Navegando por Palavras-chave "Primary prevention"
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- ItemAcesso aberto (Open Access)Ações no controle do câncer de mama : identificação das práticas na atenção primária por meio da usuária na região sudeste da cidade de São Paulo(Universidade Federal de São Paulo (UNIFESP), 2017-02-24) Marques, Carla Andreia Vilanova [UNIFESP]; Gutierrez, Maria Gaby Rivero de [UNIFESP]; Figueiredo, Elisabeth Niglio de [UNIFESP]; http://lattes.cnpq.br/5873289377529519; http://lattes.cnpq.br/4595643076722509; http://lattes.cnpq.br/8106562494475157; Universidade Federal de São Paulo (UNIFESP)Objective: to analyze the early detection of breast cancer implementation and the associated factors, for primary health care (PHC) service users from southeast of São Paulo city, according to the Ministry of Health (MoH) guideline. Method: cross-sectional study approved by the Ethics and Research Committees (nº 13926013.3.1001.5505) and conducted from October to December of 2013. The cluster sample survey in two stages was performed, considering 50% of outcome frequency in the target group, 95% of the confidence level and deff of 2.9. In the first stage, 38 of the 90 PHC service has been selected in a simple random sample. In the second stage, the proportion of the target age (35-39, 40-49, 50-69) in the population from the selected PHC services, has been considered in the distribution of the 1.117 women surveyed. The user’s randomized systematic sample has been performed, taking in account the assistance routine in some selected PHC services. The research inclusion criteria for PHC services was been ≥ 3 years in the operation time, for the women, they should be between 35 to 69 years old and been attending in those selected PHC services for ≥ 3 years. The data were collected by trained interviewers, using a validated questionnaire with 83 questions regarding to socioeconomic characteristics, breast cancer risk factors and the actions for the early detection of breast cancer. There were missing data of 167 women resulting 950 in a final sample. The outcome variables analyzed were clinical breast examination (CBE) and mammography. The independent variables were sociodemographic data, risk factor and PHC services (Family Health Strategy, Traditional and Mixed). A descriptive analysis of all the variables has been performed and afterwards, the Pearson's Chi-square test and binary logistic regression were applied, assuming p≤0.05. For the analysis of compliance, the results obtained were compared to those recommended by the MoH. Results: the majority of 950 surveyed women was married, white, with 9 to 11 years of schooling, belonged to the C economic class and did not have health insurance. The preventive practice characteristic revealed a higher prevalence of achievement for women between 50-69 years old, married, white, who were not economically active, belonged to the C economic class, with a standard risk of breast cancer. The CBE frequency was 42.9% and the mammography was 58.5%, while compliance was 39.8% and 28.6%, respectively. Regarding the PHC service to the mammography, there was a higher frequency of this exam in the Traditional PHC service and lower in the FHS. There was a greater biennial coverage of this mammography in the target women with 50 to 69 years old in the Traditional PHC and lower in the Mixed PHC, the compliance of the governmental recommendation was higher in the FHS than in the Mixed and Traditional PHC. The associated factors with mammography were: age, family history of breast cancer assessment, to perform CBE and Pap Smear, to receive age guidance to start the mammography. The associated factors with the CBE were to receive age guidance to start this examination, to have mammography, to receive age guidance to start mammography and to perform a Pap Smear. Conclusion: the mammographic performance was more frequent than the CBE, however, the exams periodicity, target age group and the hereditary breast cancer risk factors has been little considered during the users assessment on PHC services, consequently the outcome show a low coverage and compliance of the government goals. The Traditional PHC offered more mammography, but, higher compliance of the recommendation has been achieved in the FHS. The adherence predictors to preventive practices were to receive age guidance of breast cancer exams and been performed gynecological exams.
- ItemAcesso aberto (Open Access)Desenvolvimento e avaliação de cartilha educativa para idosos consumidores de álcool(Universidade Federal de São Paulo (UNIFESP), 2020-07-30) Chagas Raimundo, Camila [UNIFESP]; Ferri, Cleusa Pinheiro [UNIFESP]; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4767701Y7; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4347432J6; Universidade Federal de São Paulo (UNIFESP)Objetivo: Desenvolver e avaliar uma cartilha educativa, com ênfase em práticas de autocuidado e redução de danos, como estratégia de intervenção para reduzir o consumo de risco de álcool entre idosos. Métodos: Foram utilizados métodos mistos organizados em sete etapas: 1) Levantamento de cartilhas brasileiras sobre álcool e cartilhas destinadas à população idosa; 2) aplicação do método Delphi com profissionais especializados na área de álcool/outras drogas e envelhecimento; 3) condução do primeiro grupo focal com idosos; 4) elaboração da versão preliminar da cartilha; 5) condução do segundo grupo focal com idosos participantes do primeiro grupo focal; 6) condução do terceiro grupo focal; e 7) finalização da cartilha. Resultados e discussão: Na etapa 1 foram encontradas 50 cartilhas direcionadas ao idoso brasileiro e 18 cartilhas sobre o consumo de álcool. Nenhuma delas contemplou o consumo de álcool para a população idosa. Na etapa 2, participaram do método Delphi 33 profissionais de diversas áreas: psicologia, medicina, terapia ocupacional, assistência social, enfermagem, gerontologia, fisioterapia e farmácia. Foram realizadas três rodadas de questionários com tais profissionais, resultando em 46 afirmativas consensuais sobre conteúdos a serem priorizados na cartilha. Na etapa 3, o primeiro grupo focal foi realizado com nove idosos e permitiu identificar a emergência de conteúdos a serem priorizados nos materiais de prevenção e principalmente as crenças que os idosos tem em relação ao consumo de álcool. Após a etapa 4, que foi a construção da versão preliminar da cartilha a partir do resultado das etapas anteriores, o material foi impresso e submetido para mais dois grupos focais, com seis e doze idosos, respectivamente ( etapas 5 e 6). Na etapa 7, as sugestões e dificuldades na compreensão do material apontadas pelos idosos foram consideradas e a cartilha finalizada. Considerações finais: O presente estudo apresenta importantes contribuições no que se refere às abordagens narrativas e construtivas de materiais preventivos sobre álcool para os idosos brasileiros. Foi possível verificar que, mesmo com a revisão da literatura e a opinião de profissionais especializados (através do método Delphi), as formas de apresentação de alguns conteúdos não foram compreendidas por muitos idosos (participantes dos grupos focais), sendo necessárias adaptações para a versão final da cartilha. Por isso, o que parece ser um conteúdo “legível” para quem o desenvolve pode não sê-lo para as pessoas nas quais o material se destina. De modo adicional, muitas das discussões levantadas no presente estudo podem estender-se aos demais grupos etários.
- ItemAcesso aberto (Open Access)Family history of cardiovascular disease and non-HDL cholesterol in prepubescent non-obese children(Assoc Medica Brasileira, 2016) Strufaldi, Maria Wany Louzada [UNIFESP]; Souza, Fabíola Isabel Suano de [UNIFESP]; Puccini, Rosana Fiorini [UNIFESP]; Franco, Maria do Carmo Pinho [UNIFESP]Objective: To describe the values of non-HDL cholesterol (NHDL-c) and the frequency of a family history of early cardiovascular disease (family HCVD) in healthy prepubescent children. Analyze the association between NHDL-c and family HCVD, and possible associations with other risk factors for cardiovascular disease (CVD). METHOD: Cross-sectional study including 269 prepubescent (aged 6-10 years) schoolchildren with a normal body mass index (+1SD-2SD). Data collected: Family HCVD; weight and height, waist circumference and systemic blood pressure; lipid profile (total cholesterol TC, HDL-c, triglycerides and LDL-c), NHDL-c calculation (CT-HDL-c, cut-off = 145 mg/dL) and insulin resistance (HOMA-IR). RESULTS: High levels were found for NHDL-c in 10 (3.7%) of these schoolchildren, and family early HCVD was found in 46 (17.1%) of them. There was a weak association between family HCVD and NHDL-c (Cramer’s-V-test = 0.120; p=0.050). Among the children with NHDL-c≥145 mg/dL, 4 (40%) have family HCVD. The presence of family HCVD was not associated with the variables being studied. The variables independently associated with NHDL-c ≥ 145 mg/dL were: HOMA-IR (OR=1.7; 95CI 1.1-2.6) and diastolic blood pressure (OR=1.1; 95CI 1.02-1.2). CONCLUSION: NHDL-c values were associated with blood pressure and insulin resistance. Family HCVD was not associated with other classic risk factors for CVD, even though the frequency found was five times higher than that of high NHDL-c.
- ItemAcesso aberto (Open Access)Incidência de lesões musculoesqueléticas e uma proposta de protocolo de treinamento para prevenção de lesões de soldados do exército brasileiro(Universidade Federal de São Paulo (UNIFESP), 2014-10-17) Andrade, Michele Zukauskas de [UNIFESP]; Pinfildi, Carlos Eduardo [UNIFESP]; http://lattes.cnpq.br/6370481853776867; Universidade Federal de São Paulo (UNIFESP)Introduction: Because of the high rate of lower limb injuries to army soldiers in respect to their training and physical activities conducted on a regular basis, the present study analyzes the incidence of musculoskeletal injuries to Brazilian soldiers. One of the factors being evaluated is the mechanism of injury. Objective: The purpose of this study is to evaluate the incidence of lower limb musculoskeletal injuries to soldiers to develop a training protocol to prevent the most incident injuries. Method: A sample of 202 new Battalion soldiers was taken, and 103 of these soldiers pursued medical attention. Their records were analyzed according to the diagnostic, location, mechanism of injury, type of treatment, absence from work, and presence of previous injury and recurrence. Result: 112 lesions were diagnosed in 71 soldiers. Joint pain accounted for 55.4% of the diagnoses. The knee was the most affected site while trauma and overload were the most common mechanisms of injury. Drug treatment was used most frequently, accounting for a total of 58% of the cases. The ma jority of the sample obtained a temporary leave of absence from work for a period of 1 to 6 days or not at all. The previous injuries and recurrence were not presented as risk factors for injury. With the data received, we propose a protocol for prevention of injuries to the lower limbs, with reference to the most common mechanisms of injury, relying on exercises used in the literature. Conclusion: This study shows the knee as the most frequent site of injury and joint pain as the most common diagnosis. These results support the creation of a training protocol for the prevention of injury in lower limb, which is suggested to be practiced in future studies.
- ItemSomente MetadadadosKnowledge and practice of physicians and nutritionists regarding the prevention of food allergy(Churchill Livingstone, 2013-08-01) Ribeiro, Camila Cury [UNIFESP]; Speridião, Patrícia da Graça Leite [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background & aims: To evaluate the knowledge and practice of pediatricians, pediatric gastroenterologists, allergists and nutritionists regarding the primary prevention of food allergy.Methods: A descriptive, cross-sectional study that enrolled pediatricians (n = 80), pediatric gastroenterologists (n = 120), allergists (n = 100) and nutritionists (n = 220). A self-administered questionnaire concerning the current recommendations was used.Results: Despite the lack of current recommendations, 17.1% (n = 89) of all professionals, mainly nutritionists, recommended a maternal exclusion diet during pregnancy. More professionals in the sample group, 40.8% (n = 212), recommended a maternal exclusion diet during breastfeeding, and the rates of recommendation were higher in nutritionists and pediatricians compared to allergists and pediatric gastroenterologists (p < 0.001). Regarding the recommended timing of the introduction of complementary feeding, 41.9% (n = 218) of the professionals recommended modifying the age of introduction to prevent the development of food allergy. the majority of the professionals believed that prebiotics (61.2%; n = 318) and probiotics (44.4%; 231) prevent the development of food allergy. the recommended age of introduction for the main allergenic foods was 12 months.Conclusions: This study revealed that there are gaps in the knowledge of professionals about the primary prevention of food allergy. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
- ItemAcesso aberto (Open Access)Processos de ensino-aprendizagem para prevenção do HIV/AIDS: possibilidade para a mudança comportamental de mulheres(Universidade Federal de São Paulo (UNIFESP), 2014-09-26) Santos, Luiz Eduardo dos [UNIFESP]; Sá, Cristina dos Santos Cardoso de [UNIFESP]; Oliveira, Nara Rejane Cruz de [UNIFESP]; http://lattes.cnpq.br/5610581984121401; http://lattes.cnpq.br/9259523998158401; http://lattes.cnpq.br/3753543204483836; Universidade Federal de São Paulo (UNIFESP)The feminization of the epidemic is one of the current challenges preventing AIDS. The current prevention policies are not reducing the growth of the epidemic in this segment. This study investigated the process of teaching and learning about AIDS prevention and the apprehension of this knowledge for the possible change in attitudes of adult women assisted by Joan of Arc Institute. Research explanatory character, uses a qualitative approach, developed in four groups of family and community empowerment led by Joan of Arc Institute in the city of Bertioga, São Paulo, through a strategy called ?round of conversation? from March/2013 until February/2014. The study involved the following steps: observation in loco of 14 ?round of conversation? Wheels of Conversation developed in Bertioga Reference Centres for Social Assistance, São Paulo; interview with a professional body responsible for the implementation of the contents in the community; the application of a questionnaire for the inclusion or non-inclusion with women groups of respondents; conduct two semi-structured interviews with selected women. The goal was to understand the social and gender relations, their perception of HIV risk and the possibility of being vulnerable to AIDS. 65 questionnaires were administered to women aged between 18 and 60 years and, after the inclusion criterion for the search resulted in 22 women for the first interview, seven in group 1; four in group 2; eight in group 3 and three in group 4 In the second study, nine women were interviewed four of the group 1; one of the group 2; two of the group 3; two of the group 4. The interviews took place in two specific times in July and August/2013 and in January and February/2014, in order to analyze the results obtained in both cases, the existence of similarities or differences in absorption of information, the acquisition of new knowledge and if there is effectiveness in the teaching-learning model applied by the entity as a way to assist in developing preventive strategies that facilitate the apprehension of knowledge about AIDS, by reducing the risk of HIV infection and other STDs. For the content analysis, we use the proposed Bardin. For the groups studied, there are a difficulty in the perception of risk to HIV in their sexual-affective relationships by not recognizing its possibility of infection. The results show that women recognize the modes of transmission, prevention and protection, the main sexually transmitted diseases and that there is an evolution of knowledge between periods of interviews. However, there is no apprehension of knowledge and its practical application in their daily lives. The factors that hinder the assimilation of content are affective and desire relationships - trust, social roles and gender relations; taboos concerning sexuality; low knowledge of health education, resulting in how individuals interpret and absorb these differences. The efforts of the organization to reduce this problem are on track, with the application of ?round of conversation? as a teaching-learning strategy in health, but there is a definite methodological project to organize the actions to be applied next to this population segment. The results demonstrate the necessity of creating an Institutional Political Pedagogical Project setting, the methodological process of health education, information related to AIDS and that include all the cultural, educational and social diversity of women, drawing a parallel between sexual health and reproductive, the AIDS epidemic and gender relations. For its implementation, should consider, in addition to prior knowledge of each individual, partners or extended to the male population of their social context, different ways of learning through the exchange of experiences, stories of life and enabling informed choices preventive means according to their way of life.
- ItemAcesso aberto (Open Access)“Projeto Pele Alerta” : projeto educativo em prevenção e detecção precoce do câncer de pele direcionado a profissionais do mercado de beleza e cuidados pessoais(Universidade Federal de São Paulo (UNIFESP), 2017-06-30) Machado, Caroline Kroeff [UNIFESP]; Haddad, Alessandra [UNIFESP]; Santos, Ivan Dunshee de Abranches Oliveira [UNIFESP]; http://lattes.cnpq.br/7940183627771947; http://lattes.cnpq.br/0881683207035609; http://lattes.cnpq.br/5420573586154856; Universidade Federal de São Paulo (UNIFESP)Introduction: Skin cancer is the most frequent in many countries, including Brazil and its incidence is still growing. Early detection is the best way of reducing morbidity and mortality. Body parts like head, neck and back are of hard visualization by the person themselves. Beauty professionals spend a long time in contact with their clients` skin and annexes, having visual access to places the clients themselves have a hard time viewing. There is a potential field in which beauty professionals are informed and help early detection skin cancer suspicious lesions, sending forward to medical evaluation and possible early treatment. Objective: To develop an online educational project, directed to professionals in the beauty and personal care market, about prevention and early detection of skin cancer. Methods: Creation of the “Pele Alerta” Project (PPA), with educational videos, visual support material and website. Results: This master degree’s product is the PPA. It can be accessed through www.projetopelealerta.com. There are 4 topics at the moment, each one with a corresponding video (YouTube) and support material in PDF. The topics are: “Os raios ultravioleta e a pele”; “O câncer de pele: nosso temido inimigo”; “Proteção solar: aproveitando o Sol da maneira correta”; “Onde suspeitar de alguma lesão? “. Conclusion: an educational project regarding skin cancer has been created, and it is accessible online anywhere in Brazil.
- ItemAcesso aberto (Open Access)Survey of calcium supplementation to prevent preeclampsia: the gap between evidence and practice in Brazil(Biomed Central Ltd, 2013-11-11) Camargo, Erika Barbosa [UNIFESP]; Moraes, Luci Fabiane Scheffer; Souza, Celsa Moura; Akutsu, Rita; Barreto, Jorge Maia; Silva, Edina Mariko Koga da [UNIFESP]; Betran, Ana Pilar; Torloni, Maria Regina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); South Santa Catarina Univ UNISUL; Amazonas Fed Univ UFAM; Brasilia Fed Univ UnB; Univ Fed Piaui; WHOBackground: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality worldwide and especially in Latin America. High quality evidence indicates that calcium supplementation during pregnancy significantly reduces the incidence of preeclampsia and its consequences, including severe maternal morbidity and death. Few studies have assessed the implementation of this intervention in clinical practice. the study aimed to assess the proportion of pregnant women who received calcium supplements in Brazilian public antenatal care clinics.Methods: This cross-sectional study interviewed women waiting for antenatal care visits in 9 public clinics in 4 Brazilian cities in 2010-2012. Trained interviewers used a standardized anonymous questionnaire to collect socio demographic and obstetric data, information on ingestion of dairy products and on prescriptions received during current pregnancy.Results: A total of 788 valid questionnaires were analyzed. Participants were young (mean age 25.9), mostly multiparous (71.3%) and in the 2nd or 3rd trimesters of pregnancy at the time of interview (87.6%). Only 5.1% (40/788) had received a prescription for calcium supplements. Based on their reported ingestion of dairy products, the mean daily dietary calcium intake of the participants was 210 (+ 265) mg/day and over 90% consumed less than 1 g of calcium/day.Conclusions: Despite good quality evidence indicating the benefits of this practice especially for women with low calcium diets, less than 6% of a sample of women receiving antenatal care in Brazilian public clinics received a prescription for calcium supplements. There is an urgent need to upscale the implementation of this life-saving intervention.