TEDE Coleção:

Sentidos e significados atribuídos pelos coordenadores da atenção básica à dinâmica organizativa do acesso ao pré-natal de alto risco

2026-08-19T04:00:35Z

Título: Sentidos e significados atribuídos pelos coordenadores da atenção básica à dinâmica organizativa do acesso ao pré-natal de alto risco Autor: Cunha, Naiara Oliveira Primeiro orientador: Araújo, Mariana de Oliveira Abstract: The 1988 Federal Constitution established health as a right of all citizens and a duty of the State, instituting the Unified Health System (SUS) based on the principle of universal access. However, the existence of inequalities, influenced by socioeconomic, geographic, and cultural factors, hinders access to essential health services. Primary Health Care (PHC) plays a fundamental role in ensuring access; however, in certain situations, it is not sufficient to promote comprehensive care. In the context of High-Risk Prenatal Care (HRPC), challenges such as the lack of well-defined care pathways, unequal distribution of resources, inadequate infrastructure, and difficulties in regulation affect the effectiveness of care provided to pregnant women. Despite advances in the Maternal and Child Health Care Network (HCN), barriers to specialized care remain, particularly at the secondary and tertiary levels of care. This study aimed to: analyze the different dimensions of access to High-Risk Prenatal Care from the perspective of Primary Health Care coordinators; identify elements that facilitate or hinder access to High-Risk Prenatal Care within the context of the Health Care Network; understand how communication processes, regulation, and the organization of care pathways influence access to High-Risk Prenatal Care; and develop an analytical flowchart of the Maternal and Child Health Care Network in the Central-Northern region of Bahia. This is a descriptive and exploratory study with a qualitative approach, conducted in municipalities of the CentralNorthern region of Bahia, involving 10 Primary Health Care coordinators. Data were produced through semi-structured interviews and analyzed in light of Thematic Content Analysis as proposed by Minayo. The findings reveal that access to HRPC occurs in an unequal and fragmented manner, marked by weaknesses in the definition of care pathways, limitations in regulation, and failures in communication among health services. It was observed that, in the face of these gaps, coordinators resort to informal strategies to enable care delivery, revealing limitations in the organization and integration of the Health Care Network. Nevertheless, specific initiatives were identified, indicating potential strengths in the organization of care. As a result of this study, an analytical flowchart of access to HRPC was developed as a technical product. This flowchart represents the care trajectories of pregnant women within the network, highlighting the main access points, referral pathways, and critical bottlenecks identified from the perspective of Primary Health Care coordinators. It is concluded that, although normative advances have been achieved, challenges persist in the operationalization of the network. Strengthening management, regulation, and coordination among services is necessary to ensure access to and comprehensiveness of care for high-risk pregnant women. Instituição: Universidade Estadual de Feira de Santana Tipo do documento: Dissertação

Fatores associados à transfusão de concentrado de hemácias em recém-nascidos prétermo de muito baixo peso

2026-08-19T04:00:35Z

Título: Fatores associados à transfusão de concentrado de hemácias em recém-nascidos prétermo de muito baixo peso Autor: Nunes, Gabriela Haana Maia Oliveira Primeiro orientador: Santos, Carlos Antônio de Souza Teles Abstract: Red blood cell transfusion is a frequent intervention in very low birth weight preterm newborns and is associated with hematologic immaturity and greater clinical severity in these patients. Objective: to identify maternal, obstetric, and neonatal factors associated with red blood cell transfusion in very low birth weight preterm newborns, including the evaluation of a possible association with oropharyngeal colostrum immunotherapy. Method: an exploratory retrospective observational study was conducted using secondary analysis of data from 85 mother-infant dyads previously collected in a public neonatal hospital unit. Very low birth weight preterm newborns (VLBW-PTNB) with birth weight ≤ 1,500 g and gestational age < 37 weeks were included. Sociodemographic, maternal, and neonatal characteristics were described and compared according to the occurrence of red blood cell transfusion within the first 28 days of life, and prevalence ratios (PR) were estimated in the bivariate analysis. To identify factors independently associated with the outcome, multivariate binary logistic regression was performed, including birth weight (continuous variable), duration of mechanical ventilation ≥ 7 days, use of total parenteral nutrition > 10 days, and oropharyngeal colostrum immunotherapy, with adjustment for potential confounding factors. Analyses were performed using IBM SPSS Statistics software, version 22.0. Results: among the 85 newborns evaluated, 30 (35.3%) received at least one red blood cell transfusion within the first 28 days of life. In the bivariate analysis, gestational age < 28 weeks (PR = 2.81; 95%CI: 1.61–4.91), birth weight < 1,000 g (PR = 2.86; 95%CI: 1.57–5.21), mechanical ventilation ≥ 7 days (PR = 4.51; 95%CI: 1.73–11.75), late-onset sepsis (PR = 1.86; 95%CI: 1.05–3.27), and mortality (PR = 2.17; 95%CI: 1.22–3.84) were associated with higher prevalence of transfusion. In the multivariate analysis, higher birth weight was the only factor independently associated with lower probability of transfusion (adjusted OR = 0.996 per gram; 95%CI: 0.993–0.999; p = 0.017), indicating a progressive reduction in transfusion probability as birth weight increased. Prolonged use of total parenteral nutrition (> 10 days) showed greater magnitude of association with the outcome (adjusted OR = 2.20; 95%CI: 0.91–5.32; p = 0.080), although without statistical significance after adjustment. Prolonged mechanical ventilation (≥ 7 days) (adjusted OR = 3.02; 95%CI: 0.69–13.13; p = 0.141) and oropharyngeal colostrum immunotherapy (adjusted OR = 0.77; 95%CI: 0.24–2.45; p = 0.658) were not independently associated with the outcome. Conclusion: higher birth weight was the main independent protective factor against the need for red blood cell transfusion in very low birth weight preterm newborns, whereas oropharyngeal colostrum immunotherapy was not associated with this outcome. As technical products of the study, an educational booklet and a clinical flowchart were developed for neonatal healthcare professionals, aiming to support decision-making regarding transfusion in very low birth weight preterm newborns. Instituição: Universidade Estadual de Feira de Santana Tipo do documento: Dissertação

O cuidado às mulheres que vivem com HIV/AIDS em um município da região metropolitana de Salvador

2026-08-19T04:00:34Z

Título: O cuidado às mulheres que vivem com HIV/AIDS em um município da região metropolitana de Salvador Autor: Nunes, Daniela Maria Bastos Primeiro orientador: Pereira, Dayliz Quinto Abstract: AIDS is a lethal disease that involves not only aspects of biomedicine, but especially social and cultural issues, being a public health issue and a challenge marked by stigmas and inequalities, especially when it comes to women living with the disease. In this sense, the present research focused on the female public of the CRES in Camaçari and sought to answer the following guiding question: What is the perception of care for women living with HIV/AIDS and what is the understanding of this care for the professionals of the CRES in the municipality of Camaçari? To answer this, the general objective was defined as analyzing the perception, understanding and practice of care both of women living with HIV/AIDS and of the professionals of the CRES/Camaçari. A qualitative, descriptive and field research was adopted, with thirteen (13) women attended at the Center for Reference and Specialties in Health - CRES, in treatment for AIDS, residents of Camaçari and in the age range of 25 to 65 years; and with nine (9) health professionals who provide this care. The data collected through interviews with both groups revealed that there is perception and understanding of care, as well as an affective bond between the users of the CRES (Specialized Healthcare Center) and the professionals who provide care. Also, based on the expressions of dissatisfaction, it was possible to present improvement strategies for both groups analyzed, which can be forwarded to the competent authorities. Instituição: Universidade Estadual de Feira de Santana Tipo do documento: Dissertação

A concordância nominal de número em predicativos do sujeito no português falado em Luanda

2026-08-19T04:00:33Z

Título: A concordância nominal de número em predicativos do sujeito no português falado em Luanda Autor: Rios, Sarah de Sousa Lima Primeiro orientador: Almeida, Norma Lúcia Fernandes de Abstract: The variation in the use of nominal number agreement in subject predicates has certainly been studied in Brazilian Portuguese and Mozambican Portuguese (Scherre, 1991; Dias, 1996; Lucchesi, 2009; Antonino, 2007; Salgado, 2010; Furtado, 2017; Soares, 2022). These studies show that there are some generalizations regarding variation and change in predicates, such as the influence of subject and verb characterization on morphological number marking and the relevance of education and the status of Portuguese in African varieties that exist in situations of widespread multilingualism. Given this, the research proposed here aims to identify and analyze the social and linguistic factors that condition variation in the use of predicative structures in Portuguese spoken in Luanda, in order to broaden discussions on the topic, as well as to seek evidence that reinforces discussions about linguistic contact in the formation of African varieties of Portuguese, which coexist in multilingual contexts. Aware of the need for research that takes into account the relationship between language, society, and culture, this research is anchored in the Theory of Variation and Change (Weinreich, Labov, Herzog, 2006 [1968]). Thus, a corpus of Portuguese spoken in Angola's capital, Luanda, was used, consisting of sociolinguistic interviews recorded in 2008 and 2012, with Angolan participants who declared Portuguese as their L1 or L2. This research aims to contribute to the description of Portuguese spoken in Luanda, expanding morphosyntactic studies focused on this variety. This research contributes to the description of the Portuguese spoken in Luanda, particularly in relation to agreement patterns in subject predicates, whose education level is a relevant factor in understanding the phenomenon. This makes schools an important agent in guiding the linguistic uses of the population, which is still centered on the dichotomous conception of language as “right” and “wrong.” In addition, the age group indicates that the Portuguese spoken in Luanda is following the path of linguistic change in an innovative sense (non- application of number agreement), as young people are no longer following the rigid rules of the standard norm. Therefore, the reality of the phenomenon in Angola, despite revealing a high percentage of agreement (79%), higher than the percentage results of the urban cultured norm of Brazilian Portuguese, encourages a discussion based on the socio-historical formation of the nation and the search for the European standard still present in society, laws, and formal education processes. Instituição: Universidade Estadual de Feira de Santana Tipo do documento: Dissertação