: The prevalence of follicular inflammatory trachoma (TF) in Leste Maranhense EU and DseiMA were 0.13% and 2.94% and the prevalence of TT in Dsei-MA EU was 0.12%. The highest prevalence of TF was found in places with poor sanitation".
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6
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Helen Altoé Duar Bastos
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Challenges and potential for building public food and nutrition policy as a strategy for health promotion
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Líder : VERONICA CORTEZ GINANI
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MIEMBROS DE LA BANCA :
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VERONICA CORTEZ GINANI
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ELISABETTA GIOCONDA IOLE GIOVANNA RECINE
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MARTA AZEVEDO DOS SANTOS
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Michele Lessa de Oliveira
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Data: 02-may-2023
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Resumen Espectáculo
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Public policy is adopted to publicize the government's intentions and to guide planning regarding a given topic. In terms of food and nutrition, at the federal level, there is the National Food and Nutrition Policy, which completed 23 years in 2022. However, to meet local specificities, each State is oriented to organize its policy. In this sense, in 2021, the Federal District (FD) approved the District Food and Nutrition Policy (DFNP). Therefore, the present study's objective was to analyze the construction process of the DFNP. The research carried out was of a documentary, exploratory, and qualitative type. As a result, three products were elaborated, two scientific articles, and a technical material that consisted of the logical model. The DFNP, a demand registered since 2013 in the I District Food Safety Plan, was prepared by a technical group of health sector servants and with relevant moments of external contributions, including the deliberation of its approval by the Health Council of the FD and the public consultation. The challenge in the current phase, implementation, maintains the need to intersectoral articulate, to expand the dissemination and its use in the routine of the State Department of Health of the FD (SDHFD), in addition to giving greater visibility through sector indicators. The logical model aimed to contribute to the process of implementation of the public policy by the SDHFD: a milestone of great relevance for promoting the health of the local population and that other states of the federation use the present study to inspire the elaboration of regulations locations on the subject.
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7
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Uguiarlem Ribeiro Durães
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“REDESIGNING SCENARIOS AND WEAVING CARE: COVID-19’s experiences in a Specialized Rehabilitation Center – a look at individuals, health professionals and management.”
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Líder : EVERTON LUIS PEREIRA
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MIEMBROS DE LA BANCA :
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EVERTON LUIS PEREIRA
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JOSENAIDE ENGRACIA DOS SANTOS
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ROSAMARIA GIATTI CARNEIRO
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WEDERSON RUFINO DOS SANTOS
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Data: 05-may-2023
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Resumen Espectáculo
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“The COVID-19 pandemic has produced a protrusion in people’s lives, setting up a scenario of breaks and ruptures, a “new state” of things that are outside the social order. We have experienced the last few years undergoing several changes in our routines. Today, it seems clear that the COVID-19 pandemic is consuming us in many ways and in different ways. This dissertation aims to reflect on the follow-ups of COVID-19 in the daily lives of patients, workers and the management of a Specialized Rehabilitation Center. As a result, we obtained an article derived from a survey carried out with service users, where it was possible to understand the heritage of individuals in relation to the sequelae of COVID-19 in their bodies and in their daily lives, based on narratives of the disease; and two technical products: the first shows the process of implementing and structuring a Standard Operating Protocol and a Monitoring Bank for COVID19 cases in the service; the second, in the form of a report, presents the elaboration and implementation of a Permanent Education in Health, where it was possible to advance in thinking and discussions about the impacts of the COVID-19 pandemic. The results achieved for individuals and society (the collective) – promoting space for their voices to be heard; in the formulation of public policies – bringing to light scientific evidence; and in health practices and services – replicating the technical products. Contributing to avoid or mitigate scenarios marked by death, vulnerability, invisibility, denial and absence of the Government, as it was during and after a pandemic.”
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8
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Yago Ranniere Teixeira Santana
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“MEASUREMENT OF TUNGIASIS INFESTATION LOAD IN SOIL BY REAL TIME POLYMERASE CHAIN REACTION IN THE YANOMAMI INDIGENOUS LAND”
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Líder : CIRO MARTINS GOMES
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MIEMBROS DE LA BANCA :
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Ana Carolina Tardin Martins
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CIRO MARTINS GOMES
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RAFAEL SANTOS SANTANA
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RENATA VELÔZO TIMBÓ
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Data: 16-may-2023
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Resumen Espectáculo
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“Introduction: Tungiasis is an ectoparasitosis caused by the siphonapter Tunga penetrans. A member of the tungidae family, it is native to Central and South America and is a common parasite in rural areas throughout Brazil. T. penetrans is the causative agent of tungiasis. It is a neglected disease that affects underdeveloped regions and does not have an adequate epidemiological characterization. Soil control is essential, but there are no reliable methods for monitoring the infestation or the outcome of control actions. Objective: The main objective of the present study is to develop a molecular tool to monitor T. penetrans infestation in indigenous soils. Methods: This is a cross-sectional, analytical study that aims to develop a molecular method for measuring T. penetrans in soil. Specific primers were designed for detection of parasite DNA and synthetic genetic targets for control by means of gene cloning. A protocol for extracting and quantifying soil DNA by real-time polymerase chain reaction (qPCR) was validated. Soils from the resident population near the Auaris base pole, Yanomami region, Roraima, Brazil were evaluated. Results: The action of the Special Secretariat for Indigenous Health (SESAI) carried out evaluation and treatment of 555 patients living in 78 households. Of these, 45 patients had active tungiasis. In the present research, environmental conditions and soil assessment strategies were compared with the occurrence of tungiasis at the individual level. The number of residents who lived in each house ranged from 2 to 16. None of the evaluated houses were internally divided by walls. All the houses were built in a square or rectangular format, with an area ranging from 5 to 9 square meters. Fifty-four of the 78 (69.23%) houses evaluated had walls on all sides and a door, but 5 (6.41%) had at least one side without a wall and 19 (24.36%) had no walls. Soil sampling was carried out in 18 houses (23.08%) of the 78 evaluated. Comparing the soil finding with the occurrence of tungiasis, the level of soil infestation measured by the direct method was higher for the homes of patients with active tungiasis (p < 0.001). Laboratory data demonstrated adequate validation results for detection and quantification of T. penetrans DNA in soil. Molecular quantification of tungiasis in the evaluated soils also showed that higher amounts of DNA were related to a higher occurrence of tungiasis (p = 0.002). Discussion: The present study confirms that soil infestation by T. penetrans is related to human infection. The data also show that molecular tools can be used to evaluate actions to combat tungiasis in remote areas of the Brazilian territory.
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9
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JOÃO RENÉ DE MATTOS RODRIGUES FILHO
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PUBLIC HEALTH POLICY UNDER THE VIEW OF LEGISLATION SCIENCE: THE CASE OF PRISONAL HEALTH
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Líder : MARIA CELIA DELDUQUE NOGUEIRA PIRES DE SA
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MIEMBROS DE LA BANCA :
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MARIA CELIA DELDUQUE NOGUEIRA PIRES DE SA
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ROSAMARIA GIATTI CARNEIRO
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VERONICA CORTEZ GINANI
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MARTINHO BRAGA BATISTA E SILVA
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Data: 19-jun-2023
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Resumen Espectáculo
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This work embodied in a professional master's dissertation aimed to discuss the Science of Legislation - Legistics - as an instrument to evaluate the quality of the legal act contained in the Interministerial Ordinance n. 1 of January 2nd, 2017, and art. 4th, annex XVIII of the Consolidation Ordinance no. 2 which constituted the National Policy for Comprehensive Health Care for Persons Deprived of Liberty in the Prison System-PNAISP. It was not the objective of the work to substantially analyze the ordinances, nor to propose material changes in the policy. Methodology: This was a qualitative study in which the unit of analysis were the provisions of public prison health policy and its regulation. The normative data were collected from the health information repository of the Virtual Health Library, using the normative numbers for the location. The normative framework used for the analysis was Complementary Law 95 of 1998 in the light of the lessons of Formal Legistics, which analyzes the formalistic aspects of the legal act. Results: It was found that, although the Interministerial ordinance faithfully observed the provisions of LC 95/98, implying the need for minimal adjustments due to the time elapsed since its edition, the same cannot be said of the regulation. The text inserted in Annex XVIII of PRC-2 is confusing, without observing the good technique of normative writing, generating confusion in the applicator of the standard. Conclusion: It was concluded that the regulation of the prison health policy needs a revision of its normative text, without implying substantial changes in the policy itself
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10
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Samira Virginia de França
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“Therapeutic itineraries of patients hospitalized for covid-19: case study in a public hospital in the Federal District”
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Líder : EVERTON LUIS PEREIRA
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MIEMBROS DE LA BANCA :
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EVERTON LUIS PEREIRA
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DAPHNE RATTNER
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XIMENA PAMELA CLAUDIA DIAZ BERMUDEZ
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GUSTAVO NUNES DE OLIVEIRA
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Data: 23-jun-2023
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Resumen Espectáculo
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“Introduction: The covid-19 pandemic has shown that health systems around the world need to be increasingly prepared to deal with the complexity of health emergencies. From the perspective of health anthropology, the therapeutic script is defined as the path taken by an individual and his support network in the search for health recovery. The decisions and experiences lived along this path occur not only at the institutional level and are influenced by several cognitive, cultural and social factors. Studies on this topic can help identify the care models adopted by different people and social groups in situations of illness and understand the process of accessing health services, hopefully for the planning and management of more effective public policies. Objective: to know the therapeutic itineraries of hospitalized patients with Severe Acute Respiratory Syndrome caused by covid-19, from the onset of symptoms to the end of hospitalization. Methods: integrated case study, with triangulation of quantitative and qualitative evidence acquired from the analysis of the raw database of an observational study (clinical cohort) carried out in a public hospital in the Federal District. Results: The study described the paths taken by 233 people in the SUS between May 2020 and December 2021, in addition to exploring associations between the clinical and sociodemographic profile and the process of accessing health services. Most participants were elderly, male, black and brown, with low income and education levels and multiple comorbidities. Contrary to what is usually evidenced in studies on therapeutic itineraries in the SUS, most patients had quick access to health services and did not have to go through several units to get care. The social determinants that influenced the choice of the first service sought were education, occupation, health region of residence and economic class. The factors associated with faster access to the SUS were the type of service sought first, the severity and the socioeconomic context of the patients. Conclusion: the results of this case study can help SUS managers in the complex challenge of organizing policies that consider the influence of social determinants on access and use of health services and be capable of effectively responding to the needs of the population, especially in the context of emergencies.”
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11
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Vânia Nazaré da Costa Silva
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"A contribution from the internal audit of SUS for the analysis and evaluation of Rede Cegonha in Pernambuco"
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Líder : ROSAMARIA GIATTI CARNEIRO
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MIEMBROS DE LA BANCA :
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ROSAMARIA GIATTI CARNEIRO
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MARIA FATIMA DE SOUSA
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LAETICIA JENSEN EBLE
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MARIA CELIA DELDUQUE NOGUEIRA PIRES DE SA
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Data: 27-jun-2023
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Resumen Espectáculo
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"The Stork Network (RC) strategy aggregates actions from previous women's health policies and was created to intervene in the high rates of Maternal and Child mortality. This cross-sectional study from the years 2017 to 2020, referring to the "Analysis of Component I of the Stork Network of the State of Pernambuco" in which it analyzes the responses of the auditees to the non-conformities evidenced in the audit reports, and measures the actions developed in the audited municipalities associating to the indicators considered quality of prenatal care. It aims to identify the limitations and advances of the management on sensitive actions to the quality of prenatal care. Qualitative research supported by the Social Sciences in Collective Health inspired by the discourse analysis, which seeks the meanings of and in the narratives of the auditees. The Audit Reports, source of this research are here considered documents "historical artifacts" and "monuments" produced within the public institutions. And, quantitative through an ecological study of multiple groups, from 184 audits of the State Component of the National Audit System. Ten care actions listed in the reports were related to the indicators considered of qualification of prenatal care. The best evaluated indicators were: "Guarantee of expansion of access to high-risk prenatal care"; "Rapid testing of syphilis/HIV" (SRT); and "Laboratory tests of Habitual Risk and High Risk". The most sensitive audit evaluative indicator associated to the Average Congenital Syphilis Rate (AMCT) is the "SRHR", when analyzed in groups of municipalities. In the final evaluation, two indicators showed statistical significance when analyzed with the Perinatal Mortality Coefficient: "Guarantee of expanded access to high-risk prenatal care" and "Displacement support". It is concluded that the analysis of the variables researched reveals difficulties in the understanding of public health policy and consequently of its execution at the municipal level in Component I, as well as ratifies the incorporation of the audit as an ally of public health management to the extent that it promotes the review of work processes from the signs of non-conformities. In addition to the insufficiency in the degree of compliance in Component I of the Stork Network in Pernambuco and the importance of the significance relationship between dependent and independent variables.
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12
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Maria Cristina Ferreira de Abreu
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DIGITAL HEALTH LITERACY IN PEOPLE WITH TYPE 1 DIABETES MELLITUS IN BRAZIL
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Líder : VERONICA CORTEZ GINANI
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MIEMBROS DE LA BANCA :
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VERONICA CORTEZ GINANI
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ANA VALERIA MACHADO MENDONCA
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NOEMIA URRUTH LEAO TAVARES
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ADRIANA MARQUES PEREIRA DE MELO ALVES
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Data: 27-jun-2023
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Resumen Espectáculo
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“Diabetes Mellitus is a public health problem due to the disabilities caused when not properly treated. Self-monitoring of this disorder is an important part of the treatment and gives the diabetic person the possibility of controlling and maintaining health. In this sense, the use of digital tools can be an important ally. However, there is still a need for knowledge about how prepared people are to integrate this digital network appropriately. In this sense, the objective of the study was to analyze the level of Digital Health Literacy (LDS) among Brazilians with Type 1 Diabetes Mellitus. This is an exploratory, cross-sectional, quantitative and qualitative study. Data collection was carried out using a semi-structured questionnaire divided into a part with sociodemographic information and about diabetes mellitus care and another about LDS and perception about the use of social networks. Participation took place remotely and to attract participants, social networks were used (Facebook, WhatsApp and Instragram)..”
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13
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Adriano Santiago Dias dos Santos
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“Territorial Support Strategy: Sociocultural Analysis of the National Project for the Rapid Response to Syphilis”
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Líder : XIMENA PAMELA CLAUDIA DIAZ BERMUDEZ
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MIEMBROS DE LA BANCA :
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XIMENA PAMELA CLAUDIA DIAZ BERMUDEZ
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VERONICA CORTEZ GINANI
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EDGAR MERCHAN HAMANN
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LUCIELI DIAS PEDRESCHI CHAVES
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Data: 27-jun-2023
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Resumen Espectáculo
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“Syphilis is a persistent disease and a growing public health problem that affects men, women and children. To face this challenge, specific public policies have been developed in the country, in line with the goals proposed by the World Health Organization. The ‘National Rapid Response to Syphilis Project’ is included in this frame, implemented in some priority municipalities of Brazil. This article addresses that project, focusing on priority municipalities for syphilis in the Midwest Region, focusing its analysis on the role played by so-called institutional supporters, responsible for mobilizing institutional capacities to accelerate the implementation of syphilis agendas at the local level. The methodological procedures adopted involved the collection and systematization of indicators and goals defined by the project and the characterization of the main management and governance actions carried out in these territories. Documentary analysis techniques from secondary sources were used, focusing on the production that supported the work of these supporters with the project and synthesized in an analytical matrix. The results point to the facilitating role of supporters and the strengthening of institutional capacity to locally implement defined actions for syphilis control.”
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14
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Ghabriela Moura Boitrago
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Secondary impact of the COVID-19 pandemic on deaths by cause group in Brazil: a spatio-temporal description
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Líder : WILDO NAVEGANTES DE ARAUJO
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MIEMBROS DE LA BANCA :
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WILDO NAVEGANTES DE ARAUJO
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WALTER MASSA RAMALHO
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AMANDA COUTINHO DE SOUZA
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KATIA YUMI UCHIMURA
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Data: 28-jun-2023
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Resumen Espectáculo
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Objective: To describe the pattern of deaths by group of causes in Brazil registered from 2001 to 2022, in space and time. Methods: We conducted an ecological, descriptive-analytical study, with analysis of spatial-temporal clusters byyear in Brazilian municipalities. Secondary data sources were used, from the Mortality Information System (2001 to 2022) and the Brazilian Institute of Geography and Statistics (IBGE). The historical series of mortality rates by group of causes was analyz ed to describe the trend of deaths after the pandemic. Results: For sepsis, 47% were classified as "oscillating hot spot" and 459 municipalities as "new hot spot", with never seen mortality rates. For AIDS, 53% of the municipalities had no detected pattern, but 10% were categorized as "oscillating hot spot", indicating an increase in mortality. Conditions such as Intrauterine hypoxia/asphyxia of birth, alcoholism, cirrhosis, and chronic liver disease had municipalities classified as hot spots. In relation to falls, homicides and cancer, municipalities with hot spots or intensification patterns were identified. The mortality rate from diabetes had transitions from cold to hot spot in 81% of the municipalities. Discussion: The analysis revealed varied patterns for different diseases, such as "oscillating hot spots" for sepsis and "new hot spots" for some diseases. AIDS mortality showed a significant change in some municipalities, indicating an increase in mortality. Patterns of increase after the pandemic were also identified for other conditions such as glomerular diseases, prostate hyperplasia, maternal mortality, falls, suicides, and cancer, among others. The results varied between regions and states in Brazil
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15
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Rita de Cássia Ferreira Lins
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Evaluation of measles transmission risk areas to enhance monitoring and implementation of strategies for measles elimination in Brazil
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Líder : JONAS LOTUFO BRANT DE CARVALHO
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MIEMBROS DE LA BANCA :
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ANA CATARINA DE MELO ARAUJO
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ANA LUCIA FRUGIS YU
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JONAS LOTUFO BRANT DE CARVALHO
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WILDO NAVEGANTES DE ARAUJO
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Data: 28-jun-2023
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Resumen Espectáculo
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Introduction: Measles is a highly contagious disease that can cause several complications. In recent years, measles outbreaks have occurred in all regions, and the incidence has increased, leading to the reintroduction of the disease in Brazil with 9,325 confirmed cases. The World Health Organization (WHO) advises its member states to conduct annual risk assessments. This study aimed to estimate the risk of measles transmission in the Northern Region of Brazil prior to the reintroduction of measles in the country. Methodology: The measles risk assessment tool was used to estimate the overall risk of measles in 450 municipalities in the Northern Region of Brazil in 2017. Measles risk was calculated based on four categories of indicators, including population immunity, surveillance quality, program performance, and threat assessment, resulting in an overall measles risk score for each municipality. Subsequently, the tool assigned each municipality to a risk category, namely low, medium, high, or very high, based on the overall risk score. Results: Out of the 450 evaluated municipalities, 7 (1.6%) were classified as very high risk, 10 (2.2%) as high risk, 43 (9.6%) as medium risk, and 390 (86.7%) as low risk. The majority of municipalities classified as very high or high risk were located in the state of Pará, accounting for 42.9% and 70%, respectively. Overall risk scores ranged from 15 to 68 out of 100 possible points. There was significant variability in all four categories: population immunity ranged from 0 to 34 points, surveillance quality from 0 to 12 points, program performance from 0 to 16 points, and threat assessment from 2 to 17 points. Across all states, population immunity and program performance were consistently the categories with the lowest scores. The city of Manaus, in the state of Amazonas, was classified as very high risk by the tool, with 7,149 cases confirmed in 2018, exhibiting the second-highest incidence in the country. The municipality with the highest incidence, also in the state of Amazonas, was classified as medium risk by the tool. In the state of Pará, the majority of confirmed cases resided in the municipality of Santarém, accounting for 39 (47.0%) cases. Said municipality was classified as very high risk by the tool. Conclusions: In general, areas classified as high or very high risk in the northern region of Brazil from 2015 to 2017 experienced a high incidence of measles in 2018, suggesting the potential usefulness of the tool in planning programmatic activities that can reduce the risk of outbreaks in subsequent years. This tool also identified areas considered at high or very high risk of measles transmission years later, not only in the immediate year following the assessment. Despite limitations, the risk assessment using the WHO tool can be used as routine practice for it provides a detailed breakdown of points by category and indicator, enabling health teams in municipalities to identify the primary reasons for the identified risk.
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16
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Josivânia Arrais de Figueiredo
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Sensitivity of the Notifiable Diseases Information System (Sinan) in capturing deaths from chikungunya, in Northeast Brazil, from 2016 to 2020.
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Líder : WILDO NAVEGANTES DE ARAUJO
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MIEMBROS DE LA BANCA :
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JONAS LOTUFO BRANT DE CARVALHO
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LÍVIA CARLA VINHAL FRUTUOSO
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NOELY FABIANA OLIVEIRA DE MOURA
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WILDO NAVEGANTES DE ARAUJO
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Data: 28-jun-2023
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Resumen Espectáculo
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Introduction: Chikungunya fever is found in all countries of the world. In Brazil, several cases of the disease have already been registered, including deaths. The symptoms are fever, headache and mainly joint pain and its treatment is only symptomatic. In Brazil, the notification of chikungunya is compulsory for suspected cases and immediate for deaths, every suspect must be registered with Sinan. Due to the use of this system for disclosing deaths due to chikungunya by the Ministry of Health, an evaluation of the information system was necessary. Objective: To estimate the sensitivity of Sinan in capturing deaths due to chikungunya, in Northeast Brazil, from 2016 to 2020. Method: An evaluative study was carried out on data from deaths due to chikungunya notified on Sinan and registered on SIM, with based on guidelines contained in the CDC Guidelines. The attribute used to evaluate the information system was sensitivity. It was carried out with notifications from the Federated Units of the Northeast Region of Brazil, from 2016 to 2020, including all individuals notified in Sinan and SIM, using secondary data from the systems. The probabilistic record linkage method was used to obtain agreement between the systems, calculating the estimate of deaths from chikungunya and the sensitivity of Sinan. Data on deaths from chikungunya were described using simple absolute and relative frequencies. The research was submitted to the CEP of FS at UnB. Results: 617 deaths were reported on SINAN, 622 deaths on SIM, its concordance was 273, the estimated calculation of deaths from chikungunya was 1,404 and the sensitivity of SINAN was considered low. Of the concordance of deaths by chikungunya, 166 (60.8%) occurred in the state of Ceará, 43 (15.8%) in Rio Grande do Norte and 30 (11%) in Pernambuco. The years in which the deaths occurred were 2016 104 (38.2%) and 2017 150 (55.2%). 177 (64.8%) occurred between SE 11 and SE 22. 145 (53.1%) were male, with a median age of 75 years. Of the main signs and symptoms, 248 (90.8%) had fever, 187 (68.5%) arthralgia and 168 (62.5%) myalgia, and 219 (80.2%) were confirmed by laboratory criteria. The most frequent comorbidities were hypertension 110 (40.3%) and diabetes 68 (24.9%). In identifying the cause of death of individuals, 261 (95.6%) registered other viral fevers transmitted by mosquitoes as the underlying cause. Conclusion: In this study, it was possible to identify that a greater number of deaths due to chikungunya were registered in SIM than in Sinan. The use of the probabilistic relationship made it possible to find the agreement of deaths between the systems, calculate the estimate of the number of deaths due to chikungunya, in addition to calculating the sensitivity of Sinan. Sinan showed low sensitivity in detecting deaths from chikungunya. The highest number of deaths in the Northeast region was recorded in the state of Ceará, mainly in the period from February to April, affecting the elderly and associated with some comorbidity. Most deaths from chikungunya were recorded as the underlying cause.
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17
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Silmara Vieira da Silva
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“URBAN MOBILITY AS A SOCIAL DETERMINANT OF HEALTH: INTERSECTORALITY IN ADDRESSING INEQUITIES”
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Líder : MARIA CELIA DELDUQUE NOGUEIRA PIRES DE SA
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MIEMBROS DE LA BANCA :
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MARIA CELIA DELDUQUE NOGUEIRA PIRES DE SA
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DAIS GONCALVES ROCHA
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RAFAEL DALL'ALBA
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MARCO AKERMAN
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NABIL GEORGES BONDUKI
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Data: 28-jun-2023
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Resumen Espectáculo
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“Different conditions and possibilities of urban mobility for populations can result in health inequities, especially in large cities. Risk factors such as air pollution, traffic accidents, physical inactivity, traffic noise, lack of adequate urban infrastructure, and difficulties accessing health services due to barriers related to the urban mobility system contribute to unjust and preventable inequalities. The reduction of these inequities requires intersectoral approaches, involving collaboration between different sectors. In this study, possibilities of intersectorality within the institutional framework of sectoral policies and plans in the areas of urban mobility and health are analyzed. More specifically, intersectorality within the scope of the National Health Promotion Policy (PNPS) and the National Urban Mobility Policy (PNMU), as well as the District Health Plan 2020-2023 (PDS 2020- 2023), the Urban Transport and Mobility Master Plan of the Federal District (PDTU-DF), and the Active Mobility Plan of the Federal District (PMA-DF 2020). The integrated analysis of these juridico-political instruments, with a perspective of intersectorality and the confrontation of health inequities, had the concepts of Totality and Reification as reference points. The assumption was that the closer the policies and plans are to the concept of Totality, the greater the possibility of intersectorality, and the more comprehensive are the intersectoral initiatives in confronting inequities. At the same time, adherence to the concept of Reification results in less comprehensive initiatives with lower potential to address unjust inequalities. The result of the integrated analysis, from the conceptual lens of Totality and Reification, reflected the need for intersectorality between the two areas, in addressing health inequities, to present strategies and initiatives aligned with overcoming the hegemonic model of urban mobility”
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18
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Sumaia Cristine Coser
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Assessment of the implementation of the Regional dental prosthesis laboratorys to amplify the acess to oral reabilitation in primary atention to health in the years 2013 to 2022
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Líder : GILBERTO ALFREDO PUCCA JUNIOR
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MIEMBROS DE LA BANCA :
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GILBERTO ALFREDO PUCCA JUNIOR
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MARIA ERCILIA DE ARAUJO
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EDSON HILAN GOMES DE LUCENA
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Fernanda Campos de Almeida Carrer
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Data: 29-jun-2023
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Resumen Espectáculo
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This research aims to describe the “Regional Laboratory of Dental Prosthesis” component of the National Oral Health Policy (PNSB) from 2013 to 2022 in Brazil. It consists of a descriptive analysis about the distribution and production of dental prostheses in Brazil (macropolitical analysis), seeking to point the main strengths and weaknesses of the implementation of this strategy over the last decade. The methods consisted of two phases, the first encompassing documental analysis of the current regulations. In the second phase, temporal trend analysis was used with logarithmic transformation of the indicators and Prais-Winsten linear regression was applied. Durbin-Watson test was applied to verify the autocorrelation. The results showed that highest degree of “stationary trend” was the North region. The UF with the highest delivery of prostheses was the Southeast, while the North region had the lowest delivery of prostheses. The LRPD services rate was higher in the Northeast region, also presenting the highest number of discredited services in the analyzed period. Additionaly, the study brings reflections on the need of reviewing aspects related to this point of the Brazilian Oral Health Care Network, proposing new possibilities for LRPD normatives criteria as a referral to the General Coordination of Oral Health of the Ministry of Health, a "Cartel of prosthetic services offered in the LRPD”, considering the scope of procedures that must be incorporated by the Unified Health System - SUS, as a form of assistance to users, favoring the assumption principles of equity and greater resolution at the PHC level
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19
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Aline Almeida da Silva
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Immunization Logic Model: challenges and perspectives for the reorganization of the immunization network in Brazil
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Líder : JONAS LOTUFO BRANT DE CARVALHO
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MIEMBROS DE LA BANCA :
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EDER GATTI FERNANDES
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JONAS LOTUFO BRANT DE CARVALHO
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MARIA FATIMA DE SOUSA
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Ricardo Gadelha de Abreu
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Data: 29-jun-2023
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Resumen Espectáculo
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Objectives: Elaborate the Brazilian Immunization Logical Model (ML) , and suggestSuggest indicators for monitoring the activities proposed in the ML. Method: Evaluative, propositional study grounded in immunization policy, aiming to guide the restructuring of immunization policy in Brazil. Results: The ML construction started from the low vaccination coverage (CV) in Brazil, seeking to identify its determinants and conditioning factors to describe activities necessary for qualifi execution of the immunization policy. There were nine evaluative components: Federal, State and Municipal Management, Primary Health Care, Secondary and Tertiary Health Care, Special Immunobiologicals Reference Center, Communication, Information System and Private Sector. Conclusion: ML defines activities that assist the immunization policy reorganization , enabling the identification of gaps in the implementation of its policy, providing assertive and timely decision making, aiming at the resumption and maintenance of high CV and consequently, protection of the population regarding vaccine preventable diseases in the country.
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20
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Carolina Geralda Alves
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Evolution of research funding for sexually transmitted infections in Brazil
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Líder : JORGE OTAVIO MAIA BARRETO
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MIEMBROS DE LA BANCA :
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ANGELICA ESPINOSA BARBOSA MIRANDA
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EVERTON NUNES DA SILVA
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ISIS POLIANNA SILVA FERREIRA DE CARVALHO
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JORGE OTAVIO MAIA BARRETO
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Data: 30-jun-2023
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Resumen Espectáculo
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Sexually Transmitted Infections (STIs) are considered a global public health problem because they affect sexual, mental, and reproductive health and general health, social and economic implications. In facing these problems, scientific evidence qualifies the national response, strengthens public policies, and promotes equity in health. Therefore, STI is part of the priority research topics of the Ministry of Health (MS). Objectives: To analyze and characterize research on Sexually Transmitted Infections funded by the Ministry of Health from 2012 to 2022. Method: This is a descriptive study with a quantitative approach carried out through document analysis. Data were extracted from the Health Research Platform and thematic institutional publications. Information not publicly available was requested through the Freedom of Information Act. Results: From 2012 to 2022, 258 studies addressing nine types of STIs were financed, corresponding to a total amount of PPP$ 101,753,931.49. The highest proportion of projects was related to HIV/AIDS, both as a single theme (34.1%) and associated with other STIs. A higher proportion of research was contracted in 2013, and a reduction in contracting from 2019 onwards. Regarding the funds applied, in 2018 and 2021, higher values were observed, from PPP$ 27,239,839.98 and PPP$ 18,881,439.77, respectively. Conclusion: The study identified variations in the number of surveys contracted and funding over the years. The need for strategies that guarantee sustainable and equitable funding of research is highlighted so that policies and actions to combat STIs in Brazil are promoted based on the best scientific evidence to achieve control and elimination of these infections. The need to promote transparency of information related to financing is highlighted, in addition to improving the mechanisms for disseminating and appropriating results for the health system. Impact assessment and knowledge use studies can improve research promotion mechanisms.
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21
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Kathiely Martins dos Santos
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Clinical Practice Guidelines on leishmaniasis: mapping and quality assessment
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Líder : NOEMIA URRUTH LEAO TAVARES
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MIEMBROS DE LA BANCA :
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GUSTAVO ADOLFO SIERRA ROMERO
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JOSE ANGELO LAULETTA LINDOSO
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NOEMIA URRUTH LEAO TAVARES
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RAFAEL SANTOS SANTANA
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Data: 30-jun-2023
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Resumen Espectáculo
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Leishmaniasis is a set of diseases caused by parasites of the genus Leishmania, which, comprising more than 20 species known as human pathogens, have the potential to cause a wide spectrum of clinical syndromes. This variability is reflected in the ways of managing these diseases, especially with regard to therapy. In this context, the adoption of Clinical Practice Guidelines (GPC), initially defined as statements systematically developed to help professionals and patients make decisions about appropriate health care for clinical circumstances, is an important strategy for standardizing conduct and definition of best practices. Since the early 2000s, important GPCs on leishmaniasis have been proposed, following the trend of recent decades in relation to the production of these documents, which, despite being intense, has resulted in documents with highly variable structure and quality standards. Objective: To map the extent of world production of GPC on leishmaniasis and assess its quality. Methods: First, a scoping review was developed according to the Joanna Briggs Institute (JBI) guidelines. The literature search was carried out between April 2022 and April 2023, involving 26 databases and scientific repositories, including Medline via PubMed, Embase, VHL and Cochrane. Another 95 informational resources, including websites of international organizations, Health Technology Assessment agencies and medical societies, were included, in addition to official websites of 197 countries. The terms “leishmaniasis” AND “practice guideline” and respective synonyms and, in a complementary way, non-controlled vocabulary terms were used. The most current versions of GPCs on leishmaniasis that contained recommendations for diagnosis and/or treatment and/or clinical management aimed at any form of leishmaniasis, without language or date restriction. Documents that dealt with leishmaniasis only from the perspective of animal and/or environmental health and those of an educational or procedural nature were excluded, in addition to review articles and those resulting from original research. Data collection and analysis was performed by two independent reviewers, following the protocol steps registered at https://osf.io/2khbq/?view_only=e8a44a90535f4dfb932cc1127b4eee75. Then, the GPCs resulting from the scope review were evaluated by three independent evaluators through the application of the AGREE II instrument (Appraisal of Guidelines for Research and Evaluation). Results: Thirty-one GPCs from American (58%), European (32%), Asian (6%) and African (3%) countries were selected. Approximately 55% of them were prepared on the initiative of local governments, although GPCs were identified that were prepared on the initiative of international non-governmental organizations (23%), in partnership or not with local governments, medical societies (10%), and other private ones ( 13%). One hundred percent of the GPCs addressed the treatment of some form of leishmaniasis, while 87% also included recommendations about the diagnosis. Approximately 81% of the GPCs included the visceral form, 77% the cutaneous form and 68% the mucosal or mucocutaneous form. . Other less discussed issues were Leishmania-HIV co-infection (52%) and post-kala-azar dermal leishmaniasis (10%). In all guidelines evaluated in terms of quality, important weaknesses were identified in more than one Domain, with emphasis on “editorial independence”, “applicability” and “rigor of development”. In the overall assessment, two GPCs were recommended for use in practice without modifications, another three were recommended with modifications, and the rest were not recommended. Conclusion: It is necessary to improve the processes for formulating the recommendations contained in the GPCs on leishmaniasis, which involves the adhesion of mechanisms that grant greater editorial independence, in order to mitigate conflicting interests; the adoption of a clear and objective approach regarding the likely facilitating factors and barriers to its implementation, aiming to improve its applicability and, finally, qualify the recommendations with regard to the evidence that underlies them, in order to promote the offer of the best care for people with leishmaniasis in Brazil and worldwide.
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22
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Renata de Almeida Cavalcante
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CARE FOR PEOPLE WITH SUICIDAL BEHAVIOR IN MOBILE EMERGENCY CARE SERVICES: EVALUATION OF PROFESSIONAL APPROACHES
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Líder : DAIS GONCALVES ROCHA
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MIEMBROS DE LA BANCA :
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DAIS GONCALVES ROCHA
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DAYDE LANE MENDONCA DA SILVA
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LARISSA POLEJACK BRAMBATTI
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GUSTAVO CARVALHO DE OLIVEIRA
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Data: 30-jun-2023
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Resumen Espectáculo
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Training for health professionals has been widely defended as a fundamental way to prevent suicide, given that there are weaknesses in the training processes and difficulties of health professionals in the management of psychic crises. In Brazil, in the post-pandemic context of COVID-19, the incidence of people with episodes of crisis has increased. The mobile prehospital care service is one of the first health teams to contact and user embracement who need immediate care, and the care provided can directly influence the prognosis of patients with a suicidal crisis. The Ministry of Health (MS) promoted a training course in mental health emergencies for professionals from the Mobile Emergency Care Services (SAMU) in the 26 states and the Federal District of Brazil. The analytical study, with a quantitative and qualitative approach, was developed during the second half of 2021. In the qualitative phase, based on the video recording of the simulated stations for managing suicidal behavior, the results were categorized through simple thematic analysis. These were presented according to the main categories: approaches, facilitating and hindering aspects. In the quantitative moment, a questionnaire was applied in order to measure the attitudes of SAMU professionals towards suicidal behavior. After the training course, the professionals were able to provide a more humanized care to the person in a suicidal crisis, an alternative to the prevailing practices that rule out the possibility of adequate user embracement and treatment. The association analysis before and after the course pointed to an improvement in the professionals' feelings regarding suicidal behavior and a greater perception of professional capacity for care of this nature. Thus, it is possible to infer that permanent health education provides critical analysis and transforming action by professionals and their social contexts. It is necessary to invest in training based on psychosocial care and soft tech skills for SAMU professionals.
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23
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Alex Duarte de Araújo
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COVID-19, WOMEN AND RURAL TERRITORY: DEEDS, KNOWLEDGE AND THE SEARCH FOR HEALTH CARE IN SOBRAL - CE
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Líder : ROSAMARIA GIATTI CARNEIRO
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MIEMBROS DE LA BANCA :
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ROSAMARIA GIATTI CARNEIRO
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EVERTON LUIS PEREIRA
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MARIA FATIMA DE SOUSA
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ANTÔNIO RODRIGUES FERREIRA JUNIOR
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Data: 10-jul-2023
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Resumen Espectáculo
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“This qualitative study, based in the field of Social Sciences in Health of Collective Health, seeks to reflect on the experience that women living in the countryside had of the Covid-19 pandemic. To this end, it presents the views of three women interviewed who live in the city of Sobral in Ceara, on the following topics: fake news, fear of seeking health services because of possible contamination, the use of home remedies, the lack of multiprofessional accompaniment during the isolation period, and the economic and personal issues faced by the interviewees during the pandemic. Their practices and knowledge about the pandemic were also considered. The field research took place between March and June 2022. For data analysis we used Bardin's methodology. The results of the study showed that rural women faced significant challenges in accessing health services, such as lack of access to the internet, transportation, and information about the pandemic".
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24
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GEORGE LUIZ NÉRIS CAETANO
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The thread of Oral Memory in Traditional Medicines: reflections of the COVID19 pandemic in the medicinal practices of a folk therapist from the Federal District
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Líder : ROSAMARIA GIATTI CARNEIRO
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MIEMBROS DE LA BANCA :
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EVERTON LUIS PEREIRA
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LUCIANO BEZERRA GOMES
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MARIANNA ASSUNCAO FIGUEIREDO HOLANDA
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ROSAMARIA GIATTI CARNEIRO
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Data: 11-jul-2023
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Resumen Espectáculo
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This work seeks to understand the mystical and cosmological universe of ancestry, as well as the traditional identity dialogic, in which the individual is collective and is sustained by the threads of ancestral memory. Set in a qualitative, exploratory study, with ethnomethodological approach, in which there is the immersion in the territory of an ialorixá, resident of Ceilândia (DF), there is the contribution of the interlocutor with semi-structured interviews and the sharing of her expertise with the promotion of health care, but thought from her reality, revealing the strategies she adopts to transmit and keep her ancestral knowledge-doings-practices alive among her support network, which re-signifies the process of becoming ill along with her therapeutic itinerary. The product is the affirmation of inter-scientificity as a response to the need for health education sustained by an antiracist, plural and diverse pillar, which dialogues with health-promoting territories, building and strengthening other concepts of health, as well as valuing the sociocultural identity of those who think about health care connected to ancestral oral memory, well-living and traditional medicines.
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25
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Nádia Maria da Silva Machado
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Primary Health Care. Pay for performance. Financial Resources in Health. National Access and Quality Improvement Program (PMAQ).
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Líder : HELENA ERI SHIMIZU
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MIEMBROS DE LA BANCA :
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HELENA ERI SHIMIZU
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RAFAEL SANTOS SANTANA
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EVERTON NUNES DA SILVA
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GARIBALDI DANTAS GURGEL JUNIOR
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Data: 17-jul-2023
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Resumen Espectáculo
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“The National Program for Improving Access and Quality of Primary Care (PMAQ-AB), established in 2011, was a Brazilian pay-for-performance (P4P) model, which aimed to improve the quality of Primary Care in SUS. After its implementation, the program was evaluated according to the criteria established by the Ministry of Health, but important aspects for the characterization of these modalities were not investigated. The objectives of this study were: to analyze how the PMAQ-AB resource was applied at the local level, as a pay-for-performance strategy, as well as to verify other purposes for the application of these resources. This is a descriptive-analytical study, with a longitudinal approach, which analyzed the PMAQ-AB implementation modalities in the municipalities, over the three cycles, through an online survey carried out between October and December of 2019, regarding the forms of application of financial incentives. The first stage analyzed the national data in a comparative way between the cycles, and made an association between incentive attributes and socioeconomic, demographic and party indicators through a multinomial logit model. The second stage adopted a regional focus, considering the greater participation of the Northeastern states in the present study, making it possible to compare categories between states. The participation of managers from 798 municipalities in 22 states was obtained. The results showed that 55.4% of municipal managers used the resource to pay for performance for primary care teams. More than 54% of managers used 41 to 60% of total resources to pay teams for performance and opted for monthly periodicity. The certification of health teams was the criterion most used by managers to transfer the resource, above 70%. There was an increase in complete teams over the course of the cycles, and professionals beyond the minimum Family Health team received the incentive. The managers also used the funds for other purposes, such as purchasing equipment for the UBS and carrying out training activities. Municipalities with a larger population and with a low HDI were associated with a higher percentage of the resource destined to payment for performance and greater motivation of the teams. From the second stage of the study, the cutting for the Northeast region had a sample of 79% of the municipalities that paid PHC professionals for their performance. Especially in the third cycle, 95% of the municipalities in the state of Paraíba paid the teams. The results showed that the PMAQ resource was applied with emphasis on payment for the teams, through criteria defined in the MS, with regular payment characteristics, emphasizing non-medical professionals, also observing the infrastructure and professional qualification. An amount of 60% of the managers chose to invest the percentage of resources between 41 and 60%, with emphasis on the categories of nursing 93%, dentistry 90%, and community health agents 85%, the
certification grade was used as a criterion for the payment 79%, monthly 52%, on average in the three cycles, in addition to prioritizing infrastructure and professional qualification with investments in the purchase of equipment and continuing education. The results showed that the PMAQ resource was applied with emphasis on payment for the teams, through criteria defined in the MS, with regular payment characteristics, emphasizing non-medical professionals, also observing the infrastructure and professional qualification. It was observed that this payment-for-performance model aimed at recognizing and qualifying services and professionals. The decisions taken throughout the program cycles resulted in greater adherence, but also demonstrated the need for planning that takes into account institutional and contextual factors for greater efficiency and quality in the implementation of the model. Therefore, further studies are needed in this area to advance knowledge. It is possible to observe that the transfer of PMAQ resources to encourage access to and quality of AB services, through remuneration for performance, training of professionals and improvement of work structures, was an important strategy for strengthening Primary Care_”
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26
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LÍGIA MARIA CARLOS AGUIAR
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Nursing practices in the context of Primary Health Care in the Federal District: an analysis of the work and appreciation of nurses
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Líder : MARIA FATIMA DE SOUSA
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MIEMBROS DE LA BANCA :
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DANIELA SAVI GEREMIA
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ELIZABETE PIMENTA ARAÚJO PAZ
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MARIA DA GLORIA LIMA
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MARIA FATIMA DE SOUSA
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Data: 21-jul-2023
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Resumen Espectáculo
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The development of Brazilian Primary Health Care is directly linked to the struggle of the working class for a comprehensive health model and a universal system, as well as the development of nursing and its practices, mainly within the scope of the Family Health Strategy. Aspects related to the profile of the nursing category, its role in primary care and in the health of the family and community, and the structuring of the world of work are interconnected with nursing practices and reflect on the social recognition of the profession, influencing professional appreciation. Work is an analytical category crossed not only by the act of transforming a material into a product, but in which social relations permeated by class aspects are involved, to which elements of race/ethnicity and gender are added. It is from the perspective of work that the austerity measures inherent to the crises of capitalism result in precarious work, with implications for health practices and, therefore, for nursing. Thus, the general objective of the study is to analyze nursing practices in the context of primary health care in the Federal District, through the specific objectives: to analyze the professional and sociodemographic profile of nurses who work in primary health care. health in the Federal District; describe the practice scenarios of nurses in the health regions of the Federal District; characterize the practices developed by nurses in primary health care, according to their work processes, from the perspective of care coordination; to systematize the narration of the nurses about their perception of their practices in the scope of basic health care, regarding the social recognition and appreciation of their work; To produce a podcast dialoguing about the professionals' narratives about their daily work, with a view to publicizing nursing practices in the context of primary care through a far-reaching tool, for professional appreciation and social recognition. For this, it starts from dialectical hermeneutics for a comprehensive approach and understanding of the social environment where the object of study is developed, through a qualitative and quantitative mixed methodology that covers the collection of quantitative data through an electronic questionnaire, with analysis by the Statistical Package for the Social program Sciences. Qualitative data were collected using a semi-structured script, with audio-recorded interviews, transcribed and analyzed using the NVIVO software, with the content analysis method proposed by Bardin. Subsequently, the quantitative and qualitative data were related, in order to outline the profile of the category and their perception of work. The results of the study show that nurses working in the first level of health care in the Federal District are mostly female, brown, married, Catholic, from other municipalities and residing in the municipality where they work, trained in Brazilian institutions, graduated more than ten-year-olds and graduates. The historical, cultural and socio-demographic characteristics of the Federal District have repercussions on the nurses' perception of their daily work, the potentialities and challenges of their work, recognition and social appreciation. Furthermore, the context of the pandemic accentuated the precarious conditions of work, influencing the perception of professionals about the meaning of work and social appreciation. The study allows us to observe that the influence of historical and cultural background and elements related to the technical and social division of labor is still in force, especially under the capitalist economic order and its crises, which have repercussions on work. The pandemic has intensified deleterious working conditions, at the same time that it has boosted the collective awareness of nursing and laid bare the importance of family health as a strategy for implementing primary care and a path to transforming the health model. In this path, nursing is perceived as a pillar category in the construction of models and health systems aimed at universality, under the construction of comprehensiveness and equity, with primary care as the guiding axis of guaranteeing health as a right.
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27
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Valdirene Aparecida Anacleto Montalvão
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Quality Analysis of Causes of Death Certified_by Death Verification Services Enabled in the National Network
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Líder : IVAN RICARDO ZIMMERMANN
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MIEMBROS DE LA BANCA :
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IVAN RICARDO ZIMMERMANN
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JUAN JOSE CORTEZ ESCALANTE
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MARIA DE FÁTIMA MARINHO DE SOUZA
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VERONICA CORTEZ GINANI
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Data: 27-jul-2023
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Resumen Espectáculo
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Introduction: The National Network of Death Verification Services (RNSVO) is composed of Death Verification and Cause of Death (SVO) services established in municipalities, states and the Federal District. It was created with the objective of promoting the qualification and improvement of data on the cause of death of all deaths due to natural causes, without diagnostic elucidation, with or without medical assistance, and also to strengthen the integration and qualification of data and information on mortality through of the Mortality Information System (SIM). Objective: To analyze the quality of the causes of death attested by the Death Verification Services authorized by the RNSVO Method: An ecological analytical study was developed. Results: In 2019, 1,349,801 deaths were recorded in Brazil, of which 1,207,001 (89%) were due to natural causes. Of this total, 74,972 (6.0%) had an ill-defined underlying cause. Among the groups of Federated Units with and without SVO, 821,055 and 385,946 deaths from natural causes were recorded, with the percentage with an ill-defined cause being 6% and 8%, respectively. Of the total number of deaths from natural causes that occurred in the country, 87,251 were certified by the RNSVO, with 2% of records of ill-defined causes. Analyzing the median number of conditions recorded in Parts I and II of the medical death certificate, it was found that the result was three numbers of conditions on the lines of the certificate for the records from the RNSVO. Conclusion: It is noteworthy that in the federated units where there is an SVO enabled in the RNSVO, the percentage of deaths certified with ill-defined causes is lower than in those federated units that do not have an enabled SVO in the network. It is worth mentioning that in the RNSVO-enabled services themselves, this percentage is even lower. It is suggested that in the federated units that contain the SVO, there may be an active death surveillance in accordance with the regulated conditions for the existence of a service, considering the lower percentage of deaths attested with an ill-defined cause and a greater number of conditions in the lines of the DO certificate, both in part I and in part II.
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28
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Ana Paula Maciel Gurski
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The Specialized Component of Pharmaceutical Assistance: a comparative analysis of health policies and strategies for access to high-cost medications in Brazil and around the world.”
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Líder : RAFAEL SANTOS SANTANA
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MIEMBROS DE LA BANCA :
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NOEMIA URRUTH LEAO TAVARES
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RAFAEL SANTOS SANTANA
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RODRIGO FONSECA LIMA
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SILVANA NAIR LEITE CONTEZINI
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Data: 24-ago-2023
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Resumen Espectáculo
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“The Pharmaceutical Assistance in the Brazilian National Health System (SUS) is organized in three Components: Basic, Strategic and Specialized. The Specialized Component of the Pharmaceutical Assistance (CEAF) holds a roll of medicines that represent a high budget impact for the SUS. It includes medicines for chronic and severe medical conditions, for diseases that require a complex treatment and for refractoriness or intolerance for the first and/or second line of treatment. Besides, it performs interface with the actions in the scope of the Economic-Industrial Health Complex. Considering the evolution in the Component's structure, regarding budget, number of medicines allocated, number of patients attended and number of clinical conditions contemplated, along with other parameters, this study aims to characterize the results achieved between 2012 and 2021, presenting an actual and historical panorama of the CEAF. In addition, this study aims to critically analyze the disparity of financial investment from the national government to the different Brazilian Federal Units, regarding the acquisition of CEAF medicines. Beyond those perspectives, the present work presents a narrative about access to high-cost medicines in the world.”
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29
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Viviane Betanin Lima
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“Analysis of the supporters strategy adopted by the CONASEMS – COSEMS Network to strengthen SUS Municipal Management.”
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Líder : ANA VALERIA MACHADO MENDONCA
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MIEMBROS DE LA BANCA :
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ANA VALERIA MACHADO MENDONCA
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MARIA FATIMA DE SOUSA
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DANIELA SAVI GEREMIA
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JOSE DA PAZ OLIVEIRA ALVARENGA
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Data: 25-ago-2023
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Resumen Espectáculo
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The National Council of Municipal Health Secretariats (CONASEMS) is the representative of the 5570 Brazilian municipalities in the political and management field of the SUS, recognized as such by Decree 7508/20113. Because of this nature, it is one of the institutions with the greatest potential for capillarity and mobilization capacity with the municipalities, mainly through joint action with the collegiate bodies of the Municipal Health Secretariats in the states, the COSEMS, present in all states of the Federation. The Board took office in 2016 with the axis of its work plan the Strengthening of the Councils of Municipal Health Secretariats (COSEMS) and one of the planned actions was the Implementation of the Strategy to Support Decentralized Management, along the lines of the COSEMS of Minas Gerais, Rio de Janeiro, São Paulo, Amazonas and Paraná. In partnership with the Support Program for the Institutional Development of the Unified Health System (PROADI – SUS) and the Hospital Alemão Oswaldo Cruz (HAOC). In 2017, the project “Collaborative Network for Strengthening Municipal Management of SUS” was launched, with supporters and coordinators for all COSEMS. The project was renewed over the subsequent three years and is currently managed on a collaborative platform between Hospital Alemão Oswaldo Cruz (HAOC) and Beneficência Portuguesa de São Paulo (BP). This project aims to analyze the strategies adopted by the CONASEMS – COSEMS supporters network from 2017 to 2021, to strengthen the Municipal Management of SUS. Seeking to identify specificities and singularities of the members and the support work process with the municipal management of the SUS, I understand what support is being provided to municipal health managers in the territories. To develop the research, a qualitative methodology is being used with a participatory approach and permeated by triangulation techniques for collecting and analyzing information, which will also be linked to qualitative and quantitative analyzes that elucidate the contexts, subjects and specific objectives. For this purpose, techniques for collecting and analyzing information and a set of guiding instruments for dialogue sessions and interviews were designed. semi-structured with strategic informants, with the aim of apprehending the results of actions developed by the Network and its members, based on access to the databases available at CONASEMS
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30
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Sara Delfino da Silva
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“Course Improvement in Health of the Rede Cegonha: insertion of nursing obstetrics in childbirth scenarios”
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Líder : MAGDA DUARTE DOS ANJOS SCHERER
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MIEMBROS DE LA BANCA :
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MAGDA DUARTE DOS ANJOS SCHERER
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DAPHNE RATTNER
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ERICA LIMA COSTA DE MENEZES
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MARIA ELIANE LIEGIO MATAO
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Data: 11-sep-2023
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Resumen Espectáculo
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“Objective: To analyze, according to graduates of the Health Improvement Course, the changes that occurred in the work of obstetric nurses. Methods: This is a study with a qualitative approach that identified the perception of professional nurses who graduated from the Health Improvement Course about the possible changes that occurred in their obstetric practices. We approach the technique of content analysis under Bardin's theory, highlighting the contextualization of the study, the step by step and particularities of each phase. Participants were 31 obstetric nurses who had graduated from the improvement course offered by the Ministry of Health. Data were collected from January to March 2023 using a semi-structured self-report form, which contains 21 questions, including 3 open and 18 closed. the Project was approved by the ethics committee in research with human beings of the Federal University of Brasília-UNB, opinion n. 5.730.613/2022 and the co-participant Federal University of Rio de Janeiro-UFRJ, opinion n. 5,810,718/2022.”
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31
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Gilberto Gilmar Moresco
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PROFILE OF IMPORTED MALARIA CASES REPORTED IN BRAZIL BETWEEN THE YEARS OF 2012 AND 2021
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Líder : MARIA PAULA DO AMARAL ZAITUNE
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MIEMBROS DE LA BANCA :
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ANDRE DE MACHADO SIQUEIRA
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DIRCE BELLEZI GUILHEM
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MARIA PAULA DO AMARAL ZAITUNE
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VERONICA CORTEZ GINANI
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Data: 15-dic-2023
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Resumen Espectáculo
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The World Health Organization (WHO) recognizes malaria as an important public health problem in the world. In Brazil, approximately 99% of cases are concentrated in the Amazon region, the country's endemic area for the disease, comprising the states of Acre, Amapá, Amazonas, Pará, Rondônia, Roraima, part of Maranhão, Mato Grosso and Tocantins. The extra-amazonian region (other states and the Federal District) periodically reports some indigenous cases of malaria, that is, cases originating from endemic areas, which makes this region vulnerable to the reintroduction of the disease, given the intense flow of people coming from the amazon region and from other countries where the disease occurs. This scenario of imported malaria can impact local surveillance systems and compromise the achievement of malaria elimination goals in Brazil and the international commitments and goals assumed by the country with the WHO and the United Nations (UN), in relation to the Global Technical Strategy (GTS) and the Sustainable Development Goals (SDGs). This study aimed to analyze the imported cases of malaria notified in Brazil in the last 10 years, identifying the Probable Sites of Infection (PIL) and of notification, analyzing the time between the onset of symptoms and the diagnosis of imported cases, describing the sex, race/color and age group of the patients and the parasitic species involved in the diagnosis of these imported cases. This is a descriptive study, with analysis of secondary data from the information systems of the Ministry of Health - Sinan and Sivep-Malaria. In the analyzed period, 1,670,598 cases of malaria were reported in Brazil, with 50,009 (3.0%) reported cases of malaria imported from another country, with 48,200 cases reported in the amazon region (96.4%) and 1,809 cases reported in the extra-Amazon region (3.6%). 70.6% of the patients declared themselves to be of mixed race/color and the age group with the highest participation was 21 to 30 years old (31.1%). The species Plasmodium vivax was responsible for the highest number of cases (69.1%) and 49.8% of the diagnoses of the disease were premature, occurring within 48 hours of the onset of symptoms. During the study period, 3,798 cases of malaria were reported in the states of the extraAmazon region, 2,874 (75.7%) of which were imported from the Amazon region. Most of these records were notified in São Paulo (17.8%), Goiás (13.8%), Minas Gerais (11.8%) and Paraná (10.3%). The states of Rondônia (27.1%) and Amazonas (26.5%) were the main places of origin for these cases. 42.5% of the patients declared themselves to be of mixed race/color and the age group with the highest participation was 31 to 40 years old (25.5%). The Plasmodium vivax species was the most prevalent (87.0%), and only 16.8% of diagnoses occurred within 48 hours of the onset of symptoms. The mobility of Plasmodium infected individuals can result in reintroduction of the disease into areas where transmission has already been eliminated. Therefore, given the emphasis that imported malaria places on control and elimination efforts, it is important to know the profile of these cases in order to offer strategies that strengthen the national surveillance system in the timely identification of imported cases, especially in regions where elimination of the disease has already been achieved
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32
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Raissa Pereira Santos
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Multiprofessional Health Residencies as a means of promoting interprofessional collaborative practice
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Líder : DAYDE LANE MENDONCA DA SILVA
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MIEMBROS DE LA BANCA :
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DAYDE LANE MENDONCA DA SILVA
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FERNANDA LETICIA FRATES CAUDURO
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JUCILEIA REZENDE SOUZA
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RODRIGO FONSECA LIMA
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Data: 18-dic-2023
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Resumen Espectáculo
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“The Unified Health System is considered the largest public health program in the world, serving approximately 80% of the Brazilian population, serving the population universally, comprehensively and free of charge. It has an interprofessional character, built and consolidated as a space for health care, professional education, management and social control. In recent decades, literature and public policies implementing teamwork have addressed a broader discussion of a model that associates teamwork with practice: Interprofessional Education (IPE). It is an intervention or educational action with the purpose of improving collaboration in the care of users, in which members of more than one profession learn together, with the purpose of improving the quality of health care. Based on the need for professional practices, they responded to the demands of the SUS and interprofessional education models, committed to solving problems encountered in the work process and in the real specificities of health services. Strategically, the Multiprofessional Health Residency Programs (MHRS) were regulated by law 11,129, of June 30, 2005. This is a postgraduate modality focused on in-service training, aimed at professional categories that make up the health area, with the exception of doctors. Their objective is professional training aimed at differentiated performance in the SUS, with a view to strengthening the movement for changes in health training in Brazil. The PRMS have been an example of articulation between training and work. Given the importance of IPE in the work context of professionals based on the main principles of the SUS, the present study aimed to map what the literature addresses about the collaboration of RMS for the interprofessional training of health professionals, based on a scoping review , based on the recommendations of the Joanna Briggs Institute manual, to identify evidence from databases, identifying gaps in existing research on the topic. The study also served as a basis for the production of technical-scientific material, aiming to assist in resolving the gaps highlighted
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33
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Sarah Yasmin Lucena Gomes
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“CHARACTERIZATION AND QUALITY ASSESSMENT OF CLINICAL PRACTICE DOCUMENTS RELATED TO TUBERCULOSIS”
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Líder : RODRIGO FONSECA LIMA
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MIEMBROS DE LA BANCA :
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ARTEMIR COELHO DE BRITO
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NOEMIA URRUTH LEAO TAVARES
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RODRIGO FONSECA LIMA
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VERONICA CORTEZ GINANI
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Data: 18-dic-2023
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Resumen Espectáculo
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“Introduction: Tuberculosis (TB) is a disease known for thousands of years, with diagnosis and treatment available and relevant incidence rates, persisting as an international health concern. Like any other health condition, all actions related to its context, from disease prevention to treatment, must be guided by Clinical Practice Documents (CPD). These CPD must be developed with scientific rigor, among other aspects, and its importance should be highlighted in the approach to patients with TB by any professional on the health team, including the Community Health Agent (CHA). Objective: To characterize and evaluate the quality of CPD related to tuberculosis available in the literature and propose the updating of an instrument to guide the approach to the patient by the Community Health Agent (CHA). Method: The study has three stages: the first searching for CPD related to TB, the second referring to the characterization and evaluation of the quality of these documents and the third referring to the update of a technical product related to the topic and based on the previous stages aimed at the ACS. The search for CPDs for the management of tuberculosis was carried out in different databases using search strategies with the descriptors "tuberculosis", "guideline", "clinical protocols" and "consensus". In addition, a non-systematized search and research were also carried out through contacts established with partner countries. The second stage was carried out using the Appraisal of Guidelines for Research & Evaluation II (AGREEII) instrument and the third was carried out in accordance with the findings of the previous stages, based on the Ministry of Health document aimed at the ACS. Results: 949 documents were included from the databases. Of these, 743 were screened to read the title and abstract, of which 16 remained to read the full text. Of the 16, seven were excluded because they were outside the scope of the search or had a specific approach, leaving nine DPCs to continue the study. As for the non-systematized search, of the 43 initial DPC, 20 met the inclusion and exclusion criteria. Of the total of 29 CPDs, the majority presented important problems in more than one domain; the domains with the best evaluations were scope and purpose and clarity of presentation and those with the worst evaluations were methodological rigor and editorial independence. Considering the strengths of the CPD, aspects related to the ACS were considered and adequately made compatible with the currently valid document for subsequent validation. Conclusion: The quality of the guidelines evaluated was below expectations, even though most of them were produced in countries with a high incidence and prevalence rate of TB. There is a need for a greater approach to Evidence-Based Practice in terms of qualifying the preparation of these CPDs aimed at quality and safety of care regarding TB.”
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34
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Lívia Maria Almeida Coelho de Souza
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Access and dental care for pregnant women: a case study”
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Líder : DENISE DE LIMA COSTA FURLANETTO
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MIEMBROS DE LA BANCA :
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DENISE DE LIMA COSTA FURLANETTO
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ANA VALERIA MACHADO MENDONCA
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MARIA FATIMA DE SOUSA
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LUCIANA BENEVIDES FERREIRA
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Data: 18-dic-2023
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Resumen Espectáculo
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“Access to and oral care during pregnancy brings positive results for the pregnant woman and her baby, and therefore, oral health care should be incorporated as a routine during prenatal care. The present investigation proposed to analyze the access and dental care offered to pregnant women in Primary Health Care (PHC) in the municipality of Planaltina de Goiás, state of Goiás, as well as offering a guide to dental care for pregnant women aimed at oral health teams and managers of the aforementioned municipality. The research featured a qualitative-quantitative study design, in which, through observational, discursive and written records, a database was generated aiming to understand access and oral health care for women during pregnancy. To this end, field immersion techniques, semistructured interviews and document analysis were used to construct categories and content analysis aimed at oral health care for pregnant women. From the results found, it was observed that access to prenatal dental care should be routine in the Family Health Strategy, as it is a privileged space to promote oral health, developing pregnant women's awareness of responsibility for your health and that of your child. It was also noticed that the role of the dental surgeon in prenatal care is still deficient and surrounded by myths, fears and prejudices, both on the part of pregnant women and also among health professionals. Dental care during pregnancy must be carried out interdisciplinary. Adequate preparation of the dental surgeon, with regard to knowledge of systemic and oral changes related to pregnancy, in addition to the knowledge and use of care flows in health teams, has the potential to contribute to improving the oral health of women in gestational period and consequently refer to the achievement of goals in health indicators that are used as a tool to identify, monitor, evaluate actions and support the manager's decisions and finally, it is necessary to invest in permanent and continuing education of professionals involved in carrying out health actions, since the lack of dental care protocols generates divergent opinions among oral health professionals, insecurity during the performance of invasive procedures as well as the discontinuity of oral health care for pregnant women.”
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