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ABSTRACT Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made. Conclusion: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy.

RESUMO Objetivo: Atualizar as recomendações para embasar as decisões para o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: A elaboração desta diretriz foi feita por especialistas, incluindo representantes do Ministério da Saúde e metodologistas. O método utilizado para o desenvolvimento rápido de diretrizes baseou-se na adoção e/ou adaptação de diretrizes internacionais existentes (GRADE ADOLOPMENT) e contou com o apoio da plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Chegaram-se a 21 recomendações, incluindo recomendações fortes quanto ao uso de corticosteroides em pacientes em uso de oxigênio suplementar e recomendações condicionais para o uso de tocilizumabe e baricitinibe, em pacientes com oxigênio suplementar ou ventilação não invasiva, e de anticoagulantes, para prevenção de tromboembolismo. Devido à suspensão da autorização de uso, não foi possível fazer recomendações para o tratamento com casirivimabe + imdevimabe. Foram feitas recomendações fortes contra o uso de azitromicina em pacientes sem suspeita de infecção bacteriana, hidroxicloroquina, plasma convalescente, colchicina e lopinavir + ritonavir, além de recomendações condicionais contra o uso de ivermectina e rendesivir. Conclusão: Foram criadas novas recomendações para o tratamento de pacientes hospitalizados com COVID-19, como as recomendações de tocilizumabe e baricitinibe. Ainda são recomendados corticosteroides e profilaxia contra tromboembolismo, esta em caráter condicional. Vários medicamentos foram considerados ineficazes e não devem ser usados, no intuito de proporcionar o melhor tratamento segundo os princípios da medicina baseada em evidências e promover a economia de recursos.

https://doi.org/10.5935/2965-2774.20230136-en

Is maxillomandibular advancement an effective treatment for obstructive sleep apnea? Systematic literature review and meta-analysis
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Trindade, Paulo Alceu Kiemle

; Nogueira, Vânia dos Santos Nunes

; Weber, Silke Anna Theresa

Brazilian Journal of Otorhinolaryngology

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jun 2023, Volume 89 N. 3 Pages 503 - 510

Abstract: En | Text: En | PDF: En

Abstract Objectives To evaluate the effectiveness of maxillomandibular advancement surgery in the treatment of Obstructive Sleep Apnea by comparing the pre- and postoperative Apnea and Hypopnea Index, in addition to classifying the degree of evidence and risk of intervention bias. Methods A systematic review of the literature was carried out in the PUBMED, LILACS, EMBASE, SCOPUS, WEB OF SCIENCE and COCHRANE platforms, including cohort studies with polysomnographic follow-up, without other associated pharyngeal or nasal surgical procedures. The risk of study bias was assessed using the Modified Delphi technique. Pre- and postoperative Apnea and Hypopnea Index data were plotted for meta-analysis, and the quality of evidence was assessed using the GRADE system. Results Of 1882 references, 32 articles were selected for full-text reading, of which four studies were included, totaling 83 adults with obstructive sleep apnea who underwent maxillomandibular advancement. The meta-analysis was in favor of the intervention (DM = −33.36, 95% CI −41.43 to −25.29, p< 0.00001), with a mean percentage reduction in the Apnea and Hypopnea Index of 79.5% after surgery, even though the level of evidence was classified as very low quality by the GRADE system. Conclusion The meta-analysis was in favor of the intervention, characterizing maxillomandibular advancement surgery as an effective treatment for obstructive sleep apnea in adults.

https://doi.org/10.1016/j.bjorl.2023.02.007

Early diagnosis of autism and other developmental disorders, Brazil, 2013–2019
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Girianelli, Vania Reis

; Tomazelli, Jeane

; Silva, Cosme Marcelo Furtado Passos da

; Fernandes, Conceição Santos

Revista de Saúde Pública

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2023, Volume 57 elocation 21

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

RESUMO OBJETIVO Investigar os fatores associados ao diagnóstico precoce do autismo e de outros tipos de transtorno global do desenvolvimento (TGD) de crianças atendidas no Centro de Atenção Psicossocial Infantojuvenil do Sistema Único de Saúde, no período de 2013 a 2019, no Brasil. MÉTODOS Estudo transversal exploratório, com base nos dados do Registro das Ações Ambulatoriais de Saúde (RAAS) do primeiro atendimento de crianças de 1 a 12 anos. Foram estimados o risco relativo bruto (RRb) e ajustado (RRa), e respectivo intervalo de confiança de 95% (IC95%), utilizando o modelo de regressão de Poisson com estimativa de variância robusta. RESULTADOS Das 22.483 crianças incluídas no estudo, a maioria era do sexo masculino (81,9%), residia no mesmo município em que foi diagnosticada (96,8%) e na região Sudeste (57,7%). O diagnóstico precoce foi maior para autismo infantil (RRb= 1,48; IC95% 1,27–1,71), TGD sem designação de subtipo (RRb= 1,55; IC95% 1,34–1,80), outros TGD (RRb= 1,48; IC95% 1,21–1,81) e TGD não especificado (RRb= 1,44; IC95% 1,22–1,69) do que para autismo atípico. As crianças que residiam no mesmo município onde foi realizado o diagnóstico tiveram maior índice de diagnóstico precoce (RRb= 1,31; IC95% 1,10–1,55) do que as demais; bem como aquelas encaminhadas pela atenção básica (RRb= 1,51; IC95% 1,37–1,68) e por demanda espontânea (RRb= 1,45; IC95% 1,31–1,61) do que as oriundas de outros tipos de encaminhamento. O diagnóstico precoce foi maior a partir de 2014 e menor na região Norte quando comparada às demais. Na análise múltipla, a magnitude do RRafoi similar ao do RRb. CONCLUSÕES A identificação precoce de autismo e outros TGD tem melhorado no país, mas ainda representa cerca de 30% dos diagnósticos realizados. As variáveis incluídas no modelo foram significativas, mas ainda explicam pouco do diagnóstico precoce de crianças com autismo e outros TGD.

ABSTRACT OBJECTIVE To investigate the factors associated with the early diagnosis of autism and other types of pervasive developmental disorder (PDD) in children treated at the Psychosocial Care Center for Children and Adolescents of the Unified Health System, from 2013 to 2019,in Brazil. METHODS An exploratory cross-sectional study, based on data from the Record of Outpatient Health Actions (RAAS) of the first appointment of children aged 1 to 12 years. The gross (RRg) and adjusted (RRa) relative risks and respective 95% confidence intervals (95%CI) were estimated using the Poisson regression model with robust variance estimation. RESULTS Of the 22,483 children included in the study, the majority were male (81.9%), lived in the same municipality where they were diagnosed (96.8%) and in the Southeast region (57.7%). Early diagnosis was higher for childhood autism (RRg = 1.48; 95%CI 1.27–1.71) , PDD without subtype designation (RRg = 1.55; 95%CI 1.34–1.80), other PDD (RRg = 1.48; 95%CI 1.21–1.81) and PDD not otherwise specified (RRg = 1.44; 95%CI 1.22–1.69) than for atypical autism. Children residing in the same municipality where the diagnosis was made had a higher rate of early diagnosis (RRg = 1.31; 95%CI 1.10–1.55) than the others; as well as those referred by primary care (RRg = 1.51; 95%CI 1.37–1.68) and by spontaneous demand (RRg = 1.45; 95%CI 1.31–1.61) than those from other types of referral. Early diagnosis was higher from 2014 and lower in the North region than in the other regions. In the multiple analysis, the magnitude of RRa was similar to that of RRg. CONCLUSIONS Early identification of autism and other PDD has improved in Brazil, but it still represents about 30% of the diagnoses made. The variables included in the model were significant, but still explain little of the early diagnosis of children with autism and other PDD.

https://doi.org/10.11606/s1518-8787.2023057004710

A pesquisa qualitativa no campo da Saúde Coletiva: experiências de uma antropóloga na e com a Epidemiologia, segundo Daniela Knauth
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Carneiro, Rosamaria Giatti

; Silva, Daiana Maria Santos de Sousa

; Caetano, George Luiz Neris

; Silva, Vania Nazaré da Costa

Physis: Revista de Saúde Coletiva

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2023, Volume 33 elocation e33084

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/s0103-7331202333084

The Challenges of Implementing a Text Message Intervention to Promote Behavioral Change in Primary Care Patients With Hypertension and Diabetes
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Oliveira, João Antonio de Queiroz

; Cimini, Christiane

; Almeida, Vania

; Maia, Junia Xavier

; Resende, Raissa Eda

; Gualberto, Leticia Alves

; Santos, Pedro Henrique Lauar

; Gomes, Paulo R.

; Bonisson, Leonardo

; Paixão, Maria Cristina

; Costa, Janaina Moutinho

; Cardoso, Clareci Silva

; Santo, Karla

; Ribeiro, Antonio

; Martins, Maria Auxiliadora

; Marcolino, Milena S.

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220050

Abstract: En | Text: En | PDF: En

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

Early diagnosis of autism and other developmental disorders, Brazil, 2013–2019
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Girianelli, Vania Reis

; Tomazelli, Jeane

; Silva, Cosme Marcelo Furtado Passos da

; Fernandes, Conceição Santos

Revista de Saúde Pública

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2023, Volume 57 elocation 21

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

https://doi.org/10.11606/s1518-8787.2023057004710

Incidência de transtorno global do desenvolvimento em crianças: características e análise a partir dos CAPSi
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Tomazelli, Jeane

; Girianelli, Vania Reis

; Fernandes, Conceição Santos

Psicologia USP

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2023, Volume 34 elocation e210002

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

Abstract This article describes the accumulated incidence and characteristics of children until 12 years old with global developmental disorder (TGD) treated at CAPSi. A descriptive cross-sectional study was carried out using Register of Outpatient Health Actions. Cumulative incidence of TGD in the period 2013-2019 and the temporal trend of characteristics of children and care were evaluated using the Prais-Winsten method. It were identificated 23,657 records with first care, but 10.8% without follow-up. The cumulative incidence was 13.2/10,000, with wide variation between municipalities and large regions although several without record of cases. There was decrease in the percentage of first appointment, with an average annual increase of -17.8%. Most children were attended to in the municipality of residence (96.8%) and initially diagnosed as autism (30.6%), although 54.0% hadn’t TGD specified in the first appointment. Only 30.2% were diagnosed until three years old. Ensuring care in specialized care and early diagnosis remain challenges.

Resumen Este artículo describe la incidencia acumulada y características de los niños hasta 12 años con trastorno del desarrollo global (TGD) tratados en CAPSi. Se realizó un estudio descriptivo transversal, utilizando Registro de Acciones Ambulatorias de Salud. Se evaluó la incidencia acumulada de TGD en período 2013-2019 y tendencia temporal de características de niños y cuidado, utilizando método Prais-Winsten. Se identificaron 23.657 registros con primera asistencia, pero 10,8% sin seguimiento. La tasa acumulada fue 13,2/10.000, con amplia variación entre municipios y grandes regiones, aunque varias sin registro de casos. No hubo descenso en porcentaje de primeras visitas, con incremento medio anual del -17,8%. La mayoría de niños fueron atendidos en municipio de residencia (96,8%) y diagnosticados de autismo (30,6%), aunque el 54,0% no tenía TGD especificado en primera visita. Solo 30,2% fueron diagnosticados hasta los tres años de edad. Asegurar la atención en cuidados especiales y diagnóstico precoz temprano como desafíos.

Resumo Este artigo descreve a incidência acumulada e as características das crianças de até 12 anos com transtorno global do desenvolvimento (TGD) atendidas no CAPSi. Realizou-se estudo transversal descritivo, utilizando o Registro de Ações Ambulatoriais de Saúde. Avaliou-se a incidência acumulada de TGD no período 2013-2019 e tendência temporal das características das crianças e do atendimento pelo método de Prais-Winsten. Identificaram-se 23.657 registros de primeiro atendimento, mas 10,8% sem seguimento. A incidência acumulada foi de 13,2/10.000, com ampla variação entre municípios e grandes regiões, embora vários sem registro de casos. Observou-se queda no percentual de primeiro atendimento, com incremento médio anual de 17,8%. A maioria das crianças foi atendida no município de residência (96,8%) e recebeu diagnóstico inicial de autismo infantil (30,6%), embora 54,0% sem TGD especificado no primeiro atendimento. Apenas 30,2% foram diagnosticadas até três anos de idade. A garantia do cuidado na atenção especializada e o diagnóstico precoce permanecem como desafios.

https://doi.org/10.1590/0103-6564e210002

Efeitos Agudos do Nitrato Dietético na Pressão Central e Desempenho Cardíaco em Hipertensos: Estudo Cruzado, Randomizado e Placebo-Controlado
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Mattos, Samanta

; Cunha, Michelle Rabello

; Marques, Bianca Cristina

; d´El-Rei, Jenifer

; Baião, Diego dos Santos

; Paschoalin, Vania M. F.

; Oigman, Wille

; Neves, Mario Fritsch

; Medeiros, Fernanda

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 1 elocation e20220209

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

Abstract Background The diet’s inorganic nitrate (NO3–) may provide a physiological substrate for reducing nitrate (NO2–) to NO independent of the endothelium. Studies suggest that inorganic NO3– has beneficial effects on cardiovascular health. Objective This study evaluated the acute effects of 500 mL nitrate-rich beetroot juice (BRJ; containing 11.5mmol NO3–) on blood pressure and endothelial function in treated hypertensive patients. Methods A randomized, placebo-controlled, crossover study was conducted in treated hypertensive patients (n=37; women=62%) who underwent clinical and nutritional evaluation and assessment of central hemodynamic parameters and microvascular reactivity. The significance level was p<0.05. Results The mean age was 59±7 years, and mean systolic and diastolic blood pressures were 142±10/83±9mmHg. There was a significant increase in the subendocardial viability ratio (SEVR; 149±25 vs. 165±30%, p<0.001) and reduction in ejection duration (ED; 37±4 vs. 34±4%, p<0.001) in the beetroot phase but no significant SEVR difference in the control phase. The % increase in perfusion (155 vs. 159 %, p=0.042) was significantly increased in the beetroot phase, which was not observed in the control phase. In the beetroot phase, the change in SEVR showed a significant correlation with the change in the area under the curve of post-occlusive reactive hyperemia (AUC-PORH) (r=0.45, p=0.012). The change in ED showed a significant correlation with the post-intervention perfusion peak (r=-0.37, p=0.031) and AUC-PORH (r=-0.36, p=0.046). Conclusions The acute ingestion of BRJ by hypertensive patients resulted in an improvement of endothelial function, which was associated with higher subendocardial viability and performance in myocardial contraction.

Resumo Fundamento O nitrato inorgânico (NO3–) da dieta pode fornecer substrato fisiológico para reduzir o nitrito (NO2–) a óxido nítrico (NO) independente do endotélio. Estudos sugerem que o NO3– inorgânico tem efeitos benéficos na saúde cardiovascular. Objetivos Este estudo avaliou os efeitos agudos de 500 mL de suco de beterraba rico em nitrato (SB; contendo 11,5mmol NO3–) na pressão arterial e na função endotelial em pacientes hipertensos tratados. Métodos Estudo cruzado, randomizado, controlado por placebo foi realizado em pacientes hipertensos tratados (n=37; mulheres=62%) que foram submetidos à avaliação clínica e nutricional, avaliação dos parâmetros hemodinâmicos centrais e reatividade microvascular. O nível de significância foi p<0,05. Resultados A média de idade foi 59±7 anos e das pressões sistólica e diastólica foi de 142±10/83±9 mmHg. Houve aumento significativo na taxa de viabilidade subendocárdica (RVSE; 149±25 vs. 165±30%, p<0,001) e redução na duração da ejeção (DE; 37±4 vs. 34±4%, p<0,001) na fase beterraba, mas nenhuma diferença significativa de RVSE na fase controle. O % de aumento na perfusão (155 vs. 159%, p=0,042) cresceu significativamente na fase beterraba, o que não foi observado na fase controle. Na fase beterraba, a alteração da RVSE apresentou correlação significativa com a alteração da área sob a curva de hiperemia reativa pós-oclusiva (ASC-HRPO) (r=0,45, p=0,012). A mudança na DE mostrou uma correlação significativa com pico de perfusão pós-intervenção (r=-0,37, p=0,031) e ASC-HRPO (r=-0,36, p=0,046). Conclusão A ingestão aguda de SB por pacientes hipertensos resultou em melhora da função endotelial, que foi associada à maior viabilidade subendocárdica e desempenho na contração miocárdica.

https://doi.org/10.36660/abc.20220209

Profile of the leprosy endemic in the district of Murrupula, Nampula, Mozambique: A population-based study
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Ribeiro, Gabriela de Cássia

; Lages, Daniele dos Santos

; Lages, Ana Thereza Chaves

; Souza, Vânia Brito de

; Marega, Abdoulaye

; Lana, Francisco Carlos Félix

; Rocha, Manoel Otávio da Costa

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0321-2022

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Leprosy is a neglected chronic infection caused by Mycobacterium leprae, that is curable. The magnitude of the disease and severity of the debilitation it causes renders leprosy a public health problem. This study aimed to analyze the endemic profile of leprosy in the Murrupula district and evaluate the socioeconomic, clinical, and serological profiles of leprosy contacts. Methods: A cross-sectional study of patients with leprosy diagnosed between 2013 and 2017 and their household and community contacts was conducted in Murrupula District, Nampula Province, Mozambique. Interviews, simplified dermatoneurological examinations, Mycobacterium leprae flow (ML Flow) tests, and Mitsuda tests were performed. Results: Most of the leprosy cases were multibacillary. The patients had some degree of physical disability. ML Flow positivity was more common in household contacts of the patients diagnosed with leprosy and in community individuals who spontaneously presented for testing. In total, 17 patients were diagnosed with leprosy. Conclusions: This study revealed an active chain of transmission, hidden prevalence, and operational deficiencies in leprosy surveillance and care. The results suggest that the implementation of a public health policy for leprosy prevention and control in Nampula Province is necessary. In future, the possibility of expanding the policy to the entire country should be considered.

https://doi.org/10.1590/0037-8682-0321-2022

10.

Using of relatedness and heritability in a Eucalyptus benthamii trial for conservation and breeding
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Souza, Bruno Marchetti de

; Abreu, Lucas Moura de

; Pappas, Marilia de Castro Rodrigues

; Azevedo, Vânia

; Santos, Paulo Eduardo Telles dos

; Sousa, Valderes Aparecida de

; Santos, Rodrigo Furtado dos

; Lopes, Maria Teresa Gomes

; Aguiar, Ananda Virginia

Crop Breeding and Applied Biotechnology

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2023, Volume 23 N. 4 elocation e46452348

Abstract: En | Text: En | PDF: En

Abstract We evaluated the genetic diversity, coancestry and heritability of an E. benthamii trial. The 115 individuals were genotyped (13 SSR) and had their height and diameter at breast height (dbh) measured. Heritability was estimated using the RR-BLUP and the pairwise kinship coefficient method. An average of nine alleles per locus was observed. The expected heterozygosity (0.655) was similar to the observed heterozygosity, with the estimated inbreeding (0.02) being low. The group coancestry (0.051) demonstrates that the trees are related to some degree. The trees were clustered in five groups using the Evanno’s method. The average kinship within each group ranges from 0.042 to 0.082. The heritability estimated by RR-BLUP was low. The heritability estimated using the kinship coefficients is moderate, reaching estimated genetic gains of 14% for dbh. After knowing how genetic groups are distributed within the population, strategies for collecting, conserving, and using these germplasm resources can be performed.

https://doi.org/10.1590/1984-70332023v23n4a43

11.

Propensity to entrepreneurship and its antecedents: development and validation of a measurement scale
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BRAUM, LORENI MARIA DOS SANTOS

; NASSIF, VÂNIA MARIA JORGE

; CUNHA, JÚLIO ARAUJO CARNEIRO DA

; PAIVA, LUIS EDUARDO BRANDÃO

Cadernos EBAPE.BR

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2023, Volume 21 N. 5 elocation e2022-0254

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

Abstract This article develops and validates a Measurement Scale of the Propensity to Entrepreneurship and its Antecedents (MSPEA). The theoretical basis concerns the Propensity to Entrepreneurship and the previous individual characteristics (innovative behavior, need for autonomy, need for achievement, proactivity, self-efficacy, locus of internal/external control, tolerance/intolerance to ambiguity, risk propensity, and risk aversion). The methodological procedures involved the qualitative (selection of individual characteristics and elaboration of items) and quantitative approaches through multivariate data analysis. The results reveal that all constructs meet the necessary parameters for performing Exploratory Factor Analysis (EFA). After reduction, all presented good reliability with Cronbach’s alpha greater than 0.70, indicating that all MSPEA constructs are statistically reliable. In the final version, 56 items remained, 9 of which were of Propensity to Entrepreneurship and 47 of individual characteristics. The elaboration of items to measure the propensity to entrepreneurship and the identification of a set of individual characteristics preceding it expands the understanding of this theme since several studies did not measure it as a construct, which is the main contribution of this study. Considering that EFA is an interdependence technique in which factors are formed to show the explanatory power of a set of variables, not allowing one or more factors to be considered predictors of another factor, future research could perform the Confirmatory Factor Analysis proposing a model of how these antecedent individual characteristics can be directly or indirectly related to the Propensity to Entrepreneurship.

Resumen El objetivo fue desarrollar y validar una escala de medición de la propensión al emprendimiento y sus antecedentes (EMPEA). La base teórica se refiere a la propensión emprendedora y las características individuales previas (comportamiento innovador, necesidad de autonomía, necesidad de logro, proactividad, autoeficacia, locus de control interno/externo, tolerancia/intolerancia a la ambigüedad, propensión al riesgo y aversión al riesgo). Los procedimientos metodológicos son un estudio mixto, utilizando enfoques cualitativos (selección de características individuales y elaboración de ítems) y cuantitativos, a través del análisis multivariado de datos. Los resultados revelan que todos los constructos cumplen con los parámetros necesarios para realizar el análisis factorial exploratorio (AFE). Después de la reducción, todos mostraron una buena confiabilidad con un alfa de Cronbach superior a 0,70, lo que indica que todas los constructos EMPEA son estadísticamente confiables. En la versión final quedaron 56 ítems ‒9 de propensión al emprendimiento y 47 de características individuales‒. La elaboración de ítems para medir la propensión al emprendimiento, así como la identificación de un conjunto de características individuales que la preceden, amplía la comprensión de este tema, ya que varios estudios no lo han medido como constructo, lo cual es el principal aporte del presente estudio. Considerando que el AFE es una técnica de interdependencia en la que se forman factores para mostrar el poder explicativo de un conjunto de variables, no permitiendo que uno o más factores sean considerados predictores de otro factor, las futuras investigaciones podrían realizar un análisis factorial confirmatorio proponiendo un modelo de cómo estas características individuales precedentes pueden estar directa o indirectamente relacionadas con la propensión emprendedora.

Resumo O objetivo foi desenvolver e validar uma Escala de Mensuração da Propensão ao Empreendedorismo e seus Antecedentes (EMPEA). A base teórica diz respeito à Propensão ao Empreendedorismo e às características individuais prévias (comportamento inovador, necessidade de autonomia, necessidade de realização, proatividade, autoeficácia, locus de controle interno/externo, tolerância/intolerância à ambiguidade, propensão ao risco e aversão ao risco). Os procedimentos metodológicos são um estudo misto, utilizando as abordagens qualitativa (seleção de características individuais e elaboração de itens) e quantitativa, por meio de análise multivariada de dados. Os resultados revelam que todos os construtos atendem aos parâmetros necessários para a realização da Análise Fatorial Exploratória (AFE). Após a redução, todos apresentaram boa confiabilidade com alfa de Cronbach maior que 0,70, indicando que todos os construtos do EMPEA são estatisticamente confiáveis. Na versão final, restaram 56 itens, sendo 9 de Propensão ao Empreendedorismo e 47 de características individuais. A elaboração de itens para mensurar a propensão ao empreendedorismo, bem como a identificação de um conjunto de características individuais que o antecedem, amplia o entendimento sobre esse tema, uma vez que diversos estudos não o mensuraram como construto, sendo esta a principal contribuição do presente estudar. Considerando que a AFE é uma técnica de interdependência na qual os fatores são formados para mostrar o poder explicativo de um conjunto de variáveis, não permitindo que um ou mais fatores sejam considerados preditores de outro fator, pesquisas futuras poderiam realizar a Análise Fatorial Confirmatória propondo um modelo de como essas características individuais antecedentes podem estar direta ou indiretamente relacionadas à Propensão ao Empreendedorismo.

https://doi.org/10.1590/1679-395120220254x

12.

Acompanhamento de mulheres rastreadas para o câncer de mama com lesões provavelmente benignas no estado do Rio de Janeiro
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Santos, Juliana Agra

; Girianelli, Vania Reis

; Azevedo e Silva, Gulnar

Cadernos Saúde Coletiva

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2023, Volume 31 N. 3 elocation e31030471

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

Abstract Background Breast cancer is the leading cause of cancer deaths among women worldwide. Mammography screening can detect initial lesions, which, if treated, will have a favorable outcome in most cases. Objective To analyze the two-year follow-up of women screened for breast cancer in the state of Rio de Janeiro, who had probable benign lesions (BI-RADS® 3) in 2011. Method A retrospective cohort study with data from the Breast Cancer Information Systems (SISMAMA) and Mortality System (SIM), using a probabilistic linkage between the recovery of follow-up databases. The investigation of factors associated with repeat screening was based on Cox's proportional hazards model. Results 1261 women were identified with BI-RADS® 3 results, of which 498 women received follow-up screening in the SIS. Most presented normal or benign results in the control (51.1%). The median time for repeat screening was 12 months; with shorter time for women ≤ 70 years old, those who lived outside the capital and those who were at risk of breast cancer. Conclusion The mammography repetition time observed was longer than recommended, indicating the need to improve breast cancer screening rates.

Resumo Introdução O câncer de mama é a primeira causa de óbito por câncer entre as mulheres no mundo. O rastreamento com mamografia pode detectar lesões iniciais, que se tratadas a evolução será favorável para a maioria dos casos. Objetivo Analisar o seguimento de dois anos das mulheres rastreadas para câncer de mama no estado do Rio de Janeiro, que apresentavam lesões provavelmente benignas (BI-RADS® 3) em 2011. Método Estudo de coorte retrospectiva com dados dos Sistemas de Informação (SIS) do Câncer de Mama (SISMAMA) e de Mortalidade (SIM), utilizando relacionamento probabilístico entre as bases de dados para recuperação do seguimento. A investigação dos fatores associados à repetição do exame de controle baseou-se no modelo de riscos proporcionais de Cox. Resultados Foram identificadas 1.261 mulheres com resultado BI-RADS® 3, dentre as quais foram encontrados o seguimento de 498 mulheres nos SIS. A maioria apresentou resultado normal ou benigno no controle (51,1%). O tempo mediano da repetição do exame foi de 12 meses; com menor tempo para mulheres ≤ 70 anos, residiam fora da capital e apresentavam risco para câncer de mama. Conclusão O tempo de repetição da mamografia encontrado foi superior ao recomendado, indicando necessidade de aprimoramento do rastreamento do câncer de mama.

https://doi.org/10.1590/1414-462x202331030471

13.

A pesquisa qualitativa no campo da Saúde Coletiva: experiências de uma antropóloga na e com a Epidemiologia, segundo Daniela Knauth Coletiva Epidemiologia
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Carneiro, Rosamaria Giatti

; Silva, Daiana Maria Santos de Sousa

; Caetano, George Luiz Neris

; Silva, Vania Nazaré da Costa

Physis: Revista de Saúde Coletiva

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2023, Volume 33 elocation e33084

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/s0103-7331202333084

14.

Planejamento e Dimensionamento da Força de Trabalho em Saúde no Brasil: avanços e desafios
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Carvalho, Desirée dos Santos

; Nascimento, Elisabet Pereira Lelo

; Carmona, Silvia Aparecida Maria Lutaif Dolci

; Barthmann, Vânia Maria Corrêa

; Lopes, Maria Helena Pereira

; Moraes, Júlio César de

Saúde em Debate

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dec 2022, Volume 46 N. 135 Pages 1215 - 1237

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

RESUMO Este estudo visa a analisar a produção de conhecimento acerca do Planejamento e Dimensionamento da Força de Trabalho em Saúde (PDFTS) desenvolvida no Brasil identificando modelos e metodologias que consideram as diretrizes do Sistema Único de Saúde (SUS) para a constituição de redes de atenção regionalizadas. Trata-se de uma revisão integrativa, incluindo estudos brasileiros e com texto completo, em português, disponível nas bases de dados Capes, BVS e Google Acadêmico. As buscas retornaram 48.083 documentos e, após seleção com a ferramenta Prisma, foram incluídos 62 estudos publicados entre 2011 e 2020. A maioria das produções analisadas aborda o PDFTS com análises comparativas entre as necessidades estimadas e a disponibilidade atual, sendo mais frequentes os estudos de apenas uma categoria profissional, com destaque para a enfermagem. Os achados contribuem à promoção do debate sobre a essencialidade da força de trabalho em saúde para a conformação das redes, ao demonstrar que os métodos de cálculo privilegiam o uso de indicadores e parâmetros relacionados à oferta de serviços em estabelecimentos de saúde específicos, especialmente hospitais, não operacionalizando aspectos de regionalização e integração sistêmica da Rede de Atenção à Saúde.

ABSTRACT This study aims to analyze the production of knowledge about Planning and Sizing of the Health Workforce (PDFTS) developed in Brazil, identifying models and methodologies that consider the Guidelines of the Unified Health System (SUS) for the constitution of regionalized care networks. This is an integrative review, including Brazilian studies and full text, in Portuguese, and available in the CAPES, BVS and Google Scholar databases. The searches returned 48,083 documents and, after selection with the PRISMA strategy, 62 studies published between 2011 and 2020 were included. Most of the analyzed productions approach the PDFTS with comparative analyzes between the estimated needs and the current availability, being more frequent the studies of only one professional category, with emphasis on nursing. The findings contribute to the debate on the essentiality of the health workforce for the conformation of networks, by demonstrating that the calculation methods favor the use of indicators and parameters related to the provision of services in specific health facilities, especially hospitals, not operationalizing aspects of regionalization and systemic integration of the Health Care Network.

https://doi.org/10.1590/0103-1104202213519

15.

Planejamento e Dimensionamento da Força de Trabalho em Saúde no Brasil: avanços e desafios
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Carvalho, Desirée dos Santos

; Nascimento, Elisabet Pereira Lelo

; Carmona, Silvia Aparecida Maria Lutaif Dolci

; Barthmann, Vânia Maria Corrêa

; Lopes, Maria Helena Pereira

; Moraes, Júlio César de

Saúde em Debate

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dec 2022, Volume 46 N. 135 Pages 1215 - 1237

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

https://doi.org/10.1590/0103-1104202213519

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