PPGSCOL/CCS - Mestrado em Saúde Coletiva
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Master Thesis Classificação funcional e mortalidade em pessoas idosas: um estudo baseado na CIF e na capacidade intrínseca(Universidade Federal do Rio Grande do Norte, 2025-12-09) Faria, Bárbara Brenda de Araújo; Câmara, Saionara Maria Aires da; https://orcid.org/0000-0002-0544-7480; http://lattes.cnpq.br/8437063945554904; Ruaro, João Afonso; Nobre, Thaiza Teixeira XavierIntroduction: Both the International Classification of Functioning, Disability and Health (ICF) and the concept of intrinsic capacity (IC) aim to compile the main aspects of human functionality. Understanding the predictive capacity to identify more vulnerable people can inform health practices and policies. Aim: To analyze the capacity of an ICF core set and IC to predict mortality in community-dwelling older adults after a six-year followup. Methods: This is a longitudinal observational study, developed in the city of Santa Cruz (RN), with 101 older adults (≥60 years). Sociodemographic data, physical health assessment (ICF core set), and IC assessment in four domains were collected (cognitive: Leganés Cognitive Test; psychological: Center for Epidemiological Studies; locomotion: Short Physical Performance Battery; and vitality: grip strength manual). Occurrence of death up to 6 years after the initial assessment was obtained through the Mortality Information System. Data were analyzed using Spearman's correlation test and MannWhitney test. To assess the association between the impairment/problem index (ICF), CI, and mortality, logistic regression, adjusted for sex and age, was applied. In all analyses, a significant level of p < 0.05 was adopted. Results: 13 elderly people (12.9%) died over 6 years. There was a significant low to moderate correlation between all domains of the ICF core set and the CI score, except for the "Health services". The results for CI and the core set were significantly worse among the participants who died. Considering the regression models, the total ICF index was positively associated with mortality (p = 0.02). CI showed a marginally significant result (p = 0.05). Conclusion: The results suggest that both strategies proved useful for assessment in clinical practice and research, allowing for the early detection of modifiable factors that impact the functionality and mortality of older adults, reinforcing the importance of multidimensional assessment approaches for promoting healthy aging.Master Thesis Cárie dentária e fatores associados em estudantes universitários com deficiência da Universidade Federal do Rio Grande do Norte(Universidade Federal do Rio Grande do Norte, 2025-08-06) Lucena, Túlio de Araújo; Mendes, Tamires Carneiro de Oliveira; https://orcid.org/0000-0002-7254-4096; http://lattes.cnpq.br/0917383175974279; http://lattes.cnpq.br/0709738414998081; Noro, Luiz Roberto Augusto; https://orcid.org/0000-0001-8244-0154; http://lattes.cnpq.br/2335211528795775; Pinto, Rafaela da Silveira; http://lattes.cnpq.br/6966526416794160; http://lattes.cnpq.br/6966526416794160In Brazil, the population with disabilities accounts for approximately 8.9%, exhibiting significant inequalities in access to and quality of health services, including oral health. This study aimed to evaluate the situation of dental caries and its associated factors among university students with disabilities at the Federal University of Rio Grande do Norte (UFRN), assisted by the Secretariat of Inclusion and Accessibility. It is a cross-sectional observational study, with data collected through structured interviews and clinical dental examinations, using the DMF-T index to assess caries experience, along with the Oral Impacts on Daily Performance (OIDP) instrument to evaluate subjective perception of oral health. The sample consisted of 43 university students with different types of disabilities, predominantly physical disabilities (44.2%) and Autism Spectrum Disorder (32.6%). Most participants were aged 26 years or older (58.1%), male (55.8%), and selfidentified as Black (51.2%). The DMFT index showed a mean of 8.58 (SD = 6.56) and a median of 9, with an interquartile range between 3 and 13. Results showed a significant association between age and caries experience (p = 0.001), highlighting the cumulative nature of oral damage. It was also observed that recent dental care seeking (p = 0.003) and negative evaluations of received treatment (p = 0.006) were related to higher DMF-T scores, suggesting a reactive and unsatisfactory pattern of care. Furthermore, psychosocial aspects, such as stress related to oral condition (p = 0.012) and embarrassment to smile or speak (p = 0.004), showed a strong correlation with poorer oral health. Detailed tooth analysis revealed greater involvement of posterior teeth, especially molars, reinforcing the need for targeted preventive strategies in these regions. The findings underscore the complexity of oral health among university students with disabilities, emphasizing that dental caries is not merely a clinical marker but an indicator of inequalities and barriers faced by this population in academic and health contexts. Finally, the importance of integrated interventions addressing clinical, social, and psychosocial dimensions is highlighted to promote equity and full inclusion of these students, strengthening public policies and fostering more welcoming and effective care practices.Master Thesis Efeitos da curcumina em mulheres com sindrome pré-menstrual: uma revisão sistemática(Universidade Federal do Rio Grande do Norte, 2025-06-06) Fernandes, Anny Karoliny Pinheiro; Piuvezam, Grasiela; Medeiros, Gidyenne Christine Bandeira Silva de; https://orcid.org/0000-0001-5225-385X; http://lattes.cnpq.br/7128174927654982; https://orcid.org/0000-0002-2343-7251; http://lattes.cnpq.br/0391780760729166; https://orcid.org/0000-0002-6091-7529; http://lattes.cnpq.br/4427197731412125; Araújo, Célia Regina Barbosa de; https://orcid.org/0000-0002-9650-3870; http://lattes.cnpq.br/3197089693483877; Capucho, Helaine Carneiro; https://orcid.org/0000-0002-5438-7963; http://lattes.cnpq.br/0079781302123191; Mirabal, Isabelle Ribeiro Barbosa; https://orcid.org/0000-0002-1385-2849; http://lattes.cnpq.br/0211762022010569Many women of reproductive age say that the luteal phase is a delicate and peculiar time, as it is a period when they experience hormonal fluctuations that trigger physical, psychological, and behavioral symptoms, negatively affecting their emotional, social, and occupational environments. Such discomforts, which manifest themselves weeks before the menstrual period and are relieved after the onset of menstruation, are clinical characteristics of premenstrual syndrome (PMS), also popularly known as premenstrual tension (PMT). Given the numerous treatments available to improve symptoms, women have preferred more natural approaches, through physical exercise, proper nutrition, vitamins, and supplements. Thus, among natural interventions, curcumin stands out as an alternative for women who are more sensitive to PMS symptoms. In this perspective, the objective is to synthesize the scientific evidence on the effectiveness of curcumin supplementation in women sensitive to PMS symptoms through a systematic review. This study is a systematic review registered in the PROSPERO database (CRD420251022573), developed in accordance with the guidelines described by the Preferred Reporting Items for Systematic Reviews PRISMA-P. The electronic research databases selected for the search were PubMed, Embase, Scopus, Web of Science-Main Collection, Cochrane Central Register of Controlled Studies, and Clinical Trials, in December 2024. In addition, 623 bibliographic references were found, of which eleven studies were selected for full reading. After careful screening, six articles were included in the current Systematic Review. These studies highlight the relevance of curcumin in women's health, acting on hormone regulation and reducing oxidative stress, thus attenuating physical, behavioral, and emotional symptoms. Therefore, based on scientific findings, it is concluded that curcumin has a positive effect on PMS symptoms.Master Thesis Perfil e prática de gestores municipais da atenção à saúde da pessoa idosa no Amazonas(Universidade Federal do Rio Grande do Norte, 2025-06-26) Palha, Vivianne Karol Gomes; Mendes, Tamires Carneiro de Oliveira; Lima, Kenio Costa de; https://orcid.org/0000-0002-5668-4398; http://lattes.cnpq.br/5835673385014578; https://orcid.org/0000-0002-7254-4096; http://lattes.cnpq.br/0917383175974279; http://lattes.cnpq.br/3305239734048498; Piuvezam, Grasiela; https://orcid.org/0000-0002-2343-7251; http://lattes.cnpq.br/0391780760729166; Silva, Vanessa de Lima; https://orcid.org/0000-0002-1562-1761; http://lattes.cnpq.br/9648971267582561In Brazil, although legislation for the elderly is quite advanced, its implementation in practice has been very challenging, requiring greater efforts to promote autonomy and healthy aging, considering the significant changes in human population dynamics and the emergence of new challenges and opportunities for the age group over 60 years. In Amazonas, specific challenges such as geography, territorial dynamics, and cultural diversity require innovative solutions that meet the specific needs of its population. It is assumed that for effective management of public health policies aimed at implementing a care line for the health of the elderly, quick and timely deliberations are imperative to realize the existing policies. This study aims to analyze the profile of technical managers responsible for the implementation of health policies for the elderly. This is a descriptive, exploratory, cross-sectional research with a quantitative approach. Data collection took place through an online interview conducted via audio/video telephone calls with health action managers for elderly individuals in the Amazon municipalities in the year 2024. The study shows that the management of health actions for elderly individuals in the municipalities of Amazonas has a profile of young women in the workforce, that the interviewees have an average age of 40.4 years (±8.73), are temporarily linked to the Municipal Health Department, have been working in the department for an average of only ±2.51 years (3.12), and are graduates in Nursing. It also indicates that 89.2% of the interviewees share management responsibilities with other health actions, 65.71% are unaware of legal frameworks and other guiding documents, 54.3% have previous management experience, and 45.7% lack representation in the Municipal Councils for the Elderly. The study shows that the participating municipalities have demonstrated intentionality in the improvement, maintenance, and recovery of the functional capacity of elderly individuals. However, weaknesses in the management of elderly health are identified, expressed by: a lack of training in aging and public health policy management; and a vulnerable employment relationship, demonstrating the need to reduce job insecurity to prevent disruptions in work processes, interrupt the continuity of care, and detriment to the quality of services offered. It is recommended to invest in professional training and avoid turnover and overload of technicians to ensure management that promotes a line of care appropriate to the population's demands.Master Thesis Espiritualidade dos pacientes diante do enfrentamento do câncer: uma revisão de escopo(Universidade Federal do Rio Grande do Norte, 2023-04-28) Macedo, Sonaly Melo de; Amorim, Karla Patricia Cardoso; http://lattes.cnpq.br/6339836465951509; http://lattes.cnpq.br/6485913539348859; Bosco Filho, João; http://lattes.cnpq.br/3068285662145237; Nascimento, Rodson Ricardo Souza do; http://lattes.cnpq.br/0285782531876529INTRODUCTION: Cancer is considered a serious public health problem, according to the National Cancer Institute (INCA), in Brazil, there will be 704 thousand new cases of cancer between 2023-2025. Experiencing the pain and suffering caused by an oncological disease can make individuals trigger a greater connection with spirituality. Individual beliefs and activities have the ability to focus on hope and can be understood as a strategy for alleviating suffering. OBJECTIVE: To verify how the spirituality of cancer patients is present in the process of coping with the disease. METHOD: This is a scoping review developed in accordance with Arksey and O'Malley and Levac et al, based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The records were mapped in the Virtual Health Library databases. The search strategy was developed by combining descriptors and using the Boolean operator AND: spirituality and cancer and patients; spirituality and oncology and patients. Rayyan software was used to select articles by analyzing the title and abstract. In total, 1778 articles were obtained, of which 494 were selected according to the research questions (using the mnemonic PCC - Population–Concept– Context). In the end, 299 articles were included and analyzed. Because, although 494 articles, during the initial selection by title and abstract, were classified a priori as eligible, 195 were not accessible in CAPES Periódicos - UFRN, being excluded from the research universe. RESULTS AND DISCUSSION: Patients experienced and expressed spirituality linked to religiosity as a means of facing the disease through prayers, faith in God and healing, connection with the transcendent, reading religious scriptures, greater attendance at religious services, being close to nature and in harmony with the environment. Spirituality implied more positive aspects than negative ones. Providing meaning/purpose in life, comfort, strength, pain relief, confidence, increased feelings of peace, quality of life and less psychological suffering, helping to better face adverse situations. The perception of finitude is inherent to human beings. Faced with a diagnosis with no prospect of a cure, the individual may experience a mix of feelings interfering with their life projects, emotional/family bonds and awakening fear. As a result of these dilemmas, spirituality and/or religiosity can provide a greater sense of support to be able to face the problems experienced at the moment, bringing hope through faith and spiritual/religious beliefs. FINAL CONSIDERATIONS: Spirituality plays an important implication during the process of coping with the disease. Bringing strength, faith, hope and comfort. It may be associated with a better quality of life and psychological well-being, reducing anxiety/depression and spiritual suffering triggered by the disease.Master Thesis Associação entre o uso de polifarmácia e a ocorrência de quedas em idosos não institucionalizados(Universidade Federal do Rio Grande do Norte, 2024-01-25) Nascimento, Jeovani Almeida do; Mendonça, Ana Elza Oliveira de; Nobre, Thaiza Teixeira Xavier; https://orcid.org/0000-0002-8673-0009; http://lattes.cnpq.br/2813639308023253; https://orcid.org/0000-0001-9015-211X; http://lattes.cnpq.br/5531967242281430; https://orcid.org/0009-0002-4828-3989; http://lattes.cnpq.br/9121547977031002; Andrade, Fábia Barbosa de; https://orcid.org/0000-0002-7055-8726; http://lattes.cnpq.br/0315846984480655; Assis, Sanderson José Costa de; http://lattes.cnpq.br/6868013135086205Introduction: The elderly population faces multiple diseases, especially non-communicable chronic diseases that require continuous treatment. Polypharmacy, characterized by the use of five or more medications, is common in this age group, and the lack of training among healthcare teams can exacerbate the situation. This increases the prevalence of adverse effects and drug interactions, which in turn contributes to a higher risk of falls among the elderly. Objective: To estimate the occurrence of falls and their association with polypharmacy in the elderly. Method: It is divided into two studies: 1) Integrative literature review to investigate the prevalence of polypharmacy in the elderly in Primary Health Care, using the PCC strategy to formulate the review question "What is the occurrence of polypharmacy in the elderly in the scope of Primary Health Care?". Free full-text studies conducted with the elderly in this context and addressing polypharmacy were included, with no restrictions on methodology, language, or country of publication, during the years 2021 and 2022. and 2) Cross-sectional study conducted with 100 elderly individuals in a Basic Health Unit (UBS) in a municipality in Northeast Brazil. Data collection was carried out using the Elderly Health Notebook and Handgrip Strength (HGS). The explanatory variables for the outcome "Falls" were grouped according to demographic characteristics and health assessment of the elderly person. Descriptive and bivariate analyses were performed, followed by Multiple Poisson Regression analysis. Results: Polypharmacy was more frequent in elderly individuals undergoing treatment for chronic diseases, especially Systemic Arterial Hypertension (SAH) and Diabetes Mellitus, described in 71.4% of the studies. The frequency of polypharmacy in elderly individuals under follow-up in Primary Health Care (PHC) ranged from 18.8% to 100.0%. The most commonly used drugs were for the cardiovascular and metabolic systems. An average age of 71.5 years (SD: 6.08-6.34) was found with a predominance of females (68%). The prevalence of falls was 42%, and factors associated with the occurrence of falls were polypharmacy (p = 0.015; PR: 5.04; 95% CI 1.36-18.6), weak handgrip strength (p = 0.414; PR: 1.81; 95% CI 0.43- 7.63), and being 75 years old (p = 0.001; PR: 1.05; 95% CI 1.02-1.09). Most participants had one or more chronic diseases. Conclusion: Elderly individuals using polypharmacy require greater attention and care to prevent adverse events such as falls. The research data revealed that the prevalence of falls in the elderly was positively associated with polypharmacy, weak handgrip strength, and being 75 years old.Master Thesis Saúde digital na Atenção Primária à Saúde do SUS: comunicação entre os serviços e os usuários(Universidade Federal do Rio Grande do Norte, 2025-08-15) Silva, Amanda Jéssica Bernardo da; Uchôa, Severina Alice da Costa; https://orcid.org/0000-0002-2531-9937; http://lattes.cnpq.br/8414233332373275; http://lattes.cnpq.br/5081165735518418; Noro, Luiz Roberto Augusto; https://orcid.org/0000-0001-8244-0154; http://lattes.cnpq.br/2335211528795775; Oliveira, Ricardo Antunes Dantas de; https://orcid.org/0000-0003-0144-7288; http://lattes.cnpq.br/7112638703954011Introduction: For some decades, there has been a strong trend towards the use of digital tools as health care tools. Through these tools, the computerization of Brazilian Primary Health Care (PHC) has emerged as a new trend in communication between health services and users. Objective: This research aims to characterize digital communication practices developed by PHC units and Community Health Workers (CHW) with users in the municipality of NatalRN. Methodology: Two complementary case studies were developed: 1) Quantitative analysis of the use of Instagram by 31 health units of the PHC of Natal, using documentary analysis from Cellard's perspective and frequency analysis; 2) Qualitative study through Focus Groups with CHW to identify the use not only of Instagram but of other digital tools, as well as the technological infrastructure of the PHC units and the existence of protocols, guidelines, regulations and qualification of CHW for the use of these tools, analyzed according to Bardin. Results: Regarding the first study, the data revealed that the use of Instagram by health units intensified after the COVID-19 pandemic; teams with greater access to the platform showed a greater capacity to implement digital actions; regarding study 2, participants reported that the technological and physical structure for the use of digital tools in communication with users is precarious, requiring them to use mainly WhatsApp through their own smartphones. In addition, the lack of protocols that guide the use of these tools in the PHC of Natal was reported, resulting in the lack of professional qualification and an increase in the demand for work. Conclusion: The use of digital tools by PHC professionals in Natal is a reality, corroborating the idea that Digital Health actions, especially those involving social media, enable PHC services to contact their users. However, this use has occurred mainly through the initiative of professionals, who use their own resources because they understand the benefits of digital tools. It is expected that the findings of this research will make it possible to strengthen policies, strategies and actions regarding the use of these tools in PHC, improving communication between professionals and service users.Master Thesis Tempo de espera entre o diagnóstico e o tratamento do câncer de mama em mulheres no Brasil(Universidade Federal do Rio Grande do Norte, 2025-07-28) Silva, Paulo Vitor de Souza; Souza, Dyego Leandro Bezerra de; https://orcid.org/0000-0001-8426-3120; http://lattes.cnpq.br/9953301230987878; https://orcid.org/0000-0001-8961-9026; http://lattes.cnpq.br/7518787067765891; Mirabal, Isabelle Ribeiro Barbosa; https://orcid.org/0000-0002-1385-2849; http://lattes.cnpq.br/0211762022010569; Freitas, Yan Nogueira Leite de; https://orcid.org/0000-0002-5843-4878; http://lattes.cnpq.br/2433847214117166Introduction: Cancer remains one of the most pressing contemporary challenges in the social, economic, and public health domains. Among women, breast cancer is the most prevalent malignant neoplasm and also the leading cause of cancer-related mortality. Delays in initiating oncological treatment are recurrent, multifactorial, and associated with decreased survival rates among women. Objective: To analyze the waiting time between diagnosis and treatment initiation in women with breast cancer in Brazil. Methodology: Two methodological designs were developed. (1) An ecological time series study covering the period from 2006 to 2019, with analysis by state, for cases with and without prior diagnosis. The data were obtained from the Integrated Hospital Cancer Registry (IHCR), and the temporal trend was estimated using a Joinpoint regression model (2) Ecological spatial analysis study, conducted in the 133 Intermediate Urban Articulation Regions (IUAR), focusing on the period after the law (2013-2019). The dependent variable (start of treatment within 60 days) was extracted from the IRHC, while the independent contextual variables were obtained from the Atlas of Human Development in Brazil and the Department of Informatics (DATASUS). The detection of territorial clusters was verified by the Global Moran Index and Local Spatial Association Indicator (LISA). In the multivariate analysis, we chose to use a model with a global spatial effect. Results: (1) Cases without a previous diagnosis of breast cancer showed a greater tendency to start cancer treatment within the legal deadline of 60 days, compared to those with a previous diagnosis. This pattern was observed both before and after the enactment of the law. (2) The percentage of treatment initiation within 60 days showed a positive spatial correlation with the density of family and community physicians (p=0.007) and with the proportion of surgical procedures (p=0.001). Final Considerations: The results of this dissertation show the persistence of delays in the timely initiation of breast cancer treatment, even after the enactment of the 60-day law, especially for cases with a previous diagnosis. This indicates the influence of contextual factors, especially those related to the provision of services in the process of initiating treatment within 60 days.Master Thesis Fatores relacionados ao adoecimento, à satisfação e aos impactos do trabalho na saúde de profissionais que atuam nos Centros de Atenção Psicossocial(Universidade Federal do Rio Grande do Norte, 2025-07-17) Graça, José Mateus Bezerra da; Cavalcante, Elisângela Franco de Oliveira; https://orcid.org/0000-0002-3578-0153; http://lattes.cnpq.br/9020549482920149; https://orcid.org/0000-0002-0401-2987; http://lattes.cnpq.br/6938565052177118; Vieira, Alcivan Nunes; https://orcid.org/0000-0003-4222-6262; http://lattes.cnpq.br/0862127973452482; Severo, Ana Kalliny de Sousa; https://orcid.org/0000-0002-9548-6394; http://lattes.cnpq.br/5170430928839162; Freitas, Cláudia Helena Soares de Morais; https://orcid.org/0000-0003-0265-5396; http://lattes.cnpq.br/8905654343063318OBJECTIVE: This dissertation aimed to analyze factors related to illness, job satisfaction, and the health impacts of work among professionals at the Psychosocial Care Centers (CAPS) in the municipality of Natal, Brazil. METHODS: Two complementary methodological designs were employed. The first phase consisted of a scoping review conducted in accordance with the Joanna Briggs Institute guidelines and the PRISMA-ScR framework, mapping the available evidence on factors associated with illness, job satisfaction, and work-related health impacts in mental health services. The second phase involved a cross-sectional, descriptive, and analytical study with a quantitative approach, conducted with all professionals working in the five CAPS of Natal, thus characterizing a census. Participants included workers with a minimum of four months of employment and at least 20 weekly working hours. Data collection instruments included a sociodemographic and professional profile questionnaire, as well as two validated scales (SATIS-BR and IMPACTO-BR) to assess the correlation between job satisfaction and the impacts of work on health. RESULTS: The review identified key critical elements such as precarious employment relationships, physical and emotional overload, insufficient physical infrastructure, and weaknesses in training and professional development processes. These factors were found to be associated with mental health issues among professionals, ultimately affecting the quality of care provided. Regarding the cross-sectional study conducted, the analyses indicated moderate levels of overall job satisfaction coexisting with high physical and emotional burden. The SATIS-BR results showed higher satisfaction among professionals with interpersonal relationships within the service and the quality of care provided, while the lowest mean scores were related to working conditions. In the IMPACT-BR assessment, the most significant impacts were linked to emotional overload and team functioning, highlighting the need for targeted interventions to improve the work environment and labor conditions. Positive aspects included the quality of interpersonal relationships and the sense of autonomy at work. On the other hand, precarious employment, shorter professional experience, and lack of specific training in mental health were associated with increased vulnerability to psychological distress and lower job satisfaction. CONCLUSION: The findings demonstrate that working conditions in CAPS directly affect the physical and mental health of professionals and also influence the quality of care provided to users of the Unified Health System (SUS).Master Thesis Demandas judiciais por fórmulas nutricionais na Secretaria Municipal de Saúde de Natal: diagnóstico e perspectivas(Universidade Federal do Rio Grande do Norte, 2023-03-20) Silva, Rita Xavier Barbosa Neta; Amorim, Karla Patricia Cardoso; Martins, Leonardo; https://orcid.org/0000-0002-1188-8194; http://lattes.cnpq.br/6963079630876141; http://lattes.cnpq.br/6339836465951509; Ferreira, Maria Angela Fernandes; https://orcid.org/0000-0002-6142-948X; http://lattes.cnpq.br/4036539286429296; Oliveira, Yonara Monique da Costa; https://orcid.org/0000-0001-7541-7677; http://lattes.cnpq.br/7877043354904559Introduction: Health and food are known as socials rights according with the 1988 federal constitution, and the solicitation of nourishment formulas by judicial actions against the three spheres of management has been a way to effect this rights. Objective: To analise the judicial demands for nutricional formulas of the county of Natal/RN assisted in the period of 2010 to 2020. Metods: It´s a documental study, witch has a descriptive exploratory with a quantitative approach, in witch the analyses unity were individual law suits for solicitation of nutricional formulas, having, as defendant Natal’s city. Results and discussions: Looking at the sociodemographic features concerning to the litigant, medic-sanitary and juridic autor of judicial demands nutricional formulas of Natal/RN between the years of 2010 and 2020. Could see that, the biggest percentual was front the masculine sex (52%) and younger than 18 years (64%). The larger seccionou the demands were provenients from the north 1 sanitary district (28%) and north 2 (22%). The biggest part of the trial refers only to one disease or condition witch demanded a necessity of 54% of nourish formulas. In the most number of the trials the nurture formula was provided by the public sector (60%). The nourish formula kind most requested was the modules and suplements for adults (32%). The majoritary part of the trials was by representation of the public defensory (80%) and judicial decison occurred by sentence (60%). The most common disease are neurologic diseases (50,0%), followed by stroke (8%). The mensal cost for the atendimento of judicial demands considering all the demands from the trials in a month was R$ 40.790,48. The necessary value for the Monthly cost of the prescribed formulas on the judicial demands was between R$ 123,36 and R$ 3366,00, being the average R$ 815,00. When evaluating the Search for health care before the judicialization, is noticible that 86% searched for a servisse, although 51,2 went to health unit which do not distribute norishment formulas for free. Final considerations: The city of Natal have conditions to through your existents health care programs to improve de management by fortification with a proper financing to receive the demands withou the need of trials and with that decrase considerably the judicialization of nourishment formulas.Master Thesis Tuberculose em pessoas idosas: análise de fatores associados, tendências temporais e revisão de evidências científicas(Universidade Federal do Rio Grande do Norte, 2025-06-26) Batista, Francisco de Assis Moura; Nobre, Thaiza Teixeira Xavier; Soares, Fernanda Cunha; https://orcid.org/0000-0001-6465-3164; http://lattes.cnpq.br/8482423609963792; https://orcid.org/0000-0002-8673-0009; http://lattes.cnpq.br/2813639308023253; https://orcid.org/0000-0003-2403-4830; http://lattes.cnpq.br/3010503938552323; Mendonça, Ana Elza Oliveira de; https://orcid.org/0000-0001-9015-211X; http://lattes.cnpq.br/5531967242281430; Reis, Luciana Araújo dos; http://lattes.cnpq.br/5865016290526865Introduction: Tuberculosis (TB), despite being an ancient disease, remains a significant public health concern in Brazil and worldwide. It is caused by infection with Mycobacterium tuberculosis, also known as the Koch bacillus, and primarily affects the lungs, though it may also involve other organs. Old person are more susceptible to developing the disease due to the weakening of organ systems inherent to the aging process (senescence). Objective: To analyze the associated factors, temporal trends, and scientific evidence regarding TB in older adults. Methodology: To achieve the proposed objectives, three research products were developed. (1) A descriptive, retrospective ecological study with a quantitative, cross-sectional design was conducted to analyze the temporal trends (TT) of TB incidence (TI) and mortality (TM) rates among older adults in the Brazilian Northeast between 2012 and 2022. Data were collected from the Department of Informatics of the Brazilian Unified Health System (DATASUS), and TT was assessed using the Prais-Winsten generalized linear regression model, which accounts for first-order autocorrelation (AR1). (2) A scoping review protocol was designed to identify the main factors associated with pulmonary tuberculosis (PTB) in older adults. The protocol followed the Joanna Briggs Institute (JBI) guidelines for this type of review and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols extension for scoping reviews (PRISMA-ScR). It was registered with the Open Science Framework (OSF). (3) The final product is a scoping review, aimed at rigorously and transparently mapping the state of the art on the key factors associated with PTB in older adults. Results: Article (1) demonstrated that both incidence and mortality rates were higher among males, individuals aged 60 to 69, and those of mixed race/color. An increase in the Annual Percent Change (APC) in incidence was observed among females in the state of Pernambuco. Article (2), the scoping review protocol, provided the methodological foundation for the development of the review itself. Article (3), the resulting scoping review, revealed that PTB in older adults is influenced by multifactorial determinants, including male sex, pre-existing diabetes mellitus, tobacco use, and close contact with individuals with active TB. Final Considerations: By analyzing associated factors, temporal trends, and scientific evidence, this research revealed epidemiological, clinical, and social vulnerabilities related to TB in older adults, the three products developed underscore the urgent need for targeted public policies, strengthened epidemiological surveillance, and intersectoral approaches. The findings contribute to the development of more effective strategies for prevention, diagnosis, and management of TB in the elderly population, ultimately promoting healthier and more equitable aging.Master Thesis Custos e mortalidades por diabetes mellitus no Brasil e prevenção das doenças dos pés relacionadas ao diabetes na atenção primária à saúde(Universidade Federal do Rio Grande do Norte, 2025-02-17) Araújo, Luciana Lima de; Mendonca, Ana Elza Oliveira de; https://orcid.org/0000-0001-9015-211X; http://lattes.cnpq.br/5531967242281430; https://orcid.org/0000-0001-6103-0842; http://lattes.cnpq.br/4355093042351266; Soria, Aurora Del Carmen Rosell; Felix, Lidiany Galdino; Nobre, Thaiza Teixeira XavierIntroduction. With the ageing of the population, Brazil has been experiencing a process of demographic transition which has led to an increase in chronic non-communicable diseases, among which Diabetes Mellitus stands out. The increase in the number of people with the disease is considered a serious public health problem, given the need for high investment in both outpatient and inpatient treatment, as well as in the promotion and prevention of the disease. The latter is a challenge for the promoters of social public policies: government officials, researchers and society in general as co-responsible for self-care. According to the Brazilian Diabetes Society, around 8.8% of the world's population lives with the disease and by 2045 the number of diabetics is expected to rise to more than 628.6 million people worldwide. Objective. To analyze the mortality and costs of diabetes mellitus in Brazil and identify actions to prevent diabetic foot within the scope of Primary Health Care. Methodology. Article 1: Ecological study of spatial analysis of mortality from diabetes, with a quantitative and descriptive approach, using the specific mortality rate per 100,000 inhabitants; Article 2: Integrative literature review study, to survey publications on virtual platforms, PubMed, Virtual Health Library and Scielo. Results. Article 1 and 2: The highest mortality rates occurred in the states of Roraima (4.74), Acre (3.18), Alagoas (3.12), Amapá (3.02). The state of Amazonas was in 8th place (2.48), with the lowest rates in the Federal District (0.98) and Paraná (0.85). Article 2: Thirteen studies were selected and the main actions for preventing diabetic foot within the scope of PHC were those related to adequate foot care, including nail and skin care, and the importance of daily foot monitoring. Patients with sensory loss should be educated on how to use other sensory modalities (palpation, visual inspection with an unbreakable mirror) to detect possible foot problems early. Article 3: When analyzing the total costs of the gross domestic product of each state, the scenario indicates that the Northeast and North regions stand out. The costs of hospital services are higher than the costs of professional services. Conclusion. Although morbidity from Diabetes Mellitus is on the rise in Brazil, there has been a reduction in mortality between 2012 and 2022, except in some specific regions in the North and Northeast. When analyzing the total costs of the gross domestic product of each state, the scenario indicates that the Northeast and North regions stand out. The costs of hospital services are higher than the costs of professional services. According to the studies analyzed, the occurrence of foot damage is an avoidable complication of diabetes, but it remains a frequent condition and this leads to complex situations such as lower limb amputations and death. The studies point to the need to control diabetes complications, with emphasis on expanding the care network; implementing practice protocols in the routines of care at basic health units; health education for both professionals and patients; and guidance on self-care and regular foot assessment.Master Thesis Judicialização da saúde: análise das demandas judiciais por fórmulas nutricionais no Estado do Rio Grande do Norte(Universidade Federal do Rio Grande do Norte, 2023-11-06) Lima, Kellen Cristina Marques de; Ferreira, Maria Ângela Fernandes; https://orcid.org/0000-0002-6142-948X; http://lattes.cnpq.br/4036539286429296; http://lattes.cnpq.br/1286164305538110; Freitas, Cláudia Helena Soares de Morais; Oliveira, Yonara Monique da CostaNutrition and food play an essential role in health, supported by the National Food and Nutrition Policy and the Federal Constitution of 1988. However, nutritional formulas, which are used to treat or prevent nutritional problems, are often difficult to afford due to high costs and lack of free access through the healthcare system. This study aims to understand the judicial actions for the supply of nutritional formulas demanded against the state of Rio Grande do Norte in the period from 2017 to 2021. The study is of the exploratory descriptive type, and a database containing individual legal case data filed against the state during the aforementioned period was used. Descriptive data analysis was performed using Microsoft Excel version 2306. A total of 132 active cases were identified. The majority of claimants are female (52.3%), belonging to the child and adolescent population (40.9%). Neurological diseases accounted for 40.2% of the total indications for nutritional formulas. Regarding the origin of the claimants, most of them came from the 7th health region of RN - Natal and the metropolitan region (49%). The seizure of funds was involved in 54.5% of all cases, and the prescription for the formula was made by a nutritionist in 66.7% of cases compared to a medical prescription. In terms of costs incurred through legal claims, the total accumulated during the evaluated period was R$ 3,828,262.00, with an annual average expenditure of R$ 765,652.50. Modified and pediatric formulas accounted for the majority of costs during the evaluated period, at 44.6% and 44.1%, respectively. The average number of days between legal action and the date of the judicial decision was 28.8 days, and the total time from legal action to treatment was approximately 64.8 days. The findings revealed a notable concentration of claimants in Natal. This points to the need for a more detailed analysis of local conditions and healthcare policies to ensure that the region's specific needs are adequately met. Furthermore, there is a constant increase in the number of requests for nutritional formulas over the evaluated years. The cost of judicialization of nutritional formulas is still relatively lower in comparison to medications, suggesting an opportunity to assess resource allocation within the healthcare system to meet the nutritional needs of these claimants.Master Thesis Consumo de biodiversidade alimentar entre adultos e idosos: estudo Brazuca Natal(Universidade Federal do Rio Grande do Norte, 2025-01-29) Medeiros, Maria Fernanda Araújo de; Lima, Severina Carla Vieira Cunha; Jacob, Michelle Cristine Medeiros; https://orcid.org/0000-0001-8268-1986; http://lattes.cnpq.br/8818927353248941; Medeiros, Gidyenne Christine Bandeira Silva de; Rocha, Maria CeciliaThe evaluation of food biodiversity has been gaining prominence in nutrition due to the positive association between the diversity of consumed foods, diet quality, and individual health. However, the use of methods capable of capturing species diversity a posteriori in human diets remains limited, representing a gap for national and international studies that assess food consumption. This study aims to propose a methodology for identifying food biodiversity and analyzing the biodiversity consumption of adults and the elderly in the municipality of Natal/RN. This dissertation is a quantitative, cross-sectional, analytical study with complex sampling. Individual data were obtained from the "Brazilian Usual Consumption Assessment" (Brazuca-Natal) population-based study conducted in 2019-2020. A four-step approach was developed to identify food biodiversity a posteriori in the food consumption database of 398 participants, which consists of: 1st step) Data cleaning and verification; 2nd step) Identification of the type of processing of food items according to the Nova food classification system (G1 - Unprocessed or minimally processed foods, G2 - Culinary ingredients, G3 - Processed foods, and G4 - Ultra-processed foods); 3rd step) Taxonomic clues: assignment of scientific names to species based on vernacular names; 4th step) Inclusion of identified species in the database. We applied the DSR biodiversity indicator, adjusted per 1000 kcal, to food intake data and categorized biodiversity consumption into tertiles of unique species consumption. We analyzed the relationship between biodiversity consumption and sociodemographic and anthropometric variables using Pearson's chi-square test (p<0.05). A total of 178 varieties of food origins were identified, including 20 animal species and 158 plant or fungi species. The number of animal species under the Nova food groups were: G1=14, G2=3, G3=5, G4=5; and plant or fungi species were: G1=145, G2=10, G3=50, G4=40. The results highlight the prominence of beans, sugar, corn, rice, wheat, beef, chicken, and coffee in the diet of the Natal population. In multinomial logistic regression, we observed a positive association between biodiversity consumption and male gender and a negative association with the elderly life stage (p<0.001, both), in unadjusted and adjusted analyses. When extrapolating statistical parameters, we observed in the unadjusted analysis that residents of the North Zone are more likely to consume in tertile 1 (lower biodiversity consumption) than in tertile 3 (higher biodiversity consumption) (p 0.045), and individuals with excess weight by BMI are more likely to consume in tertile 2 (intermediate biodiversity consumption) than in tertile 3, in both unadjusted (p 0.036) and adjusted analyses (p 0.010). We conclude that the proposed methodology provides a foundation for more contextually appropriate actions in the field of nutrition. The analysis of dietary biodiversity among adults and older adults revealed that dietary biodiversity is linked to health determinants.Master Thesis Teletrabalho na Secretaria de Saúde Pública do Rio Grande do Norte(Universidade Federal do Rio Grande do Norte, 2025-02-06) Lopes, Maria Antonia Dantas e Silva; Costa, Marcelo Viana da; https://orcid.org/0000-0002-3673-2727; http://lattes.cnpq.br/1801687907907663; Castro, Janete Lima de; Góis, Palmyra Sayonara deThe COVID-19 pandemic brought profound changes to the workplace, accelerating the implementation of telework as an alternative to ensure safety and continuity of work activities. In the context of the State Secretariat of Public Health of Rio Grande do Norte (SESAP), the regulation of this modality was formalized through Decree No. 31.540/2022 and Ordinance No. 788/2023, aiming to establish criteria and requirements for the performance of remote activities. Despite the benefits related to flexibility and worker protection, adaptation faced challenges such as limited infrastructure, technological difficulties, and the need for specific regulations. This study aimed to analyze the conditions of remote work at SESAP between 2020 and 2022, focusing on aspects related to work organization, working conditions, and socio-professional relations. The research was conducted as a cross-sectional and quantitative study. Data were collected between February and April 2024 through questionnaires administered to SESAP employees who worked remotely during the analyzed period. The research instrument included a sociodemographic questionnaire and the Work Context Assessment Scale (EACT), which evaluates employees' perceptions across three dimensions: work organization, working conditions, and socio-professional relations. Data analysis used descriptive statistical techniques with the aid of SPSS and Google Sheets software. Among the 54 employees who participated in the study, 77.8% were women, reflecting the female predominance in the health administration sector. The analysis revealed a critical situation in the dimension of work organization, with an average score of 3.11, indicating task overload, deadline pressure, and strict performance monitoring. These factors suggest a work environment characterized by excessive workload and insufficient staffing. The socio-professional relations dimension had an average score of 2.07, considered satisfactory, although challenges related to cooperation among colleagues and managerial support still exist. Finally, the working conditions dimension obtained the lowest average score, 1.88, indicating that despite some specific challenges, the physical and structural environment of remote work was rated as adequate by most respondents. The results highlight the need for interventions to improve the remote work environment, such as revising institutional goals, redistributing tasks, and implementing regular breaks. Participatory management, combined with fostering interpersonal communication and leadership support, can reduce stress levels and increase employee satisfaction and productivity. Furthermore, the study underscores the importance of considering the specificities of telework to ensure healthy and sustainable working conditions. Policies that promote a balance between work demands and team capacities are essential to prevent physical and mental health issues among workers. This study contributes to the understanding of the challenges of remote work in the public health sector and to the formulation of strategies that address the needs of both workers and organizations.Master Thesis Efeito de diferentes doses do laser de baixa intensidade sobre a viabilidade celular e o estresse oxidativo em células-tronco do ligamento periodontal(Universidade Federal do Rio Grande do Norte, 2018-07-23) Mota Filho, Haroldo Gurgel; Lins, Ruthineia Diógenes Alves Uchoa; https://orcid.org/0000-0002-0047-5976; http://lattes.cnpq.br/4462076152744400; http://lattes.cnpq.br/6463272003297412; Martins, Ana Rafaela Luz de Aquino; Nóbrega, Fernando José de OliveiraLow-intensity laser therapy (LBI) is widely used in different areas of regenerative medicine, especially for its beneficial effects on cellular metabolism. In this study, the effects of LBI on cell viability and oxidative stress of periodontal ligament stem cells (PDLSCs) were evaluated. As PDLSCs were isolated the periodically extracted from human teeth. The cells then undergo a cell characterization process, through differentiation in adipogenic and osteogenic culture media, and also through analysis of stem cell surface markers in flow cytometry. After their acquisition and characterization, PDLSCs were maintained under cell growth conditions and divided into three groups: Group I (control); Group II (Laser 7.5 J/cm2) and Group III (Laser 22.5 J/cm2). The experiments were completed in quadruplicate and occurred in three time intervals (T0h, T24h and T48h). After the time intervals, the experimental tests were done to evaluate the cellular criteria. For the analysis of cell viability the MTT assay was used. The evaluation of reactive oxygen species was used as a dosage of malonaldehyde and glutathione. Preliminary results were positive as cells studied were positive for markers of mesenchymal stem cells and still differed in adipocytes and osteoblasts cell like. The results of the MTT assay were altered by Group III in relation to Group I in relation to Group II. The results of the MDA tests were significantly different in the intergroup interval at the time studied, but numerically the Group II presented as main means of absorbances. The differences between the experimental groups were not included in the GSH test. On the basis of the results concluded, irradiation with low intensity laser at higher doses (7.5 and 22.5 J/cm2) is not potentially inducing cell proliferation and that, after 48 hours of irradiation, a dose of 22.5 J/cm2 is applied to the cells of the PDLSCs system, but it is not possible, however, whether it is a deadly attack and is not significant in the release of reactive oxygen species.Master Thesis A gestão em saúde e o uso das tecnologias de informação e comunicação nos serviços de saúde durante a Covid-19(Universidade Federal do Rio Grande do Norte, 2025-01-23) Andrade, Flávia Thays Silva Araújo; Nobre, Thaiza Teixeira Xavier; Severo, Ana Kalliny de Sousa; https://orcid.org/0000-0002-8673-0009; http://lattes.cnpq.br/2813639308023253; https://orcid.org/0009-0008-0701-759X; http://lattes.cnpq.br/7809416349278789; Mendonca, Ana Elza Oliveira de; Reis, Luciana Araújo dosMaster Thesis Consequências da pandemia de Covid-19 nos processos de trabalho e nas condições de saúde de profissionais da gestão da Secretaria do Estado de Saúde Pública do Rio Grande do Norte(Universidade Federal do Rio Grande do Norte, 2025-02-03) Nascimento, Emanuelle Yasmim Silva do; Gondim, Grácia Maria de Miranda; http://lattes.cnpq.br/8361045312016183; https://orcid.org/0009-0001-8705-5666; http://lattes.cnpq.br/9125344261167746; Ferreira, Maria Angela Fernandes; Lima, Rafael Rodolfo Tomaz deAt the beginning of 2020, the global population was confronted with the pandemic caused by the SarCov-2 virus. The health crisis and the widespread dissemination of the virus significantly impacted society's way of life. In light of this scenario and given the researcher’s involvement with the study context, the following question arose: What were the repercussions of the COVID-19 pandemic on the health and working conditions of the health management workers at SESAP/RN during the first year of the pandemic? This study aims to analyze the consequences of the COVID-19 pandemic on the work processes and working conditions of central and regional-level managers at SESAP/RN. The methodology adopted in this study took a qualitative approach, utilizing document analysis to understand the actions and strategies implemented, as well as the Collective Subject Discourse (CSD) technique to interpret and collectively present the opinions and perceptions of the interviewed managers. The document analysis revealed that SESAP/RN's health management had to implement several adaptations to work processes to mitigate the impacts of the COVID-19 virus. Meanwhile, through the Collective Subject Discourse (CSD), with the participation of seven respondents, it was possible to capture managers' perceptions addressing issues not recorded in official documents, particularly those related to workers’ health and the working conditions faced during the pandemic. It is concluded that the research provided a deeper and more critical perspective on various aspects, including work organization, the resilience of management workers in adapting to the health crisis, working conditions, and the impacts on workers' health.Master Thesis Educação permanente em saúde no processo de trabalho na atenção primária: uma teoria fundamentada nos dados(Universidade Federal do Rio Grande do Norte, 2023-11-30) Araújo, Ana Beatriz Gouveia de; Cavalcante, Elisângela Franco de Oliveira; https://orcid.org/0000-0002-3578-0153; http://lattes.cnpq.br/9020549482920149; https://orcid.org/0000-0003-3537-3707; http://lattes.cnpq.br/5906766776016811; Castro, Janete Lima de; Salci, Maria AparecidaContinuing Health Education presents itself as a powerful tool to promote transformations desired by managers and workers to improve services and the health system. This study's main objectives are to understand Permanent Health Education in the work process of Primary Health Care from the perspective of professionals who work in the current context of the Unified Health System and to develop a theoretical model on Permanent Health Education in the work process in Primary Health Care in the current context of the Unified Health System. The study participants were formed by health professionals from the Basic Health Units that are part of the Western Health District of the city of Natal, Rio Grande do Norte, Brazil. This is a research with a qualitative approach that has as its methodological reference the Grounded Theory, with a structuralist approach proposed by Strauss and Corbin. Grounded Theory was chosen because it is a methodological approach that is rigorous during data collection and analysis, considering that the research will study a professional training strategy inserted into the routine and work process of professionals in a procedural manner. Data collection took place between January and May 2023 through in-depth interviews, based on the following guiding question: Talk about continuing education in your work process in primary health care. Data collection followed theoretical sampling, being carried out from three sample groups, the first composed of 16 nurses, the second by five managers and the third by a nursing technician and four community health agents. Data analysis was carried out simultaneously with data collection, with constant raising of new questions and carrying out comparative analysis, following open, axial and selective coding. The Atlas ti software, version 8, was used as a technological tool, with the appropriate license acquired. With the coding of the interviews, 1391 citations, 824 codes, four memos, 27 groups of codes and 16 networks or analytical diagrams were obtained from the analysis. After data analysis, the theoretical model was validated by the following groups: two researchers selected for their expertise in investigations, discussions and practices in Continuing Health Education; three researchers with expertise in the GT method; five participants from the study sample groups. The results achieved were divided into categories according to paradigmatic circumstances, conditions, action/interaction and consequences. The following representative categories of the phenomenon studied were elucidated: Pointing out needs and paths for implementing EPS in PHC; Facing the adversities of working in health and the need for applied knowledge and adequate working conditions; Proposing strategies and relationships that enhance the materialization of EPS; Establishing the advances arising from EPS in the context of PHC; and Declaring the difficulties of not implementing EPS in the health work process. The results provided the construction of the theoretical model that represents the understanding of Continuing Health Education in the Primary Health Care Work Process from the perspective of professionals working in the current context of the Unified Health System.Master Thesis Avaliação da judicialização de medicamentos antineoplásicos no Estado do Rio Grande do Norte(Universidade Federal do Rio Grande do Norte, 2019-06-26) Coelho, Bruna Lorena Alves; Freitas, Cláudia Helena Soares de Morais; https://orcid.org/0000-0003-0265-5396; http://lattes.cnpq.br/8905654343063318; http://lattes.cnpq.br/2475565585546526; Ferreira, Maria Ângela Fernandes; Meira, Karina Cardoso; Louvison, MariliaThe advances of health policies, in the Federal Constitution of 1988, are unquestionable. However, deficiencies in the Unified Health System made it difficult to meet the population health needs. Changes in the population epidemiological profile add to technological advances causes increasing of the lawsuit for healthcare. This practice is called Judicialization of health. Among the demands in the area of health the processes that call for medicines stand out and in this segment one of the biggest financial impacts is linked to the antineoplastic drugs. This is a descriptive, exploratory and documentary study of lawsuits claiming antineoplastic drugs that have the state of Rio Grande do Norte as sole defendant or in a regime of solidarity with the other entities of the federation. The objective of this study is to evaluate the judicialization of antineoplastic drugs involving the State of Rio Grande do Norte from 2013 to 2017. The socio-demographic characteristics of the author; Procedural characteristics of lawsuits; Medical-sanitary characteristics of the actions and administrative political characteristics of the actions were evaluated. The data were analyzed by indicators taken from the manual "Evaluation indicators and monitoring of drug lawsuits". The results show that the global expenditure of the defined temporal scope was R $ 19,266,268.30, with a larger number of cases coming from the metropolitan health region (39.5%) and Mossoró (28.5%), (44.7%), female, between 61 and 70 years (31.4%), with a more predominant diagnosis of breast cancer (19.3%). Represented by public defenders (53.7%). Most of the individuals (81.2%) had access to the medication, which had a purchase made mostly by the author of the action (81%). The phenomenon of the judicialization of antineoplastics in Rio Grande evidences the need to develop efficient means of screening to ascertain the amount of resources handled by the judicialization, and a greater dialogue among those involved, to draw up assertive strategies for financial management of health resources.