Dissertações de mestrado

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Navegando Dissertações de mestrado por Autor "Alvim, Rafael de Oliveira"

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    CONDIÇÕES DE SAÚDE DE AGENTES COMUNITÁRIOS DO MUNICÍPIO DE VITÓRIA (ES)
    (Universidade Federal do Espírito Santo, 2021-02-10) Martins, Haysla Xavier; Molina, Maria Del Carmen Bisi; https://orcid.org/0000-0001-8746-5860; http://lattes.cnpq.br/9238370951122705; https://orcid.org/0000-0001-8827-1793; http://lattes.cnpq.br/4841725678453909; Mill, José Geraldo; https://orcid.org/000000020987368X; http://lattes.cnpq.br/2497419234600362; Alvim, Rafael de Oliveira; https://orcid.org/0000-0003-3150-4239; http://lattes.cnpq.br/3204117077254917
    This is a master's dissertation addressing the theme of health conditions of Community Health Agents (CHA) in the city of Vitória/ES. Data from the research entitled “Impact of the Training of Community Health Agents in Food Education - CACEA” were analyzed and the dissertation was structured in two manuscripts (both original). The first aimed to assess the health conditions, care and life habits of CHA active in Vitória/ES and the second aimed to identify the discriminatory power of adiposity indicators for diabetes mellitus (DM) in female CHA. A questionnaire was applied to obtain sociodemographic, lifestyle and health data. Clinical, anthropometric, biochemical tests (fasting glucose and after 75 g dextrose overload, insulin, total cholesterol and fractions, and triglycerides) and hemodynamic tests were performed. Data analysis was performed using the statistical program Statistical Package for the Social Sciences - SPSS 21.0, adopting a significance level of p ≤ 5%. In the first manuscript, descriptive and association analyzes were performed. The sample consisted of 262 CHA (mean age 46.1 ± 9.3 years) mostly female, of mixed race/brown color, with high school, married marital status and belonging to socioeconomic class C. The CHA had high percentages of pre-diabetes, DM, arterial hypertension (AH), obesity, high cholesterol, hypertriglyceridemia, and metabolic syndrome. About 41% have 3 or more associated morbidities, and of those who had a previous diagnosis of DM and/or AH, a fifth did not use medication for such conditions. The use of anxiolytics and/or antidepressants was high and was associated with worse self-perception of health status. In the second manuscript, association analyzes were performed and ROC (Receiver Operational Characteristic) curves were constructed to evaluate the performance models, and the area under the curve (AUC) was used to measure the discriminatory power of DM. At AUC, the ROC curves between the markers were compared using a parametric method, using the GraphROC for Windows software. The sensitivity and specificity values for each adiposity measure were determined by analysis of ROC curves. The ideal cutoff points for Body Mass Index (BMI), Waist circumference (WC), Body Adiposity Index (BAI) and Visceral Adiposity Index (VAI) were established based on the greatest combination of sensitivity and specificity. Using data from 247 female CHAs, a frequency of DM of 17% (95%CI 12.4-22.1). is observed. WC (AUC = 0.79) has greater power to discriminate DM compared to BAI (AUC = 0.66), VAI (AUC = 0.67), and BMI (AUC = 0.74). Considering that the CHA's adherence to the study corresponds to 70% of these professionals in the city of Vitória/ES, it is possible to establish that the results found are representative of the set of professionals.
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    Consumo de bebidas alcoólicas e alterações na pressão arterial no estudo longitudinal de saúde do adulto (ELSA-Brasil)
    (Universidade Federal do Espírito Santo, 2019-12-27) Coelho, Juliana Schade; Molina, Maria Del Carmen Bisi; https://orcid.org/0000-0001-8746-5860; http://lattes.cnpq.br/9238370951122705; https://orcid.org/; http://lattes.cnpq.br/1084625938938202; Alvim, Rafael de Oliveira; https://orcid.org/; http://lattes.cnpq.br/3204117077254917; Viana, Maria Carmen Moldes; https://orcid.org/0000-0002-0464-4845; http://lattes.cnpq.br/4338126917250074
    Excessive alcohol consumption is related to increased blood pressure. The aim of this study was to investigate the relationship between alcohol consumption and changes in blood pressure after 3.3 years in participants of the Longitudinal Adult Health Study - ELSA-Brasil. Data from 3,990 participants aged 35-74 years old, male and female, from six research and educational institutions at baseline (2008-2010) and follow-up (2012-2014) were analyzed. Participants with hypertension at baseline were excluded. Socioeconomic, hemodynamic, anthropometric and health data were collected. Hypertension was defined as systolic blood pressure ≥140 mmHg and / or diastolic blood pressure ≥90 mmHg and / or use of antihypertensive medication. A questionnaire with closed questions was used to investigate the pattern of intake and frequency of alcohol consumption. The change in consumption was estimated by subtracting the total consumed in wave 2 and at the beginning of the study. After that, the values were categorized in quintiles. The values were also categorized as “stable” (value 0), reduction (<0) and increase (> 0). ANOVA and Tukey's post-hoc test were used to assess the relationship between consumption change and health variables, and paired t-test to compare moments. Crude and adjusted multivariate linear regression models were tested. The adopted significance level was 5%. There was an increase in hemodynamic variables and alcohol consumption in both sexes, being 1.6g / day in men and 0.9g / day in women (p <0.001). Higher increases in systolic blood pressure (p = 0.004) and diastolic blood pressure (p <0.001) occurred among individuals who increased their alcohol consumption at follow-up, in addition to the greater amount of total alcohol (p = 0.030) and distilled liquor (p = 0.043) was found in hypertensive men compared to normotensive men as well as greater difference. Pressure increases in the last quintile of the difference in consumption were observed in all models in diastolic blood pressure, except in model 2 in women. It is concluded that there is a positive relationship between the increase of alcohol consumption and blood pressure, and it is necessary to implement programs to control excess consumption.