Navegando por Palavras-chave "Primary Prevention"
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- ItemSomente MetadadadosAções para o controle do câncer de mama na atenção primária à saúde na perspectiva das usuárias(Universidade Federal de São Paulo (UNIFESP), 2019-09-28) Goncalves, Valterli Conceicao Sanches [UNIFESP]; Gutierrez, Maria Gaby Rivero De [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Cancer is considered an important public health problem, due to its epidemiological, social and economic relevance, in both developed and developing countries. For early detection of this condition, the Ministry of Health recommends diagnostic and screening actions, making clear the need for the tripod: population warned of signs and symptoms; health professionals trained to evaluate suspected cases and health systems, and services prepared to ensure timely diagnostic confirmation, with quality and guarantee of comprehensive care throughout the care line. It is relevant to know preventive practices related to early detection and diagnosis, since this information can support the planning of effective strategies in Primary Health Care. Objective: To evaluate the implementation of opportunistic screening actions for breast cancer control, proposed by the Ministry of Health, in Primary Health Care, through information from users. Method: Cross-sectional study conducted in 18 BHUs in the municipality of Diadema, with 675 users, aged 35-69 years, from November 2014 to March 2015. It is linked to the multicenter project entitled “Actions on Breast Cancer Control: identification of practices in Primary Care” developed by the Nursing Schools of the Federal University of São Paulo (Paulista School of Nursing / UNIFESP) and the University of São Paulo - Ribeirão Preto College of Nursing (EERP-USP), which purpose is to portray the implementation of the actions recommended by the Ministry of Health for the screening of breast cancer among users of Primary Health Care. Used a validated questionnaire which was applied after approval of the UNIFESP Research Ethics Committee. The project was approved under CAAE No. 20021714.5.0000.5505. The collected data were analyzed descriptively and analytically. Results: Of the users, 50.5% declared to be white; 44.3% married; 32.2% said they were illiterate or had completed Elementary School. 61.6% belonged to social class C and 62.1% do not perform any paid activity. Most (83.8%) used exclusively Unified Health Care System services and only 16.2% had health insurance, using it for consultations and exams. As for the risk for breast cancer, 4.7% reported having family risk factor for the neoplasm and 63.1% said the health professional asked about family risk for breast cancer; 37.5% of users at high risk for breast cancer reported having undergone breast clinical examination annually; 20.9% of users aged 50 to 69 years and at population risk performed mammography. Only 8.7% of users reported having attended an educational meeting on breast cancer. Regarding the adequacy of the parameters established by the Consensus for mammography and clinical breast examination, rates of 8.9%, 10.6% and 7.7% were found for age groups 35 to 39, 40 to 49 and 50. to 60 years, respectively. Conclusion: the opportunistic screening actions for breast cancer, carried out by Primary Health Care, need to be adjusted to comply with the guidelines proposed by the Ministry of Health in all age groups studied.
- ItemAcesso aberto (Open Access)Conhecimento e prática de médicos e nutricionistas sobre a prevenção da alergia alimentar(Universidade Federal de São Paulo (UNIFESP), 2011-01-31) Ribeiro, Camila Cury [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the knowledge and practice of pediatricians, gastroenterologists pediatricians, allergists and nutritionists regarding the primary prevention of food allergy. Methods: A descriptive cross-sectional study that enrolled pediatricians (n = 80), gastro-pediatricians (n = 120), allergists (n = 100) and nutritionists (n = 220), an amount of 520 professionals. The instrument collects used was a self-administered questionnaire prepared by the authors based on current recommendations of the major committees and societies related to prevention of food allergy. Results: The average age of professionals was 29.1 ± 5.8 years. The vast majority of the professionals was female, constituting a total 90.4% (n = 470) of respondents. The average time of graduation of professionals was 7.2 ± 5.8 years. Regarding the recommendation of exclusion diet on pregnancy, 89 (17.1%) professionals agreed with such practice, being the most indication by nutritionists. The gastro-pediatricians statistically differ from the others professionals by submitting the lowest rate of recommendation (p < 0.001). The recommendation of maternal exclusion diet on lactation was indicated by more number of professionals, constituting 40.8% (n = 212) of the sample, with the highest recommendation by nutritionists and pediatricians compared to pediatricians and allergists (p < 0.001). The duration of exclusive breastfeeding considered ideal was the period of 4 to 5.9 months indicated by 52.9% (n = 275) of professionals, according with the choices of most nutritionists, pediatricians and pediatricians. However, most allergists (65%; n = 65) indicated the range of 6 to 7.9 months. Regarding the time of introduction of complementary feeding, 218 (41.9%) professionals recommended modify the age of introduction to prevent the development of food allergy. The main period indicated was aged 6 to 7.9 months, indicated by 118 (54.1%) of respondents. Comparing the indication of the time of introduction of complementary feeding among professionals, 70 (70%) of allergists affirmed modify the time of introduction of complementary feeding (p < 0.001). The majority of special infant formulas indicated in case of impossibility of breastfeeding to prevent the development of food allergies were: Alfare® (70.6%), Neocate® (66.2%), Pregomin® (57.5%) and Nan HA® (42.1%). Conclusions: This study revealed there are misconceptions regarding the prevention of food allergy among all the categories of professionals. Our results confirm that the evaluation of knowledge and professional practice contributes to the definition of content that should be part of continuing education programs in the area of food allergy.
- ItemSomente MetadadadosHigh-sensitivity c-reactive protein and cardiovascular disease across countries and ethnicities(Hospital clinicas, univ sao paulo, 2016) Helfenstein Fonseca, Francisco Antonio [UNIFESP]; de Oliveira Izar, Maria Cristina [UNIFESP]Despite substantial differences in ethnicities, habits, cultures, the prevalence of traditional cardiovascular risk factors and affordable therapies, atherosclerosis remains the major cause of death in developing and developed countries. However, irrespective of these differences, inflammation is currently recognized as the common pathway for the major complications of atherosclerosis, stroke, and ischemic heart disease. A PubMed search was conducted for "high-sensitivity C-reactive protein'' (hs-CRP) in combination with the terms race, ethnicity, gender, prevalence, geographic, epidemiology, cardiovascular, obesity, diabetes, hypertension, cholesterol, smoking, ischemic heart disease, stroke, and mortality. This review includes the articles that pertained to the topic and additional articles identified from the reference lists of relevant publications. This review describes the marked differences in cardiovascular mortality across countries and ethnicities, which may be attributed to inequalities in the prevalence of the classic risk factors and the stage of cardiovascular epidemiological transition. However, hs-CRP appears to contribute to the prognostic information regarding cardiovascular risk and mortality even after multiple adjustments. Considering the perception of cardiovascular disease as an inflammatory disease, the more widespread use of hs-CRP appears to represent a valid tool to identify people at risk, independent of their ancestry or geographic region. In conclusion, this review reports that the complications associated with vulnerable atherosclerotic plaques are triggered by the major mechanisms of dyslipidemia and inflammation
- ItemAcesso aberto (Open Access)Manual de fotoeducação para prevenção do câncer de pele(Universidade Federal de São Paulo (UNIFESP), 2020-11-26) Almeida, Augusto Cesar De Melo [UNIFESP]; Oliveira Filho, Renato Santos De [UNIFESP]; Universidade Federal de São PauloIntroduction: Skin cancer is the most common neoplasm in Brazil and ultraviolet radiation from the sun is the main causative agent. The large number of cases of skin cancer, possible mutilation and the high cost of treatment, make this an important public health problem. The need for a personalized approach to photoeducation is emphasized, especially among risk groups, regarding photoprotection and photoexposure. Objective: To develop and validate a photo-education manual, aimed at workers who exercise their activities outdoors, as a preventive measure against skin cancer. Methods: Descriptive study, approved by the research ethics committee of Unifesp, with bibliographic survey, search for precedence, selection of the target audience for development and validation with expert judges by the Delphi Technique calculating the Content Validation Index (CVI) and evaluation by target audience. Results: The “Photo-education Manual for Skin Cancer Prevention” was developed with 24 pages, 13 chapters and registered in the ISBN. The manual was validated by specialists in two cycles using the Delphi Technique. In the first cycle, the global CVI was 0.93, in the second, after adjustments suggested by the judges, the global CVI was 0.99. Both cycles for each item were greater than 0.78, reaching the goal for validation by the experts. The agreement between the evaluators of the target audience was 100%. Conclusion: A photoeducation manual was developed and validated, aimed at workers who perform their activities outdoors, as a preventive measure against skin cancer.