DISSERTAÇÃO DE MESTRADO - PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA
URI Permanente para esta coleçãohttps://tedebc-teste.ufma.br/handle/tede/883
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Item EXPERIÊNCIAS VIVIDAS POR PROFISSIONAIS NO PROCESSO DE TRABALHO COM CRIANÇAS EM CUIDADOS PALIATIVOS.(Universidade Federal do Maranhão, 2019-02-26) MOREIRA, Jacqueline Dutra Nascimento; LAMY, Zeni Carvalho; http://lattes.cnpq.br/9896819318523369; LEMY, Zeni Carvalho; http://lattes.cnpq.br/9896819318523369; ALVES, Rosana; http://lattes.cnpq.br/5958737240424992; ALVES, Maria Teresa Seabra Soares de Britto e; http://lattes.cnpq.br/3910533965773430; CARVALHO, Ruth Helena de Souza Britto Ferreira de; http://lattes.cnpq.br/6914279050780248Pediatric Palliative Care (CPP) includes total pediatric care in the body, mind and soul, and family support. Tending its onset when a serious illness is diagnosed and continues to be a curatorial cure process. They are based on multiprofessionality and interdisciplinarity focused on evaluating and alleviating the physical, psychological, social and spiritual exercise of the child and his / her family. The objective was to understand the experiences experienced by professionals in the process of working with children in palliative care. This is an exploratory study of a qualitative approach of the phenomenological type, carried out in a university hospital from March to May 2018. The sample was chosen with the intention of involving 32 professionals from the research sector. The analysis of the ideas was carried out in search of the work process in health, contemplating like Van Manen visions. The themes that emerged were: Fragilities, disagreements and contradictions in the presentation and offer of palliative care and facilitating initiatives in palliative practice. The understanding of the lived experiences made possible the understanding of a knowledge about the association of concepts and contradictions in palliative care. Palliative Care was introduced in a terminality, to abandonment and euthanasia. Where an denial of the natural process of death prosers, it may result in the adoption of a futile treatment. The occurrence of the biomedical model and the fragmentation of care that led, in some situations, to the work process, was adopted for decision making and for the child and his family. However, as experiences have already been promoted by the integration of knowledge, and the incorporation of new tools in daily care, which promote a user-centered approach with respect to their subjectivity. It is necessary, changes in the logic of the work processes in health, in search of a collaborative work, with emphasis on the protagonism of the user, valorization of the worker and extension of the clinic.Item Nascimento por cesariana e adiposidade central em adolescentes de uma coorte de nascimentos (RPS) de uma capital do nordeste brasileiro(Universidade Federal do Maranhão, 2018-02-26) ABREU, Joana D’Arc Matos França de; LAMY FILHO, Fernando; 725.080.007-87; http://lattes.cnpq.br/3977956820339735; ALMEIDA, Cecília Claudia Costa Ribeiro de; http://lattes.cnpq.br/1783658679814263; BETTIOL, Heloisa; http://lattes.cnpq.br/1783658679814263; FRANÇA, Ana Karina Teixeira da Cunha; http://lattes.cnpq.br/8389486900285691INTRODUCTION: Caesarean section has been associated with the development of obesity and metabolic changes throughout life, but studies on the association with central fat, more associated with cardiovascular risk, are not consensual. OBJECTIVE: To evaluate the causal effect between cesarean birth and central adiposity of the body in adolescents. METHODS: A cohort study was carried out, including 601 participants, evaluated at birth and in adolescence aged 17 to 18 years. The following ratios were evaluated by DEXA as the definition of central fat: android / gynoid fat mass (A/G); trunk / total fat mass (T/T); fat mass of the trunk / limbs (T/LB) and fat mass of the trunk / legs (T/LG). A Directed Acyclic Graph (DAG) was constructed to select the variables for minimum adjustment for confounding, being selected: intrauterine growth retardation, gestational age at birth, maternal schooling, maternal smoking, mother's BMI, family income at birth and the mother's marital status. In the analysis, a marginal structural model was used, which allows a better adjustment of the confounders. We also used inverse-weighted estimators of the likelihood of exposure selection. The presence of interchangeability between the exposure groups was verified by the teballance command of the software StataTM v. 14. RESULTS: There was no statistical difference in the central fat mass of adolescents born by cesarean section or vaginal route, for the four indicators used: A/G ratios (CI 95% = -0.015, 0.018, P = 0.875); T/T ratio (CI 95% = -0.013; 0.007, P = 0.541); T/LB ratio (CI 95% = -0.048; 0.016; P = .333); T/LG ratio (CI 95% = -0.06; 0.03, P = 0.532). CONCLUSION: In the present study, no causal effect was observed between cesarean births and the higher presence of central fat in the adolescents studied.Item Consumo de alimentos processados e ultraprocessados por crianças de 13 a 35 meses e fatores associados(Universidade Federal do Maranhão, 2016-02-29) Batalha, Mônica Araujo; FRANÇA, Ana Karina Teixeira da Cunha; CPF:88099512472; FRANÇA, A.KINTRODUCTION: Healthy eating habits started from the earliest years of life are critical to growth and development of children. However, the ultra-processed products are being introduced early on children's diets and little is known about the determinants of this consumption. OBJECTIVES: To evaluate the consumption of processed and ultra-processed foods (PUP) among children of 13-35 months and associated factors. METHODS: We studied 1185 children, participants following the BRISA cohort in São Luís, Maranhão. Food consumption was investigated using the Food Survey Recall 24h and the percentage of daily caloric intake and nutrients were estimated by groups of food, classify according with the type of processing used in their fabrication. We used Poisson regression model with robust variance estimation and hierarchical approach to estimate the prevalence ratios (PR) of variables associated with high consumption of processed and ultra-processed foods. RESULTS: Mean energy consumption were 1226 kcal/day. After the adjusted analysis, there was a higher proportion of high consumption of PUP among children whose mothers had less than or equal to 8 years of study (PR 1.32; 95% CI: 1.05-1.67), 9 to 11 years of study (PR 1.24; 95% CI: 1.02-1.51) and among those who had more than 18 months of life (PR 1.29; 95% CI: 1.09-1.52). CONCLUSIONS: The knowledge of the factors related to high consumption of PUP in childhood is critical to the direction of intervention and prevention actions, targeting both mothers and children, in order to strengthen the acquisition of healthy habits early.