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Abstract Background Controlling blood pressure and glycemic levels is a challenge that requires innovative solutions. Objective To assess the feasibility of implementing a text message intervention among low-income primary care patients, as well as to assess self-reported behavioral change. Methods A set of 200 text messages was developed on healthy eating, physical activity, adherence, and motivation. Participants from Vale do Mucuri, MG, Brazil diagnosed with diabetes or hypertension or undergoing screening for those diseases, received 5 to 8 messages per week for 6 months. They answered a questionnaire to report their satisfaction and behavioral changes. Results Of the 136 patients, 117 (86.0%) answered the questionnaire. Most reported that the messages were very useful (86.3%), easy to understand (90.6%), and were very helpful for behavioral change (65.0%); 84.6% reported that they had started eating healthier. The most frequent reported lifestyle changes were: improved diet quality (85.5%), reduced portions (65.8%), and weight loss (56.4%). The majority of patients shared the messages (60.7%) with family or other acquaintances, considered the number of messages to be adequate (89.7%) and would recommend the program to others (95.7%). Conclusion An intervention based on text messages to promote behavioral change in patients with hypertension or diabetes in primary care is feasible in low-resource settings. Future studies are needed to assess the program’s long-term effects on clinical outcomes.

https://doi.org/10.36660/ijcs.20220050

Implications for Clinical Practice from a Multicenter Survey of Heart Failure Management Centers
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Bocchi, Edimar Alcides

; Moreira, Henrique Turin

; Nakamuta, Juliana Sanajotti

; Simões, Marcus Vinicius

; Casas, Alberto de Almeida Las

; Costa, Altamiro Reis da

; Assis, Amberson Vieira de

; Durães, André Rodrigues

; Pereira-Barretto, Antonio Carlos

; Ravessa, Antonio Delduque de Araujo

; Macedo, Ariane Vieira Scarlatelli

; Biselli, Bruno

; Pinto, Carolina Maria Nogueira

; Filho, Conrado Roberto Hoffmann

; Costantini, Costantino Roberto

; Almeida, Dirceu Rodrigues

; Santos Jr, Edval Gomes dos

; Soliva Junior, Erwin

; Figueiredo, Estevão Lanna

; Albuquerque, Felipe Neves de

; Paulitsch, Felipe

; Neuenschwander, Fernando Carvalho

; Figueiredo Neto, José Albuquerque de

; Brito, Flavio de Souza

; Lopes, Heno Ferreira

; Villacorta, Humberto

; Souza Neto, João David de

; Sepulveda, João Mariano

; Ayoub, José Carlos Aidar

; Vilela-Martin, José F.

; Cardoso, Juliano Novaes

; Uemura, Laercio

; Moura, Lidia Zytynski

; Maia, Lilia Nigro

; Oliveira, Lucia Brandão de

; Maia, Lucimir

; Silva, Luís Beck da

; Gowdak, Luís Henrique Wolff

; Danzmann, Luiz Claudio

; Andrade, Marcus

; Braile-Sternieri, Maria Christiane Valeria Braga

; Moreira, Maria da Consolação Vieira

; França Neto, Olimpio R

; Filho, Otavio Rizzi Coelho

; Esteves, Paulo Frederico

; Raupp-da-Rosa, Priscila

; Silva, Ricardo Jorge de Queiroz e

; Mourilhe-Rocha, Ricardo

; Viégas, Ruy Felipe Melo

; Rassi, Salvador

; Mangili, Sandrigo

; Kaiser, Sergio Emanuel

; Martins, Silvia Marinho

; Kawabata, Vitor Sergio

Clinics

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2021, Volume 76 elocation e1991

Abstract: En | Text: En | PDF: En

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

https://doi.org/10.6061/clinics/2021/e1991

Current uses of intracranial vessel wall imaging for clinical practice: a high-resolution MR technique recently available
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PACHECO, Felipe Torres

; CRUZ JUNIOR, Luiz Celso Hygino da

; PADILHA, Igor Gomes

; NUNES, Renato Hoffmann

; MAIA JUNIOR, Antônio Carlos Martins

; CAMPOS, Christiane Monteiro Siqueira

; AMARAL, Lázaro Luís Faria do

; MASSARO, Ayrton Roberto

; ROCHA, Antônio José da

Arquivos de Neuro-Psiquiatria

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oct 2020, Volume 78 N. 10 Pages 642 - 650

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

RESUMO O estudo angiográfico intracraniano não invasivo está sendo amplamente utilizado no diagnóstico de doenças vasculares intracranianas. Com a crescente demanda e o aumento subsequente do uso dessa técnica na prática clínica, radiologistas e neurologistas devem estar cientes das opções nos parâmetros de imagem e como estes afetam a qualidade da imagem, as indicações clínicas, os métodos de avaliação e as limitações na interpretação dessas imagens. Devido ao aprimoramento das técnicas de imagem por RM, a possibilidade de avaliação precisa e direta das anormalidades na parede vascular arterial (vessel wall imaging) evoluiu, agregando dados substanciais ao diagnóstico quando comparados à avaliação indireta baseada em análises de fluxo convencionais. Neste artigo, os autores discorrem sobre a avaliação e interpretação dos achados de imagem desta nova técnica e suas aplicações clínicas.

ABSTRACT Intracranial vessel wall imaging plays an increasing role in diagnosing intracranial vascular diseases. With the growing demand and subsequent increased use of this technique in clinical practice, radiologists and neurologists should be aware of the choices in imaging parameters and how they affect image quality, clinical indications, methods of assessment, and limitations in the interpretation of these images. Due to the improvement of the MRI techniques, the possibility of accurate and direct evaluation of the abnormalities in the arterial vascular wall (vessel wall imaging) has evolved, adding substantial data to diagnosis when compared to the indirect evaluation based on conventional flow analyses. Herein, the authors proposed a comprehensive approach of this technique reinforcing appropriated clinical settings to better use intracranial vessel wall imaging.

https://doi.org/10.1590/0004-282x20200044

Diagnosis of pulmonary tuberculosis in children and adolescents: comparison of two versions of the Brazilian Ministry of Health scoring system
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Carvalho, Roberta Feijó

; Carvalho, Anna Cristina Calçada

; Velarde, Luis Guillermo Coca

; Rossoni, Andrea Maciel de Oliveira

; Aurilio, Rafaela Baroni

; Sias, Selma Maria de Azevedo

; Schmidt, Christiane Mello

; Moreira, Adriana da Silva Rezende

; Martins, Pedro da Silva

; Gonçalves, Lorrayne Isidoro

; Martire, Terezinha Miceli

; Barbosa, Ana Paula Ferreira

; Santos, Ana Paula Quintanilha dos

; Romanelli, Roberta Maia de Castro

; Oliveira, Maria das Graças Rodrigues de

; Diniz, Lilian Martins Oliveira

; Carvalho, Andrea Lucchesi de

; Lucena, Sheila Cunha

; Cruz, Maria Letícia Santos

; Saavedra, Mariza Curto

; Tahan, Tony Tannous

; Rodrigues, Cristina de Oliveira

; Kritski, Afrânio Lineu

; Sant’Anna, Clemax Couto

; Cardoso, Claudete Aparecida Araújo

; Sant’Anna, Maria de Fátima Bazhuni Pombo

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e81

Abstract: En | Text: En | PDF: En

ABSTRACT The aim of this study was to evaluate the concordance between two versions of the scoring system (2011 and 2019), recommended by the Brazilian Ministry of Health, for the diagnosis of pulmonary tuberculosis (PTB) in children and adolescents. A retrospective descriptive study was performed to assess the medical records of children and adolescents with PTB, in TB units from Brazilian cities located in Rio de Janeiro, Minas Gerais, and Parana States, from January 1 st , 2004, to December 1 st , 2018. Patients aged 0 to 18 years old with a diagnosis of PTB were included. The comparison between the two scoring systems showed a moderate concordance according to the κ coefficient value = 0.625. Fourteen patients showed a reduction in the TB score, going from 30 points in the 2011, to 25 points or less in the 2019 one. Seventy one percent of these 14 patients had radiological changes suggestive of PTB and 86% had tuberculin skin tests greater than 10 mm. The study concluded that a moderate agreement was observed between the 2011 and 2019 scoring systems, with an increase in the number of patients scoring 25 points or less in 2019, which can eventually hinder the diagnosis of PTB.

https://doi.org/10.1590/s1678-9946202062081

Pandemia de coronavírus (COVID-19): o que os fonoaudiólogos devem saber
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Freitas, Andressa Silva

; Zica, Guilherme Maia

; Albuquerque, Christiane Lopes de

CoDAS

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2020, Volume 32 N. 3 elocation e20200073

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

https://doi.org/10.1590/2317-1782/20192020073 45269 downloads

Notificações de eventos adversos relacionados com a assistência à saúde que levaram a óbitos no Brasil, 2014-2016
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Maia, Christiane Santiago

; Freitas, Daniel Roberto Coradi de

; Gallo, Luciana Guerra

; Araújo, Wildo Navegantes de

Epidemiologia e Serviços de Saúde

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2018, Volume 27 N. 2 elocation e2017320

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

Resumo Objetivo: descrever os eventos adversos relacionados com a assistência à saúde resultantes em óbito. Métodos: estudo descritivo das notificações registradas no Sistema de Notificações para a Vigilância Sanitária (Notivisa) no Brasil, de junho/2014 a junho/2016; notificações registradas como ‘outros’ em ‘tipo de incidente’ foram reclassificadas. Resultados: foram registrados 417 óbitos, a maioria em adultos e idosos (85%), sem diferenças entre sexos; os estados de São Paulo (N=92), Paraná (N=75) e Minas Gerais (N=66) foram os maiores notificadores; os hospitais contribuíram com 97% dos registros, com concentração nos setores ‘terapia intensiva’ e ‘internação’; houve investigação pela unidade notificadora em 5% das notificações; na reclassificação do tipo de incidente, recuperaram-se 52 registros; o tipo de incidente mais comum foi ‘falhas durante a assistência à saúde’ (50%). Conclusão: notificações resultantes em óbito ocorreram principalmente em hospitais; foram identificadas falhas no registro e necessidade de investigação de grande proporção dos óbitos.

Abstract Objective: to describe the adverse events related to health care resulting in death. Methods: a descriptive study of reports recorded in the Brazilian Health Surveillance Notification System (Notivisa) in Brazil from Jun 2014 to Jun 2016; notifications recorded as 'other' in the 'incident type' were recoded. Results: 417 cases were recorded, mostly in adults and the elderly (85%), with no sex differences; the states of São Paulo (N=92), Paraná (N=75) and Minas Gerais (N=66) were the main reporter; hospitals contributed to 97% of the records, principally in the intensive care and hospitalization sectors; the investigation by the notifying unit occurred in 5% of cases; in the recode of the type of incident, 52 records were recovered; the most common type of incident was 'failures during health care' (50%). Conclusion: notifications resulting in death occurred mainly in hospitals; were identified failure to register and need to investigate the large proportion of deaths.

Resumen Objetivo: describir los eventos adversos relacionados con la asistencia sanitaria que resultaran en muerte. Métodos: estudio descriptivo de las notificaciones registradas en el Sistema de Notificaciones para la Vigilancia Sanitaria (Notivisa) en Brasil entre junio/2014-junio/2016; las notificaciones registradas como ‘otros’ en la variable ‘tipo de incidente’ fueron reclasificadas. Resultados: se registraron 417 casos, la mayoría en adultos y ancianos (85%), sin predominio de sexo; los estados de São Paulo (N=92), Paraná (N=75) y Minas Gerais (N=66) fueron los mayores notificantes; los hospitales contribuyeron con el 97% de los registros; la investigación por la unidad notificante se produjo en el 5% de los casos; en la reclasificación, se recuperaron 52 registros; el tipo de incidente más común fue ‘fallas durante la asistencia sanitaria’ (50%). Conclusión: las notificaciones de eventos resultantes de la muerte son principalmente de hospitales; se identificaron fallas en el registro y necesidad de más investigación de las muertes.

https://doi.org/10.5123/s1679-49742018000200004 66 downloads

Notificações de eventos adversos relacionados com a assistência à saúde que levaram a óbitos no Brasil, 2014-2016
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Maia, Christiane Santiago

; Freitas, Daniel Roberto Coradi de

; Gallo, Luciana Guerra

; Araújo, Wildo Navegantes de

Epidemiologia e Serviços de Saúde

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2018, Volume 27 N. 2 elocation e2017320

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

https://doi.org/10.5123/s1679-49742018000200004 10815 downloads

Quality of Life, Depression, Anxiety and Coping Strategies after Heart Transplantation
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Trevizan, Fulvio Bergamo

; Miyazaki, Maria Cristina de Oliveira Santos

; Silva, Yasmin Lima Witzel

; Roque, Christiane Maia Waetman

Brazilian Journal of Cardiovascular Surgery

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jun 2017, Volume 32 N. 3 Pages 162 - 170

Abstract: En | Text: En | PDF: En

Abstract Introduction: Heart transplantation is the therapeutic procedure indicated to increase the survival of patients with refractory heart failure. Improvement in overall functioning and quality of life are expected factors in the postoperative period. Objective: To identify and evaluate mental disorders and symptoms, such as depression and anxiety, quality of life and coping strategies in the post-surgical situation of heart transplantation. Methods: A cross-sectional, quantitative study with patients who have undergone heart transplantation. Participants answered to the Sociodemographic Questionnaire, Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), MINI International Neuropsychiatric Interview, Escala Modos de Enfrentamento de Problemas (Ways of Coping Scale) (EMEP) and World Health Organization Quality of Life-BREF (WHOQOL-BREF). For data analysis, the significance level was considered P≤0.05. Results: A total of 33 patients participated in the study. The BDI-II results indicated that 91% (n=30) of the patients presented a minimal level. In BAI, 94% (n=31) of the patients demonstrated minimal level of anxiety symptoms. WHOQOL-BREF showed a perception of quality of life considered good in all domains. The EMEP data have registered a problem-focused coping strategy. According to MINI, a single case of major depressive episode, current and recurrent was recorded. Conclusion: Although most participants in the sample had symptoms of depression and anxiety, only one patient was identified with moderate symptoms in both domains. The most used strategy was coping focused on the problem. Patients have classified the perceptions of quality of life as 'good', pointing out satisfaction with their health.

https://doi.org/10.21470/1678-9741-2017-0029 1955 downloads

Fatores associados à percepção e atitude de consumidores de carne bovina com certificação de origem em Uberlândia, Minas Gerais
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Lopes, Marcos Aurélio

; Maia, Érica Mariz

; Bruhn, Fábio Raphael Pascoti

; Custódio, Izadora Alvarenga

; Rocha, Christiane Maria Barcellos Magalhães da

; Faria, Peter Bittencout

Revista Ceres

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feb 2017, Volume 64 N. 1 Pages 31 - 39

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

RESUMO O objetivo deste estudo foi verificar os fatores socioeconômicos relacionados com a decisão de compra de carne com certificação de origem, além de levantar os perfis de percepção e de atitude dos consumidores de carne bovina, em Uberlândia, MG. Foi realizada a descrição das variáveis e construído um modelo múltiplo Generalized Estimating Equations (GEE) de regressão logística, para testar as possíveis associações entre as características socioeconômicas dos consumidores e os principais atributos da carne que influenciam a decisão sobre sua compra. As informações foram levantadas por meio de entrevistas com 213 consumidores, de abril a maio de 2012. A presença do carimbo do serviço de inspeção federal (SIF) ou estadual é o atributo que mais influencia a decisão de compra dos consumidores. A maioria dos entrevistados já ouviu falar sobre rastreabilidade bovina. Dentre estes, a maior parte está disposta a pagar mais pela carne com certificação de origem. Apesar disso, muitos consideram que o aumento do preço da carne é uma desvantagem da rastreabilidade. Consumidores com maior grau de escolaridade e renda apresentaram melhor conhecimento sobre este tipo de certificação, sendo esses fatores os de grande influência sobre a aceitação dos consumidores em pagar mais caro pela carne bovina rastreada.

ABSTRACT The aim of this study was to verify which socioeconomic factors are related to the decision to purchase meat with certification of origin, as well as raising the profile of perception and attitude of consumers of beef in Uberlândia/MG. We performed a description of the variables and built Generalized Estimating Equations (GEE) logistic regression model to identify possible associations between the partner-economic characteristics of the consumers and the main attributes of the meat that influence the decision for its purchase. The information had been raised by interviews with 213 consumers of April the May of 2012. The presence of the seal from the Federal Inspection Service (S.I.F) or the State Inspection Service is the attribute that more influences in the decision to purchase of the consumers. Most respondents have already heard about bovine traceability. Among these, most would be willing to pay more for meat with certification of origin. Although, considering that there are disavantages associated with traceability, especially in relation to the increase in the price of meat. Consumers with higher education and income were more knowledgeable about this type of certification, and these factors are of great influence on the acceptability of consumers to pay more for traced beef.

https://doi.org/10.1590/0034-737x201764010005 2297 downloads

10.

A regulação sanitária brasileira como parte da política de saúde: lacunas e desafios
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Maia, Christiane

; Guilhem, Dirce

Revista Panamericana de Salud Pública

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may 2016, Volume 39 N. 5 Pages 226 - 231

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

RESUMO Objetivo Apresentar e discutir os principais desafios à regulação sanitária manifestos na política de saúde brasileira estabelecida no âmbito federal. Métodos Para o presente estudo qualitativo, alicerçado na análise de políticas públicas, foram coletadas informações em documentos e entrevistas. O estudo documental subsidiou uma abordagem histórica da inserção da regulação sanitária na política de saúde brasileira entre 1999 e 2009 (primeira década de existência da Agência Nacional de Vigilância Sanitária, Anvisa). Além disso, foram conduzidas 13 entrevistas com atores selecionados por seu papel histórico, técnico ou acadêmico. Utilizou-se técnica de análise de conteúdo para definir temas que emergissem dos materiais analisados dentro da categoria “conteúdo”, que trata das diretrizes estratégicas e operacionais de programas, projetos, ações e marco normativo da política. Resultados Emergiram cinco temas que refletem os desafios à regulação sanitária no Brasil: 1) objetos sob regulação tratados de forma isolada; 2) especificidades do modelo de regulação sanitária no Brasil; 3) desconhecimento do papel da vigilância sanitária na saúde; 4) ausência de um sistema de informação; e 5) ausência de indicadores e ferramentas para avaliação das ações. Conclusões É necessário desvincular a missão da vigilância sanitária das tarefas de fiscalização para torná-la um instrumento efetivo de defesa e promoção da saúde. Para tanto, éfundamental dispor de um sistema de informação que agregue o Sistema Nacional de Vigilância Sanitária em grandes objetivos. É preciso também incorporar ferramentas para avaliação das ações, com estabelecimento de indicadores adequados.

ABSTRACT Objective To outline and discuss the main challenges for sanitary regulation contained in the federal-level Brazilian health policy. Methods For the present qualitative study, based on the analysis of public policies, information was collected from documents and interviews. Document analysis provided a historical overview of the insertion of sanitary regulation into the Brazilian health policy between 1999 and 2009 (first decade of existence of the national health surveillance agency, Anvisa). In addition, 13 interviews were carried out with actors selected for their historical, technical, or academic role in the field. Content analysis was used to define themes emerging from the materials analyzed with a focus on the “content” category, which refers to strategic and operational guidelines of policy programs, projects, initiatives, and normative framework. Results Content analysis revealed five themes that reflect the challenges to sanitary regulation in Brazil: 1) objects under regulation treated as isolated cases; 2) a Brazilian-specific model of sanitary regulation that is different from other international models; 3) ignorance regarding the role of sanitary surveillance in health care; 4) absence of an information system; and 5) absence of performance indicators and assessment tools. Conclusions Sanitary surveillance must have a mission that is disentangled from inspection tasks to become an effective instrument of health protection. For that, an information system that brings the National Sanitary Surveillance System together toward major objectives is essential. The adoption of tools for assessment of action is also required, with the establishment of adequate indicators.

1288 downloads

11.

A agroecologia como perspectiva de sustentabilidade na agricultura familiar
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Santos, Christiane Fernandes dos

; Siqueira, Elisabete Stradiotto

; Araújo, Iriane Teresa de

; Maia, Zildenice Matias Guedes

Ambiente & Sociedade

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jun 2014, Volume 17 N. 2 Pages 33 - 52

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

O presente trabalho avalia aspectos de ordem social, econômica e ambiental advindos das práticas dos agricultores familiares da APROFAM (Associação dos Produtores e Produtoras Agroecológicas de Mossoró), que comercializam semanalmente sua produção na Feira Agroecológica, de modo a analisar como proporcionam o desenvolvimento sustentável da agricultura de base familiar. Para tanto, foram realizadas entrevistas dialogadas com seis desses produtores. Os dados foram obtidos através de visita in loco, registro fotográfico e levantamento de dados qualitativos e quantitativos no período de janeiro a março de 2012. A criação da Feira possibilitou o acesso ao mercado local, organização por parte dos produtores para adquirir a certificação participativa, produção mais diversificada, aumento na renda familiar, colaborando com a permanência das famílias no campo. Observou-se, ainda, que existem desafios a serem superados, pois 75% dos entrevistados não conseguem contabilizar seus custos de produção, nem mensurar as quantidades comercializadas. Ainda, existe insuficiência de assessoria técnica, disponibilidade hídrica, entre outros, que impossibilitam o fortalecimento dessa forma de organização social.

This paper aimed at the evaluation of social, economic and environmental features arising from practices by APROFAM (Mossoró Agroecological Producers Association) family farmers, who commercialize their production at the Agroecological Fair, intending to analyze whether or not such practices provide sustainable development of family-based agriculture. Aiming at this, dialogue interviews were conducted with six producers involved in APROFAM who commercialize their production on weekly basis. Data were obtained through in loco visits, photographs and qualitative-quantitative data collection between January and March 2012. Despite the creation of the fair having granted market access and enabled producers' self-organization to acquire participative certification, more diversified production and an increase in family income, therefore promoting the permanence of the families in the countryside, challenges to be overcome could be noticed, as 75% of interviewed subjects aren't able to account their production costs or measure the commercialized quantities. There still are insufficiencies in technical advice and hydric availability, among other issues, which preclude strengthening of this social organization mode.

Este trabajo propuso evaluar aspectos de orden social, económico y ambiental derivados de las prácticas de los agricultores familiares de la APROFAM (Asociación de los Productores y Productoras Agroecológicas de Mossoró), que comercializan su producción en la Feria Agroecológica, con el fin de analizar si dichas prácticas proporcionan el desarrollo sostenible de la agricultura de base familiar. Con ese objetivo, se realizaron entrevistas dialogadas con seis productores que participan en la APROFAM y que comercializan semanalmente su producción. Los datos fueron obtenidos a través de visita in loco, registro fotográfico y recolección de datos cuali-cuantitativos en el periodo de enero a marzo de 2012. A pesar de que la creación de la feria posibilitó el acceso al mercado local, la organización por parte de los productores para adquirir la certificación participativa, una producción más diversificada y un aumento en la renta familiar, factores que ayudaron a la permanencia de las familias en el campo, se observó que existen desafíos aún sin superar, dado que el 75% de los entrevistados no consigue contabilizar sus costes de producción ni medir las cantidades comercializadas. Existen todavía insuficiencias de asesoramiento técnico y de disponibilidad hídrica, entre otras, que imposibilitan el fortalecimiento de esta forma de organización social.

65171 downloads Cited 1 time in SciELO

12.

Percepções sobre qualidade de serviços que atendem à saúde da mulher
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Maia, Christiane Santiago

; Freitas, Daniel Roberto Coradi de

; Guilhem, Dirce

; Azevedo, Anamaria Ferreira

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

may 2011, Volume 16 N. 5 Pages 2567 - 2574

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

O objetivo deste trabalho é identificar as características relacionadas à qualidade em serviços que atendem à saúde da mulher na perspectiva de profissionais de vigilância sanitária (Visa) e de coordenadores de saúde da mulher (CSM) de municípios. Trata-se de um estudo de abordagem qualitativa, efetuado por meio de entrevistas semiestruturadas. Foram selecionadas três capitais brasileiras e entrevistados três sujeitos de cada capital - um responsável e um técnico da área de Visa em serviços de saúde e um CSM. A análise das entrevistas foi realizada pela técnica de análise de conteúdo, organizando as respostas em categorias temáticas baseadas no modelo de avaliação dos serviços de saúde de Donabedian: estrutura, processos e resultados. Os técnicos de Visa relataram com maior frequência aspectos relacionados à estrutura dos serviços de saúde, como equipamentos e recursos humanos qualificados. Os responsáveis pela Visa citaram aspectos relacionados à estrutura e aos processos como priorização no atendimento. Os CSM abordaram as três categorias, com destaque para os processos. As entrevistas apontam para um possível prejuízo na avaliação por resultados. O estudo reforça a necessidade de atuação conjunta entre os setores de vigilância e assistência, a fim de promover a qualidade nos serviços.

The scope of this work is to identify the characteristics relating to the quality of women's healthcare services from the perspective of the sanitary vigilance professionals (Visa) and women's healthcare coordinators (CSM) in the municipalities. It is a study with a qualitative approach that was carried out using semi-structured interviews. Three Brazilian state capitals were selected and three individuals in each capital were interviewed, namely a Visa healthcare service chief, as well as a technician, and a CSM coordinator. The content analysis technique was adopted to organize the data and the answers were grouped into the healthcare service evaluation topics based on Donabedian's model, i.e. structure, processes, and outcomes. Visa workers reported aspects related to the structure of health services, such as equipment and qualified human resources more frequently. The Visa chief mentioned aspects related to structure and processes, such as prioritization in attendance. The CWH coordinator examined all three categories, especially processes. Analysis of interviews points to a potential distortion in evaluation by results. The study highlights the need for joint action between the surveillance and assistance sectors to improve the quality of services.

2008 downloads Cited 3 times in SciELO

13.

Percepções sobre qualidade de serviços que atendem à saúde da mulher
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Maia, Christiane Santiago

; Freitas, Daniel Roberto Coradi de

; Guilhem, Dirce

; Azevedo, Anamaria Ferreira

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

may 2011, Volume 16 N. 5 Pages 2567 - 2574

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

5908 downloads Cited 3 times in SciELO

14.

Integração entre vigilância sanitária e assistência à saúde da mulher: um estudo sobre a integralidade no SUS
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Maia, Christiane

; Guilhem, Dirce

; Lucchese, Geraldo

Cadernos de Saúde Pública

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apr 2010, Volume 26 N. 4 Pages 682 - 692

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

A integralidade é um princípio do SUS, com várias perspectivas, entre as quais a da articulação de seus serviços. O debate sobre esse princípio está presente na assistência à saúde, com destaque para a área de Saúde da Mulher, e nas diretrizes da Vigilância Sanitária. Como as duas áreas buscam a qualidade dos serviços de saúde, o objetivo é analisar a integração entre Vigilância Sanitária e assistência à saúde da mulher. Trata-se de estudo de caso, qualitativo, com entrevistas de profissionais de Vigilância Sanitária de serviços de saúde e coordenadores de Saúde da Mulher (CSM). Os achados apontam para isolamento da Vigilância Sanitária nas secretarias de saúde. A importância da integração é citada por CSM, porém não é fácil de ser aplicada. As relações, se ocorrem, são por situações emergenciais. Os trabalhadores de Vigilância Sanitária acham que não há articulação por não haver problemas na Saúde da Mulher que demandem sua participação e que, com inspeções e palestras, estão colaborando com a área. Mostram-se dificuldades à concretização da integralidade, com o desafio de articular ações em saúde, sobretudo para a Vigilância Sanitária.

Comprehensiveness is a key principle in Brazil's Unified National Health System (SUS), approached from various perspectives, including linkage between services. The debate on this principle appears in health care, especially in the area of Women's Health, and in Health Surveillance guidelines. Since both areas target quality of health services, the aim of this study is to analyze the integration between Health Surveillance and Women's Health Care. This is a qualitative case study that interviewed Health Surveillance staff in health services and coordinators of Women's Health services. The findings point to the isolation of Health Surveillance within the health secretariats. The importance of integrating the two areas is cited by Women's Health administrators, but it is difficult to implement. Collaborative relations only occur in emergency situations. The Health Surveillance professionals believe that this lack of integration is due to the fact that women's health issues do not require their participation, and that at any rate they collaborate with the area through health inspections and talks. The study detected difficulties in achieving integration between the two areas, with the persistent challenge of linking health actions, especially with Health Surveillance.

4326 downloads Cited 4 times in SciELO

15.

Terapia com anti-TNF na amiloidose renal em artrite reumatoide refratária: uma nova perspectiva terapêutica
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Nobre, Christiane Aguiar

; Callado, Maria Roseli Monteiro

; Rodrigues, Carlos Ewerton Maia

; Menezes, Dalgimar Beserra de

; Vieira, Walber Pinto

Revista Brasileira de Reumatologia

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apr 2010, Volume 50 N. 2 Pages 205 - 208

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

As amiloidoses são um grupo heterogêneo de doenças caracterizadas pelo depósito extracelular de uma substância amiloide composta por agregados de proteínas mal acopladas que se depositam longe do sítio de síntese, causando disfunção do órgão-alvo e doença clínica. A forma sistêmica mais comum é a amiloidose A (AA) secundária às infecções e às inflamações crônicas, sendo a artrite reumatoide (AR) a causa mais frequente. O tratamento da amiloidose AA consiste no controle ou na resolução da doença de base. O objetivo do presente estudo é relatar um caso de amiloidose renal secundária em paciente com AR refratária de longa duração que apresentou melhora clínica sustentada após o uso de anti-TNFα (etanercepte).

Amyloidosis is a heterogeneous group of diseases characterized by extracellular deposits of a material composed of aggregates of amyloid - a poorly coupled protein - far from the site of synthesis, causing target organ dysfunction and clinical disease. Systemic amyloidosis A (AA), secondary to infections and chronic inflammation, especially rheumatoid arthritis (RA), is the most common form of amyloid deposition. Treatment of AA consists in the control or resolution of the baseline condition. The objective of the present study was to report a case of secondary renal amyloidosis in a patient with long-term refractory RA who presented sustained clinical improvement after the use of anti-TNFα (etanercept).

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