Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-11T17:05:00Z No. of bitstreams: 2 renata_luiz_ursine.pdf: 3230501 bytes, checksum: 2f2b878292cb8aa11d8b2f215f77aeda (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-11T17:05:22Z (GMT) No. of bitstreams: 2 renata_luiz_ursine.pdf: 3230501 bytes, checksum: 2f2b878292cb8aa11d8b2f215f77aeda (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Made available in DSpace on 2016-01-11T17:05:22Z (GMT). No. of bitstreams: 2 renata_luiz_ursine.pdf: 3230501 bytes, checksum: 2f2b878292cb8aa11d8b2f215f77aeda (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Previous issue date: 2014 / Com o prop?sito de conhecer os aspectos epidemiol?gicos da Leishmaniose Visceral (LV) entre os munic?pios sob a jurisdi??o da Superintend?ncia Regional de Sa?de de Diamantina (SRSD), realizou-se um estudo da distribui??o da LV humana e canina nestes por meio de dados disponibilizados no Sistema de Informa??o de Agravos de Notifica??o e de dados registrados em livros da SRSD. No munic?pio com maior ocorr?ncia da LV humana, realizou-se o georreferenciamento dos casos humanos e caninos associados a fatores ambientais e sociais; analisou-se a percep??o das pessoas acometidas pela doen?a por meio de entrevistas; aspectos da estrutura e funcionamento do servi?o de controle da doen?a foram analisados por meio de question?rios. No per?odo de 2007 a 2012 houve a notifica??o de 79 casos de LV humana e 451 c?es positivos para a infec??o canina nos munic?pios que comp?em a SRSD. Nestes, a LV humana foi mais prevalente em crian?as, pessoas do g?nero masculino e residentes em ?reas rurais. Em Ara?ua?, munic?pio com maior transmiss?o da LV humana, houve a notifica??o de 41 casos de LV entre os anos de 2007 a 2013. Neste, a infec??o acometeu principalmente crian?as, pessoas do g?nero masculino e residentes da ?rea urbana. A distribui??o espacial dos casos de LV humana e da infec??o canina na ?rea urbana do munic?pio de Ara?ua? exibiu um padr?o aglomerado, com agrupamentos de casos humanos estatisticamente significativos a dist?ncias superiores a 350 metros e agrupamentos estatisticamente significativos de c?es infectados a dist?ncias superiores a 75 metros. A an?lise explorat?ria por meio do estimador de Kernel apontou para maior ocorr?ncia de casos humanos e caninos na ?rea central da cidade. N?o foi observada rela??o entre o ?ndice de Vegeta??o da Diferen?a Normalizada e as ?reas de maior ocorr?ncia da doen?a. A an?lise socioambiental dos ambientes domiciliares das pessoas acometidas pela LV no munic?pio de Ara?ua? revelou um predom?nio de defici?ncias em estruturas de saneamento ambiental; presen?a de arbustos, ?rvores frut?feras e diferentes animais ao redor dos domic?lios; proximidade com ambientes naturais e casas aglomeradas. Por meio das entrevistas com as pessoas que foram acometidas pela LV, foi poss?vel perceber um desconhecimento em rela??o ? doen?a, principalmente no que diz respeito ?s formas de transmiss?o. P?de-se perceber tamb?m que os m?dicos tiveram dificuldade em diagnosticar a LV e que o tratamento que estes prescreveram para os pacientes foi, no geral, demorado. De forma geral, o munic?pio de Ara?ua? desenvolve a maioria das a??es propostas pelo Minist?rio da Sa?de para o Programa de Controle da Leishmaniose Visceral (PCLV), contudo, h? necessidade de melhor estrutura??o do servi?o de controle da LV neste. A realiza??o de planejamentos para os levantamentos das demandas de materiais para a execu??o dos diagn?sticos da LV para que n?o os falte durante a realiza??o dos inqu?ritos e o estabelecimento de condi??es para a execu??o de levantamentos entomol?gicos ? uma necessidade premente. O investimento em trabalhos de educa??o em sa?de para a popula??o, educa??o continuada para os m?dicos, Agentes de Combate a Endemias e demais profissionais envolvidos no PCLV tamb?m ? fundamental. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2014. / ABSTRACT In order to know the epidemiology of visceral leishmaniasis (VL) between the municipalities under the jurisdiction of the Regional Health Superintendency of Diamantina (SRSD), carried out a study of the distribution of human and canine LV these using data available in Diseases Information system Notification and data recorded in the SRSD books. In the city with the highest occurrence of human VL was held georeferencing of human and canine cases associated with environmental and social factors; analyzed the perception of people with the disease through interviews; aspects of the structure and function of disease control service were analyzed by means of questionnaires. In the period 2007-2012 there was a notification of 79 cases of human VL and 451 dogs positive for canine infection in the municipalities that make up the SRSD. In these, the human VL was more prevalent in children, male gender and living people in rural areas. In Ara?ua?, municipality with greater transmission of human VL, there was notification of 41 cases of VL between the years 2007 to 2013. In this, the infection affected mainly children, males and gender residents of the urban area. The spatial distribution of cases of human VL and canine infection in urban Ara?ua? municipality exhibited a pattern crowded with groups of statistically significant human cases at distances greater than 350 meters and statistically significant clusters of infected dogs at distances greater than 75 meters . The exploratory analysis using the Kernel estimator pointed to a higher incidence of human and canine cases in the central area of the city. No relationship was found between the Difference Vegetation Index Normalized and areas of highest incidence of the disease. The environmental analysis of the home environments of people affected by LV in the municipality of Ara?ua? revealed a predominance of deficiencies in environmental sanitation structures; presence of shrubs, fruit trees and different animals around the household; proximity to natural environments and clustered houses. Through interviews with people who have been affected by LV, it was revealed an ignorance about the disease, particularly with regard to forms of transmission. It could be perceived also that doctors had difficulty diagnosing VL and the treatment prescribed for these patients was generally, time consuming. In general, the municipality of Ara?ua? develop most of the actions proposed by the Ministry of Health for the Control Program Visceral Leishmaniasis (PCLV), however, there is need for a better structuring of the LV control this service. The realization of plans for surveys of the demands of materials for the execution of LV diagnostics lest they miss during the surveys and the establishment of conditions for the implementation of entomological surveys is urgently needed. Investment in health education work for the population, continuing education for physicians, Fighting Endemic Diseases agents and other professionals involved in PCLV is also key.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-22T19:46:19Z No. of bitstreams: 1 WiltonRodriguesMedeiros_TESE.pdf: 1563654 bytes, checksum: faf0273ef8cdab04af297b69a25dd4ba (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-28T23:03:41Z (GMT) No. of bitstreams: 1 WiltonRodriguesMedeiros_TESE.pdf: 1563654 bytes, checksum: faf0273ef8cdab04af297b69a25dd4ba (MD5) / Made available in DSpace on 2016-03-28T23:03:41Z (GMT). No. of bitstreams: 1 WiltonRodriguesMedeiros_TESE.pdf: 1563654 bytes, checksum: faf0273ef8cdab04af297b69a25dd4ba (MD5) Previous issue date: 2015-03-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / O objetivo do estudo foi tra?ar o perfil de mortalidade do idoso no Brasil, nas duas faixas et?rias lim?trofes, aqueles com 60 a 69 anos (mais jovens) e 80 ou mais (longevos). Para isso, se buscou a caracteriza??o, tend?ncia, distin??o de diferentes perfis de mortalidade e da qualidade da informa??o e suas rela??es com o contexto socioecon?mico e sanit?rio das microrregi?es do Brasil. Para tanto, se processou a coleta de dados no Sistema de Informa??o sobre Mortalidade (SIM) e Instituto Brasileiro de Geografia e Estat?stica (IBGE). A partir dos dados foram calculados os coeficientes de mortalidade para os cap?tulos da Classifica??o Internacional das Doen?as (CID-10) e com o uso do modelo de regress?o polinomial se obteve a tend?ncia dos principais cap?tulos. Atrav?s da An?lise de Agrupamento por t?cnica n?o hier?rquica (K-Means) se obteve os perfis entre as microrregi?es brasileiras. Ademais, por meio da an?lise fatorial das vari?veis contextuais se obteve o ?ndice de Priva??o Socioecon?mica e Sanit?ria (IPSS). A tend?ncia dos CMId e da raz?o de seus valores nos dois estratos mostrou uma diminui??o da maior parte dos indicadores, principalmente das taxas de mal definidas, especialmente entre os longevos. Os perfis que emergiram foram nos idosos ?mais jovens?, o Perfil do Desenvolvimento, Perfil da Modernidade, Perfil do Paradoxo Epidemiol?gico e Perfil do Desconhecimento. Nos longevos, emergiram perfis denominados igualmente aos tr?s ?ltimos e mais o Perfil das Baixas Taxas de Mortalidade. Na compara??o das m?dias de IPSS de forma global todos os grupos diferiam entre si, em ambos os estratos et?rios. Foi feita a compara??o do Perfil do Desconhecimento, com os demais perfis, atrav?s do uso de contrastes ortogonais. Basicamente ele diferia de todos os outros, isolados ou agrupados. Embora, nos longevos este apresentou m?dia de IPSS semelhante ao Perfil das Baixas Taxas de Mortalidade. Tamb?m, foi encontrada associa??o entre os indicadores de qualidade da informa??o, CMId por causas mal definidas, Coeficiente Geral de Mortalidade para cada estrato et?rio (CGMId) e o IPSS das microrregi?es, onde foi maior a priva??o socioecon?mica sanit?ria, mais desfavor?veis foram as taxas encontradas. Diante dos achados, considera-se que apesar da diminui??o dos coeficientes de mortalidade, h? diferen?as marcantes de perfis e estes est?o relacionados ?s condi??es contextuais, como tamb?m ?s desigualdades regionais em rela??o ? qualidade da informa??o, fato que potencializa a vulnerabilidade da faixa et?ria estudada e as iniquidades em sa?de j? presentes. / The aim of the present study was to trace the mortality profile of the elderly in Brazil using two neighboring age groups: 60 to 69 years (young-old) and 80 years or more (oldest-old). To do this, we sought to characterize the trend and distinctions of different mortality profiles, as well as the quality of the data and associations with socioeconomic and sanitary conditions in the micro-regions of Brazil. Data was collected from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IBGE). Based on these data, the coefficients of mortality were calculated for the chapters of the International Disease Classification (ICD-10). A polynomial regression model was used to ascertain the trend of the main chapters. Non-hierarchical cluster analysis (K-Means) was used to obtain the profiles for different Brazilian micro-regions. Factorial analysis of the contextual variables was used to obtain the socio-economic and sanitary deprivation indices (IPSS). The trend of the CMId and of the ratio of its values in the two age groups confirmed a decrease in most of the indicators, particularly for badly-defined causes among the oldest-old. Among the young-old, the following profiles emerged: the Development Profile; the Modernity Profile; the Epidemiological Paradox Profile and the Ignorance Profile. Among the oldest-old, the latter three profiles were confirmed, in addition to the Low Mortality Rates Profile. When comparing the mean IPSS values in global terms, all of the groups were different in both of the age groups. The Ignorance Profile was compared with the other profiles using orthogonal contrasts. This profile differed from all of the others in isolation and in clusters. However, the mean IPSS was similar for the Low Mortality Rates Profile among the oldest-old. Furthermore, associations were found between the data quality indicators, the CMId for badly-defined causes, the general coefficient of mortality for each age group (CGMId) and the IPSS of the micro-regions. The worst rates were recorded in areas with the greatest socioeconomic and sanitary deprivation. The findings of the present study show that, despite the decrease in the mortality coefficients, there are notable differences in the profiles related to contextual conditions, including regional differences in data quality. These differences increase the vulnerability of the age groups studied and the health iniquities that are already present.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-10-18T22:30:52Z No. of bitstreams: 1 DISSERTA??O TACIANE.pdf: 1332823 bytes, checksum: 16624f495ae47a3674ddd9369197c8bf (MD5) / Made available in DSpace on 2016-10-18T22:30:52Z (GMT). No. of bitstreams: 1 DISSERTA??O TACIANE.pdf: 1332823 bytes, checksum: 16624f495ae47a3674ddd9369197c8bf (MD5) Previous issue date: 2015-03-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Metabolic syndrome is a set of changes consisting of dyslipidemia, glucose intolerance, hypertension, obesity and hyperinsulinemia. The study of this syndrome is of great importance to public health, since it can lead to negative outcomes that could increase their risk of cardiovascular disease in the general population. OBJECTIVE: Investigate the occurrence of metabolic syndrome and associated factors in adults treated in public health services in the city of Feira de Santana - BA. METHOD: epidemiological study, cross-sectional and exploratory conducted in 479 adults aged at least 20 years, seen at public health services in the fair city of Santana - BA. Information was obtained through structured questionnaires, anthropometric clinical and oral, and biochemists. The diagnosis of metabolic syndrome took into account the criteria proposed by the National Cholesterol Education Program - Adult Treatment Panel III / (NCEP-ATP III) and the International Diabetes Federation (IDF). Prevalence ratios were estimated (PR) and their respective confidence intervals of 95% (95% CI) and statistical significance level of 5%. Multivariate analysis was constructed using Poisson regression. RESULTS: Presented in the form of a scientific paper: "Metabolic syndrome and its associated factors in adults", to be submitted to the Journal Brazilian Archives of Endocrinology and Metabolism. The occurrence of MS ranged from 57% (NCEP / ATP III) to 62% (IDF). In the bivariate analysis female, advanced age, overweight, and some comorbidities proved to be independently associated with MS. In the hierarchic analysis, only BMI ? 30 kg / m? (NCEP-ATPIII) and no measurement of blood pressure periodically (IDF) remained independently associated with metabolic syndrome. CONCLUSIONS: The metabolic syndrome is a public health problem among individuals in this study. The body mass index ? 30 kg / m2 not regular blood pressure measurements are important predictors of the metabolic syndrome in adults. / A S?ndrome Metab?lica ? um conjunto de altera??es constitu?do por dislipidemia, intoler?ncia ? glicose, hipertens?o arterial, obesidade e a hiperinsulinemia. O estudo desta s?ndrome ? de grande relev?ncia para a sa?de p?blica, uma vez que pode ocasionar desfechos negativos capazes de aumentar o risco de doen?as cardiovasculares na popula??o em geral. OBJETIVO: Investigar a ocorr?ncia de S?ndrome Metab?lica e seus fatores associados em indiv?duos adultos atendidos em servi?os de sa?de p?blica no Munic?pio de Feira de Santana ? BA.M?TODO: Estudo epidemiol?gico, transversal, e de car?ter explorat?rio realizado em 479 adultos com idade m?nima de 20 anos, atendidos em servi?os de sa?de p?blica no munic?pio de Feira de Santana ? BA. As informa??es foram obtidas mediante aplica??o de question?rios estruturados, exames cl?nicos antropom?tricos e bucais, e bioqu?micos. O diagn?stico da s?ndrome metab?lica levou em considera??o os crit?rios propostos pelo National Cholesterol Education Program - Adult Treatment Panel III / (NCEP-ATP III) e pela Internacional Diabetes Federation (IDF). Foram estimadas raz?o de preval?ncia (RP) e seus respectivos intervalos de confian?a de 95% (IC 95%) e n?vel de signific?ncia estat?stica de 5%. A an?lise multivariada foi constru?da usando a regress?o de Poisson. RESULTADOS:Apresentados em forma de artigo cient?fico: ?S?ndrome metab?lica e seus fatores associados em indiv?duos adultos?, a ser submetido ? Revista Arquivos Brasileiros de Endocrinologia e Metabologia. A ocorr?ncia da SM variou entre 57% (NCEP/ATP III) a62% (IDF). Na an?lise bivariada, sexo feminino, faixa et?ria avan?ada, excesso de peso, e algumas comorbidades mostraram-se independentemente associados com SM. Na an?lise hierarquizada, apenas ?ndice de massa corporal ? 30kg/m? (NCEP-ATPIII) e n?o aferi??o da press?o arterial periodicamente (IDF)permaneceram independentemente associados ? s?ndrome metab?lica.CONCLUS?ES: A s?ndrome metab?lica representa um problema de Sa?de P?blica entre os indiv?duos desse estudo. O ?ndice de massa corporal ? 30kg/m2 a n?o aferi??o regular da press?o arterial s?o potenciais preditores da s?ndrome metab?lica em adultos.