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- ItemEmbargoDetecção de casos de tuberculose e atenção primária: análise da repercussão da pandemia Covid-19(Universidade Federal de São Paulo, 2024-01-12) Ribeiro, Stephanie [UNIFESP]; Hino, Paula [UNIFESP]; http://lattes.cnpq.br/6815362006090017; http://lattes.cnpq.br/2417968205674535Objetivo: Identificar a repercussão da pandemia Covid-19 nas ações de detecção de casos de tuberculose no âmbito da Atenção Primária à Saúde no município de São Paulo. Métodos: Estudo de abordagem quantitativa do tipo transversal realizado nos serviços de atenção primária localizados no município de São Paulo. A amostra foi composta por 80 unidades e os representantes foram profissionais de saúde, denominados informante chave, que estavam ativos no serviço desde janeiro de 2020. A coleta de dados ocorreu presencialmente entre dezembro de 2022 a março de 2023 e foi feita por meio de formulário estruturado constituído por variáveis dicotômicas, de múltipla escolha e de escala Likert (0-10) acerca das características das unidades e das ações de detecção da tuberculose durante o período pandêmico (2020-2022). Para análise estatística foi realizada análise descritiva, reportando as medidas de frequência absoluta e relativa, e de associação via Generalized Mixed Models, onde realizou-se a comparação de médias pelo post hoc de Bonferroni. Adotou-se nível de significância de 5% e utilizou-se os programas Jamovi versão 2.3.28 e RStudio versão 4.1.3. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Goiás (parecer no 5.671.976) e Secretaria Municipal de Saúde de São Paulo (parecer no 55.767.166). Resultados: As 80 unidades foram distribuídas proporcionalmente pelas coordenadorias de saúde do município, onde mais da metade dessas era do tipo estratégia saúde da família (53,8%). No período pandêmico houve mudanças especialmente em 2020, com aumento da carga horária (78,8%) e alteração no processo de trabalho (88,9%). A maioria das unidades oferecia diariamente consulta para sintomáticos respiratórios de tuberculose (97,5%), sendo que algumas referiram diminuição da periodicidade dessa consulta (15%). Foi identificado associação entre o período (2020-2022) com alteração na oferta de consulta de sintomáticos respiratórios (p = 0,011) e alteração na notificação dos casos de tuberculose (p = 0,017). Conclusões: Evidenciou-se que a pandemia Covid-19 repercutiu nas ações de detecção da tuberculose no âmbito da atenção primária, sobretudo em 2020.
- ItemAcesso aberto (Open Access)Educação permanente e a redução da mortalidade infantil em um município do Grande ABC – SP: um estudo de caso(Universidade Federal de São Paulo (UNIFESP), 2019-10-04) Walendy, Claudia Helena [UNIFESP]; Nicolau, Stella Maris [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Combating child mortality is a challenge for societies wishing to improve their social development indicators. This study aimed to analyze how the Municipal Health Secretariat of Mauá, SP, carried out between 2013 and 2016 a successful administrative reform in relation to the reduction of child mortality, listing this issue as a priority, with continuing education actions with emphasis on changes. of work processes with a strong sense of responsibility and intense articulation of management collectives, teams among themselves and among the various services and levels of attention of the health network. This is a case study with documentary analysis of reports and municipal ordinances related to actions to reduce child mortality, interviews with managers and health professionals who worked in the maternal child care network during this period. The results indicate that professionals report this experience as remarkable and enriching, and that even after the completion of this management, some work processes implemented were maintained, but without the same strong network articulation promoted by management. On the other hand, there are also reports of excessive pressure for results and care actions had a strong component of control over the lives of pregnant women by the teams in order to reduce child mortality.
- ItemSomente MetadadadosEfetividade de intervenção educativa para prevenção de infecções do trato urinário de idosos institucionalizados(Universidade Federal de São Paulo (UNIFESP), 2020-06-25) Silva, Joao Luis Almeida Da [UNIFESP]; Barbosa, Dulce Aparecida [UNIFESP]; Universidade Federal de São PauloObjectives: the objectives were to analyze the effectiveness of educational intervention with nursing professionals and caregivers to prevent urinary tract infections in institutionalized elderly; compare prevalence rates and associated risk factors; to verify the knowledge of the nursing staff and caregivers about signs, symptoms, risk factors, treatment and preventive measures before and after educational intervention. Methods: a quasi-experimental study carried out at a Long- Term Care Facility for the Elderly from July 2018 to July 2019 in a municipality in southern Bahia. The prevalence profile was carried out with 116 elderly people. An instrument was used for clinical evaluation of the elderly and risk factors were collected from medical records. Urine I and urine culture were collected for laboratory analysis before and after the educational intervention. The educational intervention was carried out with 20 professionals (07 from the nursing team and 13 caregivers of the elderly), organized in 4 groups. A self-administered structured questionnaire was applied in the pre-intervention period, educational intervention was carried out through 6 thematic workshops per group of professionals, reapplication of the questionnaire 6 months after the intervention. Results: the prevalence of urinary tract infection in the pre-intervention period was 33.62%. The associated factors were: female gender; use of diapers and diuretics; urinary and fecal incontinence; type 1 diabetes; benign prostatic hyperplasia and dehydration (p <0.05). It was shown that dehydration increased the chance of developing the infection by 40 times. The isolated uropathogens were all gram-negative, the most prevalent were Escherichia coli (69.2%) with good sensitivity to antimicrobials and Klebsiella Pneumoniae (20.6%) with more variable sensitivity and resistance. After the educational intervention, the prevalence of urinary tract infection decreased to 20%; the risk factors for dehydration and prolonged use of diapers were no longer associated with the condition; the most prevalent microorganisms remained. The average number of correct answers by the nursing team and caregivers, after educational intervention, increased from pre to post-test by 52% in relation to signs of urinary infection, 32% in relation to symptoms, 72.5% treatment, and 40 % on personal / behavioral and morbidity-related risk factors, 59% on conditional factors and 43.8% on preventive measures. The team of caregivers showed a greater gain in knowledge compared to the nursing team in almost all questions (p <0.05). The length of care with the elderly did not present a positive correlation with any variable (R <1; p> 0.05). Conclusion: the educational intervention was effective in producing knowledge acquisition by the nursing staff and caregivers, provided a reduction in the rate of urinary tract infections in the elderly and altered the association of the most prevalent modifiable factors in the chance of developing this type of infection.