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Avaliação de indicadores sociais e de saúde em municípios de Minas Gerais conforme tipologia rural-urbano
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Pereira, João Alves

; Damasceno, Renata Fiúza

; Vieira, Marta Raquel Mendes

; Paula, Alfredo Maurício Batista de

; Pinto, Rafaela da Silveira

; Leal, Daniele Lopes

; Haikal, Desirée Sant’Ana

Saúde em Debate

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2024, Volume 48 N. 140 elocation e8449

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT This article aims to evaluate social and health indicators of municipalities according to the rural-urban typology. This is an ecological study that used official publicly accessible data from the 853 municipalities in the state of Minas Gerais, Brazil. Descriptive and bivariate analysis were carried out using Poisson Regression and Kruskal-Wallis Test. 547 (64.12%) are rural municipalities. The highest average of the Municipal Human Development Index (MHDI) was observed among urban municipalities. The highest average coverage of the Family Health Strategy (FHS) was found among rural municipalities. In these municipalities, the best results were shown for the indicators of infant mortality, premature mortality and mortality from preventable causes, vaccine homogeneity and prevalence of malnutrition. The findings of this study show that greater FHS coverage is associated with the occurrence of better general living and health conditions in the populations served in rural municipalities. It is recommended that health managers encourage the consolidation of the FHS in communities with unfavorable socioeconomic and cultural contexts, such as remote rural locations and urban agglomerations, and the establishment of intersectoral actions with a positive impact on health.

RESUMO O presente artigo tem o objetivo de avaliar indicadores sociais e de saúde de municípios conforme a tipologia rural-urbano. Trata-se de estudo ecológico que utilizou dados oficiais de acesso público dos 853 municípios do estado de Minas Gerais, Brasil. Foram conduzidas análises descritivas e bivariadas através da Regressão de Poisson e Teste de Kruskal-Wallis. Do total de municípios, 547 (64,12%) são rurais. A maior média do Índice de Desenvolvimento Humano Municipal (IDH-M) foi observada entre os municípios urbanos. A maior média de cobertura da Estratégia Saúde da Família (ESF) foi verificada entre os municípios rurais, nos quais também foram demonstrados os melhores resultados para os indicadores de mortalidades infantil, prematura e por causas evitáveis, homogeneidade vacinal e prevalência de desnutrição. Os achados deste estudo evidenciam que uma maior cobertura da ESF está associada à ocorrência de melhores condições gerais de vida e de saúde das populações atendidas em municípios de tipologia rural. Recomenda-se aos gestores de saúde o fomento à consolidação da ESF em comunidades com contextos socioeconômicos e culturais desfavoráveis, como localidades rurais remotas e aglomerados urbanos, e o estabelecimento de ações intersetoriais com impacto positivo na saúde.

https://doi.org/10.1590/2358-289820241408449p

Overview of Chagas disease surveillance in an endemic region in Southeastern Brazil
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Rafael, Aline Ferreira

; Ferreira, Raquel Aparecida

; Mota, Ariela Ferreira

; Damasceno, Renata Fiúza

; Menezes, Agna Soares da Silva

; Lopes, Bartolomeu Teixeira

; Paulo, Gustavo Libério de

; Sabino, Ester Cerdeira

; Ribeiro, Antônio Luiz Pinho

; Quintino, Nayara Dornela

; Vieira, Thallyta Maria

Revista do Instituto de Medicina Tropical de São Paulo

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2023, Volume 65 elocation e51

Abstract: En | Text: En | PDF: En

ABSTRACT Chagas disease (CD) is a neglected disease caused by the protozoan Trypanosoma cruzi. It has high morbidity and mortality rates and mainly affects socially vulnerable populations. This is a cross-sectional study, with retrospective and prospective data collection. Using questionnaires applied to environmental surveillance coordinators, we characterized the status of CD surveillance activities in municipalities endemic for the disease in Northern Minas Gerais State (MG) and Jequitinhonha Valley (Vale do Jequitinhonha). Moreover, we spatialized the vulnerability index for chronic CD in the study area. The population consisted of 22 environmental surveillance coordinators, active in 2020, from Northern MG and Jequitinhonha Valley, 21 municipalities included in the SaMi-Trop research project, and Montes Claros municipality. After applying the questionnaires to the coordinators, a descriptive analysis of the variables was performed. To characterize the active municipalities, the explanatory variables collected in the questionnaire were compared with the dichotomous variable. Bivariate descriptive analysis was performed. Finally, geoprocessing techniques were used to spatialize the data and prepare maps. Regarding the team of endemic combat agents (ECA), 90.9% reported the lack of a specific team for CD vector control actions. Of the 22 municipalities participating in this study, nine were active (41.1%). Only 25% (n=2) of active municipalities (9% of the municipalities studied) met the target of visiting 50% of households per year. Finally, 81.1% of the coordinators stated that in their municipality, they developed actions linked to primary health care (PHC). The implementation of CD surveillance activities weakened in the endemic region. Few municipalities have a surveillance team, with low regularity of active surveillance and noncompliance with the program’s goal. The results suggest insufficient recording of activities in the information system, considering that there are municipalities that report performing the activities, but no production record was observed in the system.

https://doi.org/10.1590/s1678-9946202365051

Contextual influence on poor self-rated health in patients with Chagas disease: multilevel study
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Ferreira, Ariela Mota

; Sabino, Ester Cerdeira

; Silva, Léa Campos de Oliveira-da

; Oliveira, Cláudia Di Lorenzo

; Cardoso, Clareci Silva

; Ribeiro, Antonio Luiz Pinho

; Damasceno, Renata Fiúza

; Leite, Sâmara Fernandes

; Vieira, Thallyta Maria

; Nunes, Maria do Carmo Pereira

; Haikal, Desirée Sant’ Ana

Ciência & Saúde Coletiva

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2022, Volume 27 N. 7 Pages 2827 - 2842

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo A Doença de Chagas (DC) é reconhecida pela Organização Mundial da Saúde como uma das treze doenças tropicais mais negligenciadas do mundo. A autopercepção de saúde é considerada um melhor preditor de mortalidade do que medidas objetivas do estado de saúde, e o contexto em que se vive influencia esse preditor. O objetivo deste estudo foi avaliar a prevalência e os fatores individuais e contextuais associados à pior autopercepção em saúde de pacientes com DC de uma região endêmica do Brasil. É um estudo transversal multinível. Os dados individuais vêm de um corte transversal de um estudo de coorte denominado SaMi-Trop. Os dados contextuais foram coletados a partir de plataformas e sistemas de informações institucionais acessíveis ao público. A variável dependente foi a autopercepção de saúde. A análise foi realizada por meio de regressão logística binária multinível. Participaram do estudo 1.513 pacientes com DC, sendo 335 (22,1%) com pior autopercepção de saúde. Este estudo revelou a influência da organização/oferta do serviço público de saúde brasileiro e de características individuais na autopercepção de saúde de pacientes com DC.

Abstract Chagas disease (CD) is recognized by the World Health Organization as one of the thirteen most neglected tropical diseases in the world. Self-perceived health is considered a better predictor of mortality than objective measures of health status, and the context in which one lives influences this predictor. This study aimed to evaluate the prevalence and individual and contextual factors associated with poor self-rated health among CD patients from an endemic region in Brazil. It is a multilevel cross-sectional study. The individual data come from a cross-section of a cohort study named SaMi-Trop. Contextual data was collected from publicly accessible institutional information systems and platforms. The dependent variable was self-perceived health. The analysis was performed using multilevel binary logistic regression. The study included 1,513 patients with CD, where 335 (22.1%) had Poor self-rated health. This study revealed the influence of the organization/offer of the Brazilian public health service and of individual characteristics on the self-perceived health of patients with CD.

https://doi.org/10.1590/1413-81232022277.01682022

Contextual influence on poor self-rated health in patients with Chagas disease: multilevel study
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Ferreira, Ariela Mota

; Sabino, Ester Cerdeira

; Silva, Léa Campos de Oliveira-da

; Oliveira, Cláudia Di Lorenzo

; Cardoso, Clareci Silva

; Ribeiro, Antonio Luiz Pinho

; Damasceno, Renata Fiúza

; Leite, Sâmara Fernandes

; Vieira, Thallyta Maria

; Nunes, Maria do Carmo Pereira

; Haikal, Desirée Sant’ Ana

Ciência & Saúde Coletiva

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2022, Volume 27 N. 7 Pages 2827 - 2842

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232022277.01682022

Recommendations by the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and the Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) on vaccination in general and specifically against SARS-CoV-2 for patients with demyelinating diseases of the central nervous system
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Becker, Jefferson

; Ferreira, Lis Campos

; Damasceno, Alfredo

; Bichuetti, Denis Bernardi

; Christo, Paulo Pereira

; Callegaro, Dagoberto

; Peixoto, Marco Aurélio Lana

; Sousa, Nise Alessandra De Carvalho

; Almeida, Sérgio Monteiro De

; Adoni, Tarso

; Santiago-Amaral, Juliana

; Junqueira, Thiago

; Pereira, Samira Luisa Apóstolos

; Gomes, Ana Beatriz Ayroza Galvão Ribeiro

; Pitombeira, Milena

; Paolilo, Renata Barbosa

; Grzesiuk, Anderson Kuntz

; Piccolo, Ana Claudia

; D´Almeida, José Arthur Costa

; Gomes Neto, Antonio Pereira

; Oliveira, Augusto Cesar Penalva De

; Oliveira, Bianca Santos De

; Tauil, Carlos Bernardo

; Vasconcelos, Claudia Ferreira

; Kaimen-Maciel, Damacio

; Varela, Daniel

; Diniz, Denise Sisterolli

; Oliveira, Enedina Maria Lobato De

; Malfetano, Fabiola Rachid

; Borges, Fernando Elias

; Figueira, Fernando Faria Andrade

; Gondim, Francisco De Assis Aquino

; Passos, Giordani Rodrigues Dos

; Silva, Guilherme Diogo

; Olival, Guilherme Sciascia Do

; Santos, Gutemberg Augusto Cruz Dos

; Ruocco, Heloisa Helena

; Sato, Henry Koiti

; Soares Neto, Herval Ribeiro

; Cortoni Calia, Leandro

; Gonçalves, Marcus Vinícius Magno

; Vecino, Maria Cecilia Aragón De

; Pimentel, Maria Lucia Vellutini

; Ribeiro, Marlise De Castro

; Boaventura, Mateus

; Parolin, Mônica Koncke Fiuza

; Melo, Renata Brant De Souza

; Lázaro, Robson

; Thomaz, Rodrigo Barbosa

; Kleinpaul, Rodrigo

; Dias, Ronaldo Maciel

; Gomes, Sidney

; Lucatto, Simone Abrante

; Alves-Leon, Soniza Vieira

; Fukuda, Thiago

; Ribeiro, Taysa Alexandrino Gonsalves Jubé

; Winckler, Thereza Cristina D’ávila

; Fragoso, Yara Dadalti

; Nascimento, Osvaldo José Moreira Do

; Ferreira, Maria Lucia Brito

; Mendes, Maria Fernanda

; Brum, Doralina Guimarães

; Glehn, Felipe Von

Arquivos de Neuro-Psiquiatria

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nov 2021, Volume 79 N. 11 Pages 1049 - 1061

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O DC de Neuroimunologia da ABN e o BCTRIMS trazem, nesse documento, as recomendações sobre vacinação da população com doenças desmielinizantes do sistema nervoso central (SNC) contra infecções em geral e contra o coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), causador da COVID-19. Destaca-se a gravidade do atual momento frente ao avanço da COVID-19 em nosso País, o que torna mais evidente e importante a criação de guia de referência para orientação aos médicos, pacientes e autoridades de saúde pública quanto à vacinação, meio efetivo e seguro no controle de determinadas doenças infecciosa. O DCNI/ABN e o BCTRIMS recomendam que os pacientes com doenças desmielinizantes do SNC (ex., EM e NMOSD) sejam constantemente monitorados, quanto a atualização do seu calendário vacinal, especialmente, no início ou antes da mudança do tratamento com uma droga modificadora de doença (DMD). É importante também salientar que as vacinas são seguras e os médicos devem estimular o seu uso em todos os pacientes. Evidentemente, deve ser dada especial atenção às vacinas com vírus vivos atenuados. Por fim, é importante que os médicos verifiquem qual DMD o paciente está em uso e quando foi feita a sua última dose, pois cada fármaco pode interagir de forma diferente com a indução da resposta imune.

ABSTRACT The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.

https://doi.org/10.1590/0004-282x-anp-2021-0162 1 downloads

Serological screening for Chagas disease in an endemic region of Northern Minas Gerais, Brazil: the SaMi-Trop project
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Cruz, Dardiane Santos

; Souza, Núbia Nunes de

; Rafael, Aline Ferreira

; Damasceno, Renata Fiuza

; Ribeiro, Antonio Luiz Pinho

; Oliveira, Léa Campos de

; Sabino, Ester Cerdeira

; Ghilardi, Fábio de Rose

; Cruz Neto, Ozorino Caldeira

; Ferreira, Ariela Mota

; Haikal, Desirée Sant’Ana

; Cardoso, Clareci Silva

; Oliveira, Claudia Di Lorenzo

; Bierrenbach, Ana Luiza

; Vieira, Thallyta Maria

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e67

Abstract: En | Text: En | PDF: En

ABSTRACT Chagas disease (CD) is still a neglected disease. Infected individuals are diagnosed late, being treated in worse clinical conditions. Thus, this study aimed to analyze the prevalence and the factors associated with new confirmed cases of CD identified by serological screening in an endemic region of Minas Gerais State, Brazil. This is an analytical cross-sectional study with data from a project of the Research Center in Tropical Medicine of Sao Paulo- Minas Gerais (SaMi-Trop) conducted in two municipalities. Data collection included a questionnaire with closed questions, a venous blood collection and an ELISA serological test for CD. A total of 2,038 individuals with no previous diagnosis of CD participated in the study. The result of the serological test for CD was adopted as the dependent variable. The independent variables addressed personal issues, health conditions and lifetime housing. A descriptive analysis of individual variables was performed. Subsequently, a bivariate analysis was performed using the Pearson’s chi-square test. Households sheltering individuals positive for CD were georeferenced, and the analysis of spatial distribution was performed using the quartic function to estimate the density of the nucleus. Among the participants, 188 (9.2 %) were positive for CD. The profile of participants with CD was associated with place of residence, age, relative/family member with CD and living conditions. It is noteworthy that there are still patients with CD who are unaware of their diagnosis in both, rural and urban areas.

https://doi.org/10.1590/s1678-9946202163067 113 downloads

Salário de médicos contratados da Estratégia Saúde da Família e contexto municipal: estudo ecológico
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Pereira, João Alves

; Damasceno, Renata Fiúza

; Vieira, Marta Raquel Mendes

; Paula, Alfredo Maurício Batista de

; Haikal, Desirée Sant’Ana

Saúde em Debate

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sep 2020, Volume 44 N. 126 Pages 624 - 639

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O salário é um importante fator de atração, fixação e satisfação de profissionais médicos na Atenção Primária à Saúde (APS), sobretudo nas regiões mais remotas ou carentes. Este estudo tem o objetivo de identificar características contextuais municipais que estejam associadas ao valor do salário pago a médicos contratados da Estratégia Saúde da Família (ESF). Realizou-se um estudo ecológico e transversal com 78 municípios da Macrorregião de Saúde Norte, Minas Gerais, Brasil. A variável dependente referiu-se ao valor pago aos médicos contratados da ESF. Foram consideradas 22 variáveis independentes contextuais incluindo características sociodemográficas, de localização e indicadores assistenciais e de saúde de cada município, coletados de bases de dados oficiais. Conduziu-se Regressão Linear Múltipla. A média salarial encontrada foi de R$11.188,61 (±R$2.093,71), variando de R$6.388,20 até R$17.000,00. Após ajuste do modelo, somente a Distância ao Centro Regional manteve-se positivamente associada ao desfecho (R2=6,4%). O salário dos médicos não foi determinado por características municipais contextuais mensuráveis. Outros fatores mais subjetivos, de difícil mensuração, podem estar envolvidos na questão. Observa-se a necessidade do estabelecimento de parâmetros claros para definição do valor do salário de médicos contratados para atuação na ESF.

ABSTRACT Salary is an important factor of attraction, fixation and satisfaction of physicians in Primary Health Care (PHC), mainly in the most remote or poor regions. This study aims to identify characteristics related to municipalities that are associated to salaries paid to physicians hired from the Family Health Strategy (FHS) Program. An ecological and cross-sectional study was conducted with 78 municipalities of the Northern Health Macro-region of Minas Gerais State, Brazil. The dependent variable referred to the amount paid to the physicians hired from FHS. Twenty-two contextual independent variables were applied, including sociodemographic characteristics, location and health and care indicators of each municipality, all collected from public databases. Multiple Linear Regression was conducted. The outcome average salary was R$11,188.61 (±R$2,093.71), ranging from R$6,388.20 to R$17,000.00. After adjusting the model, only the variable ‘Distance from Regional Center’ remained positively associated to the outcome (R2=6.4%). The conclusion is that the salaries of physicians were not determined by measurable contextual municipal characteristics. Other more subjective and difficult to measure factors may be involved in the issue. Therefore, there is need to establish clear parameters so to define the salaries of physicians hired to work for FHS.

https://doi.org/10.1590/0103-1104202012603

Salário de médicos contratados da Estratégia Saúde da Família e contexto municipal: estudo ecológico
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Pereira, João Alves

; Damasceno, Renata Fiúza

; Vieira, Marta Raquel Mendes

; Paula, Alfredo Maurício Batista de

; Haikal, Desirée Sant’Ana

Saúde em Debate

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sep 2020, Volume 44 N. 126 Pages 624 - 639

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/0103-1104202012603 1101 downloads

Reações adversas ao benzonidazol no tratamento da Doença de Chagas: revisão sistemática de ensaios clínicos randomizados e controlados
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Ferreira, Ariela Mota

; Damasceno, Renata Fiúza

; Monteiro-Junior, Renato Sobral

; Oliveira, Igor Antônio Costa de

; Prates, Thalita Emily Cezário

; Nunes, Maria Carmo Pereira

; Haikal, Desirée Sant’Ana

Cadernos Saúde Coletiva

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sep 2019, Volume 27 N. 3 Pages 354 - 362

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução No Brasil, a única droga disponível para o tratamento específico do Trypanosoma cruzi, causador da Doença de Chagas (DC) é o Benzonidazol (BZN), cujas reações adversas podem propiciar a interrupção do tratamento. Objetivo O objetivo desse trabalho é quantificar a proporção de ocorrência de efeitos adversos, descrevê-los e identificar os fatores de risco associados à essa ocorrência. Método Revisão sistemática conduzida de acordo com os padrões estabelecidos pelo Preferred Reporting Items is Systematic Reviews and Metanalyses (PRISMA). Incluíram-se somente ensaios clínicos randomizados controlados. Resultados Dos 134 estudos identificados, cinco foram incluídos. O tamanho da amostra variou de 77 a 2854 pessoas, e a faixa etária dos participantes, variou de zero a 75 anos. Todos os estudos incluídos apontaram reações adversas ao uso do BZN. A frequência de reação adversa chegou a 38% e a mais comum foi o rash cutâneo. O abandono do tratamento devido à reação foi citado em três estudos, variando de 6,4% a 13,4%. Conclusão As reações adversas ao uso do BZN variaram de acordo com a idade do paciente e esquema terapêutico de dose e tempo adotado, sendo o conhecimento médico acerca dessas reações imprescindível para seu uso seguro e adesão ao tratamento.

Abstract Background In Brazil, the only drug available for the treatment of Trypanosoma cruzi, which causes Chagas' Disease (CD), is the Benznidazole (BZN) whose the adverse reactions might lead to treatment dropout. Objective The objective of this study is to quantify the proportion of occurrence of adverse effects, to describe them and to identify the risk factors associated with this occurrence. Method This is a systematic review conducted through the standards established by the Preferred Reporting Items in Systematic Reviews and Metanalyses (PRISMA). Only randomized controlled trials were included. Results Five of 134 studies were included. The sample size ranged from 77 to 2854 people, and the age range of the participants ranged from zero to 75 years old. All included studies reported adverse reactions to BZN use. The frequency of adverse reaction was 38% and the most common reaction was the skin rash. The treatment dropout caused by the adverse reactions was cited in three studies and was ranging from 6.4% to 13.4%. Conclusion The adverse reactions caused by the use of BZN varied with the age of patients and the therapeutic scheme of dose and time adopted. Therefore, medical knowledge is imperative for the safe use of BZN and adherence to treatment.

https://doi.org/10.1590/1414-462x201900030456 2418 downloads

10.

Recursos Humanos e Estratégia Saúde da Família no norte de Minas Gerais: avanços e desafios
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Barbosa, Ludmila Gonçalves

; Damasceno, Renata Fiúza

; Silveira, Denise Maria Mendes Lúcio da

; Costa, Simone de Melo

; Leite, Maisa Tavares de Souza

Cadernos Saúde Coletiva

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sep 2019, Volume 27 N. 3 Pages 287 - 294

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução O sistema público de saúde apresenta desafios à área de recursos humanos. Objetivo Avaliar os avanços e desafios na gestão dos recursos humanos inseridos na Estratégia Saúde da Família (ESF) no norte de Minas Gerais, Brasil. Método Estudo transversal com 317 profissionais vinculados à ESF: cirurgiões-dentistas, enfermeiros e médicos. Para a coleta de dados, utilizou-se questionário com variáveis sociodemográficas, econômicas, vínculo empregatício, plano de carreira, educação permanente e continuada e incentivo financeiro. Avaliou-se a remuneração conforme o sexo, o plano de carreira e a categoria profissional; a categoria profissional conforme o sexo, o plano de carreira e a educação permanente; nível de significância: p < 0,05. Resultados A maioria era mulheres (65,2%), enfermeiros (46,3%), pós-graduados (51,1%), com vínculo por contrato administrativo (67,4%), sem plano de carreira (90,8%) e incentivos financeiros (61,1%) e participava de educação permanente (57,8%). Mais de 40% trabalharam na ESF de outro município e 117 concluíram especialização em ESF/saúde pública/coletiva. Maior remuneração encontrou-se na medicina (p < 0,05) e com homens (p < 0,05). Enfermagem apresentou maior percentual de mulheres, de profissionais com plano de carreira e educação permanente (p < 0,05). Conclusão Avanços se destacam na qualificação profissional, especialistas na área e/ou capacitação em serviço. Há desafios quanto à precarização do trabalho, o que contribui para a rotatividade dos profissionais.

Abstract Background The public health system presents challenges for human resources. Objective To evaluate the advances and challenges in the management of human resources included in the Family Health Strategy - FHS in northern Minas Gerais, Brazil. Method A cross-sectional study with 317 professionals linked to the FHS: dentists, nurses and doctors was carried out. For data collection, it was used a questionnaire with variables: sociodemographic and economic characteristics, employment relationship, career path, permanent and continuing education, and financial incentive. It was also evaluated the remuneration according to gender, career plan and professional category; and professional category according to gender, career plan and permanent education; significance level p <0.05. Results The most were women (65.2%), nurses (46.3%), postgraduates (51.1%), bond by administrative contract (67.4%), no career plan (90.8%) and financial incentives (61.1%) and participated in permanent education (57.8%). More than 40% worked in the FHS of another municipality and 117 completed specialization in FHS / public / collective health. The higher remuneration was for medicine (p <0.05) and for men (p <0.05). Nursing presented higher percentage of women, of professionals with career plan and permanent education (p <0.05). Conclusion Advances stand out in professional qualification, specialists and / or capacitation in service. There are challenges concerning to the precariousness conditions of work, which contributes to the turnover of professionals.

https://doi.org/10.1590/1414-462x201900030084 1532 downloads

11.

Fatores associados à não utilização da teleconsultoria por médicos da Estratégia Saúde da Família
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Damasceno, Renata Fiúza

; Caldeira, Antônio Prates

Ciência & Saúde Coletiva

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aug 2019, Volume 24 N. 8 Pages 3089 - 3098

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Este estudo objetivou avaliar a frequência e os fatores associados à não utilização do serviço de teleconsultoria por médicos que atuam na Estratégia Saúde da Família (ESF) no Norte de Minas Gerais. Trata-se de um estudo transversal que utilizou questionário autoaplicado, previamente testado. A análise de regressão de Poisson com variância robusta foi empregada após análises bivariadas para identificação dos fatores associados à não utilização do serviço de teleconsultoria. Participaram do estudo 385 médicos de 73 municípios. A frequência de não utilização do serviço de teleconsultoria pelos médicos da ESF foi de 55,8%. Foram identificadas como variáveis associadas após análise múltipla a indisponibilidade de computador com internet na Unidade Básica de Saúde (UBS) para uso do profissional médico (p = 0,001; RP = 1,10; IC95%: 1,04-1,17), a falta de informação sobre o serviço (p < 0,001; RP = 1,47; IC95%: 1,38-1,56) e a falta de treinamento para uso da teleconsultoria (p < 0,001; RP = 1,15; IC95%: 1,08-1,24). Os resultados reforçam que a infraestrutura de informática das UBS, a divulgação do serviço e a oferta de treinamento devem direcionar as estratégias para implementação, difusão e melhoria da qualidade do serviço de teleconsultoria na atenção primária.

Abstract This study sought to evaluate the frequency and factors associated with non-use of telehealth consultancy by physicians who work in the Family Health Strategy (FHS) in the North of the State of Minas Gerais. It is a cross-sectional study that used a previously-tested self-administered questionnaire. Poisson regression analysis with robust variance was used after bivariate analysis to identify the factors associated with non-use of telehealth consultancy. A total of 385 physicians from 73 municipalities participated in the study. The frequency of non-use of telehealth consultancy by physicians in the FHS was 55.8%. After multiple analysis, the following variables were identified: the lack of availability of computers and Internet access in the Basic Health Units (BHU) for medical professionals (p = 0.001; PR = 1.10; 95% CI: 1.04-1.17), the lack of information about telehealth consultancy (p< 0.001; PR = 1.47; 95% CI: 1.38-1.56) and lack of training in telehealth consultancy (p < 0.001; PR = 1.15; 95% CI: 1.08-1.24). The results support that the informatics infrastructure of the BHU, the dissemination of the service and the training should orient the strategies for implementation, diffusion and improvement of the quality of telehealth consultancy services in primary health care.

https://doi.org/10.1590/1413-81232018248.28752017

12.

Fatores associados à não utilização da teleconsultoria por médicos da Estratégia Saúde da Família
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Damasceno, Renata Fiúza

; Caldeira, Antônio Prates

Ciência & Saúde Coletiva

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aug 2019, Volume 24 N. 8 Pages 3089 - 3098

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232018248.28752017 1871 downloads

13.

Brazilian Consensus for the Treatment of Multiple Sclerosis: Brazilian Academy of Neurology and Brazilian Committee on Treatment and Research in Multiple Sclerosis
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Marques, Vanessa Daccach

; Passos, Giordani Rodrigues dos

; Mendes, Maria Fernanda

; Callegaro, Dagoberto

; Lana-Peixoto, Marco Aurélio

; Comini-Frota, Elizabeth Regina

; Vasconcelos, Cláudia Cristina Ferreira

; Sato, Douglas Kazutoshi

; Ferreira, Maria Lúcia Brito

; Parolin, Mônica Koncke Fiuza

; Damasceno, Alfredo

; Grzesiuk, Anderson Kuntz

; Muniz, André

; Matta, André Palma da Cunha

; Oliveira, Bianca Etelvina Santos de

; Tauil, Carlos Bernardo

; Maciel, Damacio Ramón Kaimen

; Diniz, Denise Sisteroli

; Corrêa, Eber Castro

; Coronetti, Fernando

; Jorge, Frederico M. H.

; Sato, Henry Koiti

; Gonçalves, Marcus Vinícius Magno

; Sousa, Nise Alessandra de C.

; Nascimento, Osvaldo J. M.

; Gama, Paulo Diniz da

; Domingues, Renan

; Simm, Renata Faria

; Thomaz, Rodrigo Barbosa

; Morales, Rogério de Rizo

; Dias, Ronaldo Maciel

; Apóstolos-Pereira, Samira dos

; Machado, Suzana Costa Nunes

; Junqueira, Thiago de Faria

; Becker, Jefferson

Arquivos de Neuro-Psiquiatria

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aug 2018, Volume 76 N. 8 Pages 539 - 554

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O crescent arsenal terapêutico na esclerose múltipla (EM) tem permitido tratamentos mais efetivos e personalizados, mas a escolha e o manejo das terapias modificadoras da doença (TMDs) tem se tornado cada vez mais complexos. Neste contexto, especialistas do Comitê Brasileiro de Tratamento e Pesquisa em Esclerose Múltipla e do Departamento Científico de Neuroimunologia da Academia Brasileira de Neurologia reuniram-se para estabelecer este Consenso Brasileiro para o Tratamento da EM, baseados no entendimento de que neurologistas devem ter a possibilidade de prescrever TMDs para EM de acordo com o que é melhor para cada paciente, com base em evidências e práticas atualizadas. Por meio deste documento, propomos recomendações práticas para o tratamento da EM, com foco principal na escolha e no manejo das TMDs, e revisamos os argumentos que embasam as estratégias de tratamento na EM.

ABSTRACT The expanding therapeutic arsenal in multiple sclerosis (MS) has allowed for more effective and personalized treatment, but the choice and management of disease-modifying therapies (DMTs) is becoming increasingly complex. In this context, experts from the Brazilian Committee on Treatment and Research in Multiple Sclerosis and the Neuroimmunology Scientific Department of the Brazilian Academy of Neurology have convened to establish this Brazilian Consensus for the Treatment of MS, based on their understanding that neurologists should be able to prescribe MS DMTs according to what is better for each patient, based on up-to-date evidence and practice. We herein propose practical recommendations for the treatment of MS, with the main focus on the choice and management of DMTs, as well as present a review of the scientific rationale supporting therapeutic strategies in MS.

https://doi.org/10.1590/0004-282x20180078 8891 downloads

14.

O programa de educação tutorial - pet - sob a ótica dos iniciantes
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Damasceno, Renata Fiúza

; Brunório, Ludimila

; Andrade, Maria Betânia Tinti de

Reme: Revista Mineira de Enfermagem

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apr 2006, Volume 10 N. 2 Pages 160 - 165

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

This is a qualitative study from a phenomenological point of view with the objective of understanding the meaning of the Tutorial Education Program as the students see it. There were eight participants from the courses of Nursing and Dentistry from the Federal University of Alfenas, State of Minas Gerais (UNIFAL-MG) who joined the program in 2004. We found that, for the students, to participate in the program meant wide academic qualification, fulfillment of an objective, expectations on future professional qualification and the importance of the scholarship in order to carry out extracurricular activities

Se trata de un estudio de carácter cualitativo en la vertiente fenomenológica cuyo objetivo es comprender el significado de la inclusión de becarios en el Programa de Educación Tutorial - PET desde la perspectiva de los becarios iniciantes. Participaron de este estudio ocho alumnos de los cursos de Enfermería y Odontología de la Universidad Federal de Alfenas - MG que ingresaron en el PET en 2004. Según los resultados estar incluido en el PET significa recibir amplia formación académica, alcanzar un objetivo, tener expectativas para la formación profesional futura y la importancia de la beca para las actividades extracurriculares

Trata-se de um estudo qualitativo, na vertente fenomenológica, que teve como objetivo compreender o significado de estar no Programa de Educação Tutorial - PET na perspectiva de bolsistas iniciantes. Participaram deste estudo oito sujeitos dos cursos de Enfermagem e Odontologia da Universidade Federal de Alfenas (UNIFAL-MG), que ingressaram no PET no ano de 2004. Revelou-se que estar no PET significa ter acesso a uma ampla formação acadêmica; realização de um objetivo; expectativas para formação profissional futura e importância da bolsa do PET para a realização de atividades extracurriculares

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