Programa de Pós-Graduação em Saúde, Ambiente e Sociedade na Amazônia - PPGSAS/ICS

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Distribuição espacial da hanseníase e sua relação com variáveis socioeconômicas e políticas públicas, em três municípios no estado do Pará
(Universidade Federal do Pará, 2017-05-12) PINHEIRO, Bruno Vinícius da Silva; GONÇALVES, Nelson Veiga; http://lattes.cnpq.br/8811269146444725
Over the last years, the World Health Organization (WHO), the Pan American Health Organization (PAHO) and the Ministry of Health (MS) have been prioritizing geographic areas with high case detection and social determinants that increase the risk of illness of its inhabitants in favor of the geographic policies to combat the endemic leprosy. The current study aims to characterize the disease, its epidemiological, operational and socio-demographic variables and the policies developed for its control and elimination. Thus, there was a transversal, retrospective and descriptive study, on the population basis with a temporal and spatial analysis of new leprosy cases that was associated with the income population condition and the level of health services in three cities in the state of Pará : Ananindeua, Marabá and Xinguara. Using the digital cartographic basis and socioeconomic data of each city, developed by the Brazilian Institute of Geography and Statistics (IBGE) and the morbidity registered in the SINAN, the new cases diagnosed during the period of 2010 to 2015 were characterized, by census sector, aiming to subsidize the analysis, as well as intervention strategies. The Epi Info 7 and Bioestat 5.0 softwares were used for the statistical tests, in which it was hypothesized that there is a positive relationship between the epidemiological variables and the other ones. The cases were geographically referenced on site, using a Global Positioning System receiver (GPS) and theses very cases were specialized using a Geographic Information System (GIS). The Kernel estimation method was applied in order to obtain spatial analysis and aiming to highlight areas of higher case density and also where the best levels of patient care were found. The real risk of occurrence of leprosy in each area was analyzed using the Buffer technique, as from the incidence in children under 15 years old and multibacillary cases. Considering the problem and the use of the aforementioned methods and techniques, a collection of tables and graphs of the main indicators and the magnitude of the hidden prevalence of leprosy was generated, as well as a variety of digital images that express the disease spatial analysis. The results shown in thematic maps reveal an inhomogeneous distribution of leprosy in the territories, highlighting areas of greater and lower risk and allowing to identify those that could be taken as a priority by the Leprosy Control Program.
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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.
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Análise dos instrumentos normativos reguladores da aquisição de alimentos destinados à alimentação escolar municipal belenense após a emenda constitucional nº 64/10: comparação entre a práxis e a garantia social estabelecida pela “constituição cidadã”
(Universidade Federal do Pará, 2018-08-08) SILVA, Wadih Brazão e; SÁ, Naiza Nayla Bandeira de; http://lattes.cnpq.br/1712074978664736; ARAÚJO, Marília de Souza; http://lattes.cnpq.br/9371703949781020
Taking as a reference the scientific evidence that inadequate food results in a variety of health problems, as well as the fact that, from 2010, food has been elevated to the category of social law set forth in the Federal Constitution through Constitutional Amendment number 64, the present study is directed to the research about the effective observation of this right in relation to the student population that receives school meals in the city of Belém from the year of validity of said Amendment, delimiting the period from February 2010 to February 2018. Therefore, it assumed as a premise that the full realization of the social right to food only occurs if the food has nutritional value and that this condition is in the drafting of normative instruments (Bidding Documents and Public Call Records) governing the acquisition of food intended for school lunches in the municipality. The study focused on the poor quality of school meals in some schools in Belém, analyzing the normative instruments of municipal public acquisition of food for school meals in the light of the quality criteria recommended by the National School Feeding Program (PNAE) and of the dispositions of the current legislation, and proposes alternatives for the mitigation of the mentioned problem.
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As necessidades de cuidar do filho estomizado: na perspectiva da teoria comunicativa
(Universidade Federal do Pará, 2018-08-13) FERREIRA, Sandra Regina Monteiro; SANTANA, Mary Elizabeth de; http://lattes.cnpq.br/6616236152960399; https://orcid.org/0000-0002-3629-8932
The children can get urinary or gastrointestinal stomas for a variety of causes, right after birth or at any time in their life. The most common causes are congenital anomalies and traumas that occur during development and are mostly temporary anomalies. It is estimated that one in each 33 babies, born with congenital problems in the world. Objective: know the challenges faced by the mothers with the care of their stomized son. Method: It is a descriptive study with qualitative approach having as theoretical support the communicative action of Habermas. The scenario of the study was Serviço de Atenção à Pessoa com Estomia, localized at Unidade de Referência Especializada Presidente Vargas in Belém of Pará. It was performed the collections of data through semi-structured interviews with mothers of stomized children properly registered at the service of attention for stomized people. It was performed the data’s analysis using the Bardin content technique. Results: It was been interviewed 12 mothers, whom two mothers live in Belém count and the remaining in countryside of the state. The age group of children was between 8 months’ to 8 years old, considering congenital disease the main diagnosis for ostomy production and the ostomy type more incident was colonoscopy, in relation to gender, six are male and six female, time of ostomy ranged between one month of life to two years old. The mothers’ age ranged from 18 to 46 years old, related to level of education, two mothers had full high school, one had unfinished high school, five had full middle school and four had unfinished middle school. Discussion: The results of the study indicated that mothers are not adequately oriented regarding their child's stomized care, revealing fear and anguish as the biggest challenges to changing and handling collecting equipment. The stomized child needs specialized care by the multi-professional team, and especially the nurse who is the professional responsible for health education, with guidance on care and education for parents regarding the exchange of equipment and the necessary care with the peristomal skin to preparing them to the returns home time with minimal conditions to care your child. Final considerations: the mothers experience the flaws in care provision for your stomized child and they reveal the fear as the main challenge in provision of healthcare. It was verified as inadequate The educational actions provided by nurses for the mothers when it comes to guide the care of stomized children, causing the unpreparedness of mothers and contributing to the inability to perform the expected assistance at home. It was expected that the construction of an educational material target for the care of stomized child could contribute with both mothers and nursing professionals in order to provide assistance with the view to quality of life and rehabilitation of the stomized child.
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Insegurança alimentar em famílias de crianças matriculadas na rede municipal de educação infantil, Belém-PA
(Universidade Federal do Pará, 2018-08-20) LEITE, Juliane Costa; GONZAGA, Irland Barroncas; http://lattes.cnpq.br/4404609403033945
Analytical study, observational of cross-sectional design that aimed to estimate the prevalence food and nutrition insecurity among the families with enrolled children at schools from the municipal early childhood education network in Belém-PA-Brazil. As an instrument to collect data, it was used the Brazilian Scale of Insecurity Food Measurement, and, in order to evaluate the family profile, it was used the socio demographic form. It was also managed with the children anthropometric evaluation for the children nutritional situation analysis. Three hundred sixty-eight families from Belém-PA participated in the study, they were proportionally divided into six administrative districts, eighty-seven schools and six age groups. The sampling technique considered a error of 5,16% and it was a proportional stratified random. In statistical analysis of the association among the socio demographic indicators and insecurity food, the Chi-square tests were used and G test. Prevalence rates and prevalence ratios were estimated for food insecurity, and Poisson multiple regression analysis with robust variance was performed and the respective confidence intervals (CI 95%). In all tests, it was adopted the significance level (a) equal to 5%. The statistic program that was used in the reviews was BioEstat 5.3 and SPSS 24.0. As a result, it was found the prevalence of 85,6% of food and nutritional insecurity, that was distributed according to the severity gradient, in 36,4% light food and nutritional insecurity, 28,8% were moderated and 20,4% were serious. It was verified a significative statistically association between insecurity food and family income per capita, have work, education level of the family chief, received of the Bolsa Família and type of material used in the construction of the home. In the Poisson regression model, it was observed that food insecurity was associated with have a family income per capita that is less than half a minimum wage (PR = 1,61) and does not have work (PR = 1,10). The study presents an important instrument to identify those risks and permits the analysis of the investigated problems causes.
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Perspectivas de integralidade em saúde na percepção de profissionais do Núcleo Ampliado de Saúde da Família e Atenção Básica e usuários da equipe de estratégia Saúde da Família no município de Belém
(Universidade Federal do Pará, 2018-08-27) SILVA, Thaís do Socorro da Luz; SILVA, Marcos Valério Santos; http://lattes.cnpq.br/0379783635000306
Since its inception, SUS has been showing significant progress, including the creation of the Family Health Strategy (ESF), adopted as a prioritary model for the reorganization of primary health care in Brazil. In January 2008, the Family Health Support Center (Nasf) was created to expand, increase the resolutiveness and comprehensiveness of health care, and was later called the Expanded Family Health Center (Nasf-AB). Nasf-AB acts in a number of eSF, being made up of professionals from different areas of knowledge to act in support and in partnership with the eSF. This research aimed to evaluate the Nasf-AB regarding the challenges for comprehensiveness, from the perspective of professionals of two Nasf-AB teams and users of two ESF in Belém, Pará. This was a qualitative, case-study approach with participant observation. Semi-structured interviews were conducted from August to December 2017, and subsequently, the content analysis of this material. Nine professionals of two Nasf-AB teams and nine users of two ESF teams took part in this research. The results show that five professionals have postgraduate degrees, but only one has specialization in the area of Collective Health, indicating insufficient specific theoretical training of the team. Regarding the time that the users participate in the activities in Nasf-AB teams groups, the half of the sample has been doing activities for three years. Among the changes brought by the implementation of ESF reported by the users, the dynamics of scheduling appointments, improvement in access to health services and home visits by the professionals stand out. The professionals demonstrated to understand the essence of comprehensiveness in a critical way, as a fight flag for modifying health practices and consolidating the care model. It was also identified that the interviewees associated the groups of physical activities with improvements in the quality of life of the users, besides being considered the main tool to reach the comprehensiveness in the practices. Finally, it was noticed that the Nasf-AB teams studied need to move forward to offer better working conditions to professionals and stimulate practices of permanent education in health, making possible the transformation of professional practices.
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A implementação da política nacional de promoção da saúde na atenção primária sob a perspectiva de profissionais de saúde
(Universidade Federal do Pará, 2018-09-04) EUCLIDES, Kelly Lene Lopes Calderaro; NASCIMENTO, Liliane Silva do; http://lattes.cnpq.br/1267238580647081
Health promotion provides the involvement of all the actors of doing and being health, in order to be protagonists and active participants in achieving and continuing care. It brings a new view to ensure health in a universal, equitable and integral way that involves political, social, ethical, cultural and spiritual features. The implementation of the policy in primary care focuses on changes in the treatment of users, through actions that reach the full care of the individual and their families, considering the social determinants of health that make up this universe. This study aimed to understand the implementation of the National Policy on Health Promotion in primary care from the perspective of professionals working at this entry into the health system. It was a qualitative exploratory study developed in the city of Benevides, State of Pará, in 2018. We found that professionals knew about this policy and seek to implement it in their actions. However, this perception does not exempt the actions, which are still confused with attributions recommended by the Ministry of Health, or activities with ends in themselves.In primary care is essential to carry out collective health actions, in which everyone must be protagonists for health production. Health professionals should develop awareness of health promotion to users and produce their actions based on praxis, where care is not limited to meeting welfare. Thus, the real change in the praxis and paradigms of health care models is urgent, highlighting the importance of intersectoriality and multiprofessional work for the integral health promotion, its concepts and functioning, which must be capillarized professionals and makers of the health system in all their activities and levels of action and / or management.
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A voz do servidor público da UFPA: um estudo sobre os sentidos da promoção da saúde no local de trabalho
(Universidade Federal do Pará, 2018-09-21) TEIXEIRA, Maria de Nazaré Barbosa; PIANI, Pedro Paulo Freire; http://lattes.cnpq.br/6434100473666705
Introduction: The National Policy for Civil Servant’s Health and Work Security (Política Nacional de Atenção à Saúde e Segurança do Trabalho do Servidor Público Federal – PASS) is an established state policy, and is used as a legal tool for promoting and surveilling health among the public organs of the Federal Public Administration in the executive. PASS leads three principles: health assistance for civil servants; health and vigilance expertise; and health promotion. The latter recommends that changing actions must be developed in the workplace in order to reflect health gain for the servants. Methodology: Descriptive and exploratory study; qualitative research approach with a theoretical and methodological support based on the discursive practices by Spink (2010). The research consisted of a semi-structured interview, and aimed at investigating civil servants’ production of meanings on health promotion in the workplace. 17 (seventeen) federal civil servants from UFPA’s personnel took part in the interview. Result and discussion: The interviews were analyzed through two distinct processes: servants’ knowledge on “health” and “health promotion” – which was highlighted by terms/words – and the elaboration of four categories that appeared a posteriori about participants’ speech, considering: 1- the meanings about health promotion in the workplace; 2- health gain in the workplace due to health promotion; 3- health promotion, vigilance and intervention; and 4- information as a support for health gain. The categories were interpreted based on the narratives in light of the five main fields of health promotion proposed by the Ottawa charter, the guidelines that comprise the set of actions from PASS, and the theoretical background. The research result indicated the need of improving the theoretical discussions on health, risks, vulnerability, territory, intersectorality, critical autonomy, empowerment, and social participation as a way to face situations that prevent health gain. The interlocutors aim at gaining health from new social and environmental attitudes, social interactions, and health service reorientations. From the narratives, there was the need for an institutional planning that prioritizes programs and projects with the purpose of: improving UFPA’s campus infrastructure in Belém; promoting life quality in the workplace; and qualifying the servants about the policy for civil servants’ health and work security (PASS), which includes vigilance to environment and work process, and health promotion to servants. Conclusion: In the civil service, outside the healthcare sector, actions for health promotion aim at improving environment, organization, and work process in order to promote a health valuation culture through changing habits and behavioral attitudes individually and collectively, and to reduce morbimortality in the workplace. However, it can only happen through changes in social and environmental attitudes, social interactions, and health service reorientations. Furthermore, the institutional planning must have programs and projects to enhance life quality promotion in the workplace, and qualify the servants to develop their personal skills suitable for health gain.
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Katuana quilombola: consumo de açaí e risco cardiovascular em algumas comunidades quilombolas na Amazônia Oriental
(Universidade Federal do Pará, 2018-10-30) LIMA, Emanuele de Jesus Silva de; BASTOS, Maria do Socorro Castelo Branco de Oliveira; http://lattes.cnpq.br/6751930840883503
Objective: to evaluate the consumption of acai berry and your association with cardiovascular risk in some communities remaining quilombo in Eastern Amazonia, in individuals of both genders with age from 30 years. Methodology: cross-sectional study involving 165 individuals, of 7 remaining quilombos communities. Applied questionnaire on socio-economic data and habits. Acai berry consumption was measured by means of specific questionnaire of quantification and frequency of consumption. The study population was divided into two groups of high and low consumption of ACAI, based on the median daily intake of 142.9 ml/day. Result: the group with low consumption showed median 30.85 ml/day (Q25 = 0.00; Q75 = 85.71 m/l) and the group with high consumption showed 600 ml/day (Q25 = 400.00; Q75 = 1000.00 ml). The majority was composed of women with median age in both the Group of 47 years, with low educational level with years of study of less than 8 years and who do not receive benefit scholarship family. The study observed no statistically significant difference between the groups of consumption and cardiovascular risk markers and habits of the population studied. Conclusion: the consumption of Acai was not a protection factor for cardiovascular diseases in quilombo remaining communities in Eastern Amazonia.
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Perfil epidemiológico e espacial da hanseníase em menores de 15 anos de idade, na região metropolitana de Belém, estado do Pará
(Universidade Federal do Pará, 2018-12-18) OLIVEIRA, Silvio Silva; PIRES, Carla Andréa Avelar; http://lattes.cnpq.br/4043070406676676; GUERREIRO, João Farias; http://lattes.cnpq.br/1000688763895346
Leprosy is an infectious, curable disease, however, with great potential for generating physical incapacity. Knowing the impact of leprosy in children under 15 allows estimating the level of transmission, the intensity of the endemic disease and evaluating the effectiveness of health services in combating this disease, which is more prevalent in poor populations and represents a growing health problem in the this study analyzed the epidemiological profile of leprosy in children under 15 years of age and the population coverage of the Family Health Strategy in the Metropolitan Region of Belém, state of Pará, from 2006 to 2015. Quantitative study with an ecological study design in a historical series of leprosy cases reported in the years 2006 to 2015, using secondary data from the Ministry of Health's Notifiable Diseases and Basic Attention Database State of Pará, Brazil. Of the 675 cases, the majority (58.96%) were detected by referral, predominantly male (55.70%), black + brown (81.63%) and incomplete elementary school (77.48 %). The most frequent age group (65.09%) was children aged 10 to 14 years, with a predominance of paucibacillary forms and a higher frequency of dimorphic clinical form. The evolution of the standardized rate of detection of leprosy in less than 15 years, presented geographically, showed a high level of hyperendemicity in the municipalities of Castanhal, which had population coverage of the Consolidated Family Health Strategy and Marituba with intermediate coverage. It was presented with hyperendemicity in the municipality of Santa Bárbara do Pará also as a consolidated coverage and very high endemicity in the municipalities of Ananindeua with intermediate coverage, Belém with incipient coverage, Benevides and Santa Izabel do Pará with consolidated coverage. The areas of spatial autocorrelation for the transmission of the disease appeared to form two clusters, the first one involving the municipalities of Ananindeua, Belém and Benevides and the second one formed by the municipality of Castanhal located opposite to the first one. The highest densities of mean detection rates were observed in the municipalities of Marituba that spread to the municipalities of Ananindeua and Benevides and also in the municipality of Castanhal, representing to some extent the areas of greatest risk for the transmission of the disease. In the city of Belém, the capital of the State of Pará, the population coverage of the Family Health Strategy was incipient in most of the neighborhoods, although in some of the Mosqueiro Island it was consolidated, contradictorily putting those areas with the highest densities of average detection rates. The magnitude of the endemic disease, the strength of the morbidity and the tendency of the disease, indicated by the indicators of epidemiological follow-up remained high and the coverage of the Family Health Strategy, although consolidated in most municipalities, was not homogeneously distributed to guarantee universal coverage to the territories , implying in some way with this epidemiological situation, to affirm that leprosy is a serious public health problem in the Metropolitan Region of Belem.
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Adolescentes rurais: comportamentos de risco para doenças crônicas não transmissíveis em um município do interior do estado do Pará
(Universidade Federal do Pará, 2019-03-15) OLIVEIRA, Victor Vieira de; ARAÚJO, Marília de Souza; http://lattes.cnpq.br/9371703949781020
Recent studies have demonstrated the epidemiological transition and the increased occurrence of Noncommunicable Chronic Diseases (NCD), especially among adolescents in less developed countries, and in those who live in poor areas. Although it is recognized that these diseases are more commonly perceived in adults, their manifestations are the result of the interaction of risk factors acquired at an early age. Therefore, the objective of this research was to identify the risk factors for NCDs in adolescents from the rural area of a town in the northeast of the state of Pará, Brazil, as well as to present the risk factors for NCDs through the following variables: physical activity, tobacco use, alcohol consumption, Body Mass Index, waist circumference and blood pressure, identifying the possible associations between these variables with the socio-demographic, socioeconomic conditions and with the behavioral and alimentary markers. An observational, cross-sectional epidemiological study was carried out on a representative sample of students of both sexes, aged between 15 and 19 years, enrolled in the regular high school of six public schools in the rural area of the municipality of Ipixuna-PA. The data were obtained through a questionnaire and clinical evaluation, being analyzed by means of explanatory analysis and univariate and multiple logistic regression, considering a significance level of 5% (p < 0,05) and a 95% confidence interval (CI). The sample consisted mostly of female individuals, with an average age of 17 years, who were insufficiently active, who had already experienced alcohol and tobacco, belonging to the most socially vulnerable strata and who had a poor-fiber diet, but rich in fats and sugar. The sedentary lifestyle was significantly related to the female sex, while the risk of altered blood pressure and tobacco experimentation were significantly related to the male sex. Socioeconomic conditions have been shown to influence mainly blood pressure increase, tobacco experimentation, and waist circumference, while older age has been shown to be a protective factor for abdominal obesity. Likewise, the consumption and experimentation of alcohol and tobacco showed to have their use combined, as well as the presence of abdominal obesity and overweight. Inadequate feeding, in turn, was associated with the greater risk of the adolescent being insufficiently active. This study makes clear the need for more effective public policies aimed at raising awareness of the need for a healthier lifestyle among adolescents in rural areas.
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Katuana da Amazônia: consumo alimentar e associação com o risco cardiovascular em população urbana
(Universidade Federal do Pará, 2019-03-28) SOUZA, Adriano Augusto Reis; BASTOS, Maria do Socorro Castelo Branco de Oliveira; http://lattes.cnpq.br/6751930840883503
Objectives: To evaluate dietary intake and its association with the risk of coronary artery disease in urban population over 30 years of age; to describe the cardiovascular risk by the Framingham score; verify the food and food groups consumed in the study population; to analyze the association between dietary intake and the high and low risk groups by the Framingham score. Methodology: A cross-sectional study was carried out involving 267 individuals per randomized random sample from the periphery of the city of Belém do Pará. Biological samples were collected for biochemical tests and measurements of weight, height and blood pressure. A questionnaire on socioeconomic characteristics at home and a food frequency questionnaire (FFQ) were used to collect information on food consumption. The consumption of food was reclassified for analysis in regular and non-regular consumption. Cardiovascular risk was calculated from clinical and biochemical data using the Framingham cardiovascular risk scale and classifying subjects into two groups: high and low cardiovascular risk. After this classification, associations were analyzed with sociodemographic, anthropometric variables and food consumption data obtained through the FFQ. Results: 22.5% of the group were at high risk for developing coronary artery disease and 77.5% were low risk, according to the Framingham score. Of the population that presented high risk, 65% were women, 91.7% referred predominantly brown or black; 68.3% belonged to classes B and C; the median per capita income was R$ 300.70; the median age was 47 years; the median number of years of study was 8 years; 65.9% had a marital relationship; 76.7% were overweight and 41.7% had increased waist circumference. Regarding the regular food consumption of the studied population, 62.9% consumed whole milk, 13.9% red meat, 50.2% margarine, 65.5% cassava flour, 8.6% soda, 10.5% skimmed milk, 38.6% beans and 15.7% consumed five daily servings of fruit vegetables. Conclusion: The present study observed that the population studied presented a fairly homogeneous diet, probably due to the similarities of purchasing power and eating habits. Thus, this study did not find statistical association between cardiovascular risk and food consumption in this population group.
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Percepções, vivências e perspectivas de professores sobre o Programa Saúde na Escola
(Universidade Federal do Pará, 2019-04-25) PEREIRA, Fabrício Moraes; NASCIMENTO, Liliane Silva do; http://lattes.cnpq.br/1267238580647081
Health at school is the subject of relevant discussions on health promotion. From intersetoriality reflexions, literature review and field research, this study aims to understand the actions resulting from the School Health Program in municipal public schools in Belém, Pará, from the perspective of teachers. It is a descriptive-observational study, with analysis of interviews with 22 teachers of municipal public basic education. Field research took place from April to June 2018. A content analysis was carried out, proposed by Bardin, generating four thematic units: Evaluation of the SHP in Belém’s municipal schools context; The social determinants of health and the school community; Basic education teacher: inherent health educator; The indissociability of care in health-education binomial. Half of those interviewed were unaware of the program or its operation. Different modes of interaction between the program's actions managers were observed, from the most punctual and inefficient to the most contextualized and integrative. The study of social health determinants is necessary to better understand the processes and needs of these actions in the municipal school environment, with emphasis on issues of basic sanitation, food insecurity, violence and drugs. It is highlighted the need for self-recognition of the teacher as a health educator, in order to insert them in the construction of the health promotion in their pedagogical practices. The school's articulation with the school community can serve as an input for greater integration and stimulation of social control practices. It is understood the existence of challenges to overcome through the concreteness of intersectoriality: the deep-rooted effects of the biomedical model, the distortions of the conception of health promotion, the need for better understanding and application of intersectoriality, conciliation of agendas, fragmentation of health actions, professional valorization in both sectors and better quality in communication and interprofessional information exchange.
Acesso aberto (Open Access)
Pacientes portadores de diabetes mellitus tipo2 atendidos no Instituto de Previdência e Assistência do município de Belém IPAMB: aspectos epidemiológicos e genéticos
(Universidade Federal do Pará, 2019-06-18) OLIVEIRA, Bárbara de Alencar; GUERREIRO, João Farias; http://lattes.cnpq.br/1000688763895346
Diabetes mellitus has been considered a 21st century epidemic and each year the number of people with the disease increases worldwide. It is a disease caused by modifiable factors such as hypercaloric diet, sedentary lifestyle, and non-modifiable factors such as genetic heritability. The objective of this study was to describe the occurrence of genetic markers associated with type 2 diabetes mellitus in the population of the city of Belém do Pará, Brazil. The specific objectives were: to validate the association between type 2 diabetes mellitus and the genes: KCNJ11 rs5219, TCF7L2 rs7901695, PPARγ rs1801282, ABCA1 rs9282541, FTO rs8050136 and rs9939609; and investigate the association between factors related to the development and evolution of type 2 diabetes mellitus such as: BMI, waist circumference, systemic arterial hypertension, sedentary lifestyle, smoking, alcoholism and metabolic syndrome. A research form was applied and blood was collected for DNA extraction. A case-control study was conducted with 147 individuals. The sample consisted of 54 women and 49 men, totaling 103 individuals with the disease, and the control group with 27 women and 17 men without type 2 diabetes mellitus, pre-diabetes or any other type of diabetes, totaling 44 individuals. The study was carried out at the Belém Municipal Institute of Welfare and Care. Regarding the genes studied, only KCNJ11 rs5219 was statistically significant in women (n = 81, p = 0.025). Considering the factors associated with type 2 diabetes mellitus, only the metabolic syndrome presented statistical significance in both genders (p = 0.01).

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