Teses de doutorado

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Navegando Teses de doutorado por Autor "Andrade, Maria Angélica Carvalho"

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    ADAPTAÇÃO TRANSCULTURAL DO ADVERSE CHILDHOOD EXPERIENCES INTERNATIONAL QUESTIONNAIRE (ACE-IQ) DA ORGANIZAÇÃO MUNDIAL DA SAÚDE
    (Universidade Federal do Espírito Santo, 2021-02-05) Pereira, Flávia Garcia; Viana, Maria Carmen; https://orcid.org/0000-0002-0464-4845; http://lattes.cnpq.br/4338126917250074; https://orcid.org/0000-0003-0197-511X; http://lattes.cnpq.br/6941353619549683; Miranda, Angelica Espinosa Barbosa; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; Barreto, Sandhi Maria; https://orcid.org/0000-0001-7383-7811; http://lattes.cnpq.br/4454863839030427; Reichenheim, Michael Eduardo; https://orcid.org/0000-0001-7232-6745; http://lattes.cnpq.br/5771380219935512; Andrade, Maria Angélica Carvalho; https://orcid.org/0000000236906416; http://lattes.cnpq.br/5427520110626795
    Introduction: Adverse Childhood Experiences have often been reported in several sociodemographic and cultural contexts. However, the divergence among the methods used to evaluate these experiences has made it difficult to compare data among countries. In order to standardize its assessment and to facilitate strategies for prevention and management, the World Health Organization and the Center for Disease Control and Prevention developed the instrument named “Adverse Childhood Experiences International Questionnaire”. Objectives: 1) To identify, through an review of the literature, the instruments commonly used in the assessment of childhood adverse experiences in epidemiological research conducted over the past ten years and to compar their characteristics. 2) To produce a Portuguese-Brazilian version of the Adverse Childhood Experiences International Questionnaire, through the process of semantic equivalence. Methods: To identify scientific articles, esarches were performed in the Latin American and Caribbean Health Sciences Information System and the Medical Literature Analysis and Retrieval System Online. The Health Sciences Descriptors used, combined with Boolean operators, were: “child neglect OR life change events OR child abuse, adult survivors OR adult survivors of child abuse OR adult survivors of childhood trauma OR adult survivors, child abuse AND questionnaire”. The semantic equivalence of the instrument was performed in five phases: 1) obtaining two forward translations of the original instrument into Brazilian Portuguese and developing a combined version; 2) obtaining two retranslations of the combined version into English; 3) evaluation of the instrument items by a committee of experts, concerning: correspondence of the translation with the original version, relevance/importance, clarity, vocabulary, objectivity, applicability to the Brazilian context and regarding the instructional sequencing of the items; 4) preparation of a synthesis version of the retranslations and the first version of the Portuguese-Brazilian questionnaire; 5) performing two pre-tests to assess acceptability, understanding and emotional impact through face-to-face interviews, and obtaining the final version of the adapted questionnaire. Results: 1) Thirty-eight instruments were identified in the 253 scientific articles analyzed. The most commonly used instruments were described: Childhood Trauma Questionnaire, Childhood Experience of Care and Abuse, Adverse Childhood Experiences Questionnaire, Child Abuse and Trauma Scale, Early Trauma 9 Inventory Self Report, and Adverse Childhood Experiences International Questionnaire. The instruments analyzed differed regarding psychometric properties, age for application, and number of adverse experiences assessed. Considering the instruments evaluated, two have a Brazilian Portuguese version available. 2) The adapted version of the Childhood Experiences International Questionnaire produced demonstrated to be of easy application and to comprehension, and obtained a good semantic equivalence when compared to the original version. Conclusion: Several instruments assessing the exposure to childhood adverse experiences have been used, assessing different parameters and dimensions, impairing the comparability of results. The provision of an international questionnaire adapted to the Brazilian context can contribute to the expansion and standardization of epidemiological research in Brazil. Its psychometric properties still have to be further evaluated.
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    O enfrentamento da Sífilis em Vitória (ES) no quadriênio 2016-2019: avaliação para a gestão
    (Universidade Federal do Espírito Santo, 2021-12-20) Barcelos, Mara Rejane Barroso; Primo, Cândida Caniçali; https://orcid.org/0000000151412898; http://lattes.cnpq.br/4739920753105018; https://orcid.org/0000-0001-7288-9468; http://lattes.cnpq.br/0607193448491008; Lima, Rita de Cássia Duarte; https://orcid.org/0000-0002-5931-398X; http://lattes.cnpq.br/2384472795664270; Figueiredo, Karla Crozeta; https://orcid.org/0000-0003-0917-5301; http://lattes.cnpq.br/8027027232828519; Filippon, Jonathan Gonçalves; https://orcid.org/0000-0003-3907-1992; http://lattes.cnpq.br/1655529281503303; Andrade, Maria Angélica Carvalho; https://orcid.org/0000000236906416; http://lattes.cnpq.br/5427520110626795
    Syphilis is an ancient disease, which continues to be a major public health problem in the world, in Brazil, in the state of Espírito Santo and in Vitória, its capital. The municipality is the main space for the implementation of health policies, from the decentralization of the Unified Health System, through their translation into programs, projects and plans that will guide their conduct. So far, there is no record of the evaluation of the Vitoria Combat Plan against Syphilis in a systematic way. Thus, this evaluation study for management is unprecedented in the municipality. Objectives: to evaluate the actions taken to face syphilis in pregnant women, acquired syphilis and congenital syphilis, in the city of Vitória from 2016 to 2019, to describe the facilities, difficulties and contributions of the actions developed in each axis of the coping plan in the perception of the health professionals and managers, and propose an assessment model to cope with syphilis for the management of the municipality. Method: This is an evaluation study for management, of a descriptive nature, with a quali-quantitative approach, with document analysis, extracting information from health information systems (Information System on Live Births and Information System of Notifiable Diseases), concerning to the years of 2016 to 2019, and conducting 87 interviews with health professionals and 2 focus groups with managers, from the city of Vitória. Results: Although the rate of detection of syphilis in pregnant women has been rising, there was an increase in the percentage of early detection, prenatal coverage and monitoring of pregnant women, evidencing improvements to cope the syphilis in this segment of the population. The city of Vitória showed a significant reduction in the number of cases of congenital syphilis and in the incidence rate of this disease, with improvements in the indicator of follow-up of congenital syphilis. Regarding acquired syphilis, Vitória presented an adequate treatment percentage of 90.08%, with an increase in each year. However, the percentage of monitoring, according to the Ministry of Health (MS), in this period, was 35.71%. Conclusion: The evaluation of the Syphilis Coping Plan contributed to a better understanding of the problem, in addition to providing the opportunity to develop new actions aimed at improving prenatal care and, consequently, the prevention of vertical transmission of syphilis, as well as highlighting the gaps that still exist struggling syphilis, allowing the management of the health sector, access to scientific knowledge that guides decisions. As a contribution to the service, an evaluation model of the Combat Plan against Syphilis was organized and delivered to the municipality, which can be used to evaluate future periods.