Navegando por Palavras-chave "Saúde Da Família"
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- ItemAcesso aberto (Open Access)Da aprendizagem fragmentada ao desafio de uma formação integral: narrativas da construção do saber(Universidade Federal de São Paulo (UNIFESP), 2019-07-02) Araujo, Joao Felix Leandro De Sousa [UNIFESP]; Kinker, Fernando Sfair [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)For years medical training has been carried out in a fragmented way, reducing the complexity of the individual to organs and systems, neglecting socio-cultural aspects, as well as the dynamics and the interaction of the individual in the family and community sphere. Recently, with the last change made in the National Curricular Guidelines of the Undergraduate Course in Medicine (NCG) in 2014, the proposal arises that medical education should have an expanded formative character, with a general, critical, reflexive and ethical formation in purpose to form an egress enabled for action at different levels of health care, able to handle various pathological conditions indistinctly, to perform the coordination of care and management of the clinic. The objective of this study is to analyze the perceptions, expectations and experiences of undergraduate students of the third year of medicine at the Centro Universitário São Camilo, in the context of a discipline with a comprehensive approach to care, trying to understand the phenomenon of knowledge formation, starting with it is a logic of teaching fragmented by focal specialties, until arriving at one whose focus on integral care is the counterpoint of the previous formation. This is a qualitative, descriptive study, guided by the documental analysis of field diaries produced by the students, the researcher's field diary, and discourse analysis in conversation wheels, aiming to discuss the ideas and experiences in the outpatient clinic visits, as well as their role in the student's formation as a future generalist. The conclusion that has been reached is that even many changes that the medical curriculum has undergone over the last decades, we still have a categorized, fragmented formation with few moments to reflect on the practice, even in a non-flexible Fordist model, where more emphasis is placed on the content to be taught than the subjects' autonomy. At the same time, it has advanced in many dimensions of teaching, having demonstrated the research experience that the dialogic and reflexive process of teaching can contribute much with a quality education and that values the ethical aspects of care.
- ItemSomente MetadadadosEstudo Do P16Ink4A Em Carcinoma Espinocelular De Orofaringe E Cavidade Oral Para Pesquisa Do Hpv(Universidade Federal de São Paulo (UNIFESP), 2017-09-28) Greggio, Barbara [UNIFESP]; Abrahão, Marcio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To describe the presence of HPV, in its active form, in squamous cell carcinoma of the oropharynx and oral cavity, by the study of the expression of the p16INK4a protein in immunohistochemical panel, and to relate it to smoking and alcoholism. Method: We selected 46 patients with oral cavity or oropharyngeal carcinoma, that were submitted to surgical treatment between 2014 and 2016. Of the 46 patients studied, 37 were male and 9 were female. Thirty-four patients had oral cavity carcinoma and 12 had oropharynx carcinoma. The 46 paraffin-embedded tumors tissues were analyzed in an immunhistochemistry panel for p16INK4a expression to study the presence of HPV infection in those samples. Results: HPV was present in 6 patients by the immunohistochemistry study of p16INK4a, representing 13.04% among the 46 patients. Among all the male patients, HPV was present in 10.81%. Among the female patients, it was present in 22.22%. Of the 34 patients with tumor in the oral cavity, HPV was present in 4. Of the 12 patients with oropharyngeal tumor, HPV was present in 2. Of all 11 non-smoking and non-alcoholic patients, HPV was present in 3. Among the 10 smoking patients , HPV was found in 1 and among the 25 alcoholic and smoking patients, HPV presented positivity in 2. Conclusion: The presence of HPV in squamous cell carcinoma of the oropharynx and oral cavity by the immunohistochemistry study of p16INK4a was 13.04% . Among the oral cavity tumors, this presence of HPV was 11.76% and in oropharyngeal tumors this presence was 16.66%. In the group of non-smokers and non-alcoholic patients, HPV was present in 27.27%. In smokers and alcohol users, it was present in 8% and in smokers, it was present in 10%.
- ItemAcesso aberto (Open Access)Os núcleos de apoio à saúde da família e as práticas grupais. Um estudo no município de Santos/SP(Universidade Federal de São Paulo (UNIFESP), 2021) Silva, Juliana Camargo Da [UNIFESP]; Capozzolo, Angela Aparecida [UNIFESP]; Universidade Federal de São PauloAmong the various support actions developed by professionals from the Family Health Support Centers (NASF) are group practices, which are important care strategies to enable comprehensive care. This study aimed to investigate how NASF professionals in Santos / SP plan and implement group practices with the Family Health Teams (eSF) they support; and as specific objectives, to know the group actions developed by the NASF teams, to identify which strategies are used by the professionals of the NASF teams for the implementation and monitoring of group actions, and to analyze the facilities and difficulties of the NASF teams in carrying out group practices. The research was of an exploratory nature, with a qualitative approach. Two professionals were selected from each NASF team in the municipality at the time of the research, totaling 10 professionals with different training areas. The production of the data took place through three meetings in the form of a Conversation Circle, in which some triggering strategies were used to start conversations, allowing the free discourse of thoughts and propositions. Meetings were recorded and the transcripts were analyzed according to the Content Analysis / Thematic Analysis technique. The speeches of these professionals generated nuclei of meaning that were synthesized in eight themes, and these grouped into four categories: Work organization, Training, Planning and Group conceptions. Difficulties were identified for the NASF teams to carry out group practices, among which we highlight: the arduous articulation between NASF professionals and ESS professionals supported by the planning and conducting group actions carried out in the units, the little management support, the valuation of individual assistance by managers and professionals of the eSF, the charge for meeting goals, the large number of eSF that each NASF team supports, the geographical distance between the supported health units and the number of actions that NASF professionals need accomplish. There are different perspectives and conceptions of group practices among professionals that translate into a diversity of group actions, with interesting experiences that involve the participation of users, the sharing of knowledge and the appreciation of the formation of bonds between participants. It was verified the importance of guaranteeing spaces for the planning of group actions among NASF and eSF professionals, as well as moments of Permanent Education to enable the exchange and access of information, the discussion and the construction of new possibilities for group practices among the professionals of the NASF teams, as well as the professionals of the supported eSF.
- ItemSomente MetadadadosRevisão Das Atuais Propostas De Tratamento Para O Diabetes Mellitus Tipo 2 Sob A Ótica De Uma Abordagem Interdisciplinar Para A Prática Clínica Na Atenção Primária À Saúde(Universidade Federal de São Paulo (UNIFESP), 2017-07-27) Panico, Caroline Thomaz [UNIFESP]; Pititto, Bianca De Almeida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Diabetes Mellitus (DM) is a chronic disease of high prevalence and with inherent risk of disability and mortality, mainly due to its micro and macrovascular complications, being thus a serious public health problem in Brazil and in the world. Because it is an insidious and asymptomatic onset disease, the diagnosis of type 2 (T2DM) diabetes often occurs when the disease has been in place for months or years. In screening studies, about 50% of individuals with diabetes did not know how to have the disease, and when diagnosed, few patients reach the expected glycemic target. Glycemic control and management of cardiovascular risk factors commonly associated with DM2 is important for the prevention of chronic DM2 complications. The high occurrence of the disease and its complications both in Brazil and in the world led to therapeutic and pharmacological innovations, but even with this progress, reaching glycemic targets remains a challenge in the treatment of DM. In this context, this work aims to review current recommendations on DM2 management through a literary search conducted in three bibliographic databases - PubMed, EMBASE and LILACS containing articles and guidelines of the last 5 years and thus to identify similarities and divergences in the literature and the effect of an interdisciplinary team on DM2 control. The American (ADA) and Brazilian (SBD) recommendations are similar in several aspects as in the case of diagnostic criteria, primary prevention, in the individualization of the therapy orienting the change of the habits of life like consuming a varied diet, performing physical activity, weight control , cease smoking, but there are differences as in the case of glycemic targets and dietary recommendations such as the amount of intake of sugars, potassium, fats and protein. 7 Treatment and care with DM2 is complex and has been approached by several scientific societies in the form of Guidelines or Guidelines. In addition to discussions on pharmacological treatments, these guidelines reinforce the importance of taking into account the individual characteristics of the patients, multiprofessional and interdisciplinary treatment, periodic follow-up, as well as health education as self-care measures and can be given through consultations with the ESF doctor and the primary care team. In Brazil, the vast majority of patients with T2DM are followed up in the Brazilian public health system, with about 80% of primary health care having low glycemic control. Therefore, one of the relevant factors is the training of primary care professionals in DM2 care. A review of the main guidelines regarding the management of T2DM may contribute to the greater appropriation of health professionals in this regard in order to contribute to improve the scenario of the lack of glycemic control and the progression of chronic complications of DM2 still worrying in Brazil.