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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Evaluation of Current Decision Rules and Healthcare Professional Practices for Detecting Osteoporosis Risk in the Young Adult Population

Willig, Amanda Lynn 12 July 2004 (has links)
Osteoporosis is caused by a multitude of factors. An individual’s risk for experiencing a bone fracture as a senior citizen increases without early intervention. Healthcare professionals do not have access to validated survey tools to identify young adults in need of osteoporosis prevention education, although survey tools to identify postmenopausal women at high risk for low bone mass are available. The purposes of this study were to evaluate three of these survey tools for use in a younger population, and to determine if young adults with osteoporosis risk factors received bone health education from a health professional. Forty-two men and 41 women completed surveys and health questionnaires; responses were compared to bone mineral density (BMD) and content (BMC) measurements. Healthcare professionals discussed bone health with only 13% of participants. Chi-square analysis revealed that health professionals were not more likely to discuss osteoporosis with subjects based on age or gender. Participants with T-scores ≤ -1.0 were not more likely to receive bone health education. Area under the receiving operating characteristic (AUROC) curves analysis revealed that no survey tools were able to identify moderate-risk participants at T-scores ≤ -1.0, and AUROC curves for all surveys did not exceed 0.525 at this level. Two surveys detected participants at high risk for bone disease with identical AUROC curves of 0.821 at a T-score ≤ -2.0, and 0.813 at a T-score ≤ -2.5. The AUROC curves indicate that current tools designed for older women do not detect young adults with moderately low T-scores. / Master of Science
2

Primeira infância: práticas educativas na estratégia saúde da família / Early childhood: educational practices in the family healthcare strategy

Silva, E. A. S. 28 August 2012 (has links)
Submitted by JÚLIO HEBER SILVA (julioheber@yahoo.com.br) on 2016-11-17T15:41:31Z No. of bitstreams: 2 Dissertação - Edinamar Aparecida Santos da Silva - 2012.pdf: 4158782 bytes, checksum: 73b97a71b8dcd4abbfedeeed39e10fc5 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2016-11-17T16:14:03Z (GMT) No. of bitstreams: 2 Dissertação - Edinamar Aparecida Santos da Silva - 2012.pdf: 4158782 bytes, checksum: 73b97a71b8dcd4abbfedeeed39e10fc5 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-11-17T16:14:03Z (GMT). No. of bitstreams: 2 Dissertação - Edinamar Aparecida Santos da Silva - 2012.pdf: 4158782 bytes, checksum: 73b97a71b8dcd4abbfedeeed39e10fc5 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2012-08-28 / Educational practices developed in the Family Healthcare Strategy (FHS) are determinants of the health-disease process from the involved population. On the other hand, these practices are influenced by the professionals’ conceptions, by the physical spaces and by the availability of materials for their execution. The healthcare workers of the family generally have technical formation in their specific areas, but lack of formation in educational techniques. The Educational Practices (EP) developed among children ranging from zero to six years old can be grouped in two clearly opposite, traditional and liberatory strands. In this age group, children are in development of the individual and therefore the acquired formation during this stage will bring consequences to their whole lives. With the aim to characterize the realization of educational practices in the early childhood, 112 workers of the FHS from the East Sanitary District (ESD) in Goiânia (GO) were surveyed. It was decided to combine quantitative and qualitative methodology within the application of a questionnaire. Also, the physical spaces of the health units that were qualified as inadequate to carry out EP were recorded in field diaries. About the conception of EP, the most highlighted factors were transferring of information, consciousness and capacitation and disease prevention. The educational practices were predominantly classified as traditional. The most pointed sources of knowledge about this theme were the undergraduation, the specialization and the construction of informal networks of experience exchanging; and, few references in relation to permanent educational activities were performed. The addressed issues were selected by the experience of the pairs or of the documents and programs vertically indicated by the Ministry of Healthcare (MH) and Municipal Secretary of Healthcare (MSH). They are collectively discussed in the conventional spaces, using the spoken language and involving participants, especially accompanying adults. The mentioned theoreticalmethodological references that had more subsides to the actions were the manuals (MH and MSH), books and articles containing information within field of action. There was reference to the use of liberatory, in addition to support in the knowledge of their peers. The evidences of effectiveness of these actions were poorly mentioned, limiting only in the observation of improvement in health indicators, being stated by the decrease in caries prevalence (by dental professionals and community agents of healthcare), empowerment of the professionals (quoted by a doctor and a dentist) and the discrete increase in adhesion to these services by the population. The necessity of supportive materials and of complementary contents to subside the developed educational activities was highly stated. The secondary education professionals claimed not having access to permanent education activities. / As práticas educativas desenvolvidas na Estratégia Saúde da Família – ESF são determinantes do processo saúde doença da população envolvida. Estas práticas são, por sua vez, influenciadas pelas concepções dos profissionais, pelos espaços físicos e pela disponibilidade de material para sua execução tanto quanto pelo contexto histórico conforme mostrado por Dais Gonçalves Rocha (1997). Os trabalhadores da saúde da família têm de modo geral formação técnica em suas áreas específicas, porém carecem de formação em técnicas educativas. As Práticas Educativas – PE desenvolvidas junto às crianças de zero a seis anos, podem ser agrupadas de acordo com José Carlos Libâneo (2003) em duas vertentes claramente oponentes: tradicionais e libertadoras. Paulo Freire (2010) ensina que o conhecimento adquirido na infância trará consequência para toda a sua vida. Com o objetivo de caracterizar a realização de PE na primeira infância, foram pesquisados 112 sujeitos atuantes na ESF de um Distrito Sanitário de Goiânia-GO. Optou-se pela combinação de metodologia quantitativa e qualitativa na aplicação de um questionário e registro em diário de campo das observações referentes ao espaço físico das unidades de saúde da família que foi referido como inadequado à realização de PE. Nas concepções de PE destacaram-se o repasse de informação, o conscientizar/capacitar e o prevenir doenças. As PE foram classificadas predominantemente como tradicionais. As principais fontes de conhecimento apontadas foram a graduação, a especialização, a construção de redes informais de trocas de experiências e pouca referência foi feita às atividades de educação permanente. Os temas são escolhidos a partir da experiência dos pares ou dos documentos e programas indicados verticalmente pelo Ministério da Saúde – MS e Secretaria Municipal de Saúde – SMS e são abordados coletivamente nos espaços convencionais, utilizando-se a linguagem falada e envolvendo-se principalmente os acompanhantes adultos. Os referenciais teórico-metodológicos mencionados como maior subsidio às ações foram os manuais do MS/SMS e livros e artigos de conteúdos próprios da área de atuação. Houve referência ao uso de tendências pedagógicas libertadoras, além de apoio no conhecimento de seus pares. As evidências de efetividade destas práticas foram pouco referidas, destacando-se a constatação da melhoria nos indicadores de saúde percebida pela queda na prevalência de cárie por parte de profissionais da odontologia e Agente Comunitário de Saúde; empoderamento dos próprios profissionais, citado por um médico e um cirurgião dentista; melhora das práticas higienistas e aumento discreto na adesão aos serviços pela população. Este trabalho oportunizou a identificação da necessidade de material de apoio e de conteúdos complementares para subsidiar as atividades educativas desenvolvidas na ESF assim como da necessidade percebida pelos trabalhadores de nível médio que afirmaram não estarem sendo incluídos com frequência nas oportunidades de educação permanente.

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