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Vulnerabilidade ?s infec??es sexualmente transmiss?veis no contexto universit?rioGil, Maria Ang?lica Aires 30 May 2016 (has links)
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Previous issue date: 2016-05-30 / A incid?ncia de Infec??es Sexualmente Transmiss?veis (IST) ainda ? muito alta no Brasil, especialmente ? infec??o pelo V?rus da Imunodefici?ncia Humana (HIV), o que tem mobilizado governo e comunidade cient?fica para o controle dessas infec??es, pois se trata de um grave problema de sa?de p?blica. Estudos demonstram que no Brasil a clam?dia ? a IST mais incidente e que a AIDS e a s?filis s?o de notifica??o compuls?ria desde 1986. O objetivo ? analisar o conhecimento, atitudes e comportamentos da comunidade universit?ria relacionados ?s IST, para subsidiar a implanta??o de um Centro de Testagem e Aconselhamento (CTA) na Universidade Federal do Rio Grande do Norte (UFRN). Com abordagem quantitativa, delineamento descritivo transversal, do tipo levantamento de dados com amostragem estratificada proporcional, totalizando 305 question?rios autoaplicados, composto por 258 discentes, 8 docentes e 39 t?cnicos-administrativos. Os participantes apresentaram o seguinte perfil: maioria de mulheres, jovens e adultos, com ensino m?dio completo, solteiros e cat?licos. Os resultados demonstram que os participantes possuem um bom conhecimento sobre IST/HIV/AIDS, independentemente da escolaridade, havendo associa??es estat?sticas significativas entre tal conhecimento e escolaridade apenas para alguns itens, inferindo-se que o n?vel m?nimo de escolaridade apresentado pelos participantes foi suficiente para a difus?o da informa??o e do conhecimento. No que diz respeito aos comportamentos relacionados ? sa?de sexual, 84,3% dos participantes eram ativos sexualmente, e destes, 15,3% j? mantiveram rela??es sexuais com pessoas do mesmo sexo. A primeira rela??o sexual ocorreu em m?dia aos 16 anos para homens e aos 19 anos para mulheres. Verificou-se ainda que, independentemente da situa??o conjugal, a maioria (82,6%) n?o utilizava preservativo com os parceiros fixos. Quando o parceiro era ocasional, o uso do preservativo foi mais relatado (36,4%). No entanto, 33,8% das pessoas relatam n?o usar preservativo e ainda 14,1% n?o souberam ou n?o quiseram informar. Houve associa??o significativa entre usar preservativo com parceiros ocasionais e a situa??o conjugal, pois 18,9% dos participantes casados e 12,6% com uni?o est?vel, afirmaram ter usado preservativo, mas, 17,5% e 12,6% destes, n?o utilizaram. Praticamente metade dos participantes nunca realizou o teste de detec??o do HIV. A partir de 25 anos, as pessoas passam a fazer o teste. No entanto, depois dos 50 anos, h? uma invers?o, e tal como os jovens entre 16 e 25 anos, novamente h? uma divis?o entre os que fazem e os que nunca fizeram o teste. A respeito da atitude frente ? infec??o do HIV e da AIDS, 80% dos participantes revelaram que possuem medo de se relacionar com pessoas soropositivas, e essa vari?vel n?o se associou estatisticamente com nenhuma caracter?stica demogr?fica (sexo, idade, escolaridade, religi?o) ou laboral (v?nculo institucional), nos permitindo inferir que se trata de algo compartilhado pelos participantes. Os respondentes n?o vinculam a infec??o pelo HIV a grupos de risco como dependentes qu?micos e profissionais do sexo ou promiscuidade, revelando que sabem que a infec??o se relaciona com comportamentos de risco. Conclui-se que, embora a comunidade universit?ria participante tenha conhecimento sobre IST/HIV/AIDS, os comportamentos e atitudes n?o s?o consonantes com os mesmos, evidenciando vulnerabilidade. / The incidence of Sexually Transmitted Infections (STI) is still very high in Brazil, especially infection with Human Immunodeficiency Virus (HIV), which has mobilized government and scientific community to control these infections because it is a serious issue for the public?s health. Studies show that in Brazil chlamydia is the most frequent STI and AIDS and syphilis are notifiable since 1986. The objective is to analyze the knowledge, attitudes and behaviors of the university community related to STIs, to support the establishment of a Centre counseling and Testing (CTA) at the Federal University of Rio Grande do Norte (UFRN). With a quantitative approach, cross-sectional design, the kind data collection with proportional stratified sampling, totaling 305 self-administered questionnaires, composed of 258 students, 8 teachers and 39 administrative technicians. Participants presented the following profile: most women, youth and adults with high school education, single and Catholics. The results show that participants have a good knowledge of STI / HIV / AIDS, regardless of education, with significant statistical associations between such knowledge and education only for some items, inferring that the minimum level of education presented by the participants was enough to the dissemination of information and knowledge. With regard to behaviors related to sexual health, 84.3% of participants were sexually active, and of these, 15.3% have had sex with people of the same sex. The first sexual intercourse occurred on average at 16 years for men and 19 years for women. It was also found that regardless of the marital status, the majority (82.6%) didn?t use condom with fixed partners. When the partner was casual, condom use was most often reported (36.4%). However, 33.8% of people reported not using condoms and even 14.1% did not know or would not tell. There was a significant association between condom use with casual partners and marital status, as 18.9% of married participants and 12.6% with stable, said they used a condom, but 17.5% and 12.6% of those didn?t use. Nearly half of the participants never held an HIV detection test. From 25 years, people start to take the test. However, after 50 years, there is a reversal, and as young people between 16 and 25, again there is a division between those who do and those who have never been tested. Regarding the attitude to HIV infection and AIDS, 80% of participants revealed that have fear to relate to people living with HIV, and this variable was not statistically associated with any demographic characteristics (sex, age, education, religion) or labor (institutional link), allowing us to infer that it is something shared by the participants. Respondents do not bind the HIV infection risk groups such as drug addicts and sex workers or promiscuity, revealing that they know the infection is related to risk behaviors. We conclude that, although the participating university community has knowledge about STI/ HIV / AIDS, behaviors and attitudes are not in line with the same, showing vulnerability.
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Doen?a renal cr?nica como foco para a educa??o permanente em sa?deLeite, Luciana Fernandes Amaro 08 July 2016 (has links)
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Previous issue date: 2016 / A Doen?a Renal Cr?nica ? um importante problema de sa?de p?blica em todo o mundo porque sua incid?ncia e preval?ncia est?o aumentando, o custo ? elevado e medidas de preven??o precisam ser implementadas. O Inqu?rito Brasileiro de Di?lise Cr?nica mostrou que em julho de 2013, o n?mero total estimado de indiv?duos em di?lise no pa?s foi de 100.397; a taxa anual de mortalidade bruta foi de 17,9% e o n?mero absoluto de indiv?duos em di?lise tem aumentado 3% ao ano nos ?ltimos tr?s anos. Como no Brasil n?o h? dados fidedignos de DRC n?o dial?tica, para fins de programa??o, a Secretaria de Estado de Sa?de de Minas Gerais (SES/MG) estima que 11,6% dos adultos mineiros (com idade igual ou superior a 20 anos) apresentem DRC em um dos seus est?gios. Deste modo, considerando a relev?ncia e o impacto da DRC na sa?de da popula??o brasileira, o presente estudo tem por objetivo central realizar o rastreio desta doen?a em adultos em uma Estrat?gia de Sa?de da Fam?lia da cidade de Diamantina, Minas Gerais, bem como promover a capacita??o dos profissionais m?dicos e enfermeiros deste munic?pio em rela??o ? mesma. Foi realizado, atrav?s de an?lise das fichas do Sistema de Informa??o da Aten??o B?sica, o levantamento de todos os usu?rios com presen?a de algum fator de risco para o desenvolvimento da DRC na ESF Cazuza, Diamantina. Os usu?rios do Sistema ?nico de Sa?de que apresentaram fatores de risco para DRC foram convidados a participar de entrevistas onde foram coletados dados s?cio demogr?ficos, comportamentais, comorbidades e antropom?tricos. Foram coletados materiais biol?gicos (sangue e urina) para realiza??o dos exames de creatinina s?rica e urin?ria, urina rotina e prote?nas totais na urina. O valor da creatinina s?rica foi utilizado para fazer a estimativa da Taxa de Filtra??o Glomerular (TFG) utilizando o nomograma baseado na equa??o Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Na urina rotina, especial aten??o foi dada ? presen?a de hemat?ria de origem glomerular tendo como sinais a presen?a de cilindros hem?ticos ou dismorfismo eritrocit?rio. Os resultados dos exames de prote?nas totais na urina e creatinina urin?ria foram utilizados para calcular a rela??o protein?ria/creatinin?ria. Assim foi poss?vel rastrear a presen?a da DRC em 191 indiv?duos. Destes pacientes, 57,6% eram do sexo feminino, 73,8% de ra?a n?o branca, 64,4% possu?a ensino fundamental incompleto, 81,2% eram sedent?rios, 13,1% apresentaram uso abusivo do ?lcool, 63,4% eram hipertensos, 10,0% eram diab?ticos, 35,1% estavam obesos e 18,3% tinham hist?ria familiar de DRC. Com a estimativa da TFG obteve-se 53,4% no est?gio 1. O rastreio para DRC foi positivo para 14,2% dos pacientes. As informa??es obtidas dos pacientes foram utilizadas nas capacita??es no formato de m?dulos de capacita??o para m?dicos e enfermeiros que atuam na Estrat?gia de Sa?de da Fam?lia de Diamantina, MG, sendo que estes treinamentos geraram uma melhora do n?vel de conhecimento dos profissionais participantes de 8,8%. Pode-se concluir a import?ncia da atua??o dos profissionais da aten??o prim?ria a sa?de no controle dos fatores de risco para o desenvolvimento e progress?o da DRC. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2016. / Chronic Kidney Disease is an important public health problem all over the world because its incidence and prevalence have been growing, the cost to treat it is high, and prevention measures need to be implemented. The Brazilian Chronic Dialysis Survey has shown that in July 2013 the estimated total number of individuals on dialysis in the Brazil was 100,397; the annual crude death rate was 17.9%, and the absolute number of individuals on dialysis has grown by 3% a year over the last three years. Since there are no reliable data concerning non-dialytic CKD in Brazil, the Health Department of the State of Minas Gerais (Secretaria de Estado de Sa?de de Minas Gerais ? SES/MG), for planning purposes, estimates that 11.6% of the adults born in Minas Gerais (aged 20 or higher) present with CKD in one of its stages. Therefore, considering the relevance and impact of CKD on the health of the Brazilian population, the central aim of this study is to screen for this disease in adults in a Family Health Strategy in the city of Diamantina, state of Minas Gerais, as well as to promote the training of medical professionals and nurses in this municipality as far as CKD is concerned. Upon analysis of the records of the Basic HealthCare Information System, data were compiled on all users presenting any risk factor for the development of CKD in the Cazuza FHS in Diamantina. Users of the Brazilian Unified Health System (SUS) who presented risk factors for CKD were invited to participate in interviews where socio-demographic, behavioral, comorbidity, and anthropometric data were gathered. Biological materials (blood and urine) were collected for serum and urine creatinine, routine urine, and total urine protein tests. The value of serum creatinine was utilized to estimate the Glomerular Filtration Rate (GFR) using the nomogram based on the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI) equation. In the routine urine test, special attention was given to the presence of hematuria of glomerular origin characterized by the presence of red blood cell casts or dysmorphic erythrocytes.The results of the total urine protein and urine creatinine tests were utilized to calculate the proteinuria/creatinuria ratio. Thus, it was possible to screen the presence of CKD in 191 individuals. Out of these patients, 57.6% were females, 73.8% were non-whites, 64.4% had not completed their primary education, 81.2% were sedentary, 13.1% were alcohol abusers, 63.4% were hypertensives, 10.0% were diabetics, 35.1% were obese, and 18.3% had a family history of CKD. According to the GFR estimate, 53.4% of the individuals are in stage 1. The screening for CKD was positive for 14.2% of the patients. The information obtained from patients was utilized in the training provided to physicians and nurses who work in the Family Health Strategy in Diamantina, MG. This training, carried out in modules, improved by 8.8% the level of knowledge of the professionals who attended it. Hence, it can be concluded that the actions of primary health care professionals are important to control risk factors leading to the development and progression of CKD.
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