https://repositorio.ufba.br/handle/ufba/523 2026-05-05T08:05:57Z https://repositorio.ufba.br/handle/ri/44446 Título: Iniquidades sociais e os cenários de ensino-aprendizagem em um curso médico da Bahia. Autor(es): Oliveira, Emanuela de Almeida Primeiro Orientador: Santos, Liliana Abstract: Professional training in health must be aligned with assumptions that correspond to society's expectations and needs, with equity as a structuring principle. The teaching-learning scenarios of medical courses are spaces capable of generating experiences that bring students closer to the health needs of the population or the reproduction of social inequities. As a general objective, we sought to analyze the contribution of scenarios and practices to the teaching-learning process in a medical course, taking into account the promotion of equity or inequities in health. For this, qualitative research was carried out, in which the stages of document analysis, semi-structured interviews and focus groups were integrated, contemplating the perspectives of teachers, preceptors and students in relation to the study theme. A medical course at a public university in the state of Bahia (BA) was chosen to participate in this research and the teaching-learning scenario selected was a teaching hospital linked to this institution. Regarding ethical aspects, this research is in accordance with Resolutions nº 466/2012 and nº 510/2016 of the Conselho Nacional de Saúde (CNS), which regulate the ethical principles of research with human beings, ensuring the rights and duties of researchers and participants, and was submitted to the Comitê de Ética em Pesquisa (CEP) of the Instituto de Saúde Coletiva of the Universidade Federal da Bahia, approved under opinion 5.790.707. As results and discussion, in the documentary analysis, pedagogical and normative aspects contained in documents such as the Pedagogical Project of the Course and the Syllabus were identified, observing an alignment with the Diretrizes Curriculares para o Curso de Medicina de 2014; the deepening regarding equity and inequities in health occurred through interviews with preceptors and teachers and the focus group with medical students, who carried out activities in the teaching-learning scenario chosen for the investigation. The analysis plan articulated theoretical categories and empirical results, supported by the content analysis strategy. At this stage, an active experience of practices in the teaching-learning scenario studied was initially identified, through the understanding of subcategories such as “activities carried out by students”, “development of skills and competencies”, “experience”, “training with quality”, “multidisciplinary work” and “autonomy”. Next, the main perceptions of the research participants regarding the promotion of equity or inequities in health were presented, based on the day-to-day experience in the teaching-learning scenario, being evidenced in the analysis categories called “the perception of needs of health”, “the perception of equity and inequities” and “the perception of quality-equity”. Given the centrality of the study participants in the training process, the main challenges experienced and overcoming strategies perceived in the teaching-learning scenarios were also presented. As final considerations, equity was perceived in multiple statements in a manner consistent with the theoretical framework adopted in this work. Despite this, students still live with practices that generate inequities in health and challenges persist in overcoming these practices, which reinforces the need for greater attention to medical training and confronting inequalities, so that they do not reproduce inequities. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação 2025-04-17T00:00:00Z https://repositorio.ufba.br/handle/ri/44438 Título: Avaliação de impacto da política de oferta de prótese dentária no SUS do Brasil entre 2003 e 2010 e determinantes sociais. Autor(es): Silva, Ana Tereza Ribeiro da Primeiro Orientador: Chaves, Sônia Cristina Lima Abstract: Introduction: Tooth loss is recognized as a major public health problem in Brazil, with significant functional, aesthetic, and psychosocial consequences. The National Oral Health Policy, launched in 2004, incorporated oral rehabilitation into public care through the provision of dental prostheses, including the creation of Regional Dental Prosthesis Laboratories (LRPD). Despite these institutional advances, challenges remain regarding service provision, reduction of regional inequalities, and systematic evaluation. Objective:This study aimed to assess the impact of the dental prosthesis policy on prosthesis use among young people, adults, and older adults in Brazil between 2003 and 2010, considering social determinants of health. Methodology: A quasi-experimental impact evaluation study was conducted using data from the national epidemiological surveys SB Brasil 2003 and 2010, restricted to municipalities participating in both surveys. Difference-in-differences analyses were employed, comparing municipalities with and without LRPD implementation over time. Outcome variables included prosthesis use and need by age group, while explanatory variables comprised socioeconomic, demographic, and oral health coverage indicators. Nonparametric Spearman correlation tests were used to estimate adjusted associations and bivariate analyses, adopting a 5% significance level. Results: The study revealed a significant impact on the increased supply of dental prostheses in municipalities with LRPD compared to those without. However, no impact was observed on prosthesis use. The average number of prostheses provided in LRPD municipalities increased substantially, from 212.26 in 2003 to 564.82 in 2010 (p = 0.031). Although a similar increase occurred in municipalities without LRPD, the variation was not statistically significant (p = 0.301). These findings suggest that LRPD implementation stimulated prosthesis production in the Unified Health System (SUS), strengthening installed capacity and expanding the availability of rehabilitative care. It is worth noting that LRPD implementation was concentrated between 2009 and 2010, resulting in a short time window to assess potential impacts on population-level prosthesis use in the 2010–2013 survey cycle. The significant reduction in prosthesis need among adolescents and adults, regardless of LRPD presence, suggests improvements in oral health conditions driven by broader structural transformations, such as enhanced human development and educational attainment, alongside the expansion of the Family Health Strategy, preventive initiatives, and the consolidation of the National Oral Health Policy (Brasil Sorridente). Conclusion: Social inequalities, particularly those associated with the Human Development Index (HDI), illiteracy, and dental insurance coverage, remain strong determinants of prosthesis need and use. These findings reinforce the importance of integrated strategies to reduce tooth loss, expand access to oral rehabilitation, and promote greater equity in oral health. Editora / Evento / Instituição: Universidade Federal da Bahia. Instituto de Saúde Coletiva Tipo: Dissertação 2025-06-30T00:00:00Z https://repositorio.ufba.br/handle/ri/44437 Título: Atenção primária à saúde e pandemia da COVID-19 (primeira onda): aspectos normativos e ocorrência de casos entre os trabalhadores da saúde, em Salvador, Bahia, Brasil. Autor(es): Pereira, Thiago Santana Primeiro Orientador: Pereira, Rosana Aquino Guimarães Abstract: Introduction and justification. The COVID-19 pandemic highlighted the high risk of infection among health workers, especially in Primary Health Care (PHC), but there are still gaps regarding the relevance of institutional guidelines and the specificities of illness among these professionals, in part due to the scarcity of disaggregated data. Objectives. This study sought analyze the suitability of the guidance provided to PHC workers by municipal management and the clinical-epidemiological characteristics of those considered suspected or confirmed cases of COVID-19. Methodology. The research involved a documentary analysis of the standards issued between March and October 2020 at the municipal, state and federal levels, and a study descriptive cross-sectional observational study with data from the Municipal Health Department of Salvador, collected between August and October 2020 through an electronic questionnaire. 282 were included professionals. Results. The SMS-Salvador guidelines for PHC workers proved to be broadly aligned with state and federal guidelines regarding disease control measures engineering and administrative, especially with regard to the physical reorganization of units, supply of surgical masks and internal service flows. However, it was observed less initial emphasis on direct communication with workers, ongoing education and incorporation of technologies, which were only formalized as of June. There was no guidance about extending the opening hours of the units in none of the three spheres. About characteristics of the workers in the study, the average age was 40.8 years, the majority were male female (81.9%) and self-declared mixed race (50.3%) or black (39%). The most common professions were nursing technicians (21.6%), community health agents (16%) and nurses (12.8%). The majority worked in Family Health Units with three or more teams. As to symptoms, 83% met flu-like syndrome (GS) criteria, and 2.5% required hospitalization. Among those tested, 38.6% had a positive result. Of these, 61% reported symptoms of anxiety and 41% of depression. Age over 41 years and number of GS symptoms were predictors of positivity. The current definition of OS showed sensitivity of 89% and specificity of 20.8%; an alternative proposal reduced sensitivity to 73%, but increased specificity to 71%. Discussion. SMS-Salvador regulations for PHC were globally timely and pertinent and some actions, in particular the creation of the Center for Support for Workers (NAAT), were pioneers. Structural and operational difficulties, such as Inadequacy of space and scarcity of inputs made it difficult to apply the guidelines. The characterization of workers revealed similarities with national and international evidence, including female predominance, high frequency of flu-like symptoms and psychological symptoms. THE Defining flu syndrome criteria illustrates the challenge of balancing effective surveillance and preservation of the workforce. Methodological limitations include possible selection bias, memory and interpretation, in addition to risks of documentary under-recording. Conclusion. It is concluded that the municipal response was globally pertinent, but required local adaptations in the face of limitations contextual, offering substrate to guide public policies aimed at PHC in future health events of a similar nature. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação 2025-07-25T00:00:00Z https://repositorio.ufba.br/handle/ri/44436 Título: Gravidade da Covid 19: uma análise comparativa entre pacientes internados segundo o status vacinal para BCG, Bahia, Brasil, 2020-2021. Autor(es): Britto, Elisângela Alves de Primeiro Orientador: Barreto, Florisneide Rodrigues Abstract: Introduction: COVID-19 cases in Brazil have shown that there is no uniformity in the occurrence of the disease in the population (Brazil, 2022), ranging from asymptomatic infections to severe cases, even among individuals with similar conditions. Studies conducted in some countries have shown evidence that prior exposure to the BCG vaccine can induce the occurrence of less severe forms of the disease. Objective: To analyze the severity of COVID-19 in hospitalized patients, according to BCG vaccination status. Method: A cross-sectional, descriptive study compared the prevalence (95% CI) of severe manifestations of COVID-19 in 325 patients admitted to an Infectious Diseases Unit between September 2020 and March 2021, comparing them with regard to prior exposure to the BCG vaccine. Results: The study found a higher frequency of hospitalization and deaths in males, Black/Mixed race, those with low education levels, and the elderly, and a frequency of 10.4% of hospitalized patients without signs/symptoms of lung damage. A higher frequency of ventilatory support use (53.2%), ICU use (55.9%), and deaths (60%) were observed in unvaccinated patients. There was an association between BCG exposure and a lower need for ICU admission. Conclusion: The results reaffirm the importance of social and economic inequalities in hospitalization and deaths from COVID-19. They corroborate previous studies on evidence of the possible effect of BCG in reducing the severity of COVID-19, with findings of a higher prevalence of ICU use among unvaccinated individuals (PR: 1.21). The results suggest a review of the reporting criteria for severe COVID-19 in SIVEP Gripe to expand knowledge about extrapulmonary forms of SARS-CoV infection, improving clinical management protocols and implementing public policies to protect public health. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação 2025-08-06T00:00:00Z