Navegando por Orientadores "SILVA, Hilton Pereira da"

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Análise sobre a formação profissional e experiência dos médicos cooperados do programa mais médicos no Brasil
(Universidade Federal do Pará, 2018-04-03) TAVARES, Roseane Bittencourt; SILVA, Hilton Pereira da; http://lattes.cnpq.br/3917171307194821
The More Doctors Program (Programa Mais Médicos-PMM) was established in 2013 because of social pressures, from the Unified Health System (Sistema Único de Saúde-SUS) and population in general. One of its aims is to ensure the provision of medical professionals to work in Primary Healthcare (Atenção Básica-AB) in difficult access areas, due to the insufficiency of these professionals in the SUS. However, on the first calls for participation, Brazilian doctors boycotted the Program. One of the solutions for its implementation was to sign a cooperation agreement between Brazil and Cuba through the Pan American Health Organization. Thus, thousands of Cuban doctors came to Brazil to work on the PMM. However, these professionals’ arrival was widely criticized by medical associations, which affirmed that they didn’t have the necessary training to practice medicine in Brazil. That said, the objective of this study is to analyze the professional training and previous experience of the cooperated physicians participating in the PMM. To do so, we shared data with the multicentric research “Analysis of the effectiveness of the More Doctors initiative in the realization of the universal right to health and in the consolidation of the Health Services Networks”, coordinated by the University of Brasilia. Data was collected using interviews with the cooperative doctors in every regions of the country. We carried out the interviews content analysis and, in addition, we compared the curricula of Cuban and Brazilian medical schools, observing their similarities and differences. Two articles were written from this research. The first article was published in Revista Interface - Comunicação, Saúde, Educação (vol.21, Supplement I, issue 63, 2017, pp. 1257-1268) and is about how the participants understand and are involved in BA in the country. The second article was submitted to the special edition of the Revista Pan-americana de Salud Pública, which theme is “Primary Health Care in the Americas: Forty Years of Alma-Ata”, and its focus is on the qualification of the foreign physicians working in Para. As a result, we observed that Cuban doctors have adequate training in medical practice, once Cuba's medical curricula are, in general, similar to those of Brazil, they all have some postgraduate degree, and in addition they have medical experiences in other countries, due to the internationalist premise of their medical schools. Thus, there is no reason to criticize the training of these professionals, who come from a country recognized for its public health and the way they practice medicine. It is concluded that it is necessary to recognize their technical competence and learn from their humanitarian practice, which has been applied not only to the Cuban population, but also to populations from everywhere in the world where they are needed.
Acesso aberto (Open Access)
Capacidade funcional e condições sócio-ecológicas em idosos longevos: uma amostragem dos ex-combatentes da Segunda Guerra Mundial em Belém do Pará
(Universidade Federal do Pará, 2013-05-01) SOUSA, Elton Vinícius Oliveira de; SILVA, Hilton Pereira da; http://lattes.cnpq.br/3917171307194821
The suddenness that humanity grows old requires adaptations of the societies’ lifestyle and attention to the elderly people needs new paradigms between government and citizen. In Belém of Pará, Brazil, the former combatants of World War II did not participate of the Independence parade in 2010, alleged lack of physical conditions, that arouse the interest in know this parcel of the population of Pará lives, as they have participated of the parade since 1951. With this aim, the aging profile of a sample of former-combatants of World War II, who live in Belém, was described in its bioantropologic aspects, relating to transition of density and epidemiology which Brazil is passing by, especially in the North region, in which we identify few studies about human aging. Thus, this study was based on survey method and descriptive, correlational quantitative. There were two phases in the research one bibliographic and another in the field in which we collected the required sample for the study. This sample is composed of 20 Ex-combatants (Navy n = 9, Army n = 9 and Air Force n = 2), aged 90.15 ± 5.33 years. In data analysis, we used SPSS 20.0 for univariate and multivariate analysis. The dependent variable, functional capacity was assessed by the Activities of Daily Living (ADL), we applied the Katz’s model (1963), The Nutritional status was defined through the diagnoses obtained from the analysis of anthropometric variables: body mass index, triceps skinfold thickness and arm muscle circumference and overall muscle strength, through the evaluation of grip strength. The Social conditions and health were assessed by questionnaires and sociodemographic a physical examination was performed in order to identify health conditions over the life course. Ex-combatants of World War II who live in Belém (PA), men are physically active and independent in ADL (95%). This result was confirmed by the evaluation of grip strength which noted that the sample has the same levels of muscle strength when compared to other populations of elderly Brazilians. In the nutritional assessment, 30% are eutrophic while 70% are not eutrophic. In socioeconomic profile, it was found that 65% are married, 30% widowed and 5% single, averaging 5 ± 3.11 children. The education level is 40% with high school, live in good housing conditions, with a monthly income of more than five minimum wages. They are independent of unified health system. 95% are Catholic and 25% of them still hold community activities. The recreational use of alcohol was reported by 50% of the sample and 100% are non-smokers. For longevity and good functional capacity, they were attributed to favorable socioeconomic status and family support. In the analysis of the course of life, we can hypothesize them high social adaptability due to bad experiences in the war, despite being with great loss of social prestige, which is an important reason for non-participation in military parade in 2010.
Acesso aberto (Open Access)
Crianças ribeirinhas e quilombolas da Amazônia: crescimento, determinantes sociais de saúde e políticas públicas
(Universidade Federal do Pará, 2016-09-29) FILGUEIRAS, Ligia Amaral; SILVA, Hilton Pereira da; http://lattes.cnpq.br/3917171307194821
The Amazon represents over half of the tropical forests in the world and has the highest biodiversity in the world, but continues to suffer serious environmental problems due to the illegal exploitation of its resources. Human populations living in these areas are indigenous and non-indigenous, largely rural, with intense miscegenation between white settlers, the indigenous native population and Africans who came as slaves. They are small producers who depend on and deeply know the nature and its cycles and use relatively simple technology, little impact on the environment. These populations living in rural areas are considered made vulnerable, especially children. This study aimed to assess the health situation of children from three population groups of the Amazon residents National Forest Caxiuanã (PA), the Sustainable Development Reserve Mamirauá (AM) and seven Quilombo communities (Africa / Laranjituba, St. Anthony , hoses, Spring, Oriximiná, Trumpets and Abacatal - PA). 990 children were analyzed 0 to 9 years of age compared to WHO criteria from 2008 to 2015. It was found that children Caxiuanã are in deficit height / age (26.15%) and children Mamirauá (17.9%), while among the Maroons the most serious situation was in the Spring community (35.72%). The difference between them was significant (p = 0.018) and the Tukey test indicates that children Caxiuanã are worse off with regard to weight / age. In general, all communities lack environmental sanitation, running water, have substandard housing, including without bathroom or internal health, which influences the high levels of intestinal parasites, skin infections and other diseases. Access to health services is often difficult due to the distances between homes and health centers, as in most cases the transport is poor. The Amazon region is vast and difficult to manage, but if there is no serious improvements in public policies in all sectors, children in rural areas still remain distant from international growth parameters in the 21st century Therefore, it is necessary that best public health programs are developed to the Amazon region, which are reflected in better quality growth and health.
Acesso aberto (Open Access)
Doença como experiência: as relações entre vulnerabilidade social e corpo doente enquanto fenômeno biocultural no estado do Pará
(Universidade Federal do Pará, 2012-06-11) SILVA, Ariana Kelly Leandra Silva da; SILVA, Hilton Pereira da; http://lattes.cnpq.br/3917171307194821
This study examines the biosocial representation of individuals with Sickle Cell Anemia (SCA) in Pará State, Brazil, considering that this as a biocultural phenomenon, involving evolutionary, genetic, environmental, socioeconomic and cultural aspects of their daily life. The research deals with the sociability and the health issues of forty people with SCA, representing 10% of the States' cases, contacted in the Fundação Hemopa, Belém, the reference center for blood disorders in the State. The research encompasses their routine situation of social vulnerability, their perceptions of Health and Disease, treatments (Western and Folk Medicine), diagnostic, stigmas, prejudices, taboos and difficulties of access and accessibility to the services of SUS (the Brazilian National Health System). A comprehensive qualitative methodology and content analysis were used to understand the experience of persons who live daily with the instability and complexity of the disease. The personal experience of disease was uncovered though the formal conversations/interviews about the origins of the biological heritage, social relations, family entanglements and extra-familial dimensions of the individuals' in question, focusing on the evolution of SCA, especially considering the physical and psychological pain and other health complications experienced by the study's participants. The habitus in relation to their life ways is a category which includes the perception of the ethnic/racial nature of SCA, still perceived as "a disease that comes from the black people" with all its associated taboos. I conclude suggesting that many impacts of SCA are linked to the Social Determinants of Health and that there are important differences in relation to the susceptibilities of the persons, with many biosocial layers that require greater awareness by the political, clinical and primary care institutions responsible for the care of the affected citizens.
Acesso aberto (Open Access)
A donde quiera que voy me acuerdo de la mata de moriche Prácticas de salud en la transitividad migratoria de indígenas warao en Belém, Pará
(Universidade Federal do Pará, 2021-11-10) MARTÍNEZ, Karla Pamela Reveles; SILVA, Hilton Pereira da; http://lattes.cnpq.br/3917171307194821; https://orcid.org/0000-0002-3287-3522
The presence of indigenous Warao in the Venezuelan migratory flow in Brazil has generated controversies regarding health care for this group. The therapeutic trajectories of people in migratory transit show different nuances in health care during migration phases. This research identifies search factors and access to health care practices of Warao families in the city of Belém, Pará, in the north of Brazil. Research was conducted through participant observation in social assistance activities and in activities of the Consultório na Rua (“mobile medical services”), and through the narrated experiences of people who prefer to live outside the shelters. This work shows that the health care provided by the mobile medical services, therapy with Warao shamans (Wisiratu and Joarotu), therapy with ensalmists, self-medication (use of pharmaceutical drugs and home remedies), the preference for the home birth, the rejection of medical procedures, and the search for adequate food are practices that are part of Warao health care in their migratory transitivity in Belém. However, this work identifies that labor exclusion, lack of access to information and guidance from health services, little interaction of Warao migrants with health centers (Basic Health Units), among others, are factors that also intervene in under use of health services. Some recommendations are provided to redirect Warao access to the health services of the municipality. In addition, research highlighted that the permanence in Belém and the possible return to lands with extractivist processes are phases of the migratory trajectory that should continue to be discussed with respect to the irruption of the right to health as a common good for this indigenous people and their lives who were forced into displacement and marginalization.