Navegando por Orientadores "CUNHA, Carlos Leonardo Figueiredo"

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Acesso aberto (Open Access)
Assistência pré-natal e puerpério no âmbito da atenção básica no Brasil
(Universidade Federal do Pará, 2023-07-10) SOUSA, Dimauro Soares de; RODRIGUES, Diego Pereira; http://lattes.cnpq.br/8470989067617455; https://orcid.org/0000-0001-8383-7663; CUNHA, Carlos Leonardo Figueiredo; http://lattes.cnpq.br/9603271880856443; https://orcid.org/0000-0002-1891-4201
Recognizing Primary Care as the preferential gateway to public health services and its role in organizing care, investigating prenatal and puerperal care is essential for measuring its reach and quality, in order to provide subsidies for making decisions based on the results. Objectives: To analyze prenatal and postpartum care within the scope of Primary Care in Brazil. Methodology: This is a research with a quantitative and analytical approach. Brazil is the reference for this study. The variables related to the External Evaluation of the third cycle of the National Program for Improving Access and Quality of Primary Care were used for the research, Module II – Interview with the professional, coordinated by the ministry of health, from 2017 to 2018, which includes interviews with key informants. Teams were categorized by federative units and geographic regions, and data analysis were done using descriptve statistics, using absolute and relative frequency. All analyzes were done in IBM SPSS Statistics Software, version 20.0, and presented in the form of charts, graphs and figures. Results: The collection of data for the External Assessment that make up the second phase of the third cycle of the National Program for Improving Access and Quality in Primary Care, had the adhesion of 5.324 cities (95,6%). A total of 38,865 primary care teams in Brazil were evaluated, of these 36.702 (98,30%) teams perform prenatal consultations, 35.771(97,50%) presente a document proving the prenatal consultation, 36.433 (99,3%) of the primary care teams use the pregant woman’s handbook to monitor the pregnat women and 34.096(92,90) of those teams have a copymirror of the pregnant women’s handbook, or another form with equivalent information, at the Basic Health Unit. Regarding to the actions carried out by the team to guarantee the postpartum consultation up to one week after the childbirth, all of the brazilian regions have low rates of consultation at special times, in which any day of the week, with 65.4% adherence in this aspect. Conclusion: The results suggest that there are differences in prenatal and puerperal care in Brazilian regions. These results can be useful for other studies and for strengthening reginal planning actions. For managerial practice, the assistance during the prenatal and postpartum period must be repeatedly discussed.
Acesso aberto (Open Access)
Avaliação da implementação dos planos de contingência para enfrentamento da COVID-19 em hospitais universitários brasileiros
(Universidade Federal do Pará, 2023-06-06) SOUSA, Michele Monteiro; ALMEIDA, Deybson Borba de; http://lattes.cnpq.br/3390707163827574; https://orcid.org/0000-0002-2311-6204; CUNHA, Carlos Leonardo Figueiredo; http://lattes.cnpq.br/9603271880856443; https://orcid.org/0000-0002-1891-4201
The aim of this study was to evaluate the implementation of contingency plans to cope with COVID-19 in Brazilian university hospitals. Comprehensive qualitative qualitative study with semi-structured interviews applied to managers and workers of 8 federal educational institutions who participated in the construction, implementation and evaluation of contingency plans to cope with COVID-19. The textual content of the interviews was submitted to the N-vivo software. Data analysis was performed using Bardin's content analysis, and as a theoretical basis Donabedian's theory evaluating the triad structure, process and result. The profile of the 17 participants of the research was mostly female (76%), 59% are nurses and 23% act as health care managers and 23% as superintendents within the EBSERH. In the structural dimension, the lack of inputs, such as PPE and medicines, directly interfered in the effectiveness of contingency plans. It evidenced the historical demands of health professionals regarding working conditions. The results found in the dimension, structure and result evidenced the weaknesses of some university hospitals to meet the potential demand generated by the COVID-19 pandemic. This study demonstrated the importance of planning, preparing and updating guiding documents for hospital institutions, such as the contingency plan, aimed at coping with a public health emergency, as well as the need for integration between management, care, teaching and research services.
Acesso aberto (Open Access)
Prevalência de Chlamydia trachomatis e fatores de vulnerabilidade associados em uma população ribeirinha da Amazônia brasileira
(Universidade Federal do Pará, 2021-12-20) GALVÃO, José Jorge da Silva; FERREIRA, Glenda Roberta Oliveira Naiff; http://lattes.cnpq.br/7459094802051187; https://orcid.org/0000-0002-8206-4950; CUNHA, Carlos Leonardo Figueiredo; http://lattes.cnpq.br/9603271880856443; https://orcid.org/0000-0002-1891-4201
Introduction:Chlamydiatrachomatis is widely distributed in urban and non-urban populations, including riverside populations. These populations have low access to laboratory diagnosis in Primary Health Care and there are difficulties in clinical diagnosis, which do not allow the break of the chain of transmission. The riverside dwellers in the Brazilian Amazon live in an area of high incidence of sexually transmitted infections and have low socioeconomic indicators. There are no studies addressing the prevalence of Chlamydiatrachomatis and riverine populations in light of social, individual, and programmatic vulnerability factors. Objective: To identify the prevalence of Chlamydiatrachomatis and associated vulnerability aspects in an adult riverine population in the Brazilian Amazon. Method: Observational, cross-sectional study conducted among adult residents of Ilha do Combú, in the city of Belém. We adopted an expected frequency of 50%, acceptable margin of error of 5%, confidence level of 95%, design effect 1.0, which resulted in a sample of 306 participants, with an additional 8.5% being included considering a percentage of participants who did not answer or did not know. The sample size calculation was performed in the Statcalc - Sample size and power module of the EPI INFO Version 7.2.2.16 program. For data collection two questionnaires were applied, one validated and the other adapted, evaluated by judges and previously tested for the present research, with the intention of identifying the knowledge, attitudes and practices about sexually transmitted infections, besides socio-demographic data. The variables used to test the main hypothesis of the study were categorical: aspects of the individual, social and programmatic dimensions are associated with the chances of Chlamydia trachomatis infection among adult river dwellers. The dependent variable analyzed was reagent serology for CT. The diagnostic criterion for reagent serology was the detection of antibodies of the IgG and IgM classes of CT in an enzyme linked immunosorbent assay (ELISA). The independent variables analyzed corresponded to the vulnerability aspects described from the literature. To identify the prevalence of chlamydia, a peripheral blood sample was collected from the study participants. The sample then underwent analysis for IgG and IgM anti-Chlamydia trachomatis antibody detection by enzyme-linked immunosorbent assay (ELISA). Logistic regression was the method of choice for expressing the odds of finding markers of Chlamydiatrachomatis infection among those exposed to vulnerable conditions relative to the unexposed. Univariate binary regression was selected for multiple regression, adopting the stepwise model. All statistical analyses were done using Minitab 20® and Biostat 5.3® software. Significance level of 5%, 95% confidence interval (CI) and Chance Ratio (RC) were adopted. Results: The study sample consisted of 325 participants. The prevalence of Chlamydia trachomatis infection markers was 22% (72/325%; 95% CI: 17.5%; 26.4%). For the isolated IgM marker, the prevalence was 5.5% (6/109; 95% CI: 1.2%; 9.8%), with 100% of cases being female. Most participants had low educational level and low wage income, 56.6% (184/325) never attended school or had only elementary level; 68% (222/314) lived with monthly wage income less than one minimum wage. In the multiple logistic regression analysis, after adjustments, the participants who had their condom broken and were beneficiaries of government income transfer programs were almost twice as likely to have the presence of markers of Chlamydiatrachomatis infection when compared to those who did not have their condom broken. Conclusion: In this population, besides the low social conditions, vulnerability factors were found in the individual and social dimensions that increased the chances of infection by the bacteria, such as low education, low family income and poor access to health services. The identification of these aspects enables the choice of the most appropriate combined prevention strategy for these populations.