Municipality In Northeastern Brazil Research Articles

Clinical and sociodemographic factors associated with the quality of life of children and adolescents with type 1 diabetes.

To analyze clinical and sociodemographic factors associated with the health-related quality of life of children and adolescents with type 1 Diabetes Mellitus. A quantitative, cross-sectional and analytical study, developed in a municipality in northeastern Brazil, between March and September 2021, with 81 children/adolescents with type 1 Diabetes Mellitus and their guardians/caregivers. A questionnaire containing sociodemographic and clinical variables and two quality of life instruments were used. Descriptive and inferential analysis was carried out. Adolescents whose parents had a family income greater than a minimum wage had a lower prevalence of impaired quality of life when compared to those with a lower income. Adolescents with time since diagnosis of less than four years had a satisfactory quality of life, and children aged 8 to 12 years who self-administered insulin had a lower prevalence of high quality of life compared to those who did not. Adolescents with a family income of less than a minimum wage, diagnosis time of more than four years and children aged 8-12 who self-administer insulin need greater professional support to have a better quality of life.

Quality of prescription writing in Brazilian primary health care.

To evaluate the quality of prescription writing in the context of public primary health care. Prescription errors are one of the leading patient safety problems in primary care and can be caused by errors in therapeutic decisions or in the quality of prescription writing. Cross-sectional observational study conducted in a municipality in Northeastern Brazil. The assessment instrument (including 13 indicators and one composite indicator) was applied to a representative sample of drug prescriptions from the 24 Family Health Teams providing Primary Health Care in the municipality, dispensed in January 2021. Estimates of compliance and their 95% confidence intervals and graphical analysis of frequencies are assessed globally and stratified by dispensing units and prescribers. The average composite prescription writing quality on a 0-100 scale was 60.2 (95% CI 57.8-62.6). No quality criteria had 100% compliance. The highest compliance rates were found for 'frequency of administration' (98.9%) and 'identification of the prescriber' (98.9%). On the other hand, 'recorded information on allergy' (0.0%), 'patient's date of birth' (1.7%), 'nonpharmacological recommendations' (1.7%), and 'guidance on the use of the drug' (25%) were the indicators with lower compliance, contributing to 69% of the noncompliances found. The type and frequency of the errors in the quality of prescription writing uncovered in this study confirm the continuing need to tackle this problem to improve patient safety. The results identify priority aspects for interventions and further studies on the quality of prescription writing in the context of Primary Health Care in Brazil.

Factors associated with common mental disorders among farmers in a medium-sized municipality in Northeastern Brazil.

ABSTRACTOBJECTIVETo identify the prevalence and factors associated with common mental disorders among farmers living in a medium-sized municipality in Northeastern Brazil between 2019 and 2020.METHODSTrained interviewers applied the standardized questionnaire in 450 participants. Sociodemographic, health, income and working characteristics were assessed. The screening of common mental disorders was performed using the Self-Reporting Questionaire, with the cutoff point ≥ 7 for women and ≥ 5 for men. Poisson regression with robust estimation was applied to verify the prevalence ratios in the bivariate and multivariate analysis.RESULTSThe prevalence of common mental disorders among farmers was 55.1% (95%CI: 50.4–59.6). The variables that remained significant and associated with common mental disorders were: men (PR = 1.7), > 60 years old (PR = 0.5), poor or very poor self-assessment of health (PR = 1.4), previous mental health treatment (PR = 1.2), alcohol abuse (PR = 1.2) and loss of production (PR = 1.3).CONCLUSIONThese results indicate that common mental disorders are associated with individual factors and with the farmers’ context of life and work, which shows the importance of social, economic and health services support to this group of workers.

Emergency remote teaching and its impacts on Lizard.4.Future computational thinking and application development workshops

Computational thinking is a skill that has aroused the interest of education in countries. To provide opportunities for the development of this skill and knowledge about creating applications, in the training of teenagers in the 9th grade of elementary school with low IDEB in a municipality in northeastern Brazil, the Lizard.4.Future project has workshops offered since 2020. However, the impact of the covid-19 pandemic on project activities. In this article, we present its design challenges during the Lizard.Future project, and impacts, on running emergency remote learning applications. Access difficulties and instability in the support network for digital tools, in addition to the difficulty of writing and office facilities of digital tools, in addition to the difficulty of writing and resource facilities of digital tools. The result was twenty-four graduating course participants and four applications for them.

Vulnerable territories to tuberculosis-diabetes mellitus comorbidity in a northeastern Brazilian scenario.

Epidemiological investigations on tuberculosis-diabetes comorbidity using spatial analysis should be encouraged towards a more comprehensive view of the health of individuals affected by such comorbidity in different contexts. This study analyzes the territories vulnerable to tuberculosis-diabetes comorbidity in a municipality in northeastern Brazil using spatial analysis techniques. An ecological study was carried out in Imperatriz, Maranhão, Brazil. Tuberculosis-diabetes cases reported in the Brazilian Notifiable Diseases Information System between 2009 and 2018 were analyzed. Kernel density estimation and spatial scanning techniques were used to identify the areas with the greatest occurrence of spatial clusters. A heterogeneous spatial distribution was found, ranging from 0.00 to 4.12 cases/km2. The spatial scanning analysis revealed three high-risk spatial clusters with statistical significance (p < 0.05), involving eleven strictly urban sectors with a relative risk of 4.00 (95% CI: 2.60-6.80), 5.10 (95% CI: 2.75-7.30), and 6.10 (95% CI: 3.21-8.92), indicating that the population living in these areas had a high risk of tuberculosis-diabetes comorbidity. The highest concentration of cases/km2, as well as risk clusters, were found in areas with high circulation of people and socio-economic and environmental vulnerabilities. Such findings reinforce the need for public health interventions to reduce social inequalities.

Validation of the QualiPresc instrument for assessing the quality of drug prescription writing in primary health care.

Adverse events related to drug prescriptions are the main patient safety issue in primary care; however there is a lack of validated instruments for assessing the quality of prescription writing, which covers the prescriber, the patient and the drug information. To develop and validate the QualiPresc instrument to assess and monitor the quality of drug prescriptions in primary care, accompanied by a self-instruction direction, with the goal of filling the gap in validated instruments to assess the quality of prescription writing. A validation study conducted in a municipality in Northeastern Brazil, based on prescriptions prepared in January 2021 by physicians assigned to 18 Basic Health Units and filed in 6 distribution/dispensing units. Four steps were covered: 1) Analysis of content validity of each indicator (relevance and adequacy); 2) Analysis of reliability via intra and inter-rater agreement of each indicator; 3) Analysis of the utility of each indicator; 4) Construction and analysis of the reliability of a weighted composite indicator based on effectiveness and safety scores for each indicator. Twenty-nine potential indicators were listed, but only 13 were approved for validity, reliability and usefulness. Twelve indicators were excluded because of validity (<90% validity index) and four because they were not useful in the context of the study. Three weighted composite indicators were tested, but only one was approved for reliability and usefulness. The validated instrument therefore contains 13 indicators and 1 weighted composite indicator. This study demonstrates the validity, reliability and usefulness of QualiPresc for the evaluation of prescription writing in the context of primary care. Application to contexts such as secondary care and tertiary care requires cross-cultural adaptation and new content validity. Educators, managers and health care professionals can access QualiPresc online, free of charge, to assess performance and provide feedback involving drug prescribers.

Repercussions of COVID-19 on the daily lives of women living in a rural settlement.

To understand the repercussions of COVID-19 on women's daily lives in a rural settlement. A qualitative study was conducted in a rural settlement of the Landless Workers' Movement (MST) in a municipality in Northeastern Brazil between January and March 2021. Forty-eight women participated through semi-structured interviews. The data collected were analyzed by the Collective Subject Discourse method in light of the referential of pandemic processes. The grouping of the speeches unveiled similar and/or complementary meanings about the coping strategies and the feelings generated due to the pandemic. Four Central Ideas were organized: denial to progressive awareness; Perception of the problem, acceptance, and explanation of reality; Negotiation; and Retrospection/reflection. The pandemic repercussions are intrinsically related to an inhospitable reality from the perspective of the experience of women daily forgotten, marginalized, and suppressed.

Instrument validity: HIV and other sexually transmitted infections in homeless people.

to validate, through the Item Response Theory, an instrument on vulnerability to HIV and other sexually transmitted infections in homeless people. a cross-sectional study carried out between February and May 2018 with 100 homeless people in a municipality in northeastern Brazil. A sociodemographic questionnaire was applied, and another with items referring to behaviors vulnerable to HIV and sexually transmitted infections (STIs). Subsequently, it was assessed through the Item Response Theory. the items previous diagnosis of STIs (F=0.473), partner with STI symptoms (F=0.518), drug use (F=0.509), sex for money (F=0.552), STI symptoms (F=0.448), number of sexual partners (F=0.616), sharps sharing (F=0.398) and being a victim of sexual violence (F=0.347) were validated. the instrument proved to be validated, being able to identify vulnerability to HIV and other sexually transmitted infections in homeless people.

Abuse of alcohol among farmers: Prevalence and associated factors.

We sought to identify the prevalence and factors associated with alcohol abuse among farmers living in a medium-sized municipality in northeastern Brazil during 2019 and 2020. Trained interviewers applied the standardized questionnaire to 450 participants. Sociodemographic, health, income and work characteristics were investigated. The tracking of alcohol misuse was done using the CAGE questionnaire (Cut down, Annoyed by criticism, Guilty and Eye-opener), being the cut-off point ≥ 2. Poisson Regression was applied with robust estimation to verify the reasons of prevalence (RP) in bivariate and multivariate analysis. The prevalence of alcohol abuse among farmers was 32% (95% CI 27.8-36.4). Factors such as being male, having a diagnosis of mental disorder in the family, being a smoker, and using drugs were associated with the higher prevalence of the outcome. Being 60 years old or older was associated with a lower prevalence of alcohol abuse. These results indicate the need for social support to this group of workers in the context of occupational health.

Prevalence and factors associated with group B streptococcal colonization in pregnant women

Abstract Objectives: to estimate the prevalence and the factors associated with the colonization by group B streptococcus (GBS) in pregnant women from the urban area attended at health units in a municipality in northeastern Brazil. Methods: it is a cross-sectional study conducted from January 2017 to March 2018. Vagino-rectal swabs were collected from 210 pregnant women between 32 and 40 weeks of gestation. The swabs were seeded on 5% sheep blood agar and on chromogenic agar. For confirmatory identification of GBS, the CAMP test and latex agglutination were used. Descriptive analysis and univariate and multivariate association analysis were performed using a multinomial logistic model. Results: the prevalence of GBS colonization among pregnant women was 18.1% (n = 38), and a statistically significant association (p&lt;0.05) was found for income and parity variables in the group of older women in the univariate analysis, and for skin color, age and parity in the final multivariate analysis. Conclusions: the prevalence of maternal colonization by GBS was similar to that described in other studies. Although some risk factors, such as skin color, age and parity, were associated with colonization, other studies are essential to establish more information on pregnant women more likely to be colonized by GBS.

Dental Fear in Children: Association with Dental Caries and Molar Incisor Hypomineralization.

The aim of this study was to investigate the prevalence of dental fear and to evaluate its association with dental caries and molar incisor hypomineralization (MIH) in schoolchildren aged 8-10 years from a municipality in Northeastern Brazil. Data from 466 students enrolled in urban public schools in a cross-sectional study were collected. Parents/guardians answered a questionnaire addressing sociodemographic characteristics, dental fear was measured by means of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and clinical examinations were performed by three calibrated examiners for diagnosis of dental caries, using the International Caries Detection & Assessment System - ICDAS II and a previously validated index for MIH. Descriptive data analysis was performed, and associations between dental fear, dental caries and MIH were analyzed using robust Poisson regression for complex samples (p<0,05). The prevalence of dental fear was 21.6%, and the mean total CFSS-DS score was 29.97 (CI 95%=29.05-30.89). In the multivariate adjusted model, the prevalence of dental fear was associated to family income (PR=1.78; CI 95%=1.02-3.08; p= 0.041). Monthly family income was associated with dental fear in children, whereas dental caries and MIH were not associated with dental fear.

Nível de estresse de gestores de unidades básicas de saúde

Objetivo: Identificar o nível de estresse de gestores de Unidades Básicas de Saúde de um município do Nordeste do Brasil. Métodos: Trata-se de estudo do tipo descritivo, com abordagem quantitativa. Os campos de pesquisa foram as Unidades Básicas de Saúde (UBS) e as Unidades de Saúde da Família (USF) dos cinco Distritos Sanitários (Leste, Oeste, Sul, Norte I e Norte II) de Natal-RN, Brasil, no primeiro semestre de 2018, de modo que a amostra final foi de 44 gestores. Os resultados foram digitados em planilha eletrônica e a análise dos dados foi realizada por meio da estatística descritiva simples e análise inferencial. Resultados: participaram do estudo 44 gestores: a maioria do sexo feminino, com média de idade de 49,41 anos (DP = 8,92). Com relação à fase do estresse em que os gestores estavam, observou-se que 17 (38,6%) estavam na Fase de Resistência; 2 (4,5%) na fase de Quase Exaustão; e 10 (22,7%) encontravam-se na fase de exaustão. Conclusão: evidenciou-se que a maioria dos gestores das Unidades Básicas de Saúde estudadas apresentam estresse, e uma parcela desses já se insere na fase de Exaustão, que é quando o indivíduo começa a ficar suscetível ao surgimento de doenças.

UX Research applied to digital transformation of primary care in Brazil

Abstract Background Digital are powerful tools to improve the work and quality of information of primary care teams (PHC) in Brazil has been encouraged through the institution of the e-SUS Primary Care strategy (e-SUS AB). Digital tools were developed to optimize the PHC work process in collecting data on the health of the Brazilian population. The e-SUS AB application was one of those tools developed by the Ministry of Health. This simplified collection of population data. Despite technological updates, since 2015 there were updates regarding the usability of the application. Objective Aim to report on the use of UX research tools to identify changes needed in the e-SUS AB application and to propose solutions aligned with the concepts of usability. Methods For the UX Research, we used focus groups and field monitoring. As a result, we produced personas, empathy map, user journey, and user history documents. The Heuristic User Interface Design, proposed by Nielsen, was used for the application analysis. The World Health Organization's MEDHI (Monitoring and Evaluating Digital Health Interventions) protocol was used for designing solution proposals for UX Design. Results In the design process, we produced navigation sketching's flow and high-fidelity prototypes for improvement proposals. It was necessary to correlate Nielsen's 10 heuristic principles with the needs inherent to public health applications. Problems related to the freedom of control and use by the health professional and the flexibility and efficiency of use were the most significant finds. We also identified underutilization of data collected. Conclusions Based on the results found, an aesthetic reformulation was proposed to solve the heuristic problems. It was also proposed to include a new functionality: a checklist for specific conditions, thus optimizing the use of data collected for primary health care. The proposals are currently undergoing usability testing in a municipality in northeastern Brazil. Key messages We need to plan health digital tools with UX knowledge to improve analysis and decision making capabilities to pointing out strategies to face health issues in the territories. Digital tools are powerful tools to improve health care system performance.

Informal rural transport in a typical minor municipality in northeastern Brazil: Evaluation and regulation proposals

In many parts of the developing world, informal rural transport, although precarious, is the only type of transport available for urban–rural connectivity. In this context, this article aims to evaluate the level of user satisfaction, as well as to understand their main difficulties and how to improve this kind of transportation. To do that, a research was conducted among transport users, seeking to perform quantitative and qualitative analyses. Adult women represent the majority of users, but, despite the female predominance, satisfaction assessment does not depend on gender. On the other hand, the place of residence affects the perception of service quality, as rural users – perhaps more resilient – are less unsatisfied than urban residents. 78% of respondents use Toyota vans modified for passenger transportation, which they evaluate poorly. 15% use motorcycle taxi and are more satisfied, due to its adequacy in meeting individual demands. Delays and slow travel represent the main problems reported. It was also evidenced that pricing, although not regulated, was the better evaluated criterion. As a conclusion, it is proposed the development of regulation guidelines for operational purposes.

Barriers to self-care among men: discourses of men participating in a health education group.

The objective of this study was to analyze men's discourses regarding difficulties related to their participation in health services and their self-care practices in the health-disease process. In order to do so, a health education initiative was implemented with men living in the area covered by a Basic Health Unit (UBS) in a municipality in Northeastern Brazil. The initiative was designed by professionals at the UBS, and its third stage consisted of five group meetings that addressed issues related to men's health. For the analysis of discourses, a content analysis strategy was used. The experience allowed us to reflect on the importance of developing strategic actions oriented towards promoting men's engagement with health services and the self-care of users, particularly in primary care settings. This is considered within the framework of the National Policy for Comprehensive Men's Healthcare (PNAISH). Re-signifying actions oriented towards men's health and changing the perspectives of professionals attending to this population can create a sense of belonging in men with respect to spaces of health promotion, protection, and recovery.

Epidemiological, temporal and spatial dynamics of leprosy in a municipality in northeastern Brazil (2008-2017): an ecological study.

INTRODUCTION: Leprosy is a chronic infectious disease caused by Mycobacterium leprae.This study aimed to analyze the epidemiological, temporal, and spatial dynamics ofleprosy in a municipality in northeastern Brazil. METHODS: This is an ecological study on new leprosy cases in the population of Arapiraca (Alagoas, Northeast Region, Brazil), from 2008 to 2017. Data extracted from a national database were analyzed forepidemiological indicators, factors associated with physical disabilities, and spatialanalysis in the neighborhoods of Arapiraca. RESULTS: A total of 292 new cases of leprosy were recorded, particularly occurring among the following groups: women, the age group of 46-59 years, brown-skinned individuals, people with less than eight years of schooling, and urban residents; the new cases were also predominantly the tuberculoid form and were of the paucibacillary classification of the disease. Almost 1/3 of the people had some degree of physical disability, which was mainly associated with the group 60 years of age and older, black ethnicity, and the multibacillary clinical form of leprosy. The joinpoint regression showed a stationary temporal behavior of indicators. There was a heterogeneous spatial distribution with active transmission areas, especially in the neighborhoods Primavera, Baixão, Ouro Preto, and downtown. CONCLUSIONS: The epidemiological indicators revealed complexity in the process of leprosy development. These spatial and temporal studies are relevant to help in the planning, monitoring, and guidance of interventions in the municipality. The spatial analysis showed heterogeneous distribution in the analyzed neighborhoods.

Nurse as an integrator in healthcare management of children with chronic condition.

to understand the practice of the nurse in healthcare management of children with chronic condition in the hospital setting. analytical study of qualitative approach with theoretical and methodological reference of institutional ethnography. Developed in the pediatric unit of a university hospital, in a municipality in Northeastern Brazil. Data collections techniques were: participant observation, documentary analysis and semi-structured interview. Participants of the study totaled twenty professionals, including nurses, social workers, psychologists, pharmacists, nutritionists, physiotherapists, and doctors. For data analysis, it was used the Bardin's Content Analysis with interface of the Atlas.ti software. categories of analysis were "Nurse as mediator of healthcare management"; "Nursing process as a mechanism of healthcare management". considerations: the nurse proved to be essential for healthcare management of the child with chronic condition, acting as mediator of the relationship between the doctor, the members of the health team, the user and their family.

Access to oral healthcare services of adolescents of a large-size municipality in northeastern Brazil.

The aim of this study was to describe and evaluate access to oral health services among adolescents enrolled in public schools of Campina Grande, Paraíba, Brazil, a large-size municipality in the Northeast of Brazil. An observational, descriptive, analytical, quantitative, and cross-sectional study was carried out through a school survey, in which four validated questionnaires were applied to 438 adolescents aged 12 to 19 years. Data were processed using the SPSS statistical software version 20.0, with bivariate analysis and multivariate analysis through Poisson regression. About 90.9% of adolescents reported having visited the dentist at least once; however, when considering the last 6 months, this percentage fell to 48.4%. Adolescents used private services (50.2%) or the public service (49.8%). About 70.6% of interviewees reported dental treatment (61.1%) as the main reason for seeking the service. Through multivariate analysis, it was observed that the demand for the service was higher among female adolescents (60.5%, p <0.001); the other variables did not present statistically significant differences. In conclusion, the access to oral healthcare services reported by adolescents was good, but there is still a considerable part of this population with no access. Variables that presented significant associated with dental services were gender and toothache history, but only gender remained significant in the multivariate model.

Leprosy in children under 15 years of age in a municipality in northeastern Brazil: evolutionary aspects from 2003 to 2015.

INTRODUCTION The Integrated Program of Leprosy Control was initiated in 2003 in the municipality of Buriticupu, Maranhão, Brazil, an area considered hyperendemic for leprosy. Here, we present the evolution of the indicators of leprosy within the established period in children aged <15 years. METHODS: This is a descriptive study based on an active search for cases and spontaneous healthcare demand for leprosy, with an evolutionary analysis of the detection coefficient of new cases. We considered individuals aged <15 years diagnosed with leprosy from January 2003 to December 2015. To evaluate the factors associated with clinical and operational forms, Chi-square, Fisher’s exact, or Fisher-Freeman-Halton tests were performed.RESULTS A total of 61 new cases were detected (6.9% of the total leprosy cases diagnosed in the municipality during the study period), and the majority was found in males (62.3%). The most frequent operational classification was paucibacillary (67.2%), and this association increased with age. The tuberculoid clinical form was the most prevalent in both sexes and in the age range of 10 to <15 years. There was a reduction in the detection coefficient from 21.84/100,000 inhabitants in 2003 to 2.79/100,000 in 2015.CONCLUSIONS Despite the progress in the control of leprosy, this historical series shows that it is necessary to strengthen educational measures and implement control actions, so that the disease ceases to be a public health problem in the population aged <15 years.

Alterações clínicas, metabólicas e resistência à insulina entre adolescentes

Resumo Objetivo Analisar as alterações clínicas, metabólicas e sua relação com a resistência à insulina entre adolescentes. Métodos Estudo analítico, realizado com 357 adolescentes de escolas públicas estaduais de um município do Nordeste brasileiro. O formulário aplicado continha as variáveis Índice de Massa Corporal, Circunferência da Cintura, Circunferência do Pescoço, Índice de Conicidade, Pressão Arterial Média; Triglicerídeos, Glicemia, High — Density Lipoprotein Coiesteroi, Insulina e Índice Homeostasis Model Assessment, analisadas por medidas descritivas para variáveis quantitativas; e frequências para variáveis qualitativas. Foram realizados testes de associações através do Qui-quadrado e do teste Odds Ratio. Resultados A prevalência de resistência à insulina foi de 33,9%. As médias da circunferência da cintura, circunferência do pescoço, índice de conicidade, pressão arterial sistólica média e pressão arterial diastólica média estiveram elevadas respectivamente em 4,2%; 30%; 10,9%; 4,2% e 14% dos adolescentes. Os níveis de High – Density Lipoprotein colesterol estiveram diminuídos em 30,5% da amostra, ao passo que os triglicerídeos estavam elevados em 18,8%. Não foi identificada alteração na glicemia. Aqueles que apresentaram índice de massa corporal, circunferência da cintura, circunferência do pescoço, índice de conicidade e triglicerídeos com valores alterados possuíam maiores chances de apresentar resistência à insulina (OD: 3,62; 11,54; 3,50; 4,49; 3,05, respectivamente). De maneira oposta, os adolescentes com pressão arterial sistólica média, pressão arterial diastólica média e High — Density Lipoprotein colesterol alterados não apresentaram significância estatística (p&lt;0,05). Conclusão A resistência à insulina está presente entre os adolescentes, com associações positivas e significativas com alterações clínicas e metabólicas.