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- ItemEntre grades e iniquidades: o racismo como fator determinante no tratamento da tuberculose no sistema prisional brasileiro(Universidade Federal do Espírito Santo, 2025-07-10) Corrêa, Milena de Oliveira; Possuelo, Lia Gonçalves; https://orcid.org/0000-0002-6425-3678; http://lattes.cnpq.br/9903194013924888; Prado, Thiago Nascimento do; https://orcid.org/0000-0001-8132-6288; http://lattes.cnpq.br/6388559394015871; https://orcid.org/0000-0003-1014-1133; http://lattes.cnpq.br/2869267932672265; Lima, Rita de Cassia Duarte; https://orcid.org/0000-0002-5931-398X; http://lattes.cnpq.br/2384472795664270; Moura, Heriederson Savio Dias; https://orcid.org/0000-0001-7654-2402; http://lattes.cnpq.br/5096353969767784Introduction: Tuberculosis (TB) is an infectious disease with a high incidence of cases mainly in vulnerable populations, especially people deprived of their liberty (PPL). Although curable, TB continues to be one of the main causes of death from infectious diseases, exacerbated by factors such as immunosuppression, precarious conditions and structural racism. Objective: To map and identify the scientific evidence on racism in the outcome of TB treatment in the poor. Methodology: This is a scoping review guided by the recommendations of the Joan Briggs Institute (JBI) and structured according to the PRISMA-ScR roadmap, in studies published between 2014 and 2024. The search was carried out in six databases: MEDLINE/PUBMED, EMBASE, SCOPUS, WEB OF SCIENCE, COCHRANE LIBRARY and LILACS. The review strategy followed the PCC (Population, Concept, Context) approach, focusing on PPL, the impact of race/color and TB treatment outcomes. Results: The search in the six electronic databases resulted in 529 studies, including 27 articles in MEDLINE via PubMed, 89 articles in EMBASE, 73 articles in SCOPUS, 36 articles in Web of Science, 119 articles in the Cochrane Library and 185 articles in LILACS. Of these, 143 were excluded due to duplication, and 386 articles went forward to the selection phase. As a result, 79 studies progressed to the eligibility phase, of which 7 were included in the analysis. Discussion: Structural racism intensifies the vulnerability and negative outcomes of TB in the poor, mainly affecting black, people living in precarious conditions. The adoption of anti-racist policies is essential to promote equity in access to diagnosis, treatment and follow-up of the disease, contributing to the reduction of disparities and improvement in clinical outcomes.
- ItemAuriculoterapia promovendo qualidade de vida em estudantes de enfermagem de uma universidade pública(Universidade Federal do Espírito Santo, 2025-08-01) Ferreira, Gabriel Pinto; Xavier, Fabiana Gonring ; https://orcid.org/0000-0002-8256-8112; http://lattes.cnpq.br/3162042983625740; Siqueira, Marluce Mechelli de ; https://orcid.org/0000-0002-6706-5015; http://lattes.cnpq.br/5309001654924097; https://orcid.org/0000-0001-7137-7137; http://lattes.cnpq.br/6740748956614645; Piexak, Diéssica Roggia; https://orcid.org/0000-0002-3374-7843; http://lattes.cnpq.br/9940464713562965; Borges, Barbara Juliana Pinheiro ; http://lattes.cnpq.br/3318249404836724Introduction: Stress is characterized as a physical, psychological, and hormonal response that arises when the body must adapt to situations that may threaten an individual's homeostasis, potentially compromising their quality of life. In recent years, increasing attention has been directed toward the quality of life and stress levels among students in healthcare programs, particularly in nursing. Nursing is a profession inherently associated with caregiving and is thus considered one of the occupations with the highest risk for developing emotional disorders. Objective: This study aimed to evaluate the effects of auriculotherapy on and quality of life and stress levels among nursing students at a public university. Methods: A simple-blind randomized clinical trial was conducted involving 60 nursing students, who were allocated into three groups: Control Group (CG), Sham Auriculotherapy Group (SAG), and Intervention Group (IG). Participants completed a socioeconomic questionnaire, the LIPP Stress Symptom Inventory (ISSL) for stress assessment, and the WHOQOL-BREF for quality of life assessment. The intervention lasted five weeks, with evaluations conducted at three different time points. The CG received no intervention and was only monitored. The SAG received sham auriculotherapy applied to non-therapeutic points (elbow, outer ear, knee, and inner ear), while the IG received auriculotherapy at specific therapeutic points: shen men, brainstem, kidney, sympathetic, lung, liver, and anxiety points. The Friedman and Kruskal-Wallis tests with Bonferroni correction were employed to analyze differences over time, with a significance level set at p < 0.05. Results: A reduction in the number of students experiencing severe stages of stress was observed; however, no significant differences were found between the groups. Only the sham group exhibited a statistically significant change over time (p = 0.045). In terms of quality of life, the control group demonstrated significant improvements (p = 0.009) compared to the other groups, particularly in the physical, psychological, and social relationship domains.Conclusion: Auriculotherapy showed potential benefits in improving stress levels and quality of life among nursing students. Nonetheless, further research employing more rigorous methodological designs is necessary to elucidate the effectiveness of auriculotherapy in reducing stress and enhancing quality of life in this population
- ItemEpidemiologia do transtorno de compulsão alimentar e da bulimia nervosa na população residente na Região Metropolitana de São Paulo, Brasil: prevalência, distribuição e associação com doenças crônicas(Universidade Federal do Espírito Santo, 2025-07-31) Musso, Sofia Villela; Viana, Maria Carmen; https://orcid.org/0000-0002-0464-4845; http://lattes.cnpq.br/4338126917250074; https://orcid.org/0000-0002-5587-9644; http://lattes.cnpq.br/2612481398023469; Leitão, Francisco Naildo Cardoso; https://orcid.org/0000-0001-7743-2512; http://lattes.cnpq.br/6042531738477010; Abreu, Luiz Carlos de; https://orcid.org/0000-0002-7618-2109; http://lattes.cnpq.br/6796970691432850Introduction: Binge eating is often associated with multiple comorbidities, including obesity, metabolic disorders, and cardiovascular diseases, which often cause functional impairment and impose a substantial burden on health. Objective: To analyze the epidemiological profile of binge eating disorder (BED), bulimia nervosa (BN) and any binge eating disorders or behaviors (ABEDB) in a representative sample of the adult population living in the Metropolitan Region of São Paulo, Brazil. Methods: A crosssectional population-based study was conducted with a representative sample of adults living in the Metropolitan Region of São Paulo, Brazil (n=2,942). The CIDI 3.0 diagnostic interview was used to determine estimates of lifetime, 12-month and 30-day prevalence of BN, BED and ABEDB defined by DSM-IV criteria, in addition to sociodemographic data, self-reported anthropometric measures and chronic health conditions, including rheumatologic diseases, chronic pain, hypertension and cardiovascular diseases, chronic lung disease, diabetes or glucose intolerance and gastrointestinal ulcer. Statistical analysis employed cross-tabulations to assess prevalence distributions across sociodemographic variables and comorbidity with chronic conditions and overweight. Bivariate analyses and Poisson regression models adjusted for sex and age (Stata 17.0) evaluated associations, with significance of p< 0.05. Results: Lifetime, 12-month and 30- day prevalence estimates were, respectively, 2.0% (SE 0.3), 0.9% (SE 0.2) and 0.4% (SE 0.1) for BN; 4.7% (SE 0.3), 1.8% (SE 0.3) and 1.2% (SE 0.2) for BED; and 9.0% (SE 0.5), 3.4% (SE 0.4) and 2.0% (SE 0.3) for ABEDB. Women had higher prevalences of binge eating disorders and behaviors. The lifetime prevalence of ABEDB was higher among younger cohorts. No significant differences were observed in the distributions according to marital status, education or income. Lifetime prevalence of BN was higher among individuals with gastrointestinal ulcer (8.2%, SE 2.8, PR 5.2), headache (3.5%, SE 0.6, PR 2.3), cervical/lumbar pain (3.3%, SE 0.6, PR 2.1), and hypertension (3.1%, SE 0.7, PR 2.5). Lifetime prevalence of BED was higher among those with chronic lung disease (13.2%, SE 6.0, PR 3.3), arthritis/rheumatism (10.0%, SE 2.1, PR 2.8), gastrointestinal ulcer (9.2%, SE 2.6), cervical/lumbar pain (8.9%, SE 1.3) and other chronic pain (7.7%, SE 1.2, PR 1.8). Lifetime prevalence of ABEDB was higher among respondents who reported gastrointestinal ulcer (18.1%, SE 3.1, PR 2.5), cervical/lumbar pain (14.0%, SE 1.9, PR 2.0), headaches (12.8%, SE 1.2, PR 1.5), and other chronic pain (11.7%, SE 1.5, PR 1.4). Prevalence estimates of binge eating disorders and behaviors were also elevated among individuals in higher BMI categories. Conclusion: Binge eating disorders and behaviors are highly prevalent in the population studied, especially among women (11.2%; SE 0.92) and have high comorbidity with overweight, obesity and different chronic conditions, including metabolic and cardiovascular diseases, and other conditions such as chronic pain, rheumatologic diseases, and gastrointestinal ulcers.
- ItemVigilância oncológica e iniquidades no câncer do colo do útero: completude da informação e sobrevida global na rede de atenção à saúde do Espírito Santo(Universidade Federal do Espírito Santo, 2025-04-29) Schuab, Sara Isabel Pimentel de Carvalho; Grippa, Wesley Rocha; https://orcid.org/0000-0003-3572-6031; http://lattes.cnpq.br/5241970584204623; Lopes Júnior, Luís Carlos; https://orcid.org/0000-0002-2424-6510; http://lattes.cnpq.br/5919501773501977; https://orcid.org/0000-0002-8372-325X; http://lattes.cnpq.br/4847886860958146; Dell'Antonio, Larissa Soares; http://lattes.cnpq.br/7471454027993709; Almeida, Márcia Valéria de Souza; https://orcid.org/0000-0002-1318-7084; http://lattes.cnpq.br/9372951429429767Introduction: Cervical cancer remains a major public health concern in Brazil, particularly in socially vulnerable contexts and regions marked by health inequities. Strengthening oncological surveillance and care pathways depends on the quality of information recorded in Hospital Cancer Registries (HCRs), as well as an understanding of care patterns and survival determinants. This dissertation, comprising three interconnected studies, analyzed data completeness, clinical-care profiles, and cause-specific survival among women with cervical cancer treated within the Oncology Care Network (RAO) of Espírito Santo (ES). Aim: To comprehensively examine the quality of cancer registry data and cause-specific survival of women diagnosed with cervical cancer in the RAO of Espírito Santo between 2000 and 2020, based on HCR data. Methods: Retrospective observational study, developed from secondary data from the RHC of Espírito Santo. The first study evaluated 10,140 cases (2000–2020), applying the Mann-Kendall test to assess temporal trends in data incompleteness and the Friedman test to evaluate changes in information quality over time. The second study was a retrospective cohort of 7,633 women diagnosed between 2000 and 2016. HCR data were linked deterministically to the Mortality Information System (SIM/ES). Five-year cause-specific survival was estimated using the Kaplan-Meier method, and factors associated with cancer-related mortality were analyzed through Cox proportional hazards regression. Results: In the first study, most variables showed excellent completeness (<5%). However, key clinical variables—such as TNM staging, family history of cancer, and disease status at the end of treatment—had very poor completeness (>50%). A significant worsening in completeness was observed for variables such as history of alcohol consumption(p=0.001), history of tobacco consumption (p=0.007), and disease status at the end of first treatment (p<0.001). Conversely, completeness improved over time for 18 variables, including initial clinical presentation (p<0.001) and screening year (p=0.005). In the second study, the overall five-year cause-specific survival was estimated at 80.3% (95%CI: 79.4%–81.2%). Women aged ≥70 years had a 93.5% higher risk of cervical cancer-related death (HR=1.935; 95%CI: 1.520–2.464; p<0.001). Marital status without a partner was associated with higher mortality: widowed/divorced (HR=1.187; 95%CI: 1.017–1.386; p=0.030) and single women (HR=1.266; 95%CI: 1.092–1.468; p=0.002). The presence of distant metastases increased the risk of death nearly fourfold (HR=3.945; 95%CI: 3.265–4.766; p<0.001). Higher education level was protective (HR=0.621; 95%CI: 0.406–0.951; p=0.028). Regarding first-line treatment, risk of mortality was significantly higher for patients treated with chemotherapy (HR=19.576; 95%CI: 11.819–32.423), radiotherapy (HR=15.072; 95%CI: 11.291–20.121), or combined chemoradiotherapy (HR=17.953; 95%CI: 13.319–24.199), compared to surgery. Conclusion: This dissertation highlights that, although HCR data completeness is generally satisfactory, significant gaps persist in key clinical variables. Inequities in access to care, reflected in referral source and treatment patterns, compromise continuity of care. Cervical cancer survival is strongly influenced by sociodemographic and clinical factors, underscoring the need for more effective screening strategies, standardized data collection, and policies to promote equitable access to diagnosis and treatment. The findings reinforce the strategic role of HCRs in cancer surveillance, health system management, and public policy planning.
- ItemTrajetórias de clusters de sintomas oncológicos ao longo de três ciclos de quimioterapia ambulatorial: estudo longitudinal(Universidade Federal do Espírito Santo, 2025-04-24) Minarini, Etreo Junior Carneiro Da Silva; Lopes Júnior, Luís Carlos; https://orcid.org/0000-0002-2424-6510; https://buscatextual.cnpq.br/buscatextual/busca.do; http://lattes.cnpq.br/5919501773501977; https://orcid.org/0000-0003-4883-2968; http://lattes.cnpq.br/3671717404900258; Vasconcelos, Karla Anacleto; https://orcid.org/0000-0002-6462-6390; http://lattes.cnpq.br/8734476211935275; Lopes, Andressa Bolsoni; https://orcid.org/0000-0003-1244-5667; http://lattes.cnpq.br/0097480808041638; Bolina, Alisson Fernandes; https://orcid.org/0000-0002-1364-0176; http://lattes.cnpq.br/6993371391051944; Enriquez-Martinez, Oscar Geovanny; https://orcid.org/0000-0003-4561-122X; http://lattes.cnpq.br/0493747317645178Introduction: Cancer patients undergoing chemotherapy often experience multiple simultaneous symptoms, which tend to cluster into interrelated patterns known as symptom clusters. Understanding these groupings throughout treatment may support more effective care strategies, especially in outpatient settings where continuous monitoring is essential. Objective: To analyze the trajectory and composition of symptom clusters in patients with malignant neoplasms over the first three cycles of outpatient chemotherapy, and to identify the clinical factors associated with their manifestation and evolution. Methods: This prospective cohort study was conducted with 84 adult patients diagnosed with stage I, II, or III cancer who were eligible for outpatient chemotherapy at a public hospital in the Southeastern region of Brazil. Data collection was performed using the Memorial Symptom Assessment Scale (MSAS™), applied during the first three chemotherapy cycles (QT1, QT2, and QT3). Symptom clusters were identified through hierarchical cluster analysis, using Euclidean distance and Ward’s method. To compare the medians of symptom frequency, intensity, and distress across cycles, the Kruskal-Wallis test was applied, followed by Conover-Iman post-hoc tests with Bonferroni correction. Symptom prevalence between QT1 and QT3 was compared using Wilcoxon signed-rank and sign tests. Associations between clusters and sociodemographic, clinical, and therapeutic variables were assessed using the chi-square test and Fisher’s exact test, adopting a significance level of 5% (p < 0.05). Results: The mean age of participants was 57.61 years, with a predominance of female patients diagnosed with ductal carcinoma in situ of the breast. Three clusters were identified in QT1 (emotional, chemotherapy-related, and neuropsychological), and four clusters were observed in both QT2 (autonomic, gastrointestinal, systemic physical, and psychosensory) and QT3 (sensory perceptual, physiological, psychosomatic, and emotional-physical). Statistically significant differences were found among clusters regarding symptom frequency, intensity, and distress across the three cycles (p < 0.05). Clusters 3 and 4 in QT2 and QT3 showed higher median values in all three dimensions, reflecting a greater symptom burden. An increase in symptom complexity was observed throughout the treatment, with an initial predominance of emotional symptoms followed by a diversification into sensory, functional, and psychosocial domains. Three primary clusters remained consistent from QT1 to QT3: emotional, chemotherapy-related, and neuropsychological. Although no statistically significant differences were found in the overall prevalence of symptoms between QT1 and QT3, clinical trends of increased prevalence were identified in 11 of the 15 symptoms assessed. In QT1, a significant association was observed between Cluster 2 (chemotherapy-related) and age ≥65 years (p = 0.048), as well as with the presence of comorbidities (p = 0.004). In QT3, Cluster 2 was more prevalent among female patients (p = 0.005), and Cluster 4 (emotional-physical) was also associated with the female sex (p = 0.010). Cluster 3 (neuropsychological) was associated with the presence of comorbidities (p = 0.033), chemotherapy drug class 4 (p = 0.007), and low platelet-to-lymphocyte ratio (PLR) (p = 0.004), suggesting potential links between clinical-immunological status and psychocognitive distress. Conclusions: The identification and comparison of symptom clusters highlighted the complexity of the symptom experience among patients undergoing chemotherapy, reinforcing the importance of clinical interventions guided by patterns of symptom co-occurrence. While the clusters showed relative stability between the first and third cycles, internal variations in symptom composition were noted. Associations with clinical and therapeutic variables emphasize the importance of continuous monitoring and personalized care based on the predominant symptom profiles throughout treatment.