Saúde Coletiva
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Programa de Pós-Graduação em Saúde Coletiva
Centro: CCS
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URL do programa: http://www.saudecoletiva.ufes.br/pt-br/pos-graduacao/PPGSC
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- ItemAnálise de riscos competitivos da sobrevida-específica de pacientes diagnosticados com câncer de próstata no Espírito Santo : estudo de coorte retrospectivo(Universidade Federal do Espírito Santo, 2024-03-27) Grippa, Wesley Rocha; Salaroli, Luciane Bresciani; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador2; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador3; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador4; ID do co-orientador4; Lattes do co-orientador4; Lopes-Júnior, Luís Carlos ; https://orcid.org/; http://lattes.cnpq.br/; Orientador2; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; Dell'Antonio, Larissa Soares ; https://orcid.org/; http://lattes.cnpq.br/; Araújo, Jeferson Santos ; https://orcid.org/; http://lattes.cnpq.br/; Leite, Franciéle Marabotti Costa ; https://orcid.org/; http://lattes.cnpq.br/; Sarti, Thiago Dias ; http://lattes.cnpq.br/; 5º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 6º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 7º membro da banca; https://orcid.org/; http://lattes.cnpq.br/Background: Prostate cancer is one of the most common cancers in the world, being one of the main causes of premature death in men. Advances in survival analysis techniques have played an important role in recent years, especially after the development and improvement of statistical methods, with direct applications in Public Health and Oncology. Objective: To analyze the specific survival probability of patients with prostate cancer and the factors associated with the risk of death from cancer or other causes in patients diagnosed with prostate cancer who started treatment at the Oncological Care Network (OCN) in the state of Espírito Santo (ES), Brazil. Methods: This is a retrospective observational cohort study. Retrospective observational cohort study. Secondary data were collected via the Tumor Registration Form (TRF) from the Hospital-based Cancer Records (HCR) of patients who received care in a hospital in the OCN of ES, and from the Mortality Information System (SIM/ES), in the period between 2000 and 2020. All occurrences of prostate cancer proven by anatomopathological examinations (ICD-10) were included and analyzed. For data analysis, a descriptive analysis of the epidemiological profile of patients diagnosed with prostate cancer was carried out, in addition to an analysis of completeness of the epidemiological variables from HCR of the ES, which data incompleteness was classified as excellent (< 5%), good (between 5% and 10%), regular (between 10% and 20%), bad (between 20% and 50%) and very bad (> 50%), according to the percentage of missing information. For survival analysis, the deterministic linkage method was done, using the TRF records from the Integrator of the Brazilian Cancer Hospital Registry (SIS-RHC) with the records from the Mortality Information System (SIM/ES). To estimate overall specific survival, the Kaplan-Meier method and multivariate analyzes were used, based on the Cox proportional hazards model and the Fine and Gray competing risks model, in order to investigate the probability of specific death from prostate cancer. In the analysis of the adjusted models, a 5% significance level was adopted to evaluate the significant effect of each of the variables studied. All statistical analyzes were performed using the free software R and RStudio. Approved was obtained by the CCS-UFES Research Ethics Committee (Opinion Number: 5,533,541). Results: The initial dataset included 13,519 cases of prostate cancer in the HCR, recorded with diagnoses between 2000 and 2020. Conclusions: Most variables in the HCR exhibited excellent completeness, but important variables had high percentages of incompleteness, such as TNM and clinical staging, as well as alcoholism and smoking. There was a growing trend in prostate cancer incidence over the years in the ES, with a predilection for older, married men with low educational levels. Furthermore, survival analysis revealed an overall specific survival of 87.7%, and age, educational level, distant metastasis, surgery, radiotherapy, and hormone therapy were associated with the risk of specific mortality among prostate cancer patients. Taken together, these data can assist in decision-making by managers and stakeholders, to support screening and treatment programs, in addition to guiding the improvement of public policies in the area of Oncology, with a view to planning effective actions for cancer surveillance in the various assistance levels of the Health Care Network, in order to improve men’s health care.
- ItemAnálise do programa saúde na escola como estratégia de promoção da saúde(Universidade Federal do Espírito Santo, 2023-12-12) Wagmacker, André dos Santos; Carvalho, Raquel Baroni de ; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador2; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador3; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador4; ID do co-orientador4; Lattes do co-orientador4; Esposti, Carolina Dutra Degli ; https://orcid.org/; http://lattes.cnpq.br/; Orientador2; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; Pacheco, Karina Tonini dos Santos ; https://orcid.org/; http://lattes.cnpq.br/; Paiva, Saul Martins ; https://orcid.org/; http://lattes.cnpq.br/; 3º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 4º membro da banca; http://lattes.cnpq.br/; 5º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 6º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 7º membro da banca; https://orcid.org/; http://lattes.cnpq.br/Introduction: The School Health Program (Programa Saúde na Escola - PSE) was established in 2007 through a partnership between the Ministries of Health and Education of Brazil, aiming to promote the comprehensive health of public school students. Although the PSE has proven to be an important health strategy, its implementation has not yet reached its full potential, with one of the most notable weaknesses being intersectorality.Objectives: This dissertation aimed to analyze the PSE as a health promotion strategy and had the following specific objectives: to describe the implementation and results of the PSE in Brazil through a scoping literature review; to analyze the correlation between social inequalities, organization of health services, epidemiological indicators, and PSE outcomes in the municipalities of the state of Espírito Santo (ES) between 2019 and 2022; and to develop a manual to support the execution and monitoring of PSE results by Brazilian municipalities.Methods: This is a qualitative-quantitative study divided into three stages. In the first stage, a scoping review of the literature on the implementation and results of the PSE in Brazil between 2007 and 2022 was conducted. In the second stage, an ecological study was performed using public secondary data. The dependent variable considered the set of goals agreed upon in the adherence to the PSE in each cycle and was constructed with data from SISAB. The result was correlated with social variables, organization of health services, and epidemiological indicators. In the third stage, an e-book containing information on the execution and monitoring of PSE results for Brazilian municipalities was developed. Results: The scoping review revealed weaknesses in the implementation of the PSE across the country, namely: in the structure, there is insufficient training on the program's objectives, a shortage of professionals, and work overload; in the process, there is an absence of situational diagnosis and intersectoral planning, fragmented activities, and the health sector's leading role; and in the results, there were improvements in access to health services, increased adherence to the program, and perceived improvements in students' habits and learning. The ecological study showed that municipalities in ES had difficulties meeting the program's goals, especially in 2020, the peak of the COVID-19 pandemic. The Metropolitan Health Region achieved better results in the four years evaluated; a correlation was observed between social variables (HDI, CadÚnico, IDEB, and illiteracy rate), health system variables (Basic Care Coverage and Previne Brasil ISF), and epidemiological variables (Poliomyelitis Vaccination Coverage) with better PSE outcomes. The health sector was noted as the main participant in activities compared to the education sector. In the third stage, an e-book was developed containing information about the PSE, proposed methodologies to be employed in activities, and tools for monitoring its results. Conclusions: Both the literature review and the ecological study showed that municipalities face difficulties in developing the activities agreed upon in the cycles. These findings highlight the need for improvements in the program's implementation, addressing its structural and procedural weaknesses to enhance its desired outcomes and impacts. It is hoped that the developed manual will contribute to this process
- ItemAnálise ecológica dos dados de óbito por tuberculose no Espírito Santo(Universidade Federal do Espírito Santo, 2024-08-16) Oliveira, Yasmin Gurtler Pinheiro de; Catão, Rafael de Castro ; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador2; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador3; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador4; ID do co-orientador4; Lattes do co-orientador4; Prado, Thiago Nascimento do ; https://orcid.org/; http://lattes.cnpq.br/; Orientador2; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; Cola, João Paulo ; https://orcid.org/; http://lattes.cnpq.br/; Vieira, Anne Caroline Barbosa Cerqueira ; https://orcid.org/; http://lattes.cnpq.br/; 3º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 4º membro da banca; http://lattes.cnpq.br/; 5º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 6º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 7º membro da banca; https://orcid.org/; http://lattes.cnpq.br/Introduction: Tuberculosis is still a challenge for the world and is the second leading cause of death from infectious diseases. Not unlike the world scenario, Brazil has also been seeking strategies to tackle tuberculosis in order to reduce the number of new cases and deaths from the disease. To this end, ecological studies have been developed in Brazil as a tool for analyzing the points of highest incidence and prevalence of a disease in the territory, as well as a tool used to evaluate the temporal trend of the disease, showing the places that present the greatest risks for the development and worsening of a disease. Objectives: To identify in the scientific literature the methods used for ecological analysis of deaths from tuberculosis in Brazil between 2018 and 2024. To analyze the quality of data on tuberculosis care services in the municipalities of the state of Espírito Santo using information from the forms, especially the completeness of data from the notification forms in the Compulsory Notifiable Diseases Information System with the outcome of deaths from the disease, between 2015 and 2019. Methods: The PICOS search strategy and the PRISMA research protocol were used to carry out a literature review of ecological studies that addressed the topic of tuberculosis deaths and the methods adopted by the scholars. The period analyzed was from 2018 to 2024 and used the Scielo, PubMed and LILACS databases. As for the spatial analysis, this is an ecological, descriptive and exploratory study, which involved secondary data from the compulsory tuberculosis notification forms of the Compulsory Notifiable Diseases Information System made available by the Espírito Santo State Health Department. In order to assess the completeness of the information, the 2003 Centers for Disease Control and Prevention classification was used, classifying completeness as “poor”, “fair” and “excellent”. Maps were created showing the distribution of completeness in the territory of Espírito Santo in order to see which places filled in the notification forms better or worse. Results: Sixteen articles were eligible, addressing the theme of tuberculosis death in the Brazilian territory, published between 2018 and 2024. The authors used secondary data from DATASUS, mostly Mortality Information System data. Among Brazil's macro-regions, the Northeast was the territory with the most publications. The Global and Local Moran's Index was the most used method in the 13 sample, as was the spatial scanning method. Finally, all the studies presented the relationship between the territory and social determinants as an outcome. As for the completeness analysis, the total number of tuberculosis notifications closed as “TB deaths” was 347 cases, of which 271 met the eligibility criteria (not presenting the “post-mortem” entry type). The majority of cases were male, aged between 50 and 60, of brown race/color, with incomplete schooling. The state of Espírito Santo had a fair rating for the completeness of the information on the variables analyzed and the Metropolitan Region of Vitória had a poor and fair rating for the completeness of the data on the tuberculosis notification form. Conclusions: In relation to the findings of the integrative literature review, it was observed that the tools of ecological spatial analysis are reflected in maps that show the scenario of the territory and how it is possible to evaluate the temporal trend of the region of analysis. Therefore, this type of scientific method has been developed in regions where death from tuberculosis is still an alarming factor for public health, contributing to the interpretation and analysis of space in relation to the disease. With the ecological analysis of the completeness of the data from the tuberculosis notification forms that had the outcome “death from tuberculosis”, it was observed that the completeness of the data directly affects the demonstration of death in the municipalities of Espírito Santo, hindering epidemiological analysis of the population. In addition, it was observed that the flow of notifications in the territory is centralized in the state capital, with the municipality of Vitória having more notifications than residents who died from the disease. In view of this, the findings of this study emphasize the need to analyze the collective in order to help devise health strategies for dealing with tuberculosis. To this end, it is suggested that future studies explore ecological methods for analyzing the behavior of tuberculosis deaths in space and that measures and flows be planned and audited
- ItemDar o rumo nem sempre a prumo : atuação das secretárias e secretários municipais de saúde nas rotas do Brasil(Universidade Federal do Espírito Santo, 2024-06-07) Riquieri, Manuella Ribeiro Lira; Co-orientador1; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador2; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador3; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador4; ID do co-orientador4; Lattes do co-orientador4; Sarti, Thiago Dias ; https://orcid.org/; http://lattes.cnpq.br/; Orientador2; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; Carvalho, André Luís Bonifácio de ; https://orcid.org/0000-0003-0328-6588; http://lattes.cnpq.br/; Ouverney, Assis Luiz Mafort ; https://orcid.org/0000-0002-8581-3777; http://lattes.cnpq.br/; Andrade, Maria Angélica Carvalho ; https://orcid.org/; http://lattes.cnpq.br/; Almeida, Ana Paula Santana Coelho; http://lattes.cnpq.br/; 5º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 6º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 7º membro da banca; https://orcid.org/; http://lattes.cnpq.br/Não disponível
- ItemMudanças no estilo de vida em adultos e idosos brasileiros durante a pandemia de Covid-19 (SARS-CoV-2)(Universidade Federal do Espírito Santo, 2024-07-10) Urquía, Yazareni José Mercadante; Pereira, Taísa Sabrina Silva ; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador2; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador3; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador4; ID do co-orientador4; Lattes do co-orientador4; Molina, Maria del Carmen Bisi ; https://orcid.org/; http://lattes.cnpq.br/; Orientador2; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; Martins, Marcia Cristina Teixeira; https://orcid.org/; http://lattes.cnpq.br/; Pereira, Marlus Henrique Queiroz; https://orcid.org/; http://lattes.cnpq.br/; Mill, José Geraldo; https://orcid.org/; http://lattes.cnpq.br/; Lopes Júnior, Luís Carlos; http://lattes.cnpq.br/; 5º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 6º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 7º membro da banca; https://orcid.org/; http://lattes.cnpq.br/The COVID-19 pandemic brought numerous challenges to health systems and governments worldwide. Containment measures were adopted to reduce infection rates, affecting various daily activities such as eating habits, beverage consumption, physical activity, screen time, and mental health. These factors may have long-term effects on vulnerable groups, such as individuals with chronic diseases. This study aims to evaluate the relationship between social distancing and lifestyle factors in adults from southeastern Brazil during the first wave of the COVID-19 pandemic; analyze the association between loneliness and alcohol consumption during the pandemic among ELSA-Brasil participants; and assess the relationship between physical activity, screen time behavior, and non-alcoholic beverage consumption among ELSA-Brasil participants. Specific methodologies and two databases (the Ibero-American Study on lifestyle and eating habits during the pandemic and the Longitudinal Study of Adult Health - ELSA-Brasil [COVID wave]) were used. The results of this thesis are presented in three manuscripts. The first manuscript shows a decrease in breakfast consumption (12.5%) and an increase in snack consumption (24.5% in the morning and 12.5% in the afternoon) and eating between meals (20.4%). Individuals in social distancing increased their consumption of vegetables and legumes, while those not in distancing increased their consumption of fish and fast food. Most participants reported weight gain during the pandemic, and those in confinement reported more hours of sleep and higher anxiety related to COVID-19 statistics. The second manuscript highlights a high perception of loneliness and adherence to social distancing among ELSA-Brasil participants, especially women. Moderate and excessive alcohol consumption patterns predominated among men. In both sexes, total alcohol and beer consumption, both moderate and excessive, were higher among those experiencing loneliness. Among women, loneliness increased the likelihood of excessive total alcohol consumption (OR: 1.68; 95% CI 1.09-2.59) and moderate (OR: 1.35; 95% CI 1.07-1.69) and excessive beer consumption (OR: 1.72; 95% CI 1.04-2.82). Among men, loneliness had a similar effect on excessive total alcohol consumption (OR: 1.49; 95% CI 1.05-2.11) and excessive beer consumption (OR: 1.52; 95% CI 1.03-2.25). The third manuscript shows the influence of sociodemographic and lifestyle variables on the consumption of sugary beverages. Excessive screen time and physical inactivity increased the chances of consuming artificially sweetened beverages among men (OR: 2.44; 95% CI 1.54-3.84) and women (OR: 1.72; 95% CI 1.02- 2.91). This behavior was also associated with higher consumption of industrialized juices among men (OR: 2.02; 95% CI 1.15-3.53) and soft drinks among women (OR: 2.28; 95% CI 1.10-4.72). Men with adequate screen time but physically inactive had similar results (OR: 1.93; 95% CI 1.22-3.06) in the consumption of artificially sweetened beverages. In conclusion, the pandemic affected eating habits, alcohol consumption, and physical activity among Brazilian adults, highlighting the need for policies to promote healthy lifestyles, especially among vulnerable groups
- ItemPráticas integrativas e complementares em saúde : inserção no ensino, pesquisa e extensão no Centro de Ciências da Saúde de uma universidade pública(Universidade Federal do Espírito Santo, 2024-04-26) Amite, Cristiara Ferreira Lima; Co-orientador1; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador2; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador3; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador4; ID do co-orientador4; Lattes do co-orientador4; Orientador1; https://orcid.org/; http://lattes.cnpq.br/; Orientador2; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; 1º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 2º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 3º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 4º membro da banca; http://lattes.cnpq.br/; 5º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 6º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 7º membro da banca; https://orcid.org/; http://lattes.cnpq.br/Introduction: The main public policy related to the topic, National Policy on Integrative and Complementary Practices in Health, reinforces the need for training human resources and continuing education for professionals. One of the main actions defined in the guidelines is the introduction of disciplines in professional health training, that is, at undergraduate and postgraduate levels. Objective: this work is to carry out a situational diagnosis of teaching, research and extension of PICS in the Health Sciences Center of a public university. This is a cross-sectional, documentary, descriptive study with a quantitative approach on the offering of subjects and content in PICS at the teaching, research and extension level from January 2020 to December 2023, with data collection carried out from June to December 2023. The study was developed within the scope of the Research in Integrative and Complementary Practices in Health (iPICS) research group. Results: In teaching, homeopathy and phytotherapy were optional subjects in undergraduate medicine, pharmacy and nutrition courses; in nursing, there was a mandatory subject that addresses the subject of PICS; in the multi-professional residency postgraduate course there is a PICS discipline on the transversal axis, which is mandatory; In the master's and doctorate programs in public health, master's degree in nursing and pharmaceutical sciences, there is also a record of related subjects and content. In research, there are two research groups, and the record of 174 scientific publications; in extension, 19 activities. Topics generally stand out in PICS, and specifically related to medicinal plants/phytotherapy in teaching (60%) and research (20.1%); and meditation (26.3%) in extension. Conclusions: the situational diagnosis highlighted the presence of PICS in undergraduate and postgraduate education, the existence of research groups and developed research and extension activities in the university's CCS
- ItemSaúde, rizoma e feminismos : cartografia de coletivos de mulheres na universidade federal(Universidade Federal do Espírito Santo, 2024-04-28) Barbosa, Jeanine Pacheco Moreira; Co-orientador1; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador2; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador3; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador4; ID do co-orientador4; Lattes do co-orientador4; Andrade, Maria Angélica Carvalho ; https://orcid.org/; http://lattes.cnpq.br/; Orientador2; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; Cambraia, Rosana Passos ; https://orcid.org/; http://lattes.cnpq.br/; Dias, Luciana de Oliveira ; https://orcid.org/; http://lattes.cnpq.br/; Souza, Susane Petinelli ; https://orcid.org/; http://lattes.cnpq.br/; Siqueira, Luziane de Assis Ruela ; http://lattes.cnpq.br/; 5º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 6º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 7º membro da banca; https://orcid.org/; http://lattes.cnpq.br/Despite the significant presence of women in universities, it is still possible to identify traces of oppression and inequality, a legacy of modern colonialism. Understanding this phenomenon as a public health problem indicates the relevance of this research, which followed the movements of women's collectives in Brazilian federal universities, problematizing the power of these collectives based on the narratives of these women. The research used a two-stage qualitative approach, identifying the collectives present in the universities and characterizing them; and interviewing twelve women who are/were part of them. The instruments used were narrative interviews conducted via Google Meet and the construction of a field diary, which, once transcribed, gave rise to the unique stories that make up the corpus of the research. Based on the cartographic ethos, the analysis was based on the philosophy of difference and gender studies, emphasizing the approaches of intersectionality and decoloniality. The results showed the need to develop a conceptual tool, Rhizomatic Feminism, to accompany the overflowing of boundaries between feminist movements expressed by women's collectives, giving visibility to new free subjectivities, in other words, to becoming-woman. They also highlighted the leading role of women's collectives at the university in the face of the many challenges they face, emphasizing the importance of a rhizomatic approach to women's health. The work bets on the power of these collectives to produce ruptures with the racist, hetropatriarchal and capitalist heritage that perpetuates structures of exploitation of women at university. From an ethical-aesthetic-political paradigm, it argues that health is only collective when it is assumed to be an invention and a work of art, opening up to feminist listening