Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-02-10T12:59:12Z No. of bitstreams: 1 TES_VERA_ELIZABETH_CLOSS_PARCIAL.pdf: 344877 bytes, checksum: 83c1713273477d9c1c0fb821d224a93c (MD5) / Made available in DSpace on 2016-02-10T12:59:12Z (GMT). No. of bitstreams: 1 TES_VERA_ELIZABETH_CLOSS_PARCIAL.pdf: 344877 bytes, checksum: 83c1713273477d9c1c0fb821d224a93c (MD5) Previous issue date: 2015-08-27 / Population ageing has been the focus of many studies as it reflects an important transformation of society that creates a reality with new challenges to be faced. The ageing process can be categorized in two forms: normal ageing or ageing per se or senescence (with associated molecular, anatomical and physiological alterations) and usual ageing or senility (associated with diseases and disabilities). The frailty syndrome is among the most discussed current themes. Frailty is a condition in which the individual presents increased vulnerability to the development of dependency, hospitalization, institutionalization, fall-risk and mortality, among other adverse outcomes, when exposed to a stressor. Various pathophysiological processes involved in frailty are closely related to nutritional and body composition aspects, and anthropometry presents as a useful technique for evaluating these conditions. Given that frailty in its early stages is commonly seen in the elderly community and that available instruments for its identification (such as the widely used Fried Phenotype) are complex and difficult to apply in primary care, the search for simple tools becomes important. In this thesis, three original articles are presented. In the first, article, AGING INDEX DEVELOPMENT IN BRAZIL, REGIONS, AND FEDERATIVE UNITS FROM 1970 TO 2010, we sought to address the ageing index, the parameter through which to evaluate the expansion process of the elderly segment of total population in relation to the relative change in young age group. To this end, data from the Demographic Census and Social Indicators of the Brazilian Institute of Geography and Statistics (IGBE) were analysed. It was evidenced that the Brazilian population is undergoing a rapid ageing process. For the second article, DESCRIPTION OF ANTHROPOMETRIC MEASUREMENTS AND ANALYSIS OF THEIR ASSOCIATION WITH GENDER, AGE, AND FRAILTY SYNDROME IN ELDERLY ASSISTED AT THE FAMILY HEALTH STRATEGY: DATA FROM THE EMI-SUS, data from 583 elderly participants of a cross-sectional study ?Clinical and Epidemiological Study of the Elderly Attended at the Family Health Strategy (FHS) in the City of Porto Alegre (EMI-SUS)?, were analyzed. The frequency of frailty (diagnosed by Fried Phenotype) was observed to be 21.5% and pre-frailty 51.1%, and that only one of the 41 evaluated anthropometric measures was not associated with at least one of the investigated dependent variables (gender, age group or frailty). In the third article, PERFORMANCE OF ANTHROPOMETRIC MEASURES IN PREDICTING FRAILTY IN THE ELDERLY: LOGISTIC REGRESSION AND ARTIFICIAL NEURAL NETWORK MODELS, we sought to investigate the performance of 26 anthropometric measurements in predicting frailty and to develop a tool for their identification. Data from 583 participants of the EMI-SUS were analyzed, randomly divided into a learning sample (n=439) and test sample (n=144). Logistic regression and artificial neural network models were used. The neural network demonstrated a superior predictive performance to the logistic regression model and resulted in a reliable tool for identifying frailty in the elderly. The anthropometric measures of weight, biceps skinfold, sagittal abdominal diameter and waist circumference, grouped, proved to be good predictors of frailty in the elderly. / O envelhecimento da popula??o tem sido foco de muitos estudos por se tratar de uma transforma??o importante da sociedade e que implica uma realidade com novos desafios a serem enfrentados. O processo de envelhecimento pode ser categorizado em dois padr?es: o envelhecimento normal ou envelhecimento per se ou senesc?ncia (com altera??es moleculares, anat?micas e fisiol?gicas associadas) e o envelhecimento usual ou senilidade (associado a doen?as e incapacidades). Dentre as tem?ticas mais abordadas atualmente, encontra-se a s?ndrome da fragilidade. Fragilidade ? uma condi??o na qual o indiv?duo apresenta uma maior vulnerabilidade para o desenvolvimento de depend?ncia, hospitaliza??o, institucionaliza??o, queda e mortalidade, dentre outros desfechos negativos, quando exposto a um estressor. V?rios processos fisiopatol?gicos envolvidos na fragilidade t?m estreita rela??o com aspectos nutricionais e de composi??o corporal e que, na avalia??o destas condi??es, a antropometria se apresenta como uma t?cnica ?til. Considerando que est?gios iniciais de fragilidade s?o comumente observados em idosos da comunidade e que instrumentos dispon?veis para a identifica??o de fragilidade (como o fen?tipo de Fried que ? amplamente utilizado) s?o complexos e de dif?cil aplica??o na aten??o b?sica, a busca por ferramentas simples torna-se importante. Na presente tese, s?o apresentados tr?s artigos originais. No primeiro artigo, A EVOLU??O DO ?NDICE DE ENVELHECIMENTO NO BRASIL, NAS SUAS REGI?ES E UNIDADES FEDERATIVAS NO PER?ODO DE 1970 A 2010, buscou-se abordar o ?ndice de envelhecimento, par?metro atrav?s do qual se avalia o processo de amplia??o do segmento idoso na popula??o total em rela??o ? varia??o relativa no grupo et?rio jovem. Para tanto, foram pesquisados dados dos Censos Demogr?ficos e dos Indicadores Sociais do IBGE. Evidenciou-se que a popula??o brasileira se encontra em franco processo de envelhecimento. Para o segundo artigo, DESCRI??O DE MEDIDAS ANTROPOM?TRICAS E AN?LISE DE SUA ASSOCIA??O COM G?NERO, IDADE E S?NDROME DA FRAGILIDADE EM IDOSOS ASSISTIDOS NA ESTRAT?GIA SA?DE DA FAM?LIA: DADOS DO EMI-SUS, foram analisados os dados de 583 idosos participantes de um estudo transversal denominado ?Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos na Estrat?gia Sa?de da Fam?lia (ESF) do Munic?pio de Porto Alegre (EMI-SUS)?. Observou-se que a frequ?ncia de fragilidade (diagnosticada pelo Fen?tipo de Fried) foi 21,5% e de pr?-fragilidade, 51,1% e que, das 41 medidas antropom?tricas avaliadas, somente uma n?o se mostrou associada com pelo menos uma das vari?veis dependentes investigadas (sexo, faixa et?ria ou fragilidade). No terceiro artigo, PERFORMANCE OF ANTHROPOMETRIC MEASURES IN PREDICTING FRAILTY IN ELDERLY: LOGISTIC REGRESSION AND ARTIFICIAL NEURAL NETWORK MODELS, buscou-se investigar a performance de 26 medidas antropom?tricas na predi??o de fragilidade e formular uma ferramenta para sua identifica??o. Foram analisados os dados de 583 idosos participantes do EMI-SUS, divididos randomicamente em uma amostra de aprendizado (n=439) e uma amostra teste (n=144). Foram utilizados modelos de regress?o log?stica e rede neural artificial. A rede neural mostrou performance preditiva superior ? regress?o log?stica e resultou em uma ferramenta confi?vel na identifica??o de fragilidade em idosos. As medidas antropom?tricas peso, dobra cut?nea bicipital, di?metro abdominal sagital e circunfer?ncia da cintura, agrupadas, mostraram-se bons preditores de fragilidade em idosos.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-05-03T15:55:01Z No. of bitstreams: 1 TES_JANAINA_ALVARENGA_ARAGAO_COMPLETO.pdf: 3180936 bytes, checksum: 8c2565ec49dcb5d8412b181769abe70c (MD5) / Made available in DSpace on 2016-05-03T15:55:01Z (GMT). No. of bitstreams: 1 TES_JANAINA_ALVARENGA_ARAGAO_COMPLETO.pdf: 3180936 bytes, checksum: 8c2565ec49dcb5d8412b181769abe70c (MD5) Previous issue date: 2014-03-31 / Several changes have occurred on humanity in the last decades, the aging of the world population and Brazilian population. Due to the drop in mortality rates and increased life expectancy at birth, it has also increased the prevalence of chronic diseases due to transmissible diseases in developing countries. The overall objective of the study was analyze the relation between the characteristics of access to health care and assistency provided in primary care to adults and seniors of remaining quilombola communities, associated to the epidemiological and socio-cultural profile of the community where they live. A census was conducted along with community health agents, and by the end 198 remnants of quilombola communities, adults and seniors, that is being 45 years old or more, residents of the quilombola communities of Piau?, between March and December 2011. It was performed an analysis (fasting peripheral blood, and analyzed it to test the levels of HDL-cholesterol, triglycerides and glucose), anthropometric data (height, weight, arterial pressure, waist circumference), completed questionnaires regarding sociodemographic data, lifestyle and access to healthcare. Data were scanned into a database developed by TeleForm and analyzed using the Epi Info software, version 3.5.1. The botanical material was collected to get to know the practices and natural and traditional health resources in their communities. The study was approved by the Pontifical Catholic University of Rio Grande do Sul Ethics Committee. The results of this study demonstrated that the prevalence of MS was 55.4% in the quilombolas surveyed, and more prevalent in females (p <0.001). the distance between home and the health unity greater than 5 km was significantly important for a smaller chance to prefer non-traditional health knowledge, the geographical distance interfered with the access to healthcare of these communities. Therefore, it is necessary to invest in the construction of social equipment designed to meet their needs based on the historical context and where these communities live, especially in public policies of preventive health education, professional qualification of the Family Health staff, since it is in this strategy that the government investment has had the highest concentration. / V?rias mudan?as aconteceram na humanidade nas ?ltimas d?cadas, o envelhecimento da popula??o mundial e popula??o brasileira. Devido ? queda da taxa de mortalidade, e aumento da esperan?a de vida ao nascer aumentou tamb?m a preval?ncia das enfermidades cr?nicas em detrimento das doen?as transmiss?veis nos pa?ses em desenvolvimento. O objetivo geral desse trabalho foi analisar a rela??o entre as caracter?sticas de acesso de sa?de e assist?ncia prestada na aten??o b?sica dirigida aos adultos e idosos de comunidades remanescentes quilombolas, associado ao perfil epidemiol?gico e sociocultural da comunidade onde vivem. Para metodologia realizou-se um censo junto com os agentes comunit?rios de sa?de, e ao final participaram 198 volunt?rios remanescentes de comunidades quilombolas, adultos e idosos, ou seja com idade de 45 anos ou mais residentes nas comunidades quilombolas no centro sul do Piau, entre mar?o e dezembro de 2011. Que realizaram an?lises (sangue perif?rico em jejum, e analisadas para testar os n?veis de colesterol-HDL, triglicer?deos e glicemia), dados antropom?tricos (altura, peso, press?o art?ria, circunfer?ncia abdominal), responderam question?rios sobre dados, s?cio demogr?ficos, h?bitos de e de acesso de sa?de. Os dados foram digitalizados em um banco de dados desenvolvido pelo programa TeleForm e analisados pelo programa Epi Info, vers?o 3.5.1. O material bot?nico foi coletado para conhecer as pr?ticas e recursos naturais e tradicionais de sa?de de suas comunidades. A pesquisa foi aprovada pela Comit? de ?tica da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. Os resultados dessa pesquisa mostraram a preval?ncia da SM foi de 55.4% nos quilombolas pesquisados, e mais prevalente no sexo feminino (p < 0,001). A dist?ncia entre a resid?ncia e a UBS maior que 5 km foram um fator significativamente importante para a menor chance de preferir conhecimentos n?o tradicionais de sa?de, que a dist?ncia geogr?fica interferiu no acesso de sa?de dessas comunidades. Portanto ? necess?rio investir na constru??o de equipamentos sociais destinados a atender suas demandas tendo como base o contexto hist?rico e local onde vivem essas comunidades, principalmente em pol?ticas p?blicas de sa?de preventiva e na educa??o, qualifica??o dos profissionais das equipes de Sa?de da Fam?lia, pois ? nessa estrat?gia onde os investimentos governamentais tem tido maior concentra??o.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-08-29T14:06:36Z No. of bitstreams: 1 DIS_JOEL_HIRTZ_DO_NASCIMENTO_NAVARRO_PARCIAL.pdf: 326191 bytes, checksum: b4a1a4a965e905f18947117bd092e4c7 (MD5) / Made available in DSpace on 2016-08-29T14:06:36Z (GMT). No. of bitstreams: 1 DIS_JOEL_HIRTZ_DO_NASCIMENTO_NAVARRO_PARCIAL.pdf: 326191 bytes, checksum: b4a1a4a965e905f18947117bd092e4c7 (MD5) Previous issue date: 2016-03-23 / The Primary Health Care (PHC) constitutes preferably as the first level of contact of an individual with the Unified Health System and the Family Health Strategy (FHS) is the means by which the reorganization is sought in Brazil. The Ministry of Health considers relevant to assessing the PHC through the presence and extent of the essential attributes and derivatives proposed by the Primary Care Assessment Tool (PCATool-Brazil). In this sense, the present study aimed to compare the health care of the oldest in Basic Health Units (BHU) with and without ESF. It characterized by being observational, cross-sectional and quantitative approach. Fifity elderly were interviewed, aged 80 or more, users of BHU with and without FHS in the city of Porto Alegre, Rio Grande do Sul. When comparing the BHU models only services without Family Health demonstrated a high degree of orientation to the PHC for the Essential Attributes Score and the General Score of PCATool-Brazil. It was found that although the FHS be the means by which the PHC reorganizes in the country, this model does not have the intended effectiveness for the health care of the elderly. It is understood that the findings of this study contribute to new strategies in the PHC work process is designed so that receive more universality the older people and their different capacities, including those longer-lived. / A Aten??o Prim?ria ? Sa?de (APS) constitui-se preferencialmente como o primeiro n?vel de contatode um indiv?duo com o Sistema ?nico de Sa?de e, a Estrat?gia de Sa?de da Fam?lia (ESF) ? o meio pelo qual busca-se a sua reorganiza??o no Brasil. O Minist?rio da Sa?de considera relevante a avalia??o da APS atrav?s da presen?a e extens?o dos atributos essenciais e derivados propostos pelo Instrumento de Avalia??o da Aten??o Prim?ria (PCATool-Brasil). Nesse sentido, o presente estudo teve como objetivo comparar a aten??o ? sa?de de longevos em Unidades B?sicas de Sa?de (UBS) com e sem ESF. Caracterizou-se por ser observacional, transversal e com abordagem quantitativa. Foram entrevistados 50 pessoas idosas com 80 anos ou mais, usu?rias de UBS com e sem ESF do munic?pio de Porto Alegre, Rio Grande do Sul. Quando comparados os modelos de UBS apenas os servi?os sem Sa?de da Fam?lia demonstraram alto grau de orienta??o ? APS para o Escore dos Atributos Essenciais e para o Escore Geral do PCATool-Brasil. Verificou-se que apesar de a ESF ser o meio pelo qual a APS reorganiza-se no Pa?s, esse modelo ainda n?o possui a efetividade planejada para a aten??o ? sa?de das pessoas idosas. Entende-se que os achados deste estudo contribuem para que novas estrat?gias no processo de trabalho da APS sejam pensadas de forma que acolham com mais universalidade as pessoas idosas e suas diferentes capacidades, incluindo aquelas mais longevas.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2017-02-06T13:35:50Z No. of bitstreams: 1 DIS_RAQUEL_SEIBEL_PARCIAL.pdf: 457430 bytes, checksum: 6c0764371d25783fd26367cb421a27b3 (MD5) / Made available in DSpace on 2017-02-06T13:35:50Z (GMT). No. of bitstreams: 1 DIS_RAQUEL_SEIBEL_PARCIAL.pdf: 457430 bytes, checksum: 6c0764371d25783fd26367cb421a27b3 (MD5) Previous issue date: 2016-05-31 / The Mini Nutritional Assessment Short Form (MNA?-SF) is a nutritional status-screening tool in the elderly including body mass index or calf circumference as anthropometric parameter. However, it is not always possible to obtain these parameters. Thus, it is important to search for alternative parameters such as the circumference of the arm that is also used in the evaluation of nutritional status. This dissertation presents an original article entitled ACCURACY OF ARM CIRCUMFERENCE IN THE MINI NUTRITIONAL ASSESSMENT SHORT FORM whose objectives were to describe the nutritional status of elderly patients in primary health care and determine the accuracy of the use of the arm circumference in MNA?-SF for screening of nutritional status. Therefore, a cross-sectional, descriptive and analytical study was conducted, with a sample of 539 individuals aged 60 years or more, registered in the Family Healthcare in Porto Alegre-RS and were evaluated in the Epidemiological and Clinical Study Seniors Attended by the Family Healthcare in the City of Porto Alegre (EMI-SUS). Variables were investigated, such as Socio-demographic (genre, age, race, marital status, family income and education); Anthropometric [body mass index (BMI), calf circumference (CC) and arm circumference (AC)] and nutritional status (MNA? and MNA?-SF). For the classification of the AC, two variations were used, one with three categories (AC3= <21cm: 0 points; ?21 or ?22cm: 1.5 points; >22cm: 3 points) and one with two categories (AC2= < 21cm: 0 points and ?21: 3 points), taking into account the minimum and maximum values established for categories of BMI of MNA? due to its replacement by AC2, AC3. For CC, the cutoff points used were already determined to MNA?-SF (<31cm: 0 points; ?31cm: 3 points). To determine the accuracy, MNA? was considered the gold standard for nutritional risk. The mean age was 68.7 ? 6.8 years (60-100 years). Most seniors were female (63.1%). Regarding nutritional status, they were classified as being at nutritional risk or undernourished, 24.1% of the elderly by MNA? and 33.4% by MNA?-SF. Regarding the socio-demographic variables, association only between nutritional status and marital status and education was observed. Separate individuals were more often eutrophic and widowers and illiterates were more often malnourished. Correlation analysis between BMI, CC and AC was significant, positive and strong (r> 0.750, P <0.001). The agreement between the MNA?-SF with IMC and MNA?-SF with CC, MNA?-SF with IMC and MNA?-SF with AC2, MNA?-SF with IMC and MNA?-SF with AC3 was excellent (?>0.90; P<0.001). The accuracy of the four instruments showed that they all had high accuracy [MNA?-SF with IMC (aucROC= 0.940), MNA?-SF with CP (aucROC = 0.932), MNA?-SF with CB2 (aucROC = 0.926) and MNA?-SF with CB3 (aucROC = 0.927)], with good sensitivity. Thus, it can be concluded that the use of the arm circumference in MNA?-SF proved accurate for tracking the nutritional status of elderly assisted in the Family Healthcare. / A Mini Avalia??o Nutricional Vers?o Reduzida (MNA?-SF) ? um instrumento de rastreio do estado nutricional de idosos que inclui o ?ndice de massa corporal ou a circunfer?ncia da panturrilha como par?metro antropom?trico. Contudo, nem sempre ? poss?vel obter esses par?metros. Dessa forma, torna-se importante a busca por par?metros alternativos, como a circunfer?ncia do bra?o que tamb?m ? utilizada na avalia??o do estado nutricional. Nesta disserta??o ? apresentado um artigo original intitulado ACUR?CIA DA CIRCUNFER?NCIA DO BRA?O NA MINI AVALIA??O NUTRICIONAL VERS?O REDUZIDA cujos objetivos foram descrever o estado nutricional de idosos atendidos na aten??o b?sica ? sa?de e determinar a acur?cia da utiliza??o da circunfer?ncia do bra?o na MNA?-SF para rastreio do estado nutricional. Para tanto, foi realizado um estudo transversal, descritivo-anal?tico, com uma amostra constitu?da por 539 individuos, com 60 anos ou mais, cadastrados na Estrat?gia Sa?de da Fam?lia de Porto Alegre-RS e que foram avaliados no Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos pela Estrat?gia Sa?de da Fam?lia do Munic?pio de Porto Alegre (EMI-SUS). Foram investigadas vari?veis sociodemograficas (g?nero, idade, faixa et?ria, ra?a, estado civil, renda familiar e escolaridade); antropom?tricas [?ndice de massa corporal (IMC), circunfer?ncia da panturrilha (CP) e circunfer?ncia do bra?o (CB)] e do estado nutricional (MNA? e MNA?-SF). Para a classifica??o da CB, foram usadas duas varia??es, uma com tr?s categorias (CB3= <21cm: 0 pontos; ?21 ou ?22cm: 1,5 pontos; >22cm: 3 pontos) e outra com duas categorias (CB2= <21cm: 0 pontos e ?21: 3 pontos), levando-se em considera??o os valores m?nimos e m?ximos estabelecidos para as categorias do IMC da MNA? em fun??o de sua substitui??o por CB2, CB3. Para a CP, foram utilizados os pontos de corte j? determinados para a MNA?-SF (<31cm: 0 pontos; ?31cm: 3 pontos). Para determina??o da acur?cia, a MNA? foi considerada padr?o-ouro para risco nutricional. A m?dia da idade foi de 68,7?6,8 anos, (60-100 anos). A maioria dos idosos era do sexo feminino (63,1%). Quanto ao estado nutricional, foram classificados como sob risco nutricional ou desnutridos 24,1% dos idosos pela MNA? e 33,4% pela MNA?-SF. Em rela??o ?s vari?veis sociodemograficas, observou-se associa??o somente entre estado nutricional e estado civil e escolaridade. ?ndividuos separados eram mais frequentemente eutr?ficos e vi?vos e analfabetos eram mais frequentemente desnutridos. A an?lise de correla??o entre IMC, CP e CB mostrou-se significativa, positiva e forte (r>0,750; P<0,001). A concord?ncia entre os instrumentos MNA?-SF com IMC e MNA?-SF com CP, MNA?-SF com IMC e MNA?-SF com CB2, MNA?-SF com IMC e MNA?-SF com CB3 foi excelente (?>0,90; P<0,001). A acur?cia dos quatro instrumentos mostrou que todos tinham alta precis?o [MNA?-SF com IMC (aucROC= 0,940), MNA?-SF com CP (aucROC= 0,932), MNA?-SF com CB2 (aucROC= 0,926) e MNA?-SF com CB3 (aucROC= 0,927)], com boa sensibilidade. Dessa forma, pode-se concluir que a utiliza??o da circunfer?ncia do bra?o na MNA?-SF mostrou-se acurada para rastreio do estado nutricional de idosos atendidos na Estrat?gia Sa?de da Fam?lia.

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2018-11-26T10:29:25Z No. of bitstreams: 1 CEOLIN_JAMILE_DIS.pdf: 5734789 bytes, checksum: a5fc91e4d004e1c48342aa425f83a4e8 (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-11-28T11:06:54Z (GMT) No. of bitstreams: 1 CEOLIN_JAMILE_DIS.pdf: 5734789 bytes, checksum: a5fc91e4d004e1c48342aa425f83a4e8 (MD5) / Made available in DSpace on 2018-11-28T11:14:21Z (GMT). No. of bitstreams: 1 CEOLIN_JAMILE_DIS.pdf: 5734789 bytes, checksum: a5fc91e4d004e1c48342aa425f83a4e8 (MD5) Previous issue date: 2018-03-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Performance of anthropometric indicators in the prediction of metabolic syndrome in elderly people attended basic care. 2018. 118f. Dissertation (Master in Biomedical Gerontology) - Escola de Medicina da Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Porto Alegre, 2018. Introduction: Metabolic syndrome (MetS) is frequent among the elderly and is associated with negative outcomes such as cardiovascular morbidity, cancer and mortality. Studies have demonstrated the performance of anthropometric indicators in the prediction of metabolic syndrome, however, studies involving the elderly population in general and Brazilian in particular are insipient. Objectives: To describe the frequency of MetS and its components in elderly patients assisted in basic care and to determine the performance of anthropometric indicators in the prediction of metabolic syndrome. Methods: This is a cross-sectional study with 479 elderly people who were evaluated in the Epidemiological and Clinical Study of the Elderly Attended by the Family Health Strategy of the Municipality of Porto Alegre (EMI-SUS). For the diagnosis of MetS, the revised NCEP-ATPIII criterion was used. The variables under investigation were: MetS and its components (central obesity, decreased HDL-c and triglycerides, high blood pressure and glucose); (age, sex and age) and five anthropometric indicators (neck circumference, sagittal abdominal diameter (SAD), SAD/height ratio, sagittal index and conicity index]. The predictive power and cut-off points of the anthropometric indicators were determined using Receiver Operating Characteristic (ROC) curves. The anthropometric indicators that presented area under the curve (auROC)> 0.70 were considered as adequate performance. Results: The majority of the sample was female (63.5%) and had MetS (60.5%). The most frequent MetS was high blood pressure (69.5%) and the least frequent was decreased HDL cholesterol (34.9%). In the total sample, the anthropometric indicators that demonstrated adequate performance were SAD/height (cutoff point: 0.14, auROC: 0.810, 95% CI: 0.771-0.850), SAD (cut-off point: 24.65 cm, 0.777, 95% CI: 0.734-0.820) and conicity index (cut-off point: 1.57, aROC: 0.706, 95% CI: 0.660-0.753). In females, anthropometric indicators with adequate performance were the SAD (cut-off point: 23.34 cm, auROC: 0.820, 95% CI: 0.766-0.875), SAD/height (cutoff point: 0.13, auROC: 0.810 , 95% CI: 0.755-0.865), neck circumference (cutoff point: 34.09 cm, auROC: 0.782, 95% CI: 0.727-0.838), and conicity index (cutoff point: 1.56, auROC: 0.727; 95% CI: 0.666-0.788). In males, the indicators with adequate performance were SAD/height (cutoff point: 0.14, auROC: 0.768, 95% CI: 0.695-0.841), SAD (cutoff point: 25.04 cm, auROC: 0.760; %: 0.685-0.835), and conicity index (cutoff point: 1.61, auROC: 0.724, 95% CI: 0.649-0.799). Conclusions: The elderly attending the Family Health Strategy had a high frequency of metabolic syndrome (60.5%). It was observed that, of the five anthropometric indicators investigated, three (SAD/height, SAD, and conicity index) performed well in the total sample, four (SAD, SAD/height, neck circumference and conicity index) in women and three in men (SAD/height, SAD and conicity index). That is, SAD, SAD/height and conicity index were adequate in all three segments. / Desempenho de indicadores antropom?tricos na predi??o de s?ndrome metab?lica em idosos assistidos na aten??o b?sica. 2018. 118f. Disserta??o (Mestrado em Gerontologia Biom?dica) ? Escola de Medicina da Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Porto Alegre, 2018. Introdu??o: A s?ndrome metab?lica (SM) ? frequente entre idosos e associa-se a desfechos negativos como morbidades cardiovasculares, c?ncer e mortalidade. Estudos t?m demonstrado o desempenho de indicadores antropom?tricos na predi??o de s?ndrome metab?lica, contudo, estudos envolvendo a popula??o idosa em geral e brasileira em particular s?o insipientes. Objetivos: Descrever a frequ?ncia de SM e de seus componentes em idosos assistidos na aten??o b?sica e determinar o desempenho de indicadores antropom?tricos na predi??o de s?ndrome metab?lica. M?todos: Trata-se de um estudo com delineamento transversal, com 479 idosos que foram avaliados no Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos pela Estrat?gia Sa?de da Fam?lia do Munic?pio de Porto Alegre (EMI-SUS). Para o diagn?stico de SM foi utilizado o crit?rio NCEP-ATPIII revisado. As vari?veis em investiga??o foram: SM e seus componentes (obesidade central, HDL-c diminu?do e triglicer?dios, press?o arterial e glicose elevados); vari?veis demogr?ficas (idade, sexo e faixa et?ria) e cinco indicadores antropom?tricos [circunfer?ncia do pesco?o, di?metro abdominal sagital (DAS), rela??o DAS/estatura (DAS/estatura), ?ndice sagital e ?ndice de conicidade]. O poder preditivo e os pontos de corte dos indicadores antropom?tricos foram determinados por meio de curvas Receiver Operating Characteristic (ROC). Os indicadores antropom?tricos que apresentaram ?rea sob a curva (auROC) >0,70 foram considerados como desempenho adequado. Resultados: A maioria da amostra era do sexo feminino (63,5%) e apresentava SM (60,5%). O componente da SM mais frequente foi press?o arterial elevada (69,5%) e o menos frequente foi HDL-colesterol diminu?do (34,9%). Na amostra total, os indicadores antropom?tricos que demonstraram desempenho adequado foram o DAS/estatura (ponto de corte:0,14; auROC:0,810; IC95%:0,771-0,850), DAS (ponto de corte:24,65 cm; auROC:0,777; IC95%:0,734-0,820) e ?ndice de conicidade (ponto de corte:1,57; auROC:0,706; IC95%:0,660-0,753). No sexo feminino, os indicadores antropom?tricos com desempenho adequado foram o DAS (ponto de corte:23,34 cm; auROC:0,820; IC95%:0,766-0,875), DAS/estatura (ponto de corte:0,13; auROC:0,810; IC95%:0,755-0,865), circunfer?ncia do pesco?o (ponto de corte:34,09 cm; auROC:0,782; IC95%:0,727-0,838) e ?ndice de conicidade (ponto de corte:1,56; auROC:0,727; IC95%:0,666-0,788). No sexo masculino, os indicadores com desempenho adequado foram DAS/estatura (ponto de corte:0,14; auROC:0,768; IC95%:0,695-0,841), DAS (ponto de corte:25,04 cm; auROC:0,760; IC95%:0,685-0,835), e ?ndice de conicidade (ponto de corte:1,61; auROC:0,724; IC95%:0,649-0,799). Conclus?es: Os idosos atendidos na Estrat?gia Sa?de da Fam?lia apresentaram elevada frequ?ncia de s?ndrome metab?lica (60,5%). Observou-se que, dos cinco indicadores antropom?tricos investigados, tr?s (DAS/estatura, DAS, e ?ndice de conicidade) apresentaram bom desempenho na amostra total, quatro (DAS, DAS/estatura, circunfer?ncia do pesco?o e ?ndice de conicidade) nas mulheres e tr?s nos homens (DAS/estatura, DAS e ?ndice de conicidade). Ou seja, DAS, DAS/estatura e ?ndice de conicidade mostraram-se adequados nos tr?s segmentos.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-01-16T19:16:34Z No. of bitstreams: 1 MariaDeFatimaLucenaDosSantos_DISSERT.pdf: 630611 bytes, checksum: c5bd6e4022718d2909cb6f55a1a80fcb (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-01-22T13:36:48Z (GMT) No. of bitstreams: 1 MariaDeFatimaLucenaDosSantos_DISSERT.pdf: 630611 bytes, checksum: c5bd6e4022718d2909cb6f55a1a80fcb (MD5) / Made available in DSpace on 2018-01-22T13:36:48Z (GMT). No. of bitstreams: 1 MariaDeFatimaLucenaDosSantos_DISSERT.pdf: 630611 bytes, checksum: c5bd6e4022718d2909cb6f55a1a80fcb (MD5) Previous issue date: 2017-08-29 / Os profissionais de sa?de s?o fundamentais para o processo de fortalecimento do Sistema ?nico de Sa?de e, principalmente, na Aten??o Prim?ria em Sa?de ? necess?rio que o trabalhador possa garantir a continuidade das a??es, com longitudinalidade do cuidado. Diante disso, a gest?o do trabalho constitui um ponto cr?tico na implanta??o do SUS e os trabalhadores vivenciam desafios que precisam ser discutidos e enfrentados. A presente pesquisa tem como objetivo analisar a rela??o entre a gest?o do trabalho na Aten??o B?sica em Sa?de e o desempenho das equipes participantes do segundo ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade na Aten??o B?sica. As vari?veis do estudo foram o tipo de v?nculo de trabalho, tempo de atua??o na equipe de ABS, agente contratante, forma de ingresso no trabalho e a presen?a de Planos de Carreira, Cargos e Sal?rios. Como fonte de dados foram utilizados os bancos do PMAQ-AB e do Programa das Na??es Unidas para o Desenvolvimento. Os dados coletados foram submetidos a uma an?lise descritiva explorat?ria e inferencial, com um n?vel de signific?ncia de 5%. Para avaliar quantitativamente a rela??o entre as vari?veis empregou-se testes de associa??o de qui-quadrado de Pearson. Verificou-se a maior presen?a de v?nculos de trabalho precarizados em munic?pios de pequeno porte populacional e a implanta??o dos PCCS ainda ? baixa em todo Brasil. Os profissionais com v?nculos protegidos apresentaram melhores desempenhos na avalia??o do PMAQ-AB. Este tipo de v?nculo garante a perman?ncia no emprego e autonomia e isso pode contribuir para um maior envolvimento do profissional com a problem?tica de sa?de da sua ?rea de atua??o. Quanto ao porte populacional foi identificado que houve resultados mais negativos para os munic?pios de pequeno e m?dio porte. Apesar do desempenho das equipes terem sido melhores nos munic?pios de pequeno porte, deve-se considerar que h? uma maior concentra??o destes e que a certifica??o ? feita com base em c?lculo feito por desvios-padr?o. As limita??es do estudo apontam para a avalia??o do PMAQ-AB, a qual se apresenta de forma mais direta e objetiva sem intera??o aprofundada com o objeto de estudo para compreender mais detalhadamente o que est? sendo avaliado. Prop?e-se, assim, que a tem?tica seja aprofundada atrav?s de estudos qualitativos. / Health professionals are fundamental to the process of strengthening the Unified Health System and, especially, in Basic Health Care, it?s necessary that the worker can guarantee the continuity of the actions, with longitudinality of care. Thus, the work management is a critical point in the implementation of the SUS and workers experience challenges that need to be discussed and faced. The present research aims to analyze the relationship between work management in Basic Health Care and the performance of the participating teams in the second cycle of the National Program for Improving of Access and the Quality in Basic Care. The variables of the study were the bond kind of work, time of action in the ABS team, contracting agent, form of entrance into work and the presence of Career Plans, Positions and Salaries. As data source the banks of PMAQ-AB and the United Nations Development Program were used. The collected data were submitted to descriptive exploratory and inferential analysis, with a level of significance of 5%. To quantitatively evaluate the relationship between the variables, Pearson's chi-square association tests were used. It was verified the greater presence of precarious work links in counties of small size population and the implementation of PCCS is still low throughout Brazil. Professionals with protected links presented better performance in the PMAQ-AB assessment. This type of bond guarantees the permanence in employment and autonomy and this can contribute to a greater involvement of the professional with the health problem of its occupation area. About the population size, it was identified that there were more negative results for small and medium size counties. Although the performance of the teams was better in small counties, it should be considered that there is a greater concentration of these and the certification is made based on calculus realized by standard deviations. The limitations of the study point to the evaluation of PMAQ-AB, which presents more direct and objectively without deep interaction with the object of study to understand more minutely what is being evaluated. It?s proposed, therefore, that the thematic be deepened through qualitative studies.

Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-08T15:23:59Z No. of bitstreams: 2 ana_luiza_dayell_gomes_costa_sousa.pdf: 1166379 bytes, checksum: b150c0a2311af380a3baacb0591feb4e (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-08T15:24:28Z (GMT) No. of bitstreams: 2 ana_luiza_dayell_gomes_costa_sousa.pdf: 1166379 bytes, checksum: b150c0a2311af380a3baacb0591feb4e (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-08T15:25:45Z (GMT) No. of bitstreams: 2 ana_luiza_dayell_gomes_costa_sousa.pdf: 1166379 bytes, checksum: b150c0a2311af380a3baacb0591feb4e (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Made available in DSpace on 2015-01-08T15:25:45Z (GMT). No. of bitstreams: 2 ana_luiza_dayell_gomes_costa_sousa.pdf: 1166379 bytes, checksum: b150c0a2311af380a3baacb0591feb4e (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Previous issue date: 2013 / Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG) / As hospitaliza??es por condi??es sens?veis ? aten??o prim?ria s?o um indicador da capacidade resolutiva do sistema de sa?de, representando problemas que seriam potencialmente evit?veis caso houvesse uma aten??o prim?ria cont?nua, opor?tuna e efetiva. Consistem em doen?as cujo risco de interna??o poderia ser reduzido atrav?s da preven??o, diagn?stico e tratamento precoce de condi??es agudas ou do controle e acompanhamento de afec??es cr?nicas. Este trabalho teve como principal objetivo estudar o perfil regional das hospitaliza??es pedi?tricas por condi??es sens?veis ? aten??o prim?ria ? sa?de. Trata-se de um estudo anal?tico transversal, realizado por meio de inqu?rito de morbidade hospitalar com utiliza??o de dados secund?rios obtidos dos prontu?rios cl?nicos. Foram investigadas todas as interna??es de crian?as abaixo de dez anos de idade ocorridas em 2011. Os dados revelam que as interna??es por condi??es sens?veis ? aten??o prim?ria corresponderam a 31,0% do total e a 40,4% dos casos provenientes do munic?pio de Diamantina. Pneumonias bacterianas e asma foram as principais causas observadas, havendo diverg?ncias entre os diagn?sticos documentados nos prontu?rios e aqueles registrados nos laudos oficiais. Os resultados evidenciaram a import?ncia do monitoramento da aten??o prim?ria quanto ?s a??es direcionadas ? popula??o infantil, visto sua maior vulnerabilidade. Somadas a outros indicadores, as interna??es por condi??es sens?veis ? aten??o prim?ria apresentam-se como uma ferramenta de grande utilidade para a gest?o em sa?de, pois possibilitam uma vis?o mais ampla quanto ? realidade da assist?ncia prestada. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / Hospital admissions for reasons related to primary health care are said to be an indirect indicator of how successful a given health system is. They reflect conditions which could be potentially avoided if continuous, effective, adequate primary care were in place. This is mainly because the number of hospitalizations could be reduced by preventive actions and/or early diagnosis and treatment of acute conditions and monitoring of chronic diseases. The primary purpose of the present research was to provide a general overview of pediatric hospitalizations for conditions related to primary health care by examining child morbidity on the basis of secundary data from medical records. Here, we focused on hospital admissions of children under ten years (zero to nine years, 11 months and 29 days) to two hospitals in the town of Diamantina, Southeastern Brazil, in 2011 (from January, 1st to December, 31st). We found that hospitalizations for reasons related to primary health care accounted for 31% of the overall number of child admissions. When considering only the cases from Diamantina specifically, the percentage rose to 40.4%. Bacterial pneumonia and asthma were the main causes of hospitalization, although the diagnoses documented in the medical records were not consistent with official reports. Our findings support the importance of monitoring children?s primary health care given their highly vulnerable nature. We also argue that assessment of hospitalizations for conditions related to children?s primary health care can serve as a valuable tool in health management. Together with other indicators, it provides a broader overview of the assistance that is actually offered.

Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-08T15:36:43Z No. of bitstreams: 2 cleya_silva_santana_cruz.pdf: 3196384 bytes, checksum: ab5bc76d3c89cdad0a8a51f5bad61c79 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-08T15:37:58Z (GMT) No. of bitstreams: 2 cleya_silva_santana_cruz.pdf: 3196384 bytes, checksum: ab5bc76d3c89cdad0a8a51f5bad61c79 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-08T15:38:17Z (GMT) No. of bitstreams: 2 cleya_silva_santana_cruz.pdf: 3196384 bytes, checksum: ab5bc76d3c89cdad0a8a51f5bad61c79 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Made available in DSpace on 2015-01-08T15:38:17Z (GMT). No. of bitstreams: 2 cleya_silva_santana_cruz.pdf: 3196384 bytes, checksum: ab5bc76d3c89cdad0a8a51f5bad61c79 (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Previous issue date: 2013 / Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG) / Funda??o Diamantinense de Apoio ao Ensino, Pesquisa e Extens?o (Fundaep) / O Programa de Educa??o Permanente para M?dicos da Estrat?gia de Sa?de da Fam?lia foi implantado na Regi?o Ampliada de Sa?de Jequitinhonha em outubro de 2010, com a finalidade de melhorar o n?vel de resolubilidade da Aten??o Prim?ria ? Sa?de, tomando como ponto de partida a aprendizagem significativa e integrada das diversas compet?ncias cl?nicas necess?rias aos m?dicos das equipes de sa?de da fam?lia. O objetivo deste trabalho foi avaliar as a??es de planejamento, execu??o e resultados do PEP na Regi?o Ampliada de Sa?de Jequitinhonha de Minas Gerais em interface com os objetivos propostos pelo Programa. O estudo foi desenvolvido em 14 munic?pios desta Regi?o, que possu?am m?dicos da Estrat?gia de Sa?de da Fam?lia com frequ?ncia de participa??o no PEP igual ou superior a 60,0%. Participaram da pesquisa 14 gestores municipais de sa?de, 31 m?dicos e 383 usu?rios. Tratou-se de uma pesquisa de triangula??o descritiva, quantitativa e qualitativa. Utilizou-se como instrumentos de coleta de dados: 1) Question?rios estruturados dirigidos aos usu?rios, m?dicos e gestores de sa?de; 2) Relat?rios de supervisores dos GAPs para o levantamento dos temas estudados nos encontros e 3) Atestos de gestores municipais de sa?de para calcular a rotatividade profissional dos m?dicos. As entrevistas das consultas m?dicas foram filmadas e analisadas. Utilizou-se a an?lise descritiva dos dados, o teste do qui-quadrado e teste de Fisher (p = 0,05). A m?dia de idade dos m?dicos entrevistados foi de 39,5 anos, 67,7% eram do sexo masculino e 48,2% solteiros. Em rela??o ? titula??o, 45,2% dos m?dicos possu?am apenas gradua??o em medicina, sendo que 35,5% possu?am no m?ximo quatro anos de forma??o. A rela??o m?dicos inscritos/presentes nos encontros do PEP foi de 41,5% em 2011 e 38,4% em 2012. Os temas mais estudados nos encontros de GAP foram a metodologia do PEP (24,3%) e as doen?as cr?nicas n?o transmiss?veis (10,5%). Para os m?dicos participantes, o supervisor do GAP segue a metodologia proposta e os materiais atendem ?s necessidades dos grupos (100,0%). Os m?dicos (93,5% e 96,8%, respectivamente) relatam que ap?s a participa??o no PEP houve redu??o de encaminhamentos e de pedidos de exames desnecess?rios. Os m?dicos participantes (93,5%) afirmam ainda que suas consultas foram reestruturadas ap?s a participa??o no Programa. Segundo o ponto de vista de 35,7% dos gestores municipais de sa?de, os m?dicos vinculados a seus munic?pios participam do PEP apenas como forma de cumprir o Contrato do Programa Sa?de em Casa, mas para a maioria (62,5%) este n?o ? o motivo da participa??o, enquanto 50% dos Secret?rios Municipais de Sa?de afirmam que os m?dicos que s?o liberados para o PEP, n?o comparecem nos encontros. A maioria dos usu?rios (76,1%) relatou ter percebido melhora no atendimento ap?s a participa??o do m?dico no Programa. O ?ndice de rotatividade para os m?dicos que participam do PEP com frequ?ncia igual ou superior a 60,0% foi de 35,5%, enquanto para aqueles que n?o participam efetivamente do Programa o valor foi de 60,9%. Conclui-se, assim, que a Educa??o Permanente nos moldes do PEP pode melhorar o desempenho cl?nico dos m?dicos e envolver mais o usu?rio em seu tratamento, al?m de contribuir para a fixa??o de profissional na regi?o. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / ABSTRACT The Permanent Education Program for Physicians in the Family Health Strategy was implemented in the Jequitinhonha Extended Health Region in October 2010 for the purpose of improving the level of resolution capability in Primary Health Care. It took as the starting point the significant and integrated learning of the various clinical skills that the physicians in the family health teams need. The objective of this paper was to assess the planning and execution actions, as well as the results of the PEP in the Jequitinhonha Extended Health Region, in Minas Gerais state, in interface with the objectives proposed by the Program. The study was developed in 14 municipalities in this Region, which had physicians from the Family Health Strategy whose participation rate in the PEP was equal to or greater than 60 percent. 14 health managers, 31 physicians, and 383 users participated in the research. The research used a descriptive, quantitative, and qualitative triangulation approach. The following data collection tools were used: 1) Structured questionnaires addressed to users, physicians, and health managers; 2) Reports by supervisors from the Professional Development Groups (PDGs) for an overview of the topics studied in the meetings, and 3) Statements by municipal health managers to calculate the professional turnover rate of medical doctors. The interviews during medical appointments were filmed and analyzed. Descriptive data analysis, the?chi-square test? and the Fisher Test (p = 0.05), and the Pearson Correlation Test (p = 0.0.5%) were used. The average age of the interviewed physicians was 39.5 years; 67.7% were males, and 48% were single. As far as academic degree was concerned, 45.2% of the physicians only had a degree in Medicine, and 35.5% of them had graduated no more than four years prior to these interviews. The percentages of physicians who signed up for / participated in the meetings of the PEP were 41.5% in 2011 and 38.4% in 2012. The most widely studied topics in the Professional Development Group meetings were the methodology of the Permanent Education Program (24.3%) and chronic non-communicable diseases (10.5%). For the participating physicians, the supervisor of the Professional Development Group follows the proposed methodology, and the materials meet the needs of the groups (100%). The physicians (93.5% and 96.8%, respectively) reported that, after participating in the Permanent Education Program, there was a reduction in the number of unnecessary referrals and requests for medical examinations. The participating physicians (93.5%) also stated that their medical consultations were restructured after they participated in the Program. From the point of view of 35.7% of the municipal health managers, the physicians working in their municipalities attend the Permanent Education Program only to comply with the Home Health Care Program Agreement. However, for most of the municipal health care managers (62.5%), this is not the reason why physicians attend the PEP, while 50% of the Municipal Health Secretaries stated that physicians who are released to attend the PEP do not show up for the meetings. Most of the users (76.1%) reported that they noticed an improvement in the health care services after their doctor participated in the Program. The turnover rate was 35.5% for physicians whose participation in the PEP was equal to or greater than 60.0% , whereas for those who do not participate effectively in the Program the turnover rate was 60.9%. It is therefore concluded that permanent education, along the lines of the Permanent Education Program, can improve the clinical performance of the physicians and make users more involved in their treatment. Furthermore, it contributes to retaining professionals in the region.

Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-08T11:31:52Z No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) anna_luisa_alkmin_rocha.pdf: 2493527 bytes, checksum: c28cf0d1e9a581c5af1302c2a3325da8 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-11T11:06:20Z (GMT) No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) anna_luisa_alkmin_rocha.pdf: 2493527 bytes, checksum: c28cf0d1e9a581c5af1302c2a3325da8 (MD5) / Made available in DSpace on 2016-01-11T11:06:20Z (GMT). No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) anna_luisa_alkmin_rocha.pdf: 2493527 bytes, checksum: c28cf0d1e9a581c5af1302c2a3325da8 (MD5) Previous issue date: 2014 / As condi??es do trabalho, a organiza??o, a concep??o e o ambiente das atividades laborais aos quais os profissionais da aten??o b?sica do Sistema ?nico de Sa?de est?o inseridos podem ter grande influ?ncia sobre a condi??o de sa?de devido ? complexidade do servi?o. Assim, a avalia??o das condi??es de trabalho e sa?de torna-se importante instrumento de an?lise com possibilidades de interven??o em busca de melhoria da qualidade de vida dos trabalhadores. Objetivou-se, assim, conhecer a condi??o de sa?de e de trabalho dos profissionais da aten??o b?sica dos quinze munic?pios que comp?em a Regi?o de Sa?de de Diamantina/MG, atrav?s de um estudo transversal com base em um question?rio semiestruturado e com an?lises antropom?tricas. A Organiza??o Mundial da Sa?de proclama os trabalhadores de sa?de como seu mais valioso recurso, assim, como profissional da aten??o b?sica ? necess?rio que esse desperte para a pr?pria condi??o de sa?de, reconhecendo e analisando situa??es que possam influenciar e determinar a qualidade de vida. Participaram da pesquisa 290 profissionais da Estrat?gia Sa?de da Fam?lia, 42,4% atuam na aten??o b?sica por contrato tempor?rio; 84% com dedica??o exclusiva; 94,8% referem realizar carga hor?ria de 40 horas semanais. A taxa de absente?smo no servi?o nos 12 meses anterior ? pesquisa foi de 40,7% com destaque para as doen?as osteomusculares, a preval?ncia de morbidade foi relatada por 34,8% dos profissionais. Entre os participantes, 55,2% afirmam que o trabalho interfere na condi??o de sa?de. Destaca-se que 54% dos trabalhadores encontram-se acima do peso adequado e que 28,7% das mulheres e 8,6% dos homens apresentam risco aumentado para desenvolver doen?as cardiovasculares. O acidente de trabalho foi relatado por 15,5% dos participantes. A automedica??o foi relatada por 60,7% e a participa??o em atividades de promo??o ? sa?de por 24,8%. Assim, foi poss?vel verificar a condi??o de trabalho e sa?de dos profissionais que atuam na aten??o b?sica com o prop?sito que os resultados possam subsidiar a tomada de decis?o para que a sa?de do trabalhador fortale?a e seja valorizada no ?mbito da gest?o da sa?de. / 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 Working conditions, organization, conception and the environment to which basic health care professionals are subjected to while working in the Single Health System (Sistema ?nico de Sa?de ? SUS) can have a great effect on their health conditions, due to the complexity of the service. Thus, an assessment of health and working conditions is an essential instrument of analysis, with the possibility of interventions, in the search for improvements in the quality of life of workers. Therefore, the aim of the present study was to assess the health and working conditions of basic healthcare professionals in the fifteen (15) districts that make up Health Region of Diamantina/MG (Brazil). This was a cross-sectional study based on a semi-structured questionnaire and anthropometric analysis. The World Health Organization has stated that healthcare workers are its most valuable resource. Thus, the welfare of basic healthcare professionals needs to be recognized and situations that can affect and determine their quality of life must be analyzed. In total, 290 Family Health Strategy professionals participated in the present study: 42.4% were involved in basic healthcare on temporary contracts; 84% were exclusively dedicated to basic healthcare; 94.8% reported a weekly workload of 40 hours. The rate of absenteeism in the area during the 12 months prior to the study was reported as 40.7%, with a significant number of osteomuscular diseases cited. Morbidity was reported by 34.8% of the professionals. Among the participants, 55.2% stated that their job affected their health. It is notable that 54% of these workers were overweight, with 28.7% of women and 8.6% of men in the high risk category for the development of cardiovascular diseases. Accidents in the workplace were reported by 15.5% of the participants. Self-medication was reported by 60.7%, whereas participation in health-promoting activities was reported by 24.8%. Therefore, it was possible to determine the health and working conditions of basic healthcare professionals. The results of the present study could subsidize the decision making process so that health actions for workers are consolidated and valued in the environment of health management.

Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-08T13:46:06Z No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) evanildo_jose_silva.pdf: 18784813 bytes, checksum: 4c439837665ffcf764dd6b178bb1c30b (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-11T11:13:53Z (GMT) No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) evanildo_jose_silva.pdf: 18784813 bytes, checksum: 4c439837665ffcf764dd6b178bb1c30b (MD5) / Made available in DSpace on 2016-01-11T11:13:53Z (GMT). No. of bitstreams: 2 license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) evanildo_jose_silva.pdf: 18784813 bytes, checksum: 4c439837665ffcf764dd6b178bb1c30b (MD5) Previous issue date: 2014 / O Tracoma, tido equivocadamente como erradicado em nosso meio, encontra-se na lista de doen?as negligenciadas. Trata-se da maior causa de cegueira evit?vel do mundo, sendo encontrado predominantemente nos pa?ses subdesenvolvidos. Diversos trabalhos t?m demonstrado que esta doen?a se faz presente em todas as regi?es do Brasil atualmente, o que evidencia que tanto o governo (nas esferas federal, estadual e municipal) quanto a academia devem continuar a considerar o Tracoma entre as causas de cegueira em nosso meio. A necessidade de maior qualifica??o e capacita??o dos profissionais de sa?de para um melhor atendimento aos usu?rios do Sistema ?nico de Sa?de ? SUS tem feito com que sejam tentadas diferentes alternativas para atingir este objetivo. Diversas experi?ncias t?m sido efetivadas em nosso meio, com resultados exitosos. Neste trabalho procurou-se levantar a frequ?ncia de Tracoma entre os escolares de sete a quinze anos da rede p?blica do munic?pio de Turmalina, MG bem como verificar a efetividade de uma estrat?gia de educa??o permanente denominada Treinamento de Habilidades Cl?nicas ? THC na detec??o desta doen?a. A pesquisa foi realizada neste munic?pio, situado no Vale do Jequitinhonha, tendo em vista um levantamento pr?vio que demonstrou que nos ?ltimos cinco anos n?o tinha ocorrido nenhum encaminhamento de usu?rio da Aten??o Prim?ria para o servi?o de oftalmologia do munic?pio com hip?tese diagn?stica de Tracoma. Considerando que no munic?pio existem regi?es com popula??es em situa??o de alta vulnerabilidade social, portanto com caracter?sticas prop?cias para o surgimento da doen?a, suspeitou-se que os casos n?o estavam sendo diagnosticados. Participaram da pesquisa quatro m?dicos e oito enfermeiros das ESF e ainda tr?s enfermeiros que atuavam na gest?o, mas tamb?m ocasionalmente nas ESFs. Inicialmente foi feito um diagn?stico situacional visando avaliar o n?vel de conhecimento dos profissionais das ESFs de Turmalina, MG, acerca do Tracoma quando os profissionais de sa?de responderam a um question?rio a respeito do tema. Em seguida foi realizado um m?dulo de capacita??o e ap?s esta etapa foi realizado o THC. Posteriormente os profissionais de sa?de realizaram o exame de 635 estudantes sob a supervis?o do pesquisador. Os estudantes com diagn?stico de Tracoma foram submetidos ? raspagem de conjuntiva com swab e o material enviado para an?lise laboratorial. Todos os escolares diagnosticados com Tracoma foram tratados gratuitamente no SUS e suas fam?lias convidadas para que os demais membros pudessem ser examinados. Para finalizar, os profissionais responderam novamente ao question?rio que continha quest?es a respeito do tema. Os dados coletados foram analisados com aux?lio do software Statistical Package for Social Sciences, IBM Inc., USA ? SPSS, vers?o 20.0. Ao comparar a quantidade de acertos nos question?rios pr? e p?s-capacita??o, observou-se que no segundo a pontua??o foi significativamente maior que no primeiro. Entre os escolares foi encontrada uma frequ?ncia do Tracoma de 4,7%, com predom?nio nas ?reas rurais. Todas as fam?lias dos estudantes diagnosticados com Tracoma foram convidadas a realizar exames, sendo identificadas, at? o momento, 27 pessoas como portadores de Tracoma ativo. Todas foram submetidas ao tratamento custeado pelo SUS. Conclui-se ent?o que o treinamento teve impacto positivo no conhecimento dos profissionais, contribuindo para uma maior habilidade para o diagn?stico ou suspei??o diagn?stica da doen?a. Pode-se afirmar ainda que a educa??o permanente ? uma importante ferramenta a ser utilizada visando melhorar o desempenho destes. / 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 The Trachoma, had been mistakenly known as eradicated in our country is on the list of neglected diseases. It is the leading cause of preventable blindness in the world, being found predominantly in underdeveloped countries. Several studies have shown that this disease is present in all regions of Brazil today, which shows that both the government (federal, state and municipal) as the academy must continue to treat Trachoma among the causes of blindness in our midst. The need for more advanced training capable health professionals to improve the service for the National Health System ? SUS users has made different alternatives to achieve this goal . Several experiments have been effected in our midst, with successful results, highlighting the importance of this methodology. This paper sought to raise the frequency of trachoma among school children from seven to fifteen years of public network of the city of Tourmaline, MG and verify the effectiveness of a strategy of continuing education called Skills Training Clinics in the detection of this disease. The survey was conducted in this city, situated in the Valley of Jequitinhonha, considering an earlier survey that showed that in the last five years had been no referral of Primary User for the ophthalmology service of the city with a diagnosis of trachoma. Whereas in the city there are regions with populations that have high social vulnerability, with so conducive to the emergence of disease characteristics, it was suspected that the cases were not being diagnosed. Participants were four doctors and eight nurses FHT and three nurses who worked in management, but also occasionally in the FHS. Initially it was made ??a situational analysis to assess the level of knowledge of the professionals of the ESFs Tourmaline - MG, about Trachoma when health professionals completed a questionnaire on the subject. Then a training module where the theme was worked and after this step, the training of clinical skills was conducted. Later health professionals conducted the examination of 635 students, under the supervision of the researche. Students diagnosed with Trachoma underwent scraping conjunctival swabs and material sent for laboratory analysis. All students diagnosed with trachoma were treated free on the National Health System and their families were contacted so they could also be examined. Finally, practitioners responded to the questionnaire again which contained questions on the subject. The collected data were analyzed using software Statistical Package for Social Sciences, Inc. IBM, USA - SPSS, version 20.0. marital status. Comparing the amount of correct answers in the pre and post-training questionnaires, it was observed that the second score was significantly higher than the first. Among students a frequency of 4.7% Trachoma was found, predominantly in rural areas. All families of these children diagnosed with trachoma were invited to conduct examinations, 27 were identified as having active trachoma. All of them were subjected to treatment funded by the National Health System and are in a camping. The conclusion is that training had a positive impact on the knowledge of professionals, as well as the ability for the diagnosis or diagnostic suspicion of the disease. It can even be said that continuing education is an important tool to be used to improve the performance of these.