BDTD - Biblioteca Digital de Teses e Dissertações
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Educacional Product Práticas assistenciais efetivas e seguras para pessoas privadas de liberdade: compenente curricular optativo(Universidade Federal do Rio Grande do Norte, 0016-07-25) Medeiros, Diego Henrique Brilhante de; Batista, Almária Mariz; Batista, Almária MarizThe Brazilian prison system poses unique challenges to healthcare practices, particularly regarding the use of psychotropic medications and the management of mental health conditions. People deprived of their liberty, often subjected to precarious confinement, face conditions that exacerbate preexisting health problems and increase their physical and psychological vulnerability (Freitas; Caliman, 2017). Given this scenario, it is essential to train healthcare professionals to ethically, safely, and effectively address the needs of this population, promoting comprehensive and humane care (De Jesus; Scarparo; Lermen, 2013). The proposed elective course, "Effective and Safe Care Practices for People Deprived of Liberty," is an innovative initiative of the Multicampi School of Medical Sciences of the Federal University of Rio Grande do Norte (EMCM/UFRN). It aims to integrate evidence-based clinical practice teaching with the specificities of the prison environment, training undergraduate medical students to understand and address challenges related to the rational use of psychotropic drugs, the management of disruptive behaviors, and the impact of confinement conditions on care practices. Headquartered in the municipality of Caicó, in the interior of Rio Grande do Norte, the Multicampi School of Medical Sciences of the Federal University of Rio Grande do Norte (EMCM/UFRN) mission is to meet local-regional health demands, promoting excellent medical training guided by social responsibility. Students develop practical activities throughout the course in specialized health services distributed across various municipalities in the state, such as Caicó, Currais Novos, Santa Cruz, and Natal, ensuring a diverse and territorially integrated education. The school offers undergraduate medical degrees, medical residency programs (Internal Medicine, General Surgery, and Family and Community Medicine), multidisciplinary residency programs, and a Professional Master's in Education, Work, and Innovation in Medicine. The initiative aligns with national and international prison health guidelines, particularly the National Policy for Comprehensive Healthcare for Persons Deprived of Liberty in the Prison System (PNAISP), which emphasizes the need for professional training to ensure integrated care practices (Barbosa et al., 2022). It also aligns with key health education documents, such as the Global Consensus on Social Accountability of Medical Schools (GCSA, 2010), the National Curricular Guidelines for Undergraduate Medical Courses (Brazil, 2022), the National Common Core for Professional Education in Health (Brazil, 2017), and the Pedagogical Project for the EMCM/UFRN Medical Course (2023). This highlights the proposal's commitment to ethical, critical education that is committed to equity and human rights. The curricular component also aims to provide balanced theoretical and practical training, based on the principles of ethics, clinical effectiveness and care safety, valuing interventions that respect the dignity and rights of people deprived of liberty. In turn, considering the curricular organization of the EMCM/UFRN undergraduate medical school, the elective course is planned to be offered in the fourth semester. At this time, students have already been introduced to the fundamentals of Public Health, which permeate the first semesters of the course, and begin contact with topics related to mental health and the use of psychotropic drugs, particularly in the course "Mental and Behavioral Problems." Also noteworthy is the connection with the Integrated Community Experience (VIC), a longitudinal and cross-sectional component that aims to immerse students in diverse territories and settings within the Unified Health System (SUS). By integrating this axis, the elective component contributes to deepening students' connection with realities marked by social and institutional vulnerabilities, such as the prison system, promoting the development of mental health care skills from a broader, critical perspective, committed to social justice. Offering the course during this period provides a robust theoretical foundation before practical insertion between the fifth and eighth periods, in which students work in Basic Health Units and outpatient clinics, through the Family and Community Medicine axis. In this way, the course contributes to the consolidation of essential knowledge and prepares future physicians for critical, integrated practice that is sensitive to the complexities of the prison environment. The development of the curriculum component was based on three complementary strands, which ensured conceptual, methodological, and pedagogical robustness. The first consisted of an integrative review of care practices in the prison system, with an emphasis on the use of psychotropic medications, which supported the selection and organization of the program content. The second integrative review focused on teaching-learning methodologies and assessment models used in healthcare delivery for people deprived of liberty, contributing to the definition of the course's pedagogical strategies. Finally, a documentary analysis—including curricular guidelines, the EMCM/UFRN Medical School Pedagogical Project, and guiding documents for medical training—allowed the proposal to be aligned with the desired graduate profile, centered on an ethical, critical, humanistic, and socially committed education with the Unified Health System (SUS).Doctoral Thesis Qualidade e segurança de prescrições de medicamentos no âmbito da atenção primária à saúde(Universidade Federal do Rio Grande do Norte, 2022-07-01) Batista, Almária Mariz; Souza, Dyego Leandro Bezerra de; Gama, Zenewton André da Silva; https://orcid.org/0000-0003-0818-9680; http://lattes.cnpq.br/8885774273217562; https://orcid.org/0000-0001-8426-3120; http://lattes.cnpq.br/9953301230987878; https://orcid.org/0000-0001-5824-7485; http://lattes.cnpq.br/0242707170380478; Almeida, Rui Pedro Pereira de; Oliveira, Ângelo Giuseppe Roncalli da Costa; Farias, Mareni Rocha; Vale, Sancha Helena de LimaPrescribing errors are one of the main patient safety issues in primary care and may be caused by weaknesses in clinical-pharmacological and/or medication prescription writing criteria, but there is a lack of validated instruments to assess the quality of the writing of this prescription. This study aimed to develop and validate an instrument to assess the quality of drug prescription writing in primary care and to evaluate the quality of this prescription using this validated instrument. Initially, a validation study was developed via four steps: 1) Validity analysis of each indicator (relevance, adequacy and criterion); 2) Reliability analysis via intra- and inter-evaluator agreement of each indicator; 3) Analysis of the usefulness of each indicator; 4) Construction and reliability analysis of a weighted composite indicator based on the effectiveness and safety scores of each indicator. Then, a cross-sectional observational study was carried out in a municipality in the Northeast of Brazil in which QualiPresc was applied to a representative sample of prescriptions prepared by physicians from all 24 family health teams in the municipality in January/2021. The compliance of the indicators and their 95% confidence intervals were estimated in aggregate and stratified by dispensing units and prescriber. This included 29 indicators, but only 13 were approved for reliability, reliability, and usefulness. 12 indicators were removed for validity (validity index <90%) and 4 for not being useful in the context of the study. Three composite weighted indicators were tested, but only one was approved for reliability and utility. The validated instrument contains 13 indicators and 1 composite weighted indicator. The mean prescription quality level on a scale of 0-100 was 60.2 (95%CI 57.8-62.6). As for the compliance of prescriptions, the best were administration frequency (98.9%), prescriber identification (98.9%) and pharmaceutical form (85.6%). On the other hand, allergy reporting (0.0%), patient's date of birth (1.7%), non-pharmacological recommendations (1.7%) and directions on the use of the drugs (25%) were the indicators. with a lower prevalence of compliance, contributing with 69% of the non-compliances found. The mean prescription quality level on a scale of 0-100 was 60.2 (95%CI 57.78-62.55). QualiPresc's validity, reliability and usefulness are evidenced for evaluating the quality of drugs prescriptions writing in the context of primary care. The level of quality of the prescriptions evaluated is medium, but priorities were identified that should be considered in future studies and interventions for the quality of prescriptions in primary care.Master Thesis Avaliação da publicidade de medicamentos veiculada nas principais emissoras de rádio de Natal-RN(Universidade Federal do Rio Grande do Norte, 2009-07-02) Batista, Almária Mariz; Dantas, Maria Cleide Ribeiro; ; http://lattes.cnpq.br/8260624403804292; ; http://lattes.cnpq.br/0242707170380478; Raffin, Fernanda Nervo; ; http://lattes.cnpq.br/1052562183676637; Schenkel, Eloir Paulo; ; http://lattes.cnpq.br/6985652531782616Drugs advertising is one of the most important marketing resources used by the pharmaceutical industry to induce people to buy these products although they do not have the real necessity to use them. The purpose of this article is to evaluate drugs advertisings transmitted on radio stations in Natal/RN, from October 2007 to September 2008. Were collected 228 advertising pieces, where, 21 were different among themselves and corresponded to 15 drugs. The results showed that 73,3% of the drugs ads were announced on AM station and 26,7% on FM station. The majority of the drugs were constituted of analgesics (26%), following by antiacids, vitamins, phitotherapics (13% each). The legal analysis showed that each advertising had some kind of infraction. The omission of the registration number happened in each advertising, following by the totally lack of contraindications (95,2%) and contraindications DCB/DCI (76,2%). In 42,9% advertisements were observed the relation between drugs use and physique/intellectual/emotional/sexual performance and/or beauty and 33% of them had abusive exploration of illnesses. The obligatory warning was omitted in 28,6% and the offer of financial bonus happened in 9,5% cases. The content analysis demonstrated that the most persuasion and convincing elements observed were indicatives of consumption appeal (34,2%). The study indicates the necessity of the topic drugs advertisements to be treated in a wide context, that is, to be discussed as a public health concern. Although the advertising regulation and inspection is the State responsibility , this should be shared with the advertising agency, pharmaceutical industry and media. Furthermore, it is indispensable to inform and to conscience the population of their rights in such mistaken situation