|
Thèses |
|
1
|
-
GABRIELA EVANGELISTA PEREIRA
-
WORKING CONDITIONS AND MENTAL HEALTH: A STUDY WITH COMMUNITY HEALTH AGENTS IN BRAZIL
-
Leader : ISABELA CARDOSO DE MATOS PINTO
-
MEMBRES DE LA BANQUE :
-
ANA LUIZA QUEIROZ VILASBOAS
-
ISABELA CARDOSO DE MATOS PINTO
-
MONICA VIEIRA
-
Data: 30 janv. 2019
-
-
Afficher le Résumé
-
Objective: To investigate the occurrence of Common Mental Disorders among Community Health Agents in Brazil and its relationship with the working conditions of these professionals. Methodology: Cross-sectional, analytical study developed with a national sample of ACS. For data collection, a socioeconomic and demographic questionnaire and the Self Reporting Questionnaire were used. Initially, a descriptive analysis was carried out to characterize the sample in terms of its socioeconomic, demographic and working conditions characteristics. To verify the association between the characteristics of the ACS and the TMC, the data were submitted to bivariate analysis and Multiple Logistic Regression Analysis (MRA). Results: The prevalence of CMD among Brazilian ACS was 21%. The chance of having CMD was higher among female ACS, with a performance time of more than 5 years, among those who did not feel respected by colleagues and among ACS who were dissatisfied with the work. Conclusion: The results of this study show that a portion of Brazilian CHA presents symptoms that are defined as Common Mental Disorder and the findingsreinforce the association between CCT and working conditions, with respect to the aspects: seniority in the position, job dissatisfaction and sociopolitical conditions (interpersonal relations)
|
|
2
|
-
Fernanda Macedo da Silva Lima
-
ZIKA VIRUS TIMES MANAGEMENT: EXPERIENCES OF WOMEN WHO FULFILLED AFTER THE ZIKA VIRUS IN BRAZIL
-
Leader : JORGE ALBERTO BERNSTEIN IRIART
-
MEMBRES DE LA BANQUE :
-
JORGE ALBERTO BERNSTEIN IRIART
-
GREICE MARIA DE SOUZA MENEZES
-
JACQUELINE ISAAC MACHADO BRIGAGÃO
-
Data: 14 févr. 2019
-
-
Afficher le Résumé
-
The arrival of zika virus in Brazil in 2015 and its main consequence, congenital zika virus syndrome, with repercussions on fetal and child development, caused national commotion and highlighted the need for the development of special care among women of reproductive age and, mainly by pregnant women. This new situation influenced the experience of women who became pregnant soon after the epidemic of this virus in the country. However, to date, no study has investigated the experience of pregnant women according to their socioeconomic conditions and specific cultural and environmental contexts. Therefore, the objective of this study was to understand the meanings, practices and prevention strategies developed by pregnant women from different social strata of the city of Salvador-Bahia, as well as the contribution of their partners to deal with the risk of infection after the emergence of zika virus in Brazil. This is a qualitative study, based on the content analysis of semi-structured interviews with 18 pregnant women, nine from the popular classes and nine with middle-class / high-class pregnant women. These women were stratified according to level of schooling, place of residence and type of insertion in health services. The data produced showed deficiencies in the knowledge of pregnant women about important aspects of zika virus infection, although all were linked to health services for prenatal care. Social media was characterized as important information vehicles on the zika virus, which influenced the way pregnant women meant the virus. While middle-class / high-class pregnant women portrayed the zika virus as a "apprehension" or "one more concern during pregnancy," pregnant women of popular class meant zika virus as a "very serious disease" and developed feelings such as "fear", "panic”, causing them to go through the “whole insecure pregnancy”. Social stratification and the environmental context also influenced the prevention strategies developed by these women. The development of environmental and bodily practices to reduce the risk of infection were more evident among pregnant women of the popular class because they felt more exposed to the risk in the environment in which they live. The partners charged pregnant women intensively with preventive measures, but they did not develop body-care practices to avoid mosquito bites even though the virus was also sexually transmitted. Therefore, it is essential to invest in health actions that include men as subjects that are also responsible for preventive practices during pregnancy, as well as to develop training for health professionals to ensure culturally relevant information for women about zika virus infection and its consequences.
|
|
3
|
-
Juan Pablo Aguilar Ticona
-
Incidence of clinical outcomes and developmental changes in children born during the ZIKV outbreak: a cohort study in an urban community in Brazil.
-
Leader : FEDERICO COSTA
-
MEMBRES DE LA BANQUE :
-
DARCI NEVES DOS SANTOS
-
FEDERICO COSTA
-
JAMARY OLIVEIRA FILHO
-
Data: 18 févr. 2019
-
-
Afficher le Résumé
-
Northeast Brazil was the epicenter of the Zika epidemic in 2015, yet little if any prospective information exists on Zika virus (ZIKV) transmission among pregnant women from the region and clinical outcomes of their infants. We have been conducting a community-based prospective study of leptospirosis among urban slum residents since January 2013 in Salvador, Brazil. From this population, we identified women who were pregnant from January 2015 to June 2016 and identified incident Zika seroconversion events among participants by analyzing biannually collected samples for the ZIKV35 monoclonal antibody using the Blockade of Binding (BoB) assay. We evaluated adverse outcomes during pregnancy, birth and infancy by interviewing mothers and performing anthropometric measurements as well as neurologic (Hammersmith Infant Neurological Exam, HINE), audiometric and ophthalmological evaluations and examinations with Bayley Scales of Infant Development III. Among a cohort of 655 participants, 66 (10%) had at least one pregnancy during the study period. We completed follow-up for 46 (70%) of the 66 women, of whom Zika seroconversion occurred prior to, during and after pregnancy in 25 (54%), 13 (28%), and 1 (2%), respectively. The 46 infants did not have evidence of microcephaly or congenital defects at birth. However, the 13 infants of mothers who seroconverted during pregnancy had increased risk of having a low cognitive score < 1SD (RR 2.96; 95% CI 1.32 – 6.63) than the 33 infants of mothers who did not seroconvert during pregnancy (4 of 13 [31%] vs. 2 of 33 [6%], respectively). Similarly, infants of mothers who seroconverted during pregnancy had increased risk (RR 6.82: 1.54 – 30.17) of having altered behavioral audiometry findings than infants of mothers who did not seroconvert during pregnancy (5 of 13 [39%] vs. 2 of 31 [7%], respectively). These findings suggest that a significant proportion of infants exposed in utero to ZIKV develop developmental deficiencies despite the absence of clinically evident neurological sequelae.
|
|
4
|
-
ACÁCIA MAYRA PEREIRA DE LIMA
-
USE OF POST-EXPOSURE PROPHYAXIA (PEP) BETWEEN WOMEN'S WORKERS IN SEX IN BRAZIL
-
Leader : MARIA INES COSTA DOURADO
-
MEMBRES DE LA BANQUE :
-
CARLA GIANNA LUPPI
-
LAIO MAGNO SANTOS DE SOUSA
-
LEILA DENISE ALVES FERREIRA AMORIM
-
MARIA INES COSTA DOURADO
-
Data: 7 mars 2019
-
-
Afficher le Résumé
-
Background: Use of post-exposure HIV prophylaxis (PEP) is critical for women and especially for sex workers (FSW) as a method of preventing HIV transmission. However, FSW still faces barriers to PEP access in many places, including Brazil. Our objective was to analyze factors associated with PEP use among FSW after sexual assault in Brazil. Methods: A cross-sectional study of 4,245 FSW recruited in 12 Brazilian cities by respondent driven sample (RDS) in 2016. Participants were interviewed and the associations of behavioral, sociodemographic, health service related variables, social support and history of violence and discrimination with PEP use after sexual assault were analyzed. For each city, individuals were weighted using RDSII estimator. Combined data was analyzed by STATA 14 complex survey procedure using each city as a stratum and each group of women recruited by the same FSW as a cluster. Odds ratios and 95% CI were estimated using logistic regression. Results: Half of FSW was below 30 years of age and 48% did not complete high school. 73.9% black; with lower socioeconomic level (56.2%), 31% were aware of PEP, 26.3% reported an episode of sexual assault during a lifetime. After sexual assault, 7.5% used PEP, 18.7% went to a health clinic but did not have access to PEP and 73.8% did not search for health assistance. Factors associated with PEP use after sexual assault were: PEP awareness (OR: 3.71); participation in HIV educational activities (OR: 1.53); disclosure of FSW status to a health care provider (OR: 1.80) and number of clients per day (1-9 vs 10 or more) (OR: 6.67). Conclusions: Despite the existing policy for victims of sexual assault in Brazil with PEP included, PEP use after sexual assault was extremely low among FSW even for those who sought health assistance indicating inequity in access. Screening, documentation and care for victims of sexual assault, such as counselling and engagement in proper care are essential to promote access to HIV preventive services. Health services should be better qualified to care for FSW victims of sexual assault.
|
|
5
|
-
FLAVIA CONDE CABRAL E DIAS
-
HEALTH PARTICIPATION: BRAZILIAN SCIENTIFIC PRODUCTION 2003 - 2016
-
Leader : CARMEN FONTES DE SOUZA TEIXEIRA
-
MEMBRES DE LA BANQUE :
-
ANA LUIZA QUEIROZ VILASBOAS
-
CARMEN FONTES DE SOUZA TEIXEIRA
-
MARCELO NUNES DOURADO ROCHA
-
Data: 19 mars 2019
-
-
Afficher le Résumé
-
Public participation has been incorporated into ideological movements, policies and health programs for more than half a century, being included in the public debate in Brazil since the 1970s. It has been subject of conceptual controversies with advances and regressions regarding to its effective institutionalization in the context of Health Policy, particularly within the last 30 years context of the construction of the Unified Health System. It is therefore, relevant subject of scientific research, having stimulated the production of heterogeneous set of studies and research that deal with several aspects and participation practices. The objective of this work is to map and analyze the scientific production on health participation in Brazil in the period 2003-2016, aiming to characterize the temporal evolution and the distribution of the articles on the matter, according to publication vehicle and institutional origin of authors as well as, identifying and analyzing forms of participation in health addressed in the articles selected in the Scielo database. A total of 216 articles were analyzed, showing considerable growth in the period 2003-2016, the majority of which coming from authors linked to institutions in the southeast region of the country. The predominance of studies that approach institutionalized forms of engagement in health councils and conferences was found, especially at municipal level, but there are a significant number of articles that present practices of participation in disease control programs or in primary health care. Studies that analyze participation in social movements and their representatives’ involvement in the formulation of health policies were also identified. It is discussed the possible relationship of this production with the stimulus resulting from the implementation of policies, programs and institutional norms, which culminated in the implementation of the National Strategic and Participative Management Policy - PARTICIPASUS, concluding with the reflection about the risks to which this policy is exposed in the current conjuncture.
|
|
6
|
-
ANNY KAROLINY DAS CHAGAS BANDEIRA
-
Association between free time physical activity and non-alcoholic fatty liver disease in adults participating in ELSA-Brazil. Salvador; 2019
-
Leader : FRANCISCO JOSE GONDIM PITANGA
-
MEMBRES DE LA BANQUE :
-
ANDRE CASTRO LYRA
-
FRANCISCO JOSE GONDIM PITANGA
-
YUKARI FIGUEROA MISE
-
Data: 26 avr. 2019
-
-
Afficher le Résumé
-
It is estimated that the overall prevalence of non-alcoholic fatty liver disease (NAFLD), diagnosed by imaging tests, is around 25.24%. Evidences corroborates that the regular practice of physical activity provides improvement on the indexes in the lipid profile, in addition to controlling for abdominal obesity and insulin resistance, being important factors for the treatment of NAFLD. The present study aims to evaluate the association between physical activity in free time and non-alcoholic fatty liver disease in adults participating in ELSA-Brazil. A cross-sectional study with baseline data from the project "Longitudinal Study of Adult Health (ELSA-Brazil)." The sample after inclusion and exclusion criteria was composed of 12,554 public servants aged between 35 and 74 years old, actives and retirees from teaching and research institutions in six Brazilian capitals (Belo Horizonte, Porto Alegre, Rio de Janeiro, São Paulo, Salvador and Vitória), conducted between 2008 and 2010. In order to determine the association between physical activity the logistic regression model with the backward modeling was used, starting from the complete model up to the adjusted model. For the analysis of the dose-response effect in the association between AF and DHGNA derivations, dummy variables were created for comparison between the reference group (physically inactive) and each of the other strata of the variable AF (little active, active and very active). It was used IC confidence interval (95%). The analyzes were performed using the statistical program Stata, version 12.0. The results showed that the level of physical activity in the sample is low 38.69% and the prevalence of NAFLD is 39.74%. When AF is analyzed in a dichotomized way, a protective factor is observed between eutrophic / overweight men and women. Among the obese, physical activity does not behave as a significant protective factor. When AF was analyzed in four categories, it was observed that both among women and in overweight / eutrophic men, the more physical activity, the higher the protection factor compared to NAFLD. In obese women, a protective factor was observed only among those who were insufficiently active and very physically active. The dose-response effect was not observed in obese men. It is concluded that physical exercise is an important therapeutic strategy to prevent fatty liver disease. It is noticed that the greater the amount of physical activity in eutrophic / overweight individuals the more protective response to NAFLD in both men and women. In the risk group that are obese, isolated physical activity is not fully effective, especially in men, since it requires other combined therapies to collaborate to improve the health of individuals.
|
|
7
|
-
GELVISON GOMES MACÊDO
-
THE CONSTRUCTION OF THE NATIONAL POLICY OF INTEGRAL HEALTH OF THE LGBT POPULATION IN BRAZIL
-
Leader : CARMEN FONTES DE SOUZA TEIXEIRA
-
MEMBRES DE LA BANQUE :
-
AILTON DA SILVA SANTOS
-
CARMEN FONTES DE SOUZA TEIXEIRA
-
MARCELO NUNES DOURADO ROCHA
-
Data: 6 mai 2019
-
-
Afficher le Résumé
-
The aim of this study is to analyze the characteristics and tendencies of the scientific production on the Health of the LGBT Population in Brazil by seeking to identify their health problems and needs, as well as the challenges and obstacles they face in meeting their demands for actions and services and guaranteeing the right to health. It is a systematic review of the literature, in which 70 papers published from 2000 to 2018, indexed in the Scielo and Lilacs databases, were analyzed. The results show poor access to services and low quality of care for the LGBT population motivated by the occurrence of discrimination, prejudice and symbolic violence in the institutions. It was also observed that a significant percentage of individuals are engaged in unprotected sexual practices and with psychological damage. The conclusion is that there is a need for further development of research in this area, mainly on the prevalence of chronic non-communicable diseases as well as on the approach to female homosexuality and its specific health needs, in order to support the search for alternatives and the improvement of the programs which offer health care to this population, so that the full exercise of their rights is guaranteed.
The aim of this work is to analyze the process of construction of the National Policy for Comprehensive Health of Lesbians, Gays, Bisexuals, Transvestites and Transsexuals (NPCH-LGBT) in SUS. In order to do so, the theory of the public policy cycle was used as a reference to characterize the political scenario in which the process of entrance of the subject in the government agenda took place, the government and non-government actors involved in the process, the problems and proposals for their solution, actors and proposals. The collected and analyzed information was extracted from official documents of the Ministry of Health (MH), Minutes of the National Health Council (NHC), Reports of the National Health Conferences and documents prepared by entities of the LGBT Social Movement. The results show that the health of the LGBT population was incorporated into the government agenda in the 1980s when confronting the HIV / AIDS epidemic, but an expanded perspective on the problems of prejudice, discrimination, violence, and the need to address inequalities and iniquities in health that affect this population was only established after 2004, with the creation of the Brazil without Homophobia program. More specifically, regarding the construction of the National Policy for Comprehensive Health of the LGBT population, it identifies the moments in which the health problems of this group were discussed in meetings of the NHC and at the Health Conferences held between 2000 and 2007, systematizing the proposals that made up the structural bases of the NPCH-LGBT, approved by the NHC in 2009. In conclusion, the LGBT social movement can be pointed out as a political actor that, through its work in the institutional spaces, took advantage of the "window of opportunity" that was opened during the governments of Lula I and Lula II (2003- 2010), and managed to insert this theme in the agenda and to build, together with leaders and technicians of the MH, as well as with other government entities, the NPCH-LGBT.
|
|
8
|
-
JULMER CAISARA PACAYA
-
Effects of alcohol use on Brazilian Indigenous Peoples' lifestyles according to cultural contexts: a literature review.
-
Leader : MONICA DE OLIVEIRA NUNES DE TORRENTE
-
MEMBRES DE LA BANQUE :
-
JORGE ALBERTO BERNSTEIN IRIART
-
MARCOS LUCIANO LOPES MESSEDER
-
MONICA DE OLIVEIRA NUNES DE TORRENTE
-
Data: 29 mai 2019
-
-
Afficher le Résumé
-
Traditionally, there are perspectives that report that coming into contact with alcohol has a very clear repercussion on changing attitudes and behaviors of individuals and populations. Other approaches, more contextualized and critical, argue that one cannot focus exclusively on the psychoactive substance and its effects on the behavior of people or groups, but it is necessary to always observe these three concepts the substance, the individual and the context (OLIEVENSTEIN, 1985), analyzing the complex relationships established between them. In the case of the indigenous peoples, a wider and more contextualized conception of drug consumption can be identified. For example, in studies that focused on alcohol consumption (distilled and fermented beverages) as part of the cultural customs of each people, aspects that cannot be ignored (SANCHEZ, NAPPO, 2007). In spite of the wide presence in the cultures, it should be considered that the consumption of alcohol had restrictions in several of them, being only used by some that had an initiation or a knowledge on ways to communicate with the gods or spirits. The reports indicate that these cultural patterns of alcohol consumption have been transformed and, in traditional societies, are no longer practiced in ritual use and are nowadays mainly considered or represented as an "addiction" or even a "kind of disease". The old concept that was prevalent for decades has been gradually changing and the alcohol intake is today related to people who are dependent, concomitantly constructing the notion of a discriminated or even marginalized population, which would not be well regarded by society. It would be reductive analyzing itself the existence or not of the use of alcohol by indigenous populations without considering the historical or cultural reasons of alcohol consumption even to think of it as a dichotomy between normal and pathological. It might be better to try to understand how these practices, traditionally existing or created or modified from new cultural encounters, were able to operate on the behaviors of the indigenous people within the hamlet. In this case, I would highlight the owns concepts of alcoholism present in indigenous contexts, taking into account a context of globalization, as well as the continuous urbanization path of the villages that are located in the outskirts of cities. That said, it is undeniable the relationship that has been found between the abusive use of alcohol in any social space and the scourge that this has entailed. Indigenous peoples do not escape this problematic relationship. It is necessary, however, to take a systematic and critical approach of the research that has been studied about this theme in order to understand what it is possible to redeem with the objective to build a better understanding from the academic contribution. The present study considers that be found in the indigenous population, studies carried out in Brazil with the main interest of trying to show several contexts of the meaning of alcohol within the diverse indigenous populations and being able to show their own characteristics of consumption and how it has evolved along the time.
|
|
9
|
-
NATANAEL DE JESUS SILVA
-
Determinants of the double burden of malnutrition in children benefiting from the Bolsa Família Program: a longitudinal analysis of the Brazilian municipalities
-
Leader : RITA DE CASSIA RIBEIRO SILVA
-
MEMBRES DE LA BANQUE :
-
MAURICIO LIMA BARRETO
-
RITA DE CASSIA RIBEIRO SILVA
-
DJANILSON BARBOSA DOS SANTOS
-
Data: 10 juin 2019
-
-
Afficher le Résumé
-
Background: The decline in child stunting, still prevalent in socioeconomically vulnerable population groups, has been accompanied by the progressive increase in overweight and chronic noncommunicable diseases, resulting in a double burden of malnutrition (DBM) scenario in many developing countries. Objective: To measure the double burden of malnutrition and its socioeconomic determinants in children beneficiaries of a conditional cash transfer program in Brazilian municipalities. Methods: An ecological study using panel data on the prevalence of stunting and overweight in under 5-year-old children beneficiaries of the Bolsa Família Program in 4,443 Brazilian municipalities between 2008 and 2014. The municipalities were classified according to four scenarios of coexistence between stunting and overweight, including the DBM. Multinomial logistic regression models with fixed effects was conducted to assess the association between socioeconomic variables and the nutritional scenarios. Results: Mean reduction from 14.2% to 12.7% in the prevalence of stunting and mean increase from 17.2% to 18.4% in the prevalence of overweight were observed. The predominant nutritional scenarios in most municipalities were represented mainly by high rates of overweight and DBM, both associated to the progressive increase of GDP per capita. Expected years of schooling, unemployment rate, and household crowding were also associated with the scenarios analyzed. Conclusions: Our findings evidence an advanced stage of nutritional transition among children in the more socioeconomically vulnerable stratum of the Brazilian population, which is marked by an increase in the burden of overweight only or coexisting with stunting (double burden).
|
|
10
|
-
MATEUS FREIRE DE LIMA E SOUZA
-
From illicit drug to psychoactive drug: medicalization in therapeutic itineraries of young people attending a CAPSad in Salvador, Bahia
-
Leader : LENY ALVES BOMFIM TRAD
-
MEMBRES DE LA BANQUE :
-
ALBA RIVA BRITO DE ALMEIDA
-
LENY ALVES BOMFIM TRAD
-
MONICA DE OLIVEIRA NUNES DE TORRENTE
-
SERGIO DO NASCIMENTO SILVA TRAD
-
Data: 3 juil. 2019
-
-
Afficher le Résumé
-
Illegal drug use is prevalent among young individuals and is often correlated with social vulnerability. Treatment for substance abuse and addiction is usually reliant on multiple psychosocial interventions. Along with possible courses of action, young patients are often referred to psychiatric evaluation and treatment; however, current evidence does not support psychopharmacological management of cannabis or cocaine-related substance use disorders. To access how medicalization impacts young illicit drug users’ treatment choices and outcomes, a qualitative case study was carried out in a public center for psychosocial care of addiction and comorbid disorders in Salvador, Bahia. Semi-structured interviews were conducted with 14 young patients and 7 health professionals. Also, auto-ethnographic field notes were taken by the main researcher, who is also the acting psychiatrist in this healthcare center. Data analysis was based on a holistic model for therapeutic itineraries developed by Trad, L. Treatment choice was shown to be dependent on multiple external factors, including income, family status, access to healthcare facilities and legal issues. Most patients had already begun using psychiatric drugs before starting follow-up in the healthcare center. Medicalization of care in many cases resulted from a substitution of the illicit drug used as a self-care measure by a pharmaceutical treatment. Interviewed subjects also held the belief that psychiatric medication is capable of directly or indirectly reducing drug-seeking behaviors. Cordial interactions with care providers and freedom to choose the course of treatment were key aspects of positive therapeutic outcomes.
|
|
11
|
-
ELIS PASSOS SANTANA
-
KNOWLEDGE AND REFUSAL OF PURCHASE OF THE HIV SELF-TEST BY SEX WORKING WOMEN IN BRAZIL
-
Leader : MARIA INES COSTA DOURADO
-
MEMBRES DE LA BANQUE :
-
ANA MARIA DE BRITO
-
FLORISNEIDE RODRIGUES BARRETO
-
LAIO MAGNO SANTOS DE SOUSA
-
MARIA INES COSTA DOURADO
-
Data: 10 juil. 2019
-
-
Afficher le Résumé
-
Background: The recent launch of HIV self-testing (HIVST) policy (2019) in the Brazilian National Health System is expected to increase the uptake and frequency of HIV testing. Current estimate of HIV prevalence among FSW in Brazil is 5.3%. HIV testing becomes particularly relevant as a point of entry to health care and treatment. We aimed to investigate associated factors with acceptability of HIVST among FSW in Brazil. Methods: A cross-sectional study of 4,245 FSW recruited in 12 Brazilian capital cities by respondent driven sample (RDS) in 2016. Participants were interviewed and the associations of behavioral, sociodemographic, health service related variables, social support and history of violence and discrimination with HIVST acceptability were analyzed. For each city, participants were weighted using RDSII estimator. Combined data was analyzed by STATA 14 complex survey procedure using each city as a stratum and each group of women recruited by the same FSW as a cluster. Odds ratios and 95% CI were estimated using logistic regression.Results: Half of FSW was below 30 years of age and 48% did not complete high school. 73.9% self-identified as black; with lower socioeconomic level (56.2%), and were treated worse than other people in the health services for being a FSW (47.3%). 22.5% had never taken an HIV testing in a lifetime and only 32.4% were aware of HIVST before the study. Acceptability of HIVST upon explanation was high (85.6%). Factors associated with refusal were: older age (more than 40 years) (OR:1.26); self-identified as black (OR:0.71); work at street points (OR: 1,25) and number of clients per day (10 or more vs 1-9) (OR: 1,98). Conclusions: Awareness of HIVST is still low among FSW in Brazil. But it is reassuring that acceptability was high. This represents an opportunity to increase testing coverage among FSW in whom there is a gap in HIV diagnosis. Autonomy, privacy, rapid access to results, and convenience should be emphasized as motivations in developing programmatic strategies for scale-up of HIVST among FSW.
|
|
12
|
-
TIAGO BAHIA FONTANA
-
ZIKA VIRUSES IN BRAZIL (2015-2017): Entry into the Government Agenda, Alternatives and Formulation of Public Health Emergency Response.
-
Leader : SONIA CRISTINA LIMA CHAVES
-
MEMBRES DE LA BANQUE :
-
CATHARINA LEITE MATOS SOARES
-
SONIA CRISTINA LIMA CHAVES
-
WANDERSON KLEBER DE OLIVEIRA
-
Data: 18 juil. 2019
-
-
Afficher le Résumé
-
Issue: Brazil declared Public Health Emergency of International Concern (PHEIC) in November 2015, shortly after being notified about the first cases of microcephaly possibly associated with Zika virus infection. Since the declaration of PHEIC until the end of 2017, the year of its closure, the brazilian Ministry of Health (MoH) received notifications of 15,298 suspected cases of changes in growth and development possibly related to Zika virus infection and other infectious etiologies, of which 3,071 were confirmed, 339 were classified as probable and 230 as inconclusive (BRASIL, 2018). Objective: This study characterized and analyzed the state responses related to the Brazilian Federal Government in the context of PHEIC, from 2014 to 2018. Methodology: This was a case study, with a qualitative approach, based on documentary analysis, focusing on the State responses of the Brazilian Federal Government in the context of PHEIC. The official documents of the MoH and other organizations participating in the political-managerial processes of the Unified Health System (SUS) were investigated, with a theoretical-methodological perspective the Public Policy Analysis (political-national mood, entry on the agenda and alternatives), as well as the Social Determinants of Health. Results: The congenital syndrome associated with Zika virus infection reached priority in the Government Agenda in Brazil, due to a series of events, where the "Zika virus"problem was identified in April 2015 and the first mention of the problem, in the minutes of the National Health Council, occurred in November of this year, the same period in which the declaration of PHEIC was published. Therefore, between its identification and the entry on the governmental agenda, seven months passed. In the politicalnational mood, it was observed that the agenda put President Dilma Rousseff in a position of leadership with the states and municipalities, a strategic option to sustain their political capital in a period marked by changes in government and political forces with their low governability, which nevertheless did not prevent the process that culminated with its Impeachment in 2016. This study revealed three periods. The first period (2014-2015) was marked by international training in the management of public health events (Ebola and Chikungunya) and preparation for mass events (2014 FIFA World Cup and 2016 Olympic and Paralympic Games). The second period (2015-2017) was characterized by the identification of Zika virus in Brazil; identification of cases of microcephaly and other congenital alterations associated with Zika virus, with subsequent epidemic; and the learning process resulting from the response to ESPIN. The third period (2017-2018) was marked by the incorporation of new references and practices in the scope of the Health Policy, such as the obligatory entomological survey of Aedes aegypti infestation, the maintenance of the actions of the National Coordination and Control Room, and the implementation of actions integrated between Surveillance and Basic Health Care. Conclusion: Despite this, the adoption of alternatives to address the Social Determinants of Health was not implemented. The appeal to actions to combat Aedes aegypti in the community represents an ineffective effort, since structural aspects of living conditions, including urban planning, are a first condition for confronting this national problem.
|
|
13
|
-
ALINE CRISTINA GUSMAO SOUZA GOMES
-
CONTEXTUAL FACTORS ASSOCIATED WITH THE NOTIFICATION OF AUDITIVE LOSS INDUCED BY NOISE IN THE INFORMATION SYSTEM OF NOTIFICATION AGREEMENTS IN BRAZIL
-
Leader : SILVIA FERRITE GUIMARAES
-
MEMBRES DE LA BANQUE :
-
ADRIANA GALDINO BATISTA PEREIRA
-
MÁRCIA TIVERON DE SOUZA
-
SILVIA FERRITE GUIMARAES
-
Data: 24 juil. 2019
-
-
Afficher le Résumé
-
Background: Information generated by the reporting of diseases in Workers' Health (Saúde do Trabalhador – ST) on the Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação – Sinan) can be valuable for monitoring, planning actions and assessing their impact. Among work-related reportable diseases are irreversible noise-induced hearing loss (Perda Auditiva Induzida por Ruído – Pair), considered one of the most widespread and prevalent occupational health problems in the world. In Brazil, the number of cases reported in Sinan is still incipient, a fact consistent with the evidence of underreporting, common in the ST field. There is no evidence of studies investigating factors that may influence reporting of the Pair in Sinan. Objective: To investigate contextual factors associated with the reporting of the Pair on the Sinan in Brazil. Methods: Epidemiological study of mixed ecological type, exploratory, in which the units of observation were the 5,570 Brazilian municipalities between 2013 and 2015. The main variable was the reporting of Pair in Sinan. The variables were grouped into two dimensions: a) related to the municipalities: coverage by Cerest, Cerest host municipality, macroregion of the country, Unit of the Federation (UF), distance to UF capital, territorial extension, economically active and occupied population (Peao), proportion of Peao in the industries of transformation (Peao TEC), extraction and construction industry, Peao in the manufacturing industry, Peao on the extractive industry, Peao on the construction industry, Peao on formal employment and the Municipal Human Development Index (IDHM); b) related to Cerest: year of enabling, average number of employment contract, proportion of staff with statutory relationship, average number of speech therapists, and turnover of professionals. We performed both unadjusted and adjusted logistic regression with its 95% CI to assessed the association with number and proportion of municipalities that reported Pair in the Sinan according to the variables described in each dimension. The Peao was considered to be confounder a priori and included in all of the adjusted model. Statistical inferences were made with 95% confidence intervals. Results: 277 (5.0%) municipalities reported 2,588 cases of Pair in Sinan, between 2013-2015. Mato Grosso do Sul had the highest proportion of notifying municipalities (25.3%). In the adjusted model of the variables related to municipalities dimension, we observed a greater likelihood among those municipalities with coverage by Cerest, to be a Cerest host municipality, belonging to the Midwest region, with less distance to the UF capital and with a high/very high IDHM. Belonging to the North region was negatively associated with the Pair notification in these municipalities. In the dimension of the variables related to Cerest, we observed a greater likelihood associated with the municipalities that had at least one speech pathologist in the Cerest team and had low turnover of professionals. Conclusion: The reporting of Pair in Brazilian municipalities was influenced by contextual factors, either by the characteristics of the municipalities themselves and by the characteristics of the Cerest whose area of coverage they belong.
|
|
14
|
-
FRANCIANA CRISTINA CAVALCANTE NUNES DOS SANTOS
-
QUALITY OF OCCUPATION RECORDS IN ASBESTOS‐RELATED DISEASES – ANALYSIS OF DATA OF THE MORTALITY INFORMATION SYSTEM IN BRAZIL.
-
Leader : VILMA SOUSA SANTANA
-
MEMBRES DE LA BANQUE :
-
EDUARDO ALGRANTI
-
EDUARDO LUIZ ANDRADE MOTA
-
VILMA SOUSA SANTANA
-
Data: 29 juil. 2019
-
-
Afficher le Résumé
-
Objective – To estimate the quality of occupation records in the Mortality Information System, SIM, for deaths caused by asbestos‐related diseases in Brazil.
Methods – This is a cross‐sectional study, carried out with deaths records of 16 or more years of age in Brazil, registered in SIM, from 2000 to 2016. The underlying or contributing causes were filtered for asbestos‐related diseases: mesothelioma, asbestosis and pleural plaques. The "occupation" field was analyzed for completeness and consistency.
Results – From a total of 3,764 death records, 20.2% (n=760) lack occupation data. Non‐valid occupation records accounted for 40.1% (n=1,508), mainly filled with “retired” or “housewives”, not formal job titles. Cases of asbestosis show the worst occupation record quality, 69.0% of missed/inconsistent, followed by 64.2% for pleural plaques. The poor quality of the occupation record was higher than 50.0% of the DAA records in all regions of the country. There were no significant differences in the quality of occupation records in relation to the specific diagnoses, whether DAA or others.
Conclusion – The quality of occupation records in SIM needs to have better completeness and records consistency for both asbestos‐related diseases and other diagnoses.
|
|
15
|
-
TATIANA SOUZA OLIVEIRA
-
THE CHILDREN OF ZIKA: meanings attributed to the association between microcephaly and Zika virus epidemic, by caregivers of the affected children and their care experiences
-
Leader : MARCELO EDUARDO PFEIFFER CASTELLANOS
-
MEMBRES DE LA BANQUE :
-
MARCELO EDUARDO PFEIFFER CASTELLANOS
-
JORGE ALBERTO BERNSTEIN IRIART
-
ALESSANDRA SANTANA SOARES E BARROS
-
Data: 8 août 2019
-
-
Afficher le Résumé
-
The epidemic of the Zika virus, which was characterized as a mild infection, began to take on the national scene when a possible association with the increase in the number of microcephaly cases in children was suggested. From the doctors' suspicion to recognition by the Ministry of Health, the feeling of uncertainty only increased. The birth of children with brain malformations, hitherto little seen by the media and the authorities, has become a concern that required fast decision-making and the need to disseminate information. It is striking how the less privileged classes were mostly hit. Thus, the family impact that this event has caused and the process of vulnerability to which the most affected families were exposed decades ago in Brazil, aroused the interest in researching on this subject. Overall objective: To understand the meanings attributed by caregivers of children with ZIKV associated microcephaly to such an event and how these meanings relate (or not) to their care experiences. Specific objectives: to identify the caregivers' view on the etiology of microcephaly associated with ZIKV, as well as the possible role of the State in relation to the control of some of its determinants; understand the caregivers' gaze in front of this child, considering their experience of care; to identify if the situations of vulnerability to which these families are exposed, are present in their narratives. Methodological strategies: A qualitative research was carried out involving mothers of children with ZIKV associated microcephaly seen at the Sarah / Salvador unit of the Sarah Network of Locomotor Apparatus Hospitals. Initially, a sociodemographic survey of 261 mothers of children diagnosed with microcephaly and ZIKV, attended at that unit, was carried out through chart analysis. Then, semi-structured interviews were conducted with 25 of these mothers, recorded and transcribed. The thematic analysis of content of the transcriptions, guided by Symbolic Interactionism, was carried out. Results: The majority of mothers attended came from peripheral districts of Salvador and from the interior, and education was predominant among those who attended high school. It was observed that mothers have no doubt that microcephaly is a consequence of virus contamination. The media were the main sources of information. Despite recognizing the increased environmental risks to which they are exposed, most mothers do not relate them to social inequalities. The meanings attributed to the relationship between the epidemic and the microcephaly are directed to experiences of biographical rupture, which situate the challenges faced in the family and work context. These challenges involved the abandonment of work activities, social isolation and the need to seek help to support the shared care of their children. The interactions that emerged with the epidemic, the gestation and birth of a child with microcephaly by ZIKV led these mothers to re-signify the care of their children, their life projects and to organize themselves as a new collective subject. Conclusions: By bringing the caregivers' understanding of the phenomenon to the table, we foster the debate with the objective of giving visibility to these children and their families, aiming at discussing policies that can support them in face of the permanent illness and the absence of State as intermediary of this process.
|
|
16
|
-
FILIPE MATEUS DUARTE SIMÕES
-
I arrive picking up people: analysis of young gay narratives about seeking care after the discovery of HIV infection in Salvador, Bahia
-
Leader : LUIS AUGUSTO VASCONCELOS DA SILVA
-
MEMBRES DE LA BANQUE :
-
LUIS AUGUSTO VASCONCELOS DA SILVA
-
MARCELO EDUARDO PFEIFFER CASTELLANOS
-
MARIA INES COSTA DOURADO
-
VERIANO DE SOUZA TERTO JUNIOR
-
Data: 19 août 2019
-
-
Afficher le Résumé
-
In Brazil, over the last 10 years, there has been a growing picture of HIV / AIDS among young people, with an increase in the detection rate, especially among young gay men and other men who have sex with men (MSM). Also in recent years, reference to new prevention and treatment technologies has impacted the natural history of HIV infection and the narratives of young people and others living with HIV. In the 4th decade of the HIV / AIDS epidemic, these elements have enabled full medical management and clinical “normalization” of HIV, assuming it is a regular part of health and social relations. The present work has as main scope to understand aspects of the trajectories of young gay men after the discovery of their HIV positive serology. To this end, narrative interviews were conducted with 14 young gay men who were diagnosed in 2016, as part of an epidemiological survey conducted in the city of Salvador-Bahia. In this direction, the ways in which these young people start to build their daily relationships based on HIV will be discussed, as well as the repercussions in the process of searching for a health service and the process of continuous care of HIV. For some young people, from the discovery of the new serological condition, daily life will be inhabited by a lot of “ingredients”, such as the challenges in the field of work and family, the expectation of a “matched love” or even a “transaction”. casual ”that overcomes the presence (secret or revealed) of HIV, as well as being experienced with the presence of individual, collective and programmatic obstacles to maintaining their health care. Thus, even in times of “normalization” of AIDS, the daily life after this event will not be uniform for everyone, since revealing or keeping serology secret can be a challenge, a complex process along which it is present. if the fear of rejection, the idea of guilt and the feeling of shame, as stigma, prejudice and discrimination still justify difficulties
|
|
17
|
-
ANNE SOARES SILVEIRA
-
Analysis of the offer in specialized and hospital care in the Metropolitan Region of Salvador.
-
Leader : JAIRNILSON SILVA PAIM
-
MEMBRES DE LA BANQUE :
-
ALCIONE BRASILEIRO OLIVEIRA
-
JAIRNILSON SILVA PAIM
-
LIGIA MARIA VIEIRA DA SILVA
-
THAIS REGIS ARANHA ROSSI
-
Data: 27 août 2019
-
-
Afficher le Résumé
-
The analysis of the Brazilian health system reveals the expansion of access and coverage of basic care and complex care processes. However, it maintains the problems that affect the provision of services. For example, the concentration of resources of medium and high complexity in large urban centers and, above all, the dependence of SUS on the private sector. With the objective of analyzing the adequacy of the offer in specialized and hospital care, a study was carried out on the aggregates of the supply of health facilities and the potential coverage of beds, consultations, equipment and medical professionals, having as a unit of analysis the municipalities that integrate the Metropolitan Region of Salvador, Bahia, between the years of 2012 and 2017. Secondary data were used in the Outpatient Information System of SUS, National Register of Health Establishments, Brazilian Institute of Geography and Statistics and National Agency of Supplementary Health. The existing national parameters for the public sector served as a reference for the evaluation of the offer. There was a concentration of health centers in the city of Salvador (82.7%), of which 90.7% did not attend the SUS. In turn, there is a high supply of diagnostic and deficit equipment in all the medical specialties analyzed. Even though hospital beds offer the recommended standard, SUS beds account for less than 50% of the total. The findings of this study may contribute especially to the organization of the service network in RMS, aiming to assist in health planning, as well as giving greater visibility to the social control to be exercised by the population.
|
|
18
|
-
Arlindo Pacheco dos Santos Neto
-
REGULATORY ASSESSMENT OF CARE TO WOMEN VICTIMS OF SEXUAL VIOLENCE IN A REFERENCE SERVICE IN SALVADOR
-
Leader : ANA LUIZA QUEIROZ VILASBOAS
-
MEMBRES DE LA BANQUE :
-
ALBERTO PEREIRA MADEIRO
-
ANA LUIZA QUEIROZ VILASBOAS
-
GREICE MARIA DE SOUZA MENEZES
-
NADIRLENE PEREIRA GOMES
-
Data: 28 août 2019
-
-
Afficher le Résumé
-
It is estimated globally that 2 to 5% of women are victims of sexual violence, an incidence of 12 million cases each year, which is 20% of women victims of violence worldwide. In Brazil, it is estimated that every seven minutes a woman is a victim of sexual violence. This is anevaluative of Normative type study, whose objective was to analyze the attention to women victims of sexual violence, based on the perception of medical professionals in a reference service in Salvador Bahia. Therefore, the theoretical-logical and logical-operational models were constructed, based on Technical Standards of Brazilian Ministry of Healththat guide the attention to people victims of sexual violence. The data were collected through semi-structured interviews, applied face to face with obstetricians directly involved in the care of women assisted in the service, besides the unit manager. Then, the data were analyzed considering the judgment matrix that punctuated the actions taken, in the light of those provided for the Technical Standards according to four dimensions: Humanization of Care; Availability and Sufficiency of Inputs; Information Registration; Collection of Traces; Knowledge of Technical Standards and Service Disclosure. The results show that the attention in the studied service is partially implemented. The discussion was held by arranging the dimensions in two strands: Humanization of services and Knowledge of the Technical Standard and dissemination of the service. The importance of professional medical training, the disclosure of this service to strengthen their visibility and the access to women victims of sexual violence was considered.
|
|
19
|
-
CAMILE BATISTA CABRAL
-
Child Development in the Context of Primary Care: intervention model for children with disabilities and caregivers
-
Leader : DARCI NEVES DOS SANTOS
-
MEMBRES DE LA BANQUE :
-
DARCI NEVES DOS SANTOS
-
MONIQUE AZEVEDO ESPERIDIAO
-
STELLA MARIS NICOLAU
-
SILVIA DE OLIVEIRA PEREIRA
-
Data: 27 nov. 2019
-
-
Afficher le Résumé
-
The policy of people with disabilities has not translated into the implementation of a line of care in Primary Care or structured operational proposals, making child care still insufficient and unclear at this level of care. The occurrence of the microcephaly outbreak and other changes resulting from Zika Virus increased the number of children with disabilities, highlighting structural problems in the provision of health care, giving visibility to this issue. This study aims to analyze the limits and possibilities of resources of primary care, to characterize the nature of care for the promotion of child development and the mental health of family members, considering the technological density required in this care space and its relations with the family. specialized level of attention. A systematic integrative review was conducted to identify available evidence to guide practice with children and their families in the context of AB. Primary studies that described actions implemented in the context of primary care between 2014 and 2018 were examined. This study categorized: 4 training programs, use of 12 different types of screening instruments and identified 11 actions, five of which support / stimulate development, five family support and one community based. early detection (use of screening tools). In general, these have led to increased levels of development and social participation; provision of community health / resource guidance and information; definition of therapeutic project articulated with other levels of attention; and family welcome. This review provided evidence of the gap in assistance for monitoring child development in the context of PHC, especially for children with disabilities. The nature of these studies also brings an important reflection on the available interventions, since most of them focus on screening and detection, leaving aside the space where life happens: the family and the community.
|
|
20
|
-
MICHELLE CASTRO MONTOYA FLORES
-
Accommodations provided in the cognitive performance assessment instrument: an experience with children with multiple disabilities with congenital Zika virus syndrome.
-
Leader : DARCI NEVES DOS SANTOS
-
MEMBRES DE LA BANQUE :
-
ANDREA PEROSA SAIGH JURDI
-
DARCI NEVES DOS SANTOS
-
LETICIA MARQUES DOS SANTOS
-
Data: 2 déc. 2019
-
-
Afficher le Résumé
-
Zika Virus Congenital Syndrome (ZVCS) comprises a set of defects and alterations that interfere with the course and progress of the Central Nervous System (CNS) maturation, resulting in multiple system disabilities that may interfere with the child's cognitive skills and with the social and family interaction. Given this condition, it is emphasized the importance of conducting an early assessment of development proposing the use of accommodations in the Instruments enabling greater precision in the estimation of results than conventional tests, with the option of the Bayley Scale. The aim of this study was to describe Bayley Instrument proposed accommodations for the assessment of the development of children with multiple disabilities. The study was delineated as a literature review and articles published between 2001 and 2018 in the PubMed, Scielo, Lilacs and CAPES indexed periodicals were selected. Following the search strategy, 69 articles were identified and based on the inclusion and exclusion criteria of the present study, only 04 articles were selected at the end. It was also included for final analysis the Manual with accommodations for the Bayley Instrument prepared as a technical guideline to assist Bayley's administration with accommodation in the cohort study to which the present work is linked. Regarding the accommodations used, the studies classified as: material, procedural and instructional accommodations, observing that most of them were proposed in the tests to predominantly minimize the condition of motor and sensory disabilities. The results showed that children with multiple disabilities can benefit from accommodations for performance evaluation especially on Bayley's cognitive scale. Similar results could be observed in possible studies using accommodations in the evaluation of children with multiple disabilities due to ZVCS.
|
|
21
|
-
STEFFANE CAVALCANTI RODRIGUES
-
I know that what I live many other women live in: A feminist-political perspective on caring for women's lives Community Health Workers
-
Leader : CLARICE SANTOS MOTA
-
MEMBRES DE LA BANQUE :
-
CLARICE SANTOS MOTA
-
ILZE ZIRBEL
-
MONICA LIMA DE JESUS
-
YEIMI ALEXANDRA ALZATE LOPEZ
-
Data: 4 déc. 2019
-
-
Afficher le Résumé
-
There is an unequal allocation around care tasks that is not random and obeys an oppressive structure of society, functioning through hierarchies of sex, race / color and social class. Among the caregivers are more women, black and poor women; Among those receiving the most intensive care (in quality and quantity) are the richest white men in the population. We observe that the base of the Brazilian social pyramid (black and poor women) corresponds to a population of professionals of primary care of the SUS, the Community Health Agents, which are a professional category formed mainly by women, the blackest and poorest. among the other professionals. These women are differentially held responsible for care work, which entails various conditions of vulnerability throughout their lives. The main objective of this dissertation is to understand the realities of care present in the lives of women Community Health Agents living in the rural area of Chapada Diamantina, Bahia. We resorted theoretically and methodologically to the ethics of care, the political theory and the concept of intersectionality thought from the perspective of feminist authors. Six months of fieldwork were conducted at the Caeté-Açú Family Health Unit, Bahia, with data collection supported by participant observation and narrative interviews. The results point to gender inequalities and vulnerabilities associated with care tasks in the lives of these women, which were listed in macro and micro categories. Among them, women's socialization, differentiated responsibility, self-care, reciprocity, sexual and racial division of domestic work, public and private spheres, family, maternity and violence. We conclude that the strengthening of the socialization of care and public policies that aim to contribute to the end of social inequalities, gender and race / color, present in care work, mean the strengthening of fairer and more democratic models of society. Care needs to be understood as a priority political responsibility and the balance of their practices needs to be made between actresses and social actors, as advocated by a political-feminist perspective of care.
|
|
22
|
-
FABÍOLA AZEVEDO ARAÚJO
-
CHALLENGES OF INTEGRAL CARE TO SICKLE DISEASE: LIMITS AND POSSIBILITIES OF PROFESSIONAL AWARENESS THROUGH AN EXTENSION COURSE IN EAD
-
Leader : CLARICE SANTOS MOTA
-
MEMBRES DE LA BANQUE :
-
CLARICE SANTOS MOTA
-
JANE MARY DE MEDEIROS GUIMARÃES
-
LILIANA SANTOS
-
ODETE MESSA TORRES
-
Data: 18 déc. 2019
-
-
Afficher le Résumé
-
The Collective Health Extension Course on Comprehensive Health Care for People with Sickle Cell Disease (ExtSCDF) emerged as a demand from the Ministry of Health to advance the inclusion of people with sickle cell disease (DF) in the primary care network, aiming at the offer of actions aimed at health promotion and prevention of complications of the disease. The course was designed to raise awareness and meet the knowledge and learning needs of primary care professionals about sickle cell disease and aimed to reach 1,500 health professionals, covering the whole of Brazil. The focus on Primary Care was due to the fact that, in addition to being the first professionals to treat users with the disease in health facilities, they are also those who have less approach to the theme, hitherto restricted to the scope of specialized care, under the sieve of hematologists, depriving the person living with the disease of comprehensive care. However, throughout the course, other professionals were inserted, as well as people of social control, members of the Associations of people with DF. This study aims to analyze the limits and possibilities of the ExtSCDF Course for sensitizing health professionals in the perception of students living in Salvador. Interviews were conducted with people who took the course in Salvador, Bahia, through a semi-structured script, analyzed using the Content Analysis technique. From the reports of the study participants, it was found that the course provided much more possibilities than limits for changes in the work practices of these professionals when encountering people living with sickle cell disease. This shows that the course somehow managed to sensitize professionals to the point of implementing and even modifying their work practices contributing to comprehensive care.
|
|
23
|
-
ANTONIO ANGELO MENEZES BARRETO
-
Unemployment and suicide in the Brazilian population in a capitalist crisis scenery.
-
Leader : LUIS EUGENIO PORTELA FERNANDES DE SOUZA
-
MEMBRES DE LA BANQUE :
-
LUCIENEIDA DOVÁO PRAUN
-
LUIS EUGENIO PORTELA FERNANDES DE SOUZA
-
SILVIA RODRIGUES JARDIM
-
VILMA SOUSA SANTANA
-
Data: 18 déc. 2019
-
-
Afficher le Résumé
-
In the last three decades of the 20th century, capitalism experienced a series of historical and social transformations that significantly impacted the world of work. In 2008, a financial crisis broke out in the United States (USA), which ended up undermining many of the financial institutions in this country, and damaging much of the global financial system. One of the outcomes of the global crisis of capitalism is unemployment. Understanding that health is socially determined, many studies have evaluated changes in suicidal behavior related to economic crises and its association with unemployment, mainly. Our study aims to estimate the association between unemployment and suicide among the Brazilian population in the previous period (2011-2013) and during the economic crisis 2014-2016. It is a cross-sectional study, using the death records of the Brazilian population for the period 2011 a 2016. Mortality data were extracted from the Mortality Information System (SIM) of the Ministry of Health (MS), coded according to the International Statistical Classification of Diseases and Health-Related Problems, in its tenth revision (ICD-10). The results that the suicide profile of the Brazilian population in the crisis period was similar to the profile in the pre-crisis period, in certain aspects – men and white race/color – and distinct in other – women, age group, race/color, education, marital status and work situation (employed and unemployed). Over the period 2011-2016, trends in Mortality Coefficients (CM) for suicide in employed and unemployed people evolved in such a way that it is possible to identify a percentage increase in the two groups. In both periods, occupations of retiree/pensioner, housewive, agribusiness worker in general, agricultural steering-wheel worker, bricklayer and the student were those with the highest proportions of suicide cases. Our results are not fully aligned with those of the other revised studies. As convergence we can cite the increase in the general suicide rate in the period of crisis, and in particular a greater increase in suicide rates among unemployed when compared to employed people; the risk of suicide in the occupations of housewives and farm workers; the fact that CM by suicide are higher in the indigenous population when compared to other categories of the variable race/color; a higher proportion of suicide cases and a higher risk of suicide mortality among men. However, our findings diverge from studies that found a greater risk of suicide for businessmen and some high-ranking officials in times of economic crisis. The analysis adjusted by the covariates identified lower chances of suicide among the unemployed in relation to the employed people, both in the pre-crisis period and in the period of economic crisis. Although the results found for the period of crisis presented statistical significance, suggesting the existence of a non-casual association between unemployment and suicide, it cannot be said that the outcome studied suffers effects of unemployment.
|
|
|
Thèses |
|
1
|
-
ELZO PEREIRA PINTO JUNIOR
-
IMPACT OF PRIMARY HEALTH CARE IN HOSPITALIZATION BY AVOIDABLE CAUSES IN CHILDREN UNDER 1 YEAR
-
Leader : ROSANA AQUINO GUIMARAES PEREIRA
-
MEMBRES DE LA BANQUE :
-
FÚLVIO BORGES NEDEL
-
LEILA DENISE ALVES FERREIRA AMORIM
-
MAURICIO LIMA BARRETO
-
PATTY FIDELIS DE ALMEIDA
-
ROSANA AQUINO GUIMARAES PEREIRA
-
Data: 24 janv. 2019
-
-
Afficher le Résumé
-
Hospitalizations for ambulatory care sensitive conditions (HACSC) are considered avoidable through the organization of a primary health care (PHC) system that guarantees resolute services. Given the magnitude of HACSC, this phenomenon is considered an important public health problem, especially for children. This thesis aimed to evaluate the impact of PHC on avoidable hospitalizations of children under-one-year-old in Brazil. It is composed of five articles that employ different methodologies to describe indicators and evaluate the impact of large-scale public health interventions on health outcomes. The first two articles are descriptive, and the other three adopted quasi-experimental methods. Articles 1 and 2, which aimed to analyse trends in rates and expenditures for HACSC, utilized time trend analysis and calculated Annual Percentage Change (APC) based on Prais-Winsten linear models. Joinpoint regression was applied to estimate APC in specific segments of a historical series and, based on its values and the size of each segment, to appraise the Average Annual Percentage Change (AAPC). Results from these two studies showed that there was a 7.4% reduction in HACSC rates in children under-one-year-old (APC=-7,4%; IC95%:-10,9; -3,8), and an average annual fall of 3.3% (AAPC=-3,3; IC95%: -4,8; -1,7) in expenditures due to said hospitalizations, which decreased from 154.57 to 84.32 million reals between 2000 and 2015. The third article, which evaluated the effect of the Family Health Strategy (FHS) on avoidable hospitalizations in children, applied negative binomial regression models, with panel data. Its results showed that the consolidation of coverage of the FHS was associated with a reduction in HACSC. Effects were found in all municipality strata, except for those with a population above 500 thousand inhabitants; the strongest effects were found in municipalities with a population between 50,000 and 100,000 inhabitants (RR=0,74; IC95%:0,69-0,80). The fourth article aimed to evaluate the impact of the More Doctors Programme (MDP), in its supply of physicians for PHC services throughout Brazil, and it was carried out by employing an Interrupted Time Series (ITS). It was observed that, prior to the institution of the MDP, Brazilian municipalities jointly presented a stagnated trend in rates of physicians acting within PHC services, with the lowest rates found among the municipalities that adhered to the programme. After the implementation of the MDP there was a rise in the rates of the municipalities that joined the programme; however, stagnation remained present in the municipalities that did not. The observed differences in rates of physicians in PHC between the two groups were found to be statistically significant. It should be highlighted that, in the municipalities with at least 20% of the population living in extreme poverty, the group that adhered to the MDP presented such a rise in rates of physicians in PHC that they overtook the rates of the municipalities that had not joined the programme. These findings clearly point at the success of the programme. The last article evaluated the impact of the MDP on HACSC of children under-one-year-old in Brazil, through a combination of quasi-experimental methods. The criteria used to define the MDP as an intervention were the duration of MDP program and proportion of physician of the MDP over the total amount of physician acting in PHC. In order to make the groups more comparable in terms of confounding covariables, Propensity Score Matching (PSM) was employed. Said covariables were identified through the development of a theoretical model. The Difference-in-Difference (DiD) method was used to estimate the impact of the intervention, with a negative binomial regression model, adjusting the analyses with Kernell scores obtained through the PSM. It was shown that the MDP achieved a reduction in HPCSC in children under-one-year-old and in new-borns in municipalities with a significant proportion of the population living in poverty. This thesis has highlighted that the consolidation of the coverage of the Family Health Strategy, and the creation of the More Doctors Programme may be considered effective interventions for the improvement of the health conditions of Brazilian children. Consequently, it highlighted the importance of strengthening PHC as a structuring principle of the Unified Health System, including providing it with the financial sustainability necessary for the development of its services.
|
|
2
|
-
SILVÂNIA SALES DE OLIVEIRA SILVA
-
DECISION AND IMPLEMENTATION OF THE EBSERH MODEL: the case of university hospitals in Bahia
-
Leader : ISABELA CARDOSO DE MATOS PINTO
-
MEMBRES DE LA BANQUE :
-
ANA LUIZA QUEIROZ VILASBOAS
-
ISABELA CARDOSO DE MATOS PINTO
-
KATIA REJANE DE MEDEIROS
-
MARCIA TEIXEIRA
-
RITA DE CASSIA DUARTE LIMA
-
Data: 7 févr. 2019
-
-
Afficher le Résumé
-
The research addresses hospital management as an important theme in the analysis of public health policies and is an object of constant concern on the part of managers. The delimitation related to university hospitals (HU) was the focus of the analysis of the present study. The Brazilian Hospital Services Company (EBSERH) was created in 2011 to manage the HU in Brazil, and considered for the research an alternative management model for SUS. Thus, the general objective of this study is to analyze the formulation and implementation process of the EBSERH model in the University Hospitals of the Federal University of Bahia / UFBA from 2010 to 2017. And as specific objectives, identify the legal and normative frameworks for the creation of EBSERH; describe how the decision process was made by the UFBA model (scenarios, actors, decision making and political alternatives); analyze the process of implementation of the EBSERH management in the HU of UFBA and analyze the work management policy adopted by the company from the perspective of the different actors involved in the process. For this purpose, the reference of the Public Policy Cycle is used, and for the production of information from secondary sources through documentary analysis and primary sources, making a total of 85 interviews with managers and workers of the HU. The Public Policy Cycle is taken as theoretical reference. The approval of EBSERH at UFBA was the result of numerous tensions arising from different positions of actors involved in decision arenas. The different actors participated in the process motivated by diverse interests, ideologies and objectives. The conflicts permeated the whole process, from the proposal of the policy, the announcement, the approval of the Law, the decision in the University Council, until the signing of the contract with the company. The implementation of the EBSERH policy occurred in a context of uncertainty and worker dissatisfaction. In relation to labor management, there was a sharp increase in labor relations and inequalities between workers of different legal ties and wage conditions. The results suggest that in relation to the previous model the new model implanted in the HU is close to the proposal of the New Public Management in relation to the results policy and focus on a new performance of the public service. The theoretical framework proved to be an important analytical tool, allowing to clarify several relatively obscure points about how the decisions are made, also indicating crucial aspects of the elaboration and implementation of EBSERH in UFBA
|
|
3
|
-
VINICIO OLIVEIRA DA SILVA
-
GRADUATION IN COLLECTIVE HEALTH IN BRAZIL: MULTIPLE VIEWS ON TEACHING
-
Leader : ISABELA CARDOSO DE MATOS PINTO
-
MEMBRES DE LA BANQUE :
-
CARMEN FONTES DE SOUZA TEIXEIRA
-
CRISTINA MARIA D AVILA TEIXEIRA
-
DANIEL CANAVESE DE OLIVEIRA
-
ISABELA CARDOSO DE MATOS PINTO
-
LILIANA SANTOS
-
Data: 26 févr. 2019
-
-
Afficher le Résumé
-
This study deals with the process of construction / reconstruction of the professional identities of the professors of undergraduate courses in Public Health in Brazil and their relationship with the training of the sanitarist. An exploratory study of a qualitative nature was carried out, taking as objective the identity of the professors of the undergraduate courses in Collective Health in Brazil, analyzed based on the theory of the construction of the social and professional identities of Claude Dubar. The general objective, therefore, is to analyze the process of construction / reconstruction of the professional identities of the professors of undergraduate courses in Collective Health in Brazil. The specific objectives include: a) characterize the training, the socio-professional trajectory and the practice of the professors of the graduation courses in Collective Health; b) analyze the perception of the teachers about the courses and the field of Collective Health; c) discuss the relationship between the process of construction / reconstruction of the professional identity of teachers and the training of sanitarians. The production of the data adopted the technique of semi - structured interviews, of the individual type - depth. The analysis of the material was carried out starting from the theory of the construction of the social and professional identities. The results of this study evidenced that, in fact, the CGSC implantation involved teachers with diverse backgrounds in Health and Human and Social Sciences, a characteristic diversity of the field of Collective Health, triggering a process of reconstruction of their professional identity that may present itself as a sequence of identity forms throughout their socio-professional trajectory. Aiming the construction of a teaching identity, from the processes of socialization, influenced by both professional factors and the typical forms of their individual trajectories, social worlds and systems of practices. It is hoped that these results and reflections can contribute to the identification of issues and challenges that need to be overcome in the scope of collective health training, as well as in the debate about the constitution of this field.
|
|
4
|
-
SUÉLEM MARIA SANTANA PINHEIRO FERREIRA
-
THE EFFECT OF THE PERIODONTAL CONDITION ON THE DETERMINATION OF THE CLINICAL EVOLUTION OF CHRONIC RENAL DISEASE
-
Leader : MARIA ISABEL PEREIRA VIANNA
-
MEMBRES DE LA BANQUE :
-
CARLOS ALBERTO LIMA DA SILVA
-
CAROLINA LARA NEVES
-
ISAAC SUZART GOMES FILHO
-
MARIA DA CONCEICAO NASCIMENTO COSTA
-
MARIA ISABEL PEREIRA VIANNA
-
SIMONE SEIXAS DA CRUZ
-
Data: 27 mars 2019
-
-
Afficher le Résumé
-
Some investigations address periodontitis as a non-traditional risk factor for complications and progression of CKD. Thus, the objective of this study was to investigate the association of periodontal conditions and periodontitis with CKD in individuals under hemodialysis treatment. The results were organized in three scientific papers. The first article included a systematic review with meta-analysis of studies investigating the association of periodontitis with outcomes related to the complication or progression of CKD. The meta-analytic association measures indicated a positive association of periodontitis with hypoalbuminemia (PR = 2.47, 95% CI: 1.43-4.26), high levels of C-reactive protein (PR = 1.39, 95% CI = 1.07- 1.81), death due to disease (RR = 2.29, 95% CI: 1.67-3.15) and death from all causes (RR = 1.73, 95% CI = 1.32-2.27). The other two articles are part of a prospective cohort study of prognosis, performed with 217 individuals with CKD under hemodialysis treatment in Feira de Santana-BA. Data were collected through questionnaire, oral examination and medical records. The follow up of the individuals was performed between August 2016 and December 2018. The second paper investigated the association of periodontal parameters with the evolution of laboratory biomarkers used in clinical monitoring. The CAL was negatively correlated with mean serum calcium levels (p = 0.021), phosphorus (p = 0.020) and albumin (p = 0.025) at 12 months follow up. In addition, individuals with higher CAL had significant changes in the levels of phosphorus (p = 0.053) and alkaline phosphatase (p = 0.005) in the first six months of follow-up. Individuals with higher PD had a significant increase in serum alkaline phosphatase levels (p = 0.008) between 0 and 6 months of follow-up. In addition, dental loss was negatively correlated with mean levels of phosphorus (p <0.001) and albumin (p = 0.001) over a 12-month follow-up period. In the third paper, the effect of periodontal condition on survival and risk of death was estimated. Individuals with greater tooth (p=0.025) loss and greater CAL (p<0.01) had lower survival. Those with the highest CAL also had the risk of death increased more than twice (HR = 2.88; 95% CI: 1.55-5.36 / adjusted HR = 2.28; 95% CI: 1.12-4.62). It was concluded that the periodontal condition was positively associated with the biomarkers of complication and progression of CKD.
|
|
5
|
-
PATRICIA MAIA VON FLACH
-
EXPERIENCES OF SOCIAL SUFFERING AND MOVEMENTS OF RESISTANCE BETWEEN WORKERS AND PEOPLE OF STREET (USERS OF ALCOHOL AND OTHER DRUGS), IN THE SQUARE OF THE TWO HANDS - SALVADOR-BAHIA
-
Leader : MONICA DE OLIVEIRA NUNES DE TORRENTE
-
MEMBRES DE LA BANQUE :
-
ANTONIO NERY ALVES FILHO
-
LENY ALVES BOMFIM TRAD
-
LUIS AUGUSTO VASCONCELOS DA SILVA
-
Leon de Souza Lobo Garcia
-
MONICA ANGELIM GOMES DE LIMA
-
MONICA DE OLIVEIRA NUNES DE TORRENTE
-
Data: 17 avr. 2019
-
-
Afficher le Résumé
-
This study aimed to analyze the experiences of social suffering and resistance movements expressed and/or constituted in the daily life and in the encounter between professionals working with street people and street people. It is justified by the social relevance of the theme, and also by the fact that this is a problem that isn’t much studied in the perspective of the relationship between workers and street people. It is a research that uses the ethnographic approach, having the Square of Duas Mãos, in the Comércio district (Salvador-BA) and its surroundings, as the area of study. The subjects that participated in the research were defined based on the encounters in the field of research, in the case of street people, and chosen according to criteria detailed in the methodology of the study, in the case of professionals working with street people. The most important theoretical and methodological reference, although in dialogue with other authors, was Pierre Bourdieu's reflexive sociology, finding support also in the studies and reflections of the bioethics field for the undeniable defense of the dignity and sacredness of human life. Different research techniques were used, namely: open interviews with key informants; participant observation of the daily life of street people and the relationship established between them and the workers; participant observation of supervision meetings of street professionals working with street people; group interview with the movement of the street population - Feira de Santana nucleus. The analysis of the data was based on the hermeneutics of Paul Ricoeur. As main results, it was verified that: (1) the violence imposed as a condition for living and surviving is the greatest of the violence and suffering to which street people are submitted. To let someone die or to kill in the name of justice and social protection of the ruling classes has been the fate of these people; (2) whether from the point of view of use and/or trade, drugs are an important factor in classifying and defining the position of street people in the social space, making it even more disqualified and unnecessary and, therefore, the main target of a Penal State that declares war on drugs, in fact, declaring war and extermination of people with low social value; (3) the reception and recognition, time and patience, the bonding and betting of the workers in the street and/or with street people, make it possible, under certain bioethical conditions, to change the “effects of destiny” and the construction of emancipatory solutions; (4) This study recognizes the power of good encounters - in all their beauty, joy, and refinement - for the construction of political meanings and resistance movements, born in between one another, workers and street people.
|
|
6
|
-
GEORGE AMARAL SANTOS
-
Practices of trans men for the production of a better life: on resist-existing.
-
Leader : LUIS AUGUSTO VASCONCELOS DA SILVA
-
MEMBRES DE LA BANQUE :
-
EDUARDO SODRÉ DE SOUZA
-
FRAN DEMETRIO
-
LITZA ANDRADE CUNHA
-
LUIS AUGUSTO VASCONCELOS DA SILVA
-
MONICA DE OLIVEIRA NUNES DE TORRENTE
-
Data: 26 avr. 2019
-
-
Afficher le Résumé
-
Knowledge produced in the field of health on the experience of trans men is still concentrated on the pathologization, essentialization of identities and individualization of eminently social aspects of the trans experience. This has contributed towards the production of suffering in this group, either due to the compulsory requirement of conforming their performance to the criteria of eligibility for access to healthcare, or to the processes of disengagement, stigmatization and exclusion on account of being certified as sick. The objective was to analyze the practice of trans men for producing a better life. The Actor-Network Theory emerges as a useful approach to provide insights on the dynamics of trans men in living their lives – a routine conducted through the inter-action among different groups, senses, institutions and things. The research technique was the Shadowing, used to accompany, during nine months, three trans men in their networks of associations. To resist, in the context of this study, takes up the sense of a “determination to exist”. Hence, resist-existing addresses the practices of trans men to produce a better life for themselves, steeped in the context of rejection for dissenting from the standards of gender. This could mean from strategies for coexisting or not with family members to complex architectures for maintaining their existence. In their practices, the agents of this research evoked such diverse and complex actors as are their lives. Beer; testosterone; parents; friends; buddies; doctors; social movements; trans collectives; software for smartphones; food; online virtual social networks; health, justice, higher education institutions; healthcare services; catholic saints; candles; rosaries; medicaments and a countless network of actors, elements of an unstable cloud of practices producing a better life. The constitution of the trans man from the mimesis of the cis-man or antithesis of the cis-woman puts the trans man in a lower place and establishes a narrative is presented in biomedical practices, in some academic practices, and the practices of political disputes with this population. This is embodied by some trans men and produces suffering in their experiences by putting them in unattainable paths and in no way producing care. However, other arrangements are starting points "from" trans identities, in which a better life, a multiple reality, emerges and operates realities capable of disputing with the cisheteronormative constructs. Aesthetics, semiology, trans narratives and materiality that do not stem from the cis-gender as mandatory alterity are powers that cry out to be strengthened and find/produce echoes in some trans people with whom my paths have crossed during the organization of this study
|
|
7
|
-
KAIO VINICIUS FREITAS DE ANDRADE
-
EFFECTS OF SOCIAL PROTECTION STRATEGIES AND SOCIAL DETERMINANTS IN TUBERCULOSIS AND HANSENIASIS
-
Leader : SUSAN MARTINS PEREIRA
-
MEMBRES DE LA BANQUE :
-
MAURICIO LIMA BARRETO
-
SUSAN MARTINS PEREIRA
-
JOILDA SILVA NERY
-
MARIA LUCIA FERNANDES PENNA
-
GERSON PENNA
-
Data: 29 avr. 2019
-
-
Afficher le Résumé
-
Tuberculosis (TB) and leprosy are infectious diseases whose effective control requires not only the strengthening of prevention, diagnosis and treatment programs, but also social protection strategies that contribute to the socioeconomic development of the most vulnerable populations and to coping with financial difficulties arising from illness. Objectives: 1) To identify and evaluate evidence on the effects of social protection on TB treatment outcomes in low- and middle-income countries or those with high disease burden; 2) To analyze the association between the outcome of the treatment with the sociodemographic characteristics and the social benefits received by individuals with TB followed in Salvador, Bahia; 3) To identify the association of geographic and socioeconomic factors with the abandonment of global leprosy treatment and according to the operational classification (paucibacilar - PB and multibacillary - MB), geographic region and area of residence (urban and rural) of leprosy cases in a subpopulation of the "Cohort of 100 million Brazilians"; 4) To evaluate the effect of the Bolsa Família Program (PBF) on the coefficient of detection of new leprosy cases in children under 15 years of age living in the Brazilian municipalities highly endemic to this disease. METHODS: To reach objective 1, a systematic review of the studies carried out in low- and middle-income countries or with high TB burden, published between 1995 and 2016, was conducted through PubMed / MEDLINE, Scopus, Web databases of Science, ScienceDirect and LILACS.
Only studies that investigated the effects of social protection strategies on TB treatment outcomes were included, with 25 studies selected for the systematic review. The meta-analyzes were performed with 9 randomized and controlled studies, totaling 1,687 participants. To reach objective 2, a cohort study was conducted in Salvador, Bahia, during 2014-2016, in which individuals with pulmonary TB residing in Salvador, Bahia, who were receiving social benefits during the treatment period, were followed up. from September 2014 to October 2016. The bivariate associations between TB treatment outcome, socio-demographic characteristics and social benefits were analyzed. To reach goal 3, a cohort study was conducted, in which a multivariate hierarchical analysis of the geographic and socioeconomic factors associated with the abandonment of treatment by individuals with leprosy whose families were enrolled in the Federal Government's Cadastro Único para Programas Social (CadÚnico) for Social Programs, through a linkage between the CadÚnico and the Notification (SINAN-leprosy) during 2007-2014. Additional stratified analyzes were performed according to the operational classification (PB / MB), region and area of residence of the cases (rural / urban). To reach objective 4, an ecological study was carried out, with Brazilian municipalities as units of analysis during 2004-2015. The main independent variables were PBF coverage for the target population (poor and extremely poor families) and for the total population of the municipalities studied. Data were obtained from public databases. Included in the analysis were 1,120 (out of 5,570) Brazilian municipalities. In the multivariate analysis, negative binomial models with fixed effects were used for panel data, adjusted for the municipal coverage of the Family Health Strategy (ESF) and for a set of sociodemographic covariates. Results: 1) regarding objective 1: social protection strategies were successfully associated with TB treatment (RR = 1.09, 95% CI 1.03-1.14), cure (RR = 1.11, 95% CI 95 %: 1.01-1.22) and lower risk of treatment abandonment (RR = 0.63, 95% CI 0.45-0.89). Não foram detectados efeitos sobre falha terapêutica e mortalidade; 2) referentes ao objetivo 2: foram acompanhados 216 indivíduos, sendo 79,6% curados. Maior proporção de cura associou-se com escolaridade > 9 anos (87,5%; p=0,028), união conjugal (86,3%; p=0,031) e densidade domiciliar ≤ 2 pessoas/dormitório (84,1%, p=0,013), adotando-se como referência indivíduos com escolaridade ≤ 9 anos, sem união conjugal e densidade domiciliar > 2 pessoas/dormitório. Maior proporção de cura também foi verificada entre indivíduos que recebiam benefícios governamentais e não governamentais (90,5%) ou somente benefícios diretos, que consistiam em transferências de recursos financeiros diretamente os beneficiários (81,6%); 3) referentes ao objetivo 3: De 20.063 casos novos de hanseníase inscritos no CadÚnico e diagnosticados durante 2007-2014, 1.011 (5,0%) abandonaram o tratamento. Este desfecho associou-se com: residência na Região Norte do Brasil (OR = 1,57; IC95% 1,25-1,97); etnia negra (OR = 1,29; IC95% 1,01-1,69); não possuir renda (OR = 1,41; % CI 1,07-1,86), possuir renda familiar ≤ ¼ do salário mínimo vigente (OR = 1,42; IC95% 1,13-1,77), residir em domicílios com iluminação doméstica informal ou sem fornecimento de eletricidade (OR = 1,53; IC95% 1,28-1,82) e em domicílios com densidade maior que 1 indivíduo/cômodo (OR = 1,35; IC95% 1,10-1,66); 4) referentes ao objetivo 4: Foi identificada uma tendência crescente na cobertura mediana do PBF e uma tendência decrescente no coeficiente de detecção de casos novos de hanseníase em indivíduos com menos de 15 anos de idade. Esse indicador foi reduzido significativamente nos municípios com maiores coberturas de PBF da população-alvo (RR= 0,75; IC 95% 0,63–0,88) e maiores coberturas do PBF da população total dos municípios incluídos no estudo no período de 2004-2015 (RR=0,85; IC 95% 0,79–0,93). Conclusão: estratégias de proteção social capazes de contribuir não somente para o alívio imediato da pobreza, mas também que tenham impactos positivos sobre outros determinantes da TB e hanseníase devem ser incorporadas aos programas governamentais para o seu efetivo controle e alcance das metas de eliminação de ambas as doenças.
|
|
8
|
-
ANA CLARA PAIXAO CAMPOS
-
COURSE OF ASTHMA SYMPTOMS BETWEEN CHILDHOOD AND ADOLESCENCE: USES, LIMITS AND PERSPECTIVES OF ANALYSIS STRATEGIES IN LONGITUDINAL STUDIES
-
Leader : LEILA DENISE ALVES FERREIRA AMORIM
-
MEMBRES DE LA BANQUE :
-
ALINE ARAUJO NOBRE
-
ALVARO AUGUSTO SOUZA DA CRUZ FILHO
-
LEILA DENISE ALVES FERREIRA AMORIM
-
MAURICIO LIMA BARRETO
-
ROSEMEIRE LEOVIGILDO FIACCONE
-
Data: 29 avr. 2019
-
-
Afficher le Résumé
-
Despite efforts to identify risk factors / protection for asthma / asthma symptoms, the etiology of the disease remains poorly understood, as well as its dynamics over time, especially in the transition from childhood to adolescence. Initially, a systematic review of the use of statistical methods in longitudinal asthma studies over the past 20 years has been performed. Forty-five epidemiological studies were identified, which demonstrated the incipient use of statistical methods for longitudinal data with repeated outcome measures and, therefore, studies that longitudinally assessed the risk factors associated with asthma / asthma symptoms at various stages of the disease. life, such as childhood and adolescence. This was followed by a study involving longitudinal asthma data from the Social Changes Project, Asthma and Allergy in Latin America (SCAALA-Salvador), with participants followed from childhood to adolescence to assess risk factors associated with asthma. Longitudinal occurrence of asthma / asthma symptoms from childhood to adolescence through the application of three advanced statistical techniques for repeated-measures data modeling. Additionally, we evaluated the impact of missing data on the longitudinal data analysis of asthma, as well as the use of multiple imputation as a strategy to deal with missing data in covariates and outcome, considering different percentages and missing data mechanisms, Overall, estimates of the GHG and multilevel logistic models were consistent in the same direction, demonstrating the deleterious effect of atopy, maternal asthma, and common maternal mental disorder on the occurrence of asthma symptoms over time. Analyzes with missing data and multiple imputation showed that the presence of missing covariate is more harmful than missing in the outcome, and that if a single variable has a high percentage of missing data the estimates obtained using imputation may be invalid. .
Finally, Latent Class Analysis (LCA) was used to define childhood and adolescent asthma phenotypes, as well as Latent Transition Analysis (LTA) to explore the longitudinal patterns of asthma symptoms. , evaluating the transitions between such phenotypes and the effect of predictors that were associated with the longitudinal occurrence of asthma symptoms. The phenotypes found were named "Healthy" and "Symptomatic". About 5% of healthy individuals in childhood became symptomatic in mid-childhood, the same being observed in the transition from mid-childhood to adolescence. Maternal common mental disorder has been identified as a risk factor for unhealthy states in both childhood and adolescence. Longitudinal studies are essential for the study of asthma, as its natural history remains poorly understood, and there is still no consensus on the factors that contribute to its dynamics over time. As asthma is the most common childhood disease and is responsible for high costs for the health system, the identification of associated factors can contribute substantially to the formulation of strategies aimed not only at preventing the disease, but at controlling it during child development. in adolescence.
|
|
9
|
-
MARCELE CARNEIRO PAIM
-
OBSERVATORIES: INFORMATION AND COMMUNICATION NETWORKS FOR HEALTH POLICIES?
-
Leader : MARIA LIGIA RANGEL SANTOS
-
MEMBRES DE LA BANQUE :
-
ANTONIO MARCOS PEREIRA BROTAS
-
MARIA LIGIA RANGEL SANTOS
-
MARIA NATALIA PEREIRA RAMOS
-
MESSIAS GUIMARAES BANDEIRA
-
MONIQUE AZEVEDO ESPERIDIAO
-
Data: 29 avr. 2019
-
-
Afficher le Résumé
-
The democratization and ease of publication of information, based on the new information and communication technologies (ICT), has been bringing the moments of production and sharing of knowledge in health, as well as the formation of networks, more intensely. In recent decades, there has been increasing use of observatories or a network of observatories, as an institutional device for health and for health policies. This study proposes to analyze the potential and limits of these observatories in the production and dissemination of knowledge to contribute to the formulation and monitoring of health policies by managers and society. It contemplates the accomplishment of the mapping of health observatories and typification regarding the structure; institutions and subjects; resources; preferential public and linguistic repertoires; usability and interactivity; identification of information, content, thematic, seeking to analyze the constraints, functionalities and characteristics that may or may not constitute network observatories. It is intended to be based on Cyberculture and the Actor-Network Theory to better understand how human and non-human actors can associate themselves in the composition of hybrid networks. The methodological options include: a) literature review about existing narratives about health observatories, characterizing the scientific production on Brazilian and international experiences dedicated to the analysis of policies and systems, b) exploratory study of multiple cases to identify Brazilian and international observatories from countries with universal health systems, focusing on the analysis of health policies; c) multi-case study that analyzed the associations that make up the health observatories as sociotechnical networks in policy contexts and analyzes of health systems from the Theory-Actor-Network. The present research also proposes to study the dynamics of the observatories from the perspective of performance in networks and to develop a theoretical-methodological model for the analysis of health observatories.
|
|
10
|
-
ADROALDO DE JESUS BELENS
-
EXPERIENCE OF VIRTUAL COMMUNITY DEPRESSION ON FACEBOOK
-
Leader : MARIA LIGIA RANGEL SANTOS
-
MEMBRES DE LA BANQUE :
-
MARIA LIGIA RANGEL SANTOS
-
LENY ALVES BOMFIM TRAD
-
MÁRCIA CRISTINA ROCHA COSTA
-
MARIA NATALIA PEREIRA RAMOS
-
ANTONIO MARCOS PEREIRA BROTAS
-
Data: 30 avr. 2019
-
-
Afficher le Résumé
-
Depression has been considered a serious and high-incidence disease, which is a public health problem in all regions of the world, since it is the major cause of disability and because it has causal relationships with established social conditions in some countries (WHO, 2010). The aim of the study was to analyze the experience of depression in a virtual community on Facebook. This is a qualitative study. The netnographic method was used to produce data and analysis on the experience of depression Facebook. For this, the immersion in the field, through non-participant observation, the collection of archival data and interviews with administrators and community participants were the techniques used for data production. Results and Discussion: The international review of the literature on Facebook and Depression made it possible to know how researchers from different areas have addressed the issue and to identify the absence, in the Brazilian scientific literature on mental health, of this type of research; the ethnographic method contributed to the recognition of new objects and problems in the study of depression; and also to understand how actors suffering from depression seek out social networks to receive emotional support to learn about illness and caregiving; and to report emotions resulting from concrete social relationships, being affected by depression, generating more emotional distress. The mapping and characterization of the community allowed us to understand the social profile of the community and to analyze the reports about the experience of depression, whose members of the Facebook community expressed their emotions of sadness, melancholy, mourning and the meanings attributed to suffering, pain, stigmas, invisibility and social exclusion in daily life. These impressions were debated in closed virtual environments. It is concluded that communities closed on Facebook, as a field of research, enabled from the reports of its members, to understand the experience of depression, the production of meanings around suffering. Because they felt protected from their identity as people from their face-to-face environment, they were motivated to discuss issues and issues of their public and private life by associating them with depression and without restriction. It was in these collective talks that we saw the construction of webs of meanings about the experience of psychic suffering. Reports of depression in this community, as well as others observed, associate members' situations in their daily lives with people close and distant; they talk about themselves and the other; their perceptions about illness and the social stigmas they face. Finally, the immersion in the field from an ethnographic research revealed the meanings and particularities of the virtual environment only translated by those suffering from depression.
|
|
11
|
-
ALDER MOURÃO DE SOUSA
-
Children care dynamics of familial violence situations in Primary Health Care: a view about relations of power and governmentality
-
Leader : CECI SA DE ALENCAR VILAR
-
MEMBRES DE LA BANQUE :
-
ANA CLARA DE REBOUCAS CARVALHO
-
ANTONIO MARCOS CHAVES
-
CECI SA DE ALENCAR VILAR
-
LUIZA JANE EYRE DE SOUZA VIEIRA
-
YEIMI ALEXANDRA ALZATE LOPEZ
-
Data: 10 mai 2019
-
-
Afficher le Résumé
-
The author of this research took as starting point the ideas of Michel Foucault about power, which is configured in a web of productive relations. Based on two primary health care units as a scenario for this research, the meaning of power has been analyzed through the positive side - not the coercive one - through the angle that builds and care for. Here visualized in its relations with the knowledge and the production of discourse with truth effects, as well as in the governmentality strategies when operating in the health services and to realize the transformation the Family Health Strategy public policy in delivery of services to the population. Aiming to investigate the care dynamic of children under intra familial violence in the Family Health Strategy multidisciplinary teamwork scenario, the author of this research has followed their activities for eight months in two different health units in a popular area of Salvador - Bahia. A qualitative approach has been utilized through the direct observation of the professionals’ daily activities such as home visits, childcare consultation, educational group and team meetings. Field diary and interviews have also been used, resulting in 71 reports and 19 interviews, which have been coded and analyzed using ATLAS.ti software. Analytic contribution of this research focus on the care dynamic for children, which has few academic publishing on the thematic. Taking into consideration the territory description of Family Health Strategy units and the context of violence as part of the personal life and professional job, the result comes up with other nuances of child care in circumstances of physical, psychological, sexual violence and neglect. The analysis is focused on the Family Health Strategy team activities, where are discussed the power exercised by professionals and by family members, that leads and interferes in the following up of the identified cases. These findings not only support well-known academic published data but also it adds new information related to child care. The care activities performed through consultations and home visits are also relevant in this context, as well as the services’ organization practiced by the governmentality local authority via programs implemented in the Family Health Strategy units. This shape the care performed by the professionals within biomedical parameters. Some subjective topics are discussed in this document such as intra familial violence, particularly those ones with stress and feelings related to care in the social context of needy people. Taking the family as the center of the basic assistance, and child health care as a priority, children are seeing in primary health care mainly for vaccination and childcare medical consultations. Nevertheless, it is noticeable that the priorities are to achieve the management target setting, which does not contain question related to violence involving children. In addition to that, there is a limited staff’s repertoire to deal with different parental care modalities resulting in denial, evasiveness and avoidance of violence toward children under this public health service.
|
|
12
|
-
SARA CRISTINA CARVALHO CERQUEIRA
-
The CONASS and the lines of construction of SUS: political analysis of the period 2006-2016.
-
Leader : CARMEN FONTES DE SOUZA TEIXEIRA
-
MEMBRES DE LA BANQUE :
-
ALCIDES SILVA DE MIRANDA
-
ANA LUIZA QUEIROZ VILASBOAS
-
CARMEN FONTES DE SOUZA TEIXEIRA
-
LUCIANA DIAS DE LIMA
-
MONIQUE AZEVEDO ESPERIDIAO
-
Data: 3 juin 2019
-
-
Afficher le Résumé
-
This work intends to analyze the political action of CONASS, in the Lula and Dilma governments, based on the facts produced in the period, the projects defended by it and the political position assumed in relation to the SUS building process. It is a unique ex-ploratory case study (YIN, 2005), of the CONASS action in the health policy process in Brazil, from 2006 to 2016, taking as initial milestone the approval of the "Pacto pela Vida, em Defesa do SUS e de Gestão” (BRASIL, 2006) and as a final mark the President Dilma Roussef's impeachment process in 2016. Documents used by CONASS, semi-structured interviews with key informants, and the researcher's field diary were used as sources of evidence, built during the period in which she lived the daily work of the CONASS Ex-ecutive Secretariat at its headquarters in Brasilia/DF, from September 24 to December 12, 2018. Documents used by CONASS, semi-structured interviews with key informants, and the researcher's field diary, built during the period in which she lived the daily work of the CONASS Executive Secretariat at its headquarters in Brasilia/DF. The results in-dicate CONASS's evolution of the role of political representation of health secretaries in the process of conducting the SUS at the national level, assuming, gradually, a strategic importance in the formulation and implementation of health policies, within states and in some municipalities, playing a relevant role of technical support and cooperation to the SES. In this sense, the analysis of the CONASS action in the period studied, evidences the strengthening of the governance (SUS) network in the Lula I and II Governments (2006-2010), in spite of the conflicts about financing, insofar as the CONASS acted in consonance with the Ministry of Health and CONASEMS, at various times, printing, a directionality to the SUS implementation process consistent with its principles and guide-lines. However, in the Dilma I government (2011-2014) the tension between the relation-ship between MS and CONASS was verified, due to some facts produced at the moment in the federal government, which pointed in the opposite or at least different direction , of the one that had been defended by CONASS. In the Dilma II government (2015-2016), tensions accumulated, to the point of threatening the fabric of the network by the increase of conflicts between the actors participating in the SUS governance process. In this pro-cess, CONASS's institutionality ensured a political independence that makes it indispen-sable in the defense of the SUS, remaining as a "trench" of resistance to the attacks on the SUS filed by both the Executive and Legislative and Judiciary in the 2006-2016.
|
|
13
|
-
LAISE REZENDE DE ANDRADE
-
THE CHOICE OF PUBLIC-PRIVATE PARTNERSHIP FOR MANAGEMENT HOSPITALAR NA BAHIA: Actors, interests and strategies
-
Leader : ISABELA CARDOSO DE MATOS PINTO
-
MEMBRES DE LA BANQUE :
-
MONIQUE AZEVEDO ESPERIDIAO
-
LUIS EUGENIO PORTELA FERNANDES DE SOUZA
-
ISABELA CARDOSO DE MATOS PINTO
-
MARCIA TEIXEIRA
-
ADEMAR ARTHUR CHIORO DOS REIS
-
Data: 11 juin 2019
-
-
Afficher le Résumé
-
ABSTRACT The Unified Health System, the result of a broad process of struggle, led by the politicalideological conception of the Movement for Brazilian Sanitary Reform has been opposed by the hegemonic political forces that defended the broad participation of the private sector in management, attention and financing of health. In this perennial context of disputes, new management models presented themselves as capable of solving old problems of health management, such as people management, infrastructure, and propagating themselves as having innovative management modes. One of these models, the Public-Private Partnership (PPP), has been promoted by the World Bank through consultancies in several countries around the world and in Brazil has been gaining space in the health sector. In the context of chronic crisis, characterized by the low capacity to finance new structures, associated with the restrictions of the fiscal responsibility law, the State of Bahia extended its scope of use management models and adhered to the PPP model for hospital management. In view of this, the question that guided the research was why and how was the PPP model for hospital management adopted in SUS? With the purpose of analyzing the processes of decision making and incorporation of this model for hospital management in Bahia. The detailing of the plot unfolded in the decision-making process was based on the theoretical framework constituted by Public Policy Cycle and Power Games Theory; in bibliographical review and; interviews with key players in the decision-making process. The research pointed out the difficulties of hospital management in health, discussed the advantages and disadvantages of management models to address these problems and concluded that determinants not only financial, but political and ideological marked the decision process about the model in the State, which had as a promoter and consultant, for design and feasibility of the project, the right arm of the World Bank, the International Finance Corporation.
|
|
14
|
-
JOAO HENRIQUE ARAUJO VIRGENS
-
Political analysis in health: theoretical-methodological contributions about the dynamics structural, conjunctural, and political actions
-
Leader : CARMEN FONTES DE SOUZA TEIXEIRA
-
MEMBRES DE LA BANQUE :
-
MARCELO EDUARDO PFEIFFER CASTELLANOS
-
LUIS EUGENIO PORTELA FERNANDES DE SOUZA
-
CARMEN FONTES DE SOUZA TEIXEIRA
-
TATIANA WARGAS DE FARIAS BAPTISTA
-
LILIA BLIMA SCHRAIBER
-
Data: 12 juin 2019
-
-
Afficher le Résumé
-
ABSTRACT The interest of collective health researchers in the the study of political process has grown in recent years and has contributed to the deepening of epistemological criticism and to the theoretical-methodological development of a research strand that has been termed ‘political analysis in health'. Therefore, this thesis aims to both systematize some of these elaborations, as well as to problematize them, with a purpose of overcoming that is epistemologically based on a dialectical approach, developed by an involved subject; methodologically in textual analysis currents chosen to examine the scientific productions reviewed, either systematically or narratively; and theoretically in marxist and anarchist approaches, which privilege to treat three moments in an articulated way: (1) the analysis of structural and conjunctural aspects, so as to think together about the 'state of things' that lasts in time and the facts of different past, including the most recent one, which tries to accompany the present, at the local and international level; (2) the elaboration of objectives and proposals that subsidize their projects, that is, that fuel expectations about the future; (3) the constitution of the subjects, their articulations and the act of putting in place, at present, strategies and tactics based on the past, but with a future-oriented look. Analyzing the articles, different theories and methods were identified, but it is worth noting the fact that most do not bother to make them explicit. As regards the analysis of the conjuncture, theoretical and methodological elaborations were found that subsidize its application in the scientific field and, in the case of applying it to the study of specific sectors such as health, it was evident the importance of avoiding that the look is limited to them, since to disregard factors that extrapolate them can harm the action. Concerning the studies about the health movement, it was observed that the choice of theoretical and methodological references impacted both the privileged aspects and scope of the analyzes, as well as the subjects actions. It is worth highlighting the fact that many scholars of the Brazilian Sanitary Reform present themselves as political subjects of the movement. On the other hand, the main silencing identified is related to the organization of these subjects and this is one of the factors that leads to questions about formulations that propose to treat it as a single cohesive organization. It was possible to identify actions triggered by several individual and collective subjects, but the articles consider little the way they were related organizationally, either within the groups that added individual subjects or those that were constituted from links between collective subjects, in a format that has similarities with the federations identified in the anarchist referential. It was also perceived the importance of an epistemological construction that allows to strengthen convergence elements between the scientific praxis and the concrete action of the subjects, including in what refers to their political praxis. In this respect, a problem to be faced is the continuity of relations of oppression that do not depend only on the fact that one has means of production, but are also fed by inequalities in access to decision-making spaces and by 'scientifically grounded' coercive impositions.
|
|
15
|
-
CARLA MARIA LIMA SANTOS
-
Social construction of oral health care for disabled persons in Brazil
-
Leader : SONIA CRISTINA LIMA CHAVES
-
MEMBRES DE LA BANQUE :
-
MARIA GUADALUPE MEDINA
-
MONIQUE AZEVEDO ESPERIDIAO
-
SANDRA MARIA FERRAZ MELLO
-
SILVIA DE OLIVEIRA PEREIRA
-
SONIA CRISTINA LIMA CHAVES
-
Data: 19 juin 2019
-
-
Afficher le Résumé
-
The concept of disability refers to the close relationship between the conception of this social phenomenon and the State's political responses. At the intersection between oral health care and disabled persons, the National Oral Health Policy - PNSB (2004), can be considered as a response of the Brazilian State to oral health problems. The PNSB addresses the person with disabilities as "people with special needs," signaling that the classification of PcD is a disputed object. This study analyzed the construction of the Brazilian State's political responses to the oral health problems of the disabled person between 1992 and 2012. The National Program of Integrated Dental Care for the Special Patient (1992) and the implementation of the Network of Care for the Disabled Person (RCPcD), under the Unified Health System (2012), were adopted as historical milestones. The analysis of social space adopted as theoretical reference the reflexive sociology of Pierre Bourdieu and the propositions of Patrice Pinell for the socio-historical analysis of health policies. The space of struggle of the disabled person and the interface with the oral health care were built with their social agents, trajectories, positions, dispositions and decision-making, through semi-structured interviews and documentary analysis. Factorial statistical analysis was applied to confront the findings about the social space disposition and definition of the dominant pole. Thirty social agents were interwied, the ones with the highest bureaucratic and political capitals were preponderant in the demarcation of the dominant fraction. The militant and dental capitals were not frequent in this pole of domination. This evidence reveals the protagonism of State agents, and their relationship in the political field, in the acts of appointment. The State assumed the concept of metafield, holder of metacapital, therefore the space of struggle of the dominants of all the social fields. The acknowledgment of health needs, including oral health, of the disabled person occurred due to pressures from associative spaces and external pressures, with the United Nations Organization (ONU) being the most expressive international body. The need for oral health care for PcD was more frequently related to people with mental disability. The difficult accessibility of mentally handicapped users to the SUS dental services was referred to as persistent. This fact explains the attempt of a network of attention to reconfigure the access. The recent construction of the care network and the absence of evaluation tools do not make it possible to establish the impacts generated by the implementation of the Network of Care for the Person with Disabilities.
|
|
16
|
-
SISSE FIGUEREDO DE SANTANA
-
State Management of Oral Health Care in Brazil: modeling and evaluation of implantation.
-
Leader : SONIA CRISTINA LIMA CHAVES
-
MEMBRES DE LA BANQUE :
-
ANA ÁUREA ALÉCIO DE OLIVEIRA RODRIGUES
-
CLAUDIA FLEMMING COLUSSI
-
LIGIA MARIA VIEIRA DA SILVA
-
MONIQUE AZEVEDO ESPERIDIAO
-
SONIA CRISTINA LIMA CHAVES
-
Data: 26 juin 2019
-
-
Afficher le Résumé
-
Problems: extensive academic production related to the National Oral Health Policy (PNSB) in Brazil has been published since 2000, with prioritization of analyzes in the municipal and federal spheres, secondary to the performance of the state level. However, the state authorities have been understood as fundamental in the configuration of the Brazilian federative arrangement for conducting public policies. Objective: This thesis analyzed the implementation of state management of public oral health care in a state of the Brazilian Northeast, and sought to understand elements of the social trajectory of the agents involved and their points of view about the state sphere and the historical conditions of possibility of implementation of the oral health policy at the state level. Methodology: this is a research of an evaluative, exploratory and qualitative nature. In the first moment, a logical model was elaborated to subsidize the evaluation of the state management. International guidelines on health management, state health management reports, state and national health plans, as well as national and international studies were reviewed, with the consequent development of a matrix of criteria and standards, validated by a committee of eleven area experts through the Delphi consensus method. Fifteen leaders, coordinators and technicians related to the oral health area of the state were interviewed. The assignment of points in the matrix was performed by two evaluators separately, based on the triangulation of evidence from key informants, on-site observation and documentary analysis. Finally, it characterized the social trajectories and dispositions of agents involved in the state bureaucratic field of oral health, from the categories agent, dispositions and field, developed by the French sociologist Pierre Bourdieu. Results and discussion: This study revealed that the degree of implementation of oral health management in the state investigated was incipient, reaching 32.8% of the total score, with difficulties related mainly to the lack of communication between the areas within the institution, infrastructure problems and lack of regional public health care projects. Nevertheless, the "tools for implementing the policy" and "accountability" were considered intermediate, reaching 37.2% and 37% respectively of the total points in these dimensions. As for the analysis of the trajectories, the majority graduated in public institutions, with balance in the studied group in relation to the social origin. The insertion in the state bureaucratic field was influenced by the disposition directed to the bureaucratic field, restlessness with the public service, reduction of the private market and the expansion of collective health. The agents' trajectory evidenced a low intersection of the bureaucratic field of oral health with the political and scientific fields, besides the low political disposition of the agents of the state bureaucracy. There is a group composed predominantly of women, with a sanitary disposition, driven by universal interest, expressing their "love for the clinic and public health". In this sense, the ambivalence of dentist / sanitary identity due to the influence exerted by the dental field of origin may make it difficult for dentists to fight within the state bureaucratic field. Final considerations: The present study pointed out that it is probable that the agents' disposition, in view of their adjustment to the bureaucratic field, can facilitate or obscure the conformation of the agenda, the accountability and the management by operations.
|
|
17
|
-
ÍTALO RICARDO SANTOS ALELUIA
-
Analysis of an interstate health region: from political design to power dynamics.
-
Leader : MARIA GUADALUPE MEDINA
-
MEMBRES DE LA BANQUE :
-
MARIA GUADALUPE MEDINA
-
LUIS EUGENIO PORTELA FERNANDES DE SOUZA
-
ANA LUIZA QUEIROZ VILASBOAS
-
JOSE ANTONIO DE FREITAS SESTELO
-
ANA LUIZA D AVILA VIANA BESKOW
-
Data: 3 juil. 2019
-
-
Afficher le Résumé
-
Interstate Health Regions (IHR) are emerging areas and that are still deprived of appropriate care in the regionalization policy of Brazilian Public Health System (SUS). They are typified by a relevant political complexity due to its triple interdependence, in which, besides the Union and municipalities, they aggregate at least two states with distinct configurations that goes from epidemiological profile to inequalities of political-administrative power. IHR are unique territories that involve both federal entities and several public and private actors and institutions with multiple and divergent interests in a federative model of shared power and without a sufficient juridical framework for sustaining agreements and deliberations. In such complex and heterogeneous scenarios as the IHR, there are gaps to be answered that comprises since how decisions are made in such spaces until the power dynamics features among the actors and institutions. We performed a political analysis of Pernambuco-Bahia IHR. It is a case study that assembles evidence organized by management spheres. We adopted the theoretical basis of the Triangle of Government and the Theory of Social Production by Carlos Matus. Data production included interviews with 35 key respondents and analysis of 499 documents from the municipal to the national scenario. We will present the political background of IHR; the actors and the decision-making process for the formulation of regional design; governance conditions and government capacity in the IHR; the power dynamics, emphasizing the most influential actors and their motivations; the power typologies in dispute, and the conflicting and cooperative features in the region. The region political design emerged from intermunicipal financial disputes and its decision-making process was subsided by multiple actors from municipal to national scenario. The decisions outcomes were permeated by several disputes and progressed towards the implementation of an Interstate Health Network (REIS). Governability conditions in the region were adverse to the implementation of REIS as its project was highly redistributive among the three government spheres and due to unequal control of political, economic, technical, and administrative variables among the social actors. There was not sufficient government capacity of the actors and institutions to operationalize the Interstate Network and its political design was limited to the uncertain institutional ambience and restricted to the ideological plane. Power distribution in IHS was directed to influential actors in health sector as well as on economic and political groups that affect regional decisions. The federal states had unequal political capacities and an ambience of conflictive relations, with double public and private dependency and an extensive network of influential actors with predominantly economic, partisan, or personal motivations. There were several power disputes in the HIS and, among them, the economic and political ones was dominating, with cooperative relations more conducive to little transparent agreements and conflicts that combined, essentially, divergences on realities and interests readings. Overall, the regional power dynamics dissociated itself from the purposes of an Interstate Health Network, revealing that we are much more in the direction of market disputes and political power aspirations than in the way of building institutional alternatives for consolidating interstate health and cooperative health policies.
|
|
18
|
-
EDUARDO MARINHO BARBOSA
-
Occupational exposures of potential health interest in homebased work.
-
Leader : VILMA SOUSA SANTANA
-
MEMBRES DE LA BANQUE :
-
VILMA SOUSA SANTANA
-
JORGE ALBERTO BERNSTEIN IRIART
-
HELENO RODRIGUES CORRÊA FILHO
-
JANDIRA MACIEL DA SILVA
-
LETICIA COELHO DA COSTA NOBRE
-
Data: 23 août 2019
-
-
Afficher le Résumé
-
Background: Approximately 5% of the occupied population in Brazil works in their own households. However, little is known about they work conditions, especially occupational-related exposures that can potentially affect their health. Objectives: This study describes the occupational characteristics, and occupational exposures, potential risk factors for health, among home-based informal workers (HBW). Materials and methods: This study is part of National Health System (SUS) Integration Project, of teaching-research-cooperation, an initiative of the Institute of Collective Health, Federal University of Bahia (ISC-UFBA), carried out in the Health District of Freedom, Salvador, the state of Bahia, Brazil. One of its subprojects, the Occupational Health Integration in Primary Health Care, trained community health agents (CHA) to participate in the workers‘ health care and surveillance. As part of the diagnosis and training, this cross-sectional survey was carried out with workers living in areas covered by the Family Health Strategy and Community Health Agents Program (Primary Health Care). Data from the Primary Health Care Information System (SIAB) was used to identify HBW in the catchment area. Later, trained interviewers joined CHA household visits to collect detailed occupational data. Electronic questionnaires on tablets were used, together with quantitative measurements of formaldehyde (ppm) and noise (dB(A)) assessed by dosimeters. Results: In the areas covered by Primary Health Care in the Health District, 468 HBW were identified, mostly from retail (35.3%), production and sale of food (25.8%), personal services/beauty (17.1%), clothing manufacturing (9.4%), and others (12.4%). The majority of workers was female (77.1%), from 40 years of age or older (67.3%) and own-account (92.5%), with over 44 hours of work time per week (62.5%), with no vacations (63.0%). Most reported working every day (45.0%). The prevalence of perceived noise-related occupational exposure (P-NE), i.e. when one needs to raise the voice to be understood, was 16.4%. It was higher in the group of more than 44 hours per week (20.1%), with higher income (19.1%) and among those of 18 to 39 years of age (18.9%). Among 18 samples from 10 beauty salons, the level of formaldehyde in the air was above the limit of 0.3 ppm (American Conference of Governmental Industrial Hygienists, ACGIH) in 9 (50.0%) measurements. Among female beauty service workers, hairdressers had a mean noise exposure of 75.1 dB (A), less than the maximum LAEq, 8 h = 85 dB (A) as defined by the National Institute for Occupational Safety and Health), higher, however, than the levels for the home environment (Brazilian Association of Technical Standards, ABNT) of LAeq = 40 dB for living room and LAeq = 30 dB in bedrooms. Conclusions: Informal workers in HBW are commonly poor, have long working hours, with almost no resting time. They are mostly women, from services and trading and do not contribute to social insurance. They are commonly exposed to occupational noise, notably from external sources, and to chemical agents, specifically formaldehyde, known carcinogenic. These findings support the participation of Primary Health Care teams in the informal work environment surveillance, and their strategic role in prevention of occupational health hazards and their health effects in workers and families.
|
|
19
|
-
MARINA LUNA PAMPONET
-
Adolescent Lifestyles: Behavior Patterns and Their Determinants
-
Leader : ROSANA AQUINO GUIMARAES PEREIRA
-
MEMBRES DE LA BANQUE :
-
ANA LUISA PATRAO MARTINS
-
DANIELLE SOUTO DE MEDEIROS
-
LEILA DENISE ALVES FERREIRA AMORIM
-
MONICA LEILA PORTELA DE SANTANA
-
ROSANA AQUINO GUIMARAES PEREIRA
-
Data: 30 août 2019
-
-
Afficher le Résumé
-
Lifestyle is defined as the set of habits and customs, way of life, influenced and modified by the process of socialization, which has effect for health. In adolescence at the same time that the individuals experiment biological, cognitive, emotional and social changes, they experience an important moment for the implementation of new practices and behaviors related to lifestyle. This thesis presents as an objective to characterize the lifestyle patterns, measured through an latent indicator to the observaded data, concerning the behavior related to diet, physical activity, use of alcoholics drinks and tobacco, and identify the lifestyle patterns and their determinants in a population of adolescents. To achieve the proposed objectives, this thesis was developed through three studies: 1. Lifestyle patterns: a review of the use of latent class analysis (LCA) to measure lifestyle in international literature; 2. Lifestyle patterns in adolescence: a study of LCA; 3. Determinants of adolescent lifestyle patterns. Methods: The first study was developed from a systematic review of the international literature, while the other two were cross-sectional studies using baseline data from the PROSE project, with a sample of 2,212 high school adolescents from ten municipalities of Bahia. The analyzes considered the study design with complex sampling, being applied latent class analysis (LCA). Results: The first study demonstrated, given the complexity of using the lifestyle construct in empirical studies, that there is still no clear evidence on how behaviors aggregate, with a wide variety of behaviors and indicators used by the studies, futher more the predominance of behaviors related with physical activity, diet, alcohol and tobacco use in the lifestyles clusters. The analyzes considered the study design, being applied LCA. Results: The first study demonstrated the complexity of using the lifestyle construct in empirical studies but there is still no clear evidence on how behaviors aggregate. The wide variety of behaviors and indicators used in the studies contributed to the difficulty of comparing and systematizing the literature. The second study pointed out that the lifestyle construct differs by gender, although for both they were presented by three latent classes: Class 1, "healthy" (with unconditional probability of 43.5% for women and 73,6% for boys); Class 2, "Less healthy in terms of physical activity and diet" lifestyle (49.8% for women and 15.9% for boys); and Class 3, “Consumers of alcohol and tobacco” (6.6% for women 6.6% and 10.5% for boys). The third study identified risk factors that increased the chances of adopting unhealthy standards: for class 2, negative self-evaluation of health for both gender and presenting health problems or nonspecific symptoms for boys. For class 3, the risk factors, among girls, were working and presenting health problems or nonspecific symptoms, and, among boys, they were late in school and having a smoking father or mother with high alcohol consumption. alcohol. The determinants that decreased the chances of belonging to the less healthy classes were: for class 2, to present sports courts or exercise places in the neighborhood, for both gender, and among girls, to have more friends, and to have religion. for class 3 between both gender. Conclusions: The lifestyle construct has been studied by suitable methods for the combination or aggregation of behaviors, although the literature presents a wide variety regarding the behaviors and indicators, making it difficult. the comparison between studies. Adolescent lifestyles are differentiated by gender, as their determinants. Further research and longitudinal studies are recommended to better understand the determinants of lifestyles and changes in behavioral patterns throughout life cycles.
|
|
20
|
-
LIVIA ANGELI SILVA
-
The emergency of hygiene and public health in Bahia (1840 – 1889)
-
Leader : LIGIA MARIA VIEIRA DA SILVA
-
MEMBRES DE LA BANQUE :
-
FLÁVIO COELHO EDLER
-
HELOISA MARIA MENDONÇA DE MORAIS
-
LIGIA MARIA VIEIRA DA SILVA
-
LUIS EUGENIO PORTELA FERNANDES DE SOUZA
-
MONIQUE AZEVEDO ESPERIDIAO
-
Data: 19 sept. 2019
-
-
Afficher le Résumé
-
Hygiene and public health in Bahia, as an academic discipline and intervention object, respectively, are investigated and considered by the specialized literature as part of the events from the first half of the XIX century. Several interpretations on their meaning are elaborated and supported mainly on Foucault concepts on social medicine. However, a little attention has been provided to the institutionalization process, from the analysis of the existing relationships among the physicians involved with such production of knowledge and practices, which main reference was in Europe with the development of a hygienist movement, foremost the French one. This investigation, based on social-historical approach of Pierre Bourdieu, aimed at understanding the emergence of hygiene and public health in the nineteenth century Bahia, questioning the existence of a social space for relationships, implicated with population health issues. We sought from this theory, to understand the logic of the constitution of the medical, political and bureaucratic fields, which emerged in that period in Brazil and that were related to the investigated social space. The findings showed that the creation of the Salubrity Council and the beginning of the inaugural thesis of the medical school provided a space for debates and circulation of ideas from 1840 on. Even given that hygiene did not occupy a status of specialized knowledge, physicians from several areas got involved on the discussion and academic production, occupying some positions on government, towards to population health. In this analysis, two moments with distinct characteristics were identified. The first one, between 1840 and 1865, in which the bureaucratic field, by the salubrity council, and then the Hygiene commissions, was the great propeller for the debates and the approximation of the physicians to these issues. The second moment, from 1866 and 1889, highlighted a distinct dynamics on the medical and bureaucratic fields. On the one hand, there was an emptying of the govern participation, with the deactivation of the salubrity council. On the other hand, the category was already better organized by its own entities and by the “Gazeta Médica da Bahia” (Bahia Medical Gazette), which became the agglutinative microcosms of the debates on public health. However, in both periods, we did not find any elements allowing to characterize hygiene and health public as specific spaces for fights, involving agents from several education and work areas. The involvement with themes correlated to the hygiene discipline and the occupation of public offices was restrict to the medical field, involving the political and bureaucratic fields by the insertion of the physicians in both of them. The institutionalization of the actions underwent discontinuities and the preponderance of the political logic over the technical and scientific knowledge was the hindrance for the implementation of governmental actions. Thus, at Bahia, during the studied period, we noticed a development, distinct from the one observed in other countries in which the hygienist movement consolidated the knowledge production, the creation of specialized journals and, foremost, on the formulation of propositions towards to facing the population health issues.
|
|
21
|
-
CAMILA REGO AMORIM
-
RESILIENCE AND BEHAVIOR MEASURES ON BEHAVIORAL PROBLEMS IN ADOLESCENTS OF A COMMUNITY SAMPLE IN SALVADOR-BA
-
Leader : DARCI NEVES DOS SANTOS
-
MEMBRES DE LA BANQUE :
-
DARCI NEVES DOS SANTOS
-
LETICIA MARQUES DOS SANTOS
-
FLORISNEIDE RODRIGUES BARRETO
-
CRISTIANE OTERO REIS SALUM
-
CAMILA BARRETO BONFIM
-
Data: 16 oct. 2019
-
-
Afficher le Résumé
-
Although the relationship between resilience and mental health has been widely discussed in the last decades, there are gaps in the knowledge produced about methodological aspects used in epidemiological studies, adding a restricted approach to adolescence, thus giving relevance to this theme. This study began with a literature review on types of measures and main findings of epidemiological studies that used the Resilience Scale (RS), a reliable and validated instrument in several countries including Brazil, and was considered the most appropriate for studies with adolescents. . Several measures have been used to evaluate this construct, including quantitative measures obtained by the sum total of scale responses and qualitative measures with adoption ratings whose criteria for choice have not been well established and thus can be considered arbitrary. Even so, the findings showed protective effects exerted by resilience to the health-disease process in several populations exposed to adverse situations, including adolescents. This was followed by a study to identify safer criteria for classifying RS scores and thus distinguishing subgroups of individuals according to resilience levels in a community sample of 1015 adolescents, using latent class analysis (LCA). Through this analysis were found models consisting of three classes defined as high, medium and low for the two dimensions called personal competence and acceptance of self and life. These LCA models were evaluated by the goodness of fit criteria and the assessment of association with behavioral problems was statistically significant only for the dimension of self-acceptance and life. Finally, this classification obtained by the LCA was used to analyze the role of resilience in the relationship between maternal mental health and the occurrence of behavioral problems among adolescents in a cross-sectional design. It was found that both maternal mental health and resilience acceptance of self and life influenced the occurrence of behavioral problems in adolescence in opposite directions, risk and protection respectively. However, no change in the effect of maternal mental health resilience on the occurrence of behavioral problems in adolescents was found. Thus, the classification of subjects according to level of resilience through LCA and the protective effect of resilience on adolescent mental health in a context of adversity found in this study constitutes a relevant contribution to epidemiological knowledge, which may guide future research on this issue that presents scarcity mainly in adolescence.
|
|
22
|
-
TATIANE COSTA MEIRA
-
Epidemiology of noise exposure and hearing loss among manufacturing workers in Bahia, Brazil, 2014-2018
-
Leader : SILVIA FERRITE GUIMARAES
-
MEMBRES DE LA BANQUE :
-
CLAUDIA GIGLIO DE OLIVEIRA GONÇALVES
-
MÁRCIA TIVERON DE SOUZA
-
SILVIA FERRITE GUIMARAES
-
THAIS CATALANI MORATA
-
VILMA SOUSA SANTANA
-
Data: 30 oct. 2019
-
-
Afficher le Résumé
-
ABSTRACT Introduction: Working in the manufacturing industry commonly involves high levels of noise. The main consequence of this is Noise-induced Hearing Loss, a common occupational disease which, although preventable, is irreversible and usually acquired during a worker’s most productive years, causing harm to the individual, their family and society. There are gaps about the extent of this problem in Brazil and globally, particularly in relation to gender differences. Aim: To assess the extent of noise exposure and hearing loss in workers in the manufacturing industry and its subsectors, taking into account gender differences. Methods: We conducted an initial theoretical study aimed at immersion in the issue of gender differences at work, with a focus on hearing health. We then conducted epidemiological studies using secondary data referring to all workers in companies in Bahia that implemented the Environmental Risks Prevention Programme (Programa de Prevenção de Riscos Ambientais: PPRA) and the Occupational Health Medical Control Programme (Programa de Controle Médico de Saúde Ocupacional: PCMSO) through the Bahia Regional Department of the Social Service of Industry between 2014 and 2018; manufacturing industries were classified according to the National Classification of Economic Activities. The main variables were noise exposure, in line with the PPRA assessment, and hearing loss, as defined by audiometry. We estimated the prevalence for each subsector of the manufacturing industry, separating men and women. Results: Few studies include any discussion of the issue of gender when addressing hearing loss in workers and there is a certain neglect of women in these studies. Between 2014 and 2018, 129,860 workers were assessed from companies from all 24 manufacturing industry subsectors, 73.5% of these were men. During this period, the prevalence of noise exposure was 13.9%, estimated as 16.9% in men and 5.6% in women. Among men, exposure to noise at work was more common in the manufacture of wood, tobacco, non-metallic minerals and textile products, and machinery and equipment. For women, exposure to noise at work was more common in the manufacture of textiles, tobacco and metal, except machinery and equipment. Hearing loss among workers exposed to noise was 17.8%, estimated as 19.2% among men and 5.8% among women. For men, at least 1 in 4 workers had hearing loss in seven of the 24 subsectors: the manufacture of machinery and equipment; miscellaneous products; electrical machinery, apparatus and materials; tobacco products; other transport equipment, except motor vehicles; beverages; and the printing and reproduction of recorded media. Among women, hearing loss was more prevalent in the manufacture of furniture, tobacco products and clothing articles and accessories. We also noted variations in the degree of noise exposure and hearing loss between occupations, with differences between men and women. Conclusion: Measures adopted to avoid noise exposure and hearing loss in the manufacturing industry are inadequate, given that a significant portion of workers continue to be at risk. Planning interventions must prioritize workers in those subsectors that involve more vulnerable activities and occupations and must recognize evidence of gender differences. Keywords: Noise, Occupational; Hearing Loss; Industry; Occupational Health; Epidemiology.
|
|
23
|
-
VANESSA CRUZ SANTOS
-
Family and community violence, ethnic / racial aspects and externalizing behavioral problems in adolescence.
-
Leader : DARCI NEVES DOS SANTOS
-
MEMBRES DE LA BANQUE :
-
CAMILA BARRETO BONFIM
-
CLAUDIA DE SOUZA LOPES
-
DARCI NEVES DOS SANTOS
-
FLORISNEIDE RODRIGUES BARRETO
-
LETICIA MARQUES DOS SANTOS
-
Data: 13 nov. 2019
-
-
Afficher le Résumé
-
Characterized by behavioral deficits or surpluses, behavioral problems affect around 20% of adolescents worldwide. It usually begins in childhood with life-long repercussions, occurring differently among distinct ethnic-racial groups. Race / skin color, as a socially, historically and culturally determined construct, coupled with the biogeographic ancestry which indicates the place of origin of each person's ancestors, has suggested that certain racial-ethnic groups have historically been marked by iniquities. most vulnerable to its consequences. There is also an indication that the experience of social inequalities among black and high-grade African adolescents favors exposure to family and community violence in the course of life and other stressful events related to the occurrence of externalizing behavioral problems in adolescence. However, there is a gap in the scientific production on this relationship, especially in the field of epidemiological knowledge. Thus, this study aims to investigate the effect of family violence in childhood and of subsequent exposure to community violence in the occurrence of externalizing behavioral problems in adolescence, analyzing the influence of adolescent biogeographic ancestry and skin race / color, as modifiers of effect on adolescence. relationship. Cross-sectional study conducted with 755 adolescents from the first and second wave of follow-up of a cohort recruited from 24 micro areas in Salvador's peripheral neighborhoods, as sample units of the Social Changes, Asthma and Allergy in Latin America (SCAALA) project. The instruments used will be the Youth Self Report (YSR), to estimate the occurrence of behavioral problems among adolescents; Parent-Child Conflict Tactics Scales (CTSPC) to verify adolescent exposure as a child to family violence; questionnaire to verify the exposure to community violence in adolescence and its perception of its level, as well as sociodemographic questionnaire to characterize sociofamily aspects. For the genotyping of biogeographic ancestry will use DNA samples from African, European and Native American adolescents. The first analysis plan will describe the studied population. To verify associations between family and community violence and externalizing behavioral problems, considering the selected covariates, the bivariate and multivariate logistic regression analysis was used, estimating odds ratios (OR) and respective 95% confidence intervals (95% CI). %). In order to analyze the possible effect modifications for the studied associations, multivariate logistic regression modeling was used using the backward procedure. For this, the population was stratified according to race / skin color and degree of individual biogeographic ancestry. Effect modifiers were considered as variables whose OR in one stratum was outside the CI of the other stratum.
|
|
24
|
-
SHIRLEI DA SILVA XAVIER
-
CONCEPTIONS AND MANAGEMENT PRACTICES IN A STATE HEALTH SECRETARIAT
-
Leader : ISABELA CARDOSO DE MATOS PINTO
-
MEMBRES DE LA BANQUE :
-
ISABELA CARDOSO DE MATOS PINTO
-
JANETE LIMA DE CASTRO
-
KATIA REJANE DE MEDEIROS
-
MONIQUE AZEVEDO ESPERIDIAO
-
THAIS REGIS ARANHA ROSSI
-
Data: 11 déc. 2019
-
-
Afficher le Résumé
-
Healthcare organizations can be seen as social microcosms if we consider the complexity and scope of the actions they need to operate. They have a large contingent of professionals, hierarchically distributed, with a view to the development of their characteristic activities. In addition to being a wide range of possibilities, involving the creativity of those who are yearning for processes, such activities depend on varied knowledge and skills. The formation that the different actors had throughout their lives and the experiences they had in the practice of professional practice also compose this scenario, favoring a constant search for the subjects to match the knowledge brought with the challenges posed by the practice within the institutions. In this sense, occasionally managers and technicians may be led to fill positions and develop management functions with little preparation and low appropriation of the work object for which they were held responsible. This study aimed to analyze the concepts and practices of management in different contexts of the State Secretariat of Health of Bahia. Bourdieu's concepts of social space and capital, Matus's ability to govern and Mendes- Gonçalves's health work process were used as theoretical support. This is a qualitative research, carried out in two SESAB units, using semi-structured interviews and document analysis as techniques. Twenty-nine interviews were conducted from August to October 2018, with eight technicians and twenty-one managers. Among the documents that have been analyzed are the State Guidelines for Surveillance and Comprehensive Health Care, the Participatory Multiannual Plan - PPA (2016-2019), the State Health Plan - PES (2016-2019), the Annual Health Programming - PAS (2016, 2017) and the Annual Management Reports - RAG (2016, 2017). Crossing the categories formation and professional experience that underlie the concept of government capacity formulated by Matus and adopted for this study, to the cultural and bureaucratic capitals of Bourdieu's theory, it was observed that most of the interviewed agents are strengthened by the trajectories that they have been developing, to act in the subspace of health management. However, those agents whose trajectories are still far from this scope need to be contemplated by formative actions that prepare them for the exercise of their functions. In addition, and more broadly, the reorganization of work processes, in which teamwork and knowledge sharing prevail, using more democratic, horizontal and participatory management perspectives seem to favor the development of agents, even though initially present low volume of cultural and bureaucratic capital. It is hoped that the results of this study may contribute to the development of agents working in health management subspaces, with regard to the social valuation of the work performed by their own peers and society in general. In addition, the perspective is that the elements highlighted lead to work management practices and promotion of training processes more appropriate to the real needs of the secretariat.
|
|
25
|
-
CAMILA DOS SANTOS SOUZA ANDRADE
-
“From numbers to people”: Sociality, violence and vulnerabilities in the daily lives of poor and homeless families in Salvador - Bahia.
-
Leader : LENY ALVES BOMFIM TRAD
-
MEMBRES DE LA BANQUE :
-
LENY ALVES BOMFIM TRAD
-
LITZA ANDRADE CUNHA
-
SUELY FERREIRA DESLANDES
-
MARIA CONCEIÇÃO OLIVEIRA COSTA
-
CLAUDIA MASCARENHAS FERNANDES
-
Data: 17 déc. 2019
-
-
Afficher le Résumé
-
The research aims to analyze the spatial distribution of intrafamilial violence in the child segment in neighborhoods of Salvador - BA and the implications of violence and social vulnerability in the social experiences of poor families and street children. The thesis is characterized by a mixed method. In the quantitative domain, a descriptive and exploratory study was conducted with the cases of violence reported by the public health units of the Unified Health System - SUS, obtained from the child segment of the continuous component of the Violence and Accident Surveillance System (VIVA). The results showed that the children were victims of various violence, mainly physical and sexual, involving those female, in the home environment, practiced by family member and people known to the victim. With the data of cases of violence, an ecological study was possible, having as a unit of spatial analysis the neighborhoods of Salvador, georeferenced by the addresses of residence of children victims of violence. The spatial distribution of intrafamily violence in the child segment was associated with determinants of living conditions. Among the clusters, the Calabar, Alto das Pombas, Comercio, Centro Historico, Liberdade and Uruguay neighborhoods presented high risk (high - high) spatial clusters for child violence and spatial modeling, the variables: men at home and receiving up to ½ salary had an increasing effect on the rate of child violence. Identifying the risk areas (neighborhoods) for this type of violence was determined the qualitative field of research. The chosen neighborhoods were: Alto das Pombas, Comércio and Calçada. In the neighborhoods of Commerce and Calçada, in the squares of the hands and the seas respectively an ethnography was performed. The daily experiences of homeless families were analyzed focusing on structural violence and social vulnerability, through narrative categories: meeting with families; the relationship with drugs; with fear and social protection. It provided an opportunity to understand and discuss the processes of disruption, rualization, behaviors and feelings mobilized in everyday situations of street life. In the Alto das Pombas neighborhood through the Municipal School, the experiences of children (8 to 11 years old) about violence and family were observed through drawings, speeches of the “Incomplete Sentences Game” and participant observation in interactive dynamics. When reporting about family, they evoked positive attributes and reported to be an unhappy family where violence is present. As for the drawings it was possible to verify different types of families (nuclear, single parent female) and in the child contexts of intrafamily violence were portrayed in the drawings: as the force of the father, perpetrator of aggression and the feeling of not belonging to the family, excluding themselves from the family. drawing. In this same locality a familiar narrative was analyzed in light of Kaztman's (1999) social vulnerability. In the three levels (macro, medium and micro) of the opportunity structure, it was observed that access to Bolsa Família, school, Family Health Strategy, NGOs, neighbors network and job search are positive elements for reducing vulnerability but insufficient for social mobility and good quality of life. Admittedly, violence and social vulnerability produce social consequences and disruptions in the daily lives and experiences of these subjects, whose consequences and implications reverberate in interactions, care among family members, especially children, in safety nets and ultimately in sociability.
|
|