Made available in DSpace on 2014-12-17T15:43:53Z (GMT). No. of bitstreams: 1 GerlieneMSA_DISSERT.pdf: 1373192 bytes, checksum: ae98ef68760a45b957ffea40dff5d730 (MD5) Previous issue date: 2013-02-22 / Many surveys are conducted comparing oral health conditions with individual variables, such as socioeconomic and demographic factors. However, in the same way that individuals differ among themselves, the groups also have their own characteristics and the effects of this differentiation must be researched. Brazil, despite being one of the major economic powers of the world and shows an improvement in the average value of its health indicators, is also one of the most unequal and remains among the countries with the greatest health inequities. The purpose of this study was to investigate the importance of social determinants on the contextual level oral health among Brazilian adolescents, population not much researched by the literature. The research was made using an ecological approach in order to identify possible inequalities between cities and capitals. Using data from SBBrasil 2010 it was evaluated less common outcomes (loss of first molar, dental care index and T-Health) which provide information on the degree of morbidity of caries and health level of dental tissues, in addition to analyze the related services. The association of these oral health indicators with socioeconomic factors such as income, employment, education and inequality, collected from Census 2010, was analyzed by simple and multiple linear regressions. The study included the 27 state capitals and four clusters representing the municipalities of the country. It was possible to see better access to services in locations with better income distribution. However, the strong association of contextual factors related to poverty, low levels of education and poor housing and jobs with poorer levels of oral health in adolescents seems to overshadow the effects of income inequalities on dental caries in the country. In some locations, particularly within the North and Northeast, whichever one keeps dentistry mutilating, whose effects are already noticeable in its adolescent population. Access to restorative services in Brazil remains limited and unequal. The results of this study highlight the inequities in oral health in the country and show the need of the inclusion of new perspectives on the traditional approach of Preventive Dentistry and education models in Dentistry. Tackling health inequalities in oral health in the country requires the cooperation of various actors involved in the process and the inclusion of oral health in the context of overall health. The social determinants approach, as well as evaluating the distribution of oral diseases in the country and its inclusion in the context of overall health, should guide the implementation of programs and oral health practices in order to contribute to the reduction of inequalities / Muitas pesquisas s?o realizadas confrontando condi??es de sa?de bucal com vari?veis individuais, como fatores socioecon?micos e demogr?ficos. No entanto, da mesma forma que os indiv?duos divergem entre si, os grupos tamb?m possuem caracter?sticas pr?prias e os efeitos dessa diferencia??o precisam ser pesquisados. O Brasil, apesar de ser uma das maiores pot?ncias econ?micas do mundo e vir apresentando uma melhoria no valor m?dio de seus indicadores de sa?de, ? tamb?m um dos mais desiguais e permanece entre os pa?ses com maiores iniquidades em sa?de. A proposta deste estudo foi pesquisar a import?ncia dos determinantes sociais a n?vel contextual na sa?de bucal de adolescentes brasileiros, popula??o pouco pesquisada na literatura. A pesquisa foi feita atrav?s de uma abordagem ecol?gica, no intuito de identificar poss?veis desigualdades entre munic?pios e capitais. Utilizando dados do SBBrasil 2010, foram avaliados desfechos menos comuns (perda do 1? molar, ?ndice de cuidados odontol?gicos e T-Health) que fornecem informa??es sobre o grau de morbidade da c?rie e o n?vel de sa?de dos tecidos dent?rios, al?m de abordar aspectos relacionados aos servi?os. A associa??o destes indicadores de sa?de bucal com fatores socioecon?micos como renda, emprego, educa??o e desigualdade, coletados do CENSO 2010, foi analisada por meio de regress?o linear simples e m?ltipla. Os dom?nios do estudo inclu?ram as 27 capitais brasileiras e 4 clusters representativos dos munic?pios do interior do pa?s. Foi poss?vel constatar um melhor acesso aos servi?os em localidades com melhor distribui??o de renda. No entanto, a forte associa??o de fatores contextuais relativos ? pobreza, baixos n?veis de educa??o e m?s condi??es de moradia e emprego com piores n?veis de sa?de bucal em adolescentes parece ofuscar os efeitos das desigualdades de renda sobre os agravos bucais no pa?s. Em algumas localidades, em especial no interior das regi?es Norte e Nordeste, continua prevalecendo uma odontologia mutiladora, cujos efeitos s?o percept?veis j? em sua popula??o adolescente. O acesso aos servi?os restauradores no Brasil ainda permanece limitado e desigual. Os resultados deste estudo evidenciam as iniquidades em sa?de bucal no pa?s e mostram a necessidade da inclus?o de novas perspectivas na abordagem tradicional da Odontologia Preventiva e nos modelos de educa??o em Odontologia. O combate a essas iniquidades requer a coopera??o dos v?rios autores envolvidos no processo e a inclus?o da sa?de bucal no contexto da sa?de geral. A abordagem dos determinantes sociais, bem como a avalia??o da distribui??o das doen?as bucais no territ?rio brasileiro e sua inclus?o no contexto da sa?de em geral, devem nortear a implementa??o de programas e a??es em sa?de bucal, de forma a contribuir para a redu??o das desigualdades

Made available in DSpace on 2014-12-17T14:47:03Z (GMT). No. of bitstreams: 1 CarolineENKV_DISSERT.pdf: 3807500 bytes, checksum: a47dd134372904c5d622a5ed69238b91 (MD5) Previous issue date: 2013-11-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / One of the Primary Health Care strategies for adolescent health is the growth and development follow-up and the early detection of overweight adolescents. Even though the School Health Program in Brazil proposes to evaluate the nutritional state of the school population in the corresponding community health units, not all cities have adhered to the Program and many nurses do not recognize overweight as a problem in their territory. The objective of the study was to identify the nurse?s participation in the screening of overweight adolescent students in their work territory. Cross sectional study conducted in eight state supported schools of the municipality of Natal/RN and in four Primary Health Units. The total student population was 27.277. A stratified sample was statistically calculated based on the student population of the four city geographical zones: 112 North , 74 West; 108 East; and 78 South, totalizing 372 adolescents. The students were selected by a probability process where eight schools were first selected, two per district, until the number per subsample in each district was reached. Four primary health nurses, responsible for the health units were included. Two instruments were used for data collection, a screening questionnaire and a semi-structured interview form for questioning of the nurses. The content of both instruments was validated. Anthropometric and health data were collected from the students and analyzed with descriptive and analytical statistics. Interview data were transcribed and submitted to content analysis. The nursing diagnosis of overweight was identified in 50 (13,5%) of the adolescents and its association with consumption of foods that have cardiovascular risk (canned foods, pasta and fried food). An association of the nursing diagnosis was identified with family history (diabetes, hypertension, obesity, and kidney disease). The nurses judged that care of overweight adolescents was important but noted difficulties because of the absence of this population in the health units, because of their work overload, and the lack of school articulation. The nurses do not have impacting actions with this population and delegate the responsibility to other professionals. It is concluded that overweight is a nutritional problem relevant to the adolescent school population in Natal/RN, with a 13,5% prevalence and that it is related to food consumption with cardiovascular risk and family health history. The nurses consider overweight as an important public health problem but do not envision ways to maintain linkage with adolescents and with the school to promote the needed care / Uma das principais estrat?gias da enfermagem na Aten??o prim?ria em Sa?de (APS) ? o acompanhamento do crescimento e identifica??o precoce do excesso de peso em adolescentes. Apesar dos incentivos do Programa Sa?de na Escola (PSE) no Brasil, que prop?s avaliar o estado nutricional dos escolares pelas Unidades B?sicas de Sa?de (UBS), ainda n?o h? ades?o de todos os munic?pios e muitos enfermeiros n?o reconhecem o excesso de peso como um problema. O objetivo desse estudo foi identificar a participa??o do enfermeiro da APS no screening de adolescentes escolares com excesso de peso na sua ?rea de atua??o. Estudo transversal, realizado em oito escolas estaduais de Natal-RN e em quatro UBS. A popula??o de alunos das escolas estaduais foi 27.377. Com base em procedimento estat?stico, definiu-se uma amostra estratificada pelas quatro zonas municipais: 112 na Norte, 74 na Oeste, 108 na Leste e 78 na Sul, o que totalizou 372 adolescentes. Na sele??o de alunos, sortearam-se aleatoriamente as escolas e as turmas participantes, at? totalizar o tamanho das subamostras por zona. Participaram quatro enfermeiras respons?veis pelas UBS inclu?das. Dois instrumentos de coleta de dados foram utilizados, um formul?rio para o screening e um roteiro de entrevista semi-estruturada para questionar os enfermeiros. O conte?do dos instrumentos foi validado por especialistas. A coleta de dados com os adolescentes compreendeu a verifica??o de peso, altura e condi??es de sa?de e analisados por meio estat?stica descritiva e anal?tica. Os ?udios das entrevistas foram gravados, transcritos e analisadas quanto ao conte?do. Dentre os adolescentes, 50 (13,5%) foram identificados com o Diagn?stico de Enfermagem (DE) excesso de peso, com associa??o ao consumo de alimentos de risco cardiovascular (embutidos, macarr?o e fritura). Identificou-se associa??o entre o DE e a hist?ria familiar de doen?as (diabetes, hipertens?o, obesidade e doen?a nos rins). As enfermeiras julgaram fundamental a assist?ncia aos adolescentes com excesso de peso, mas apontaram dificuldades devido a pouca procura dessa clientela pelos servi?os de sa?de, pelo excesso de tarefas que realizam nas UBS e pela baixa articula??o com as escolas. Elas se isentaram de condutas de maior impacto e atribu?ram a outros profissionais a responsabilidade maior. Conclui-se que o excesso de peso ? um desvio nutricional relevante na popula??o de adolescentes de escolas estaduais de Natal/RN, com frequ?ncia de 13,5% e que o problema est? relacionado ao consumo de alimentos de risco cardiovascular e ? hist?ria familiar de doen?as. Os enfermeiros consideram o excesso de peso como importante problema de sa?de p?blica, que necessita de assist?ncia de enfermagem, mas n?o vislumbram estrat?gias para manter o v?nculo com o adolescente e com a escola para promover a assist?ncia resolutiva diante esse DE

?rea de Concentra??o: Pol?ticas de integra??o sa?de e educa??o. / ?rea B?sica: Sa?de P?blica. / ?rea de Avalia??o: Sa?de Coletiva. / Submitted by repositorio ufvjm (repositorio@ufvjm.edu.br) on 2016-10-17T16:40:48Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) renan_neves_da_mata.pdf: 1746344 bytes, checksum: 62c14a8c9822f174f0cc588c58781320 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-10-24T15:49:10Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) renan_neves_da_mata.pdf: 1746344 bytes, checksum: 62c14a8c9822f174f0cc588c58781320 (MD5) / Made available in DSpace on 2016-10-24T15:49:10Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) renan_neves_da_mata.pdf: 1746344 bytes, checksum: 62c14a8c9822f174f0cc588c58781320 (MD5) Previous issue date: 2015 / Estudo composto de referencial te?rico (revis?o narrativa) acompanhado de pesquisa qualitativa realizada por meio de entrevistas. A revis?o narrativa foi realizada com consulta em bases de dados cient?ficos, abrangendo o per?odo dos ?ltimos dez anos (2005-2015), com a qual se objetivou identificar as publica??es relativas ? tem?tica: forma??o do profissional de sa?de para atender o adolescente no contexto da Aten??o Prim?ria a Sa?de (APS). Optou-se por realizar a coleta do material de forma n?o sistem?tica, o banco de dados foi sendo complementado com os materiais encontrados, pela busca de cita??es nas publica??es inicialmente identificadas, ?rg?os governamentais e autores relevantes na ?rea. Os artigos encontrados abordavam no campo da sa?de do adolescente, predominantemente, temas como: sexualidade, doen?as sexualmente transmiss?veis, drogas, viol?ncia, gravidez na adolesc?ncia. Foram escassos os estudos que buscaram contextualizar a forma??o dos profissionais de sa?de para atender essa clientela, em especial por meio da APS, fato que ressalta a import?ncia deste trabalho. No tocante a pesquisa qualitativa foi estudada a perspectiva dos profissionais que atuam em Estrat?gia de Sa?de da Fam?lia (ESF) acerca de seu processo de forma??o profissional, durante a gradua??o, para cuidar dos adolescentes. Trata-se de um estudo explorat?rio de natureza qualitativa. Participaram 11 trabalhadores da aten??o prim?ria ? sa?de de munic?pios da Microrregi?o de Diamantina/MG. Os dados foram obtidos por meio de 11 entrevistas abertas e analisados conforme a An?lise de Conte?do. As informa??es convergiram para tr?s categorias: 1)o preparo na gradua??o para atender os adolescentes na ESF; 2)assist?ncia insatisfat?ria prestada ao adolescente; 3)perspectivas para a melhora da forma??o e dos profissionais. O processo de ensino adotado nas universidades apresenta reflexos claros na assist?ncia prestada pelos profissionais, que se sentem despreparados para atender o p?blico que vivencia a fase da adolesc?ncia. Nesse sentido, ? fundamental o di?logo cont?nuo entre institui??es de ensino, Sistema ?nico de Sa?de, e comunidade, para que as fragilidades no processo de forma??o e assist?ncia em sa?de possam ser reconhecidas e superadas. / Disserta??o (Mestrado) ? Programa de P?s-gradua??o em Ensino em Sa?de, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2015. / Study consists of theoretical (narrative review) accompanied by qualitative research through interviews. The narrative review was conducted in consultation with scientific databases covering the period of the last ten years (2005-2015), with which aimed to identify publications on the theme: training of health professionals to meet the teen in the context of Primary Health Care (PHC). It was decided to carry out the collection of unsystematically material, the database has been supplemented with the materials found, the search for citations in the initially identified publications, government agencies and relevant authors in the area. Articles found addressed in adolescent health field, predominantly topics such as sexuality, sexually transmitted diseases, drugs, violence, teenage pregnancy. Few are the studies that sought to contextualize the training of health professionals to serve this clientele, especially through the APS, a fact that underscores the importance of this work. Regarding the qualitative research we studied the perspective of professionals working in the Family Health Strategy (FHS) about their training process, for graduation, to care for adolescents. This is an exploratory qualitative study. Attended 11 workers of primary health micro-region's municipalities from Diamantina/MG. Data were obtained from 11 open interviews and analyzed according to Content Analysis. The information converged on three categories: 1)preparing the graduation to meet the teenagers in the FHS; 2)poor care provided to adolescents; 3)prospects for the improvement of training and professional. The teaching process adopted in universities has clear effects on the assistance provided by professionals who feel unprepared to meet the public who experience adolescence. Therefore, it is essential to ongoing dialogue between educational institutions, the National Health System, and community so that the weaknesses in the process of education and health care can be recognized and overcome.