https://repositorio.ufba.br/handle/ufba/519 Mon, 04 May 2026 05:08:25 GMT 2026-05-04T05:08:25Z http://repositorio.ufba.br:80/retrieve/8f76dc7e-9a35-4cfd-9d80-f1785aad9163/brasao_ims_final.png https://repositorio.ufba.br/handle/ufba/519 https://repositorio.ufba.br/handle/ri/44399 Título: Prematuridade na Bahia: análise temporal, espacial e de fatores de risco associados Autor(es): Pinilla Castellanos, Maria Cristina Primeiro Orientador: Moraes Bezerra, Vanessa Abstract: Prematurity is the leading cause of morbidity and mortality in the first four weeks of a newborn's life, influenced by sociodemographic, healthcare, maternal, and territorial factors. In Bahia, the occurrence of premature births appears to be stable over time, and the determinants of this condition remain poorly understood. In this context, a cohort study of live births was conducted between 2012 and 2024, with the objective in research 1 of analyzing the temporal trend and identifying risk factors associated with prematurity. For the temporal trend analysis, the annual percentage change (APC) and the average period change (AAPC) were calculated using Jointpoint regression analysis. To assess the association of sociodemographic, healthcare, and maternal-fetus/child related variables, Poisson regression with robust variance was performed, considering prematurity (gestational age less than 37 weeks of gestation) as the outcome variable. In study 2, the objective was to analyze the spatial distribution and identify the spatial autocorrelation patterns of prematurity in the state of Bahia, from 2012 to 2024. To analyze the spatial association of prematurity, the Univariate Global Moran's I index and the Univariate Local Moran's I index (LISA) were used to identify the clusters. In article 1, the prematurity rate remained stationary during the period 2012-2024. During the same total period, an increasing trend in prematurity was observed for the following categories: low maternal education; having fewer than six prenatal appointments; being over 35 years old; having a cesarean delivery; and a history of one or more stillbirths. The factors associated with the occurrence of prematurity were: low maternal education; single marital status; fewer than six prenatal consultations; extremes of maternal age; cesarean delivery; one or more stillbirths; and male newborn sex. In article 02, prematurity rates showed a heterogeneous spatial distribution among the municipalities of Bahia. Positive spatial autocorrelation was identified in all analyzed periods, with a decrease in I in the analyzed periods. Additionally, LISA identified a High-High (HA) type cluster, indicating that municipalities with high prematurity rates are surrounded by municipalities also with high rates, persistent in the West and Southwest macro-regions of health in all analyzed periods. From the second three-year period onwards, the Northeast and South macro-regions began to integrate these clusters. On the other hand, the East macro-region presented low-low (LL) type clusters, corresponding to municipalities with low prematurity rates surrounded by municipalities with equally low rates, maintained throughout all analyzed periods. The findings of these studies update the panorama of prematurity in Bahia, identifying a stationary prematurity rate over time. Sociodemographic, healthcare, and maternal and fetal/child factors were associated with higher prematurity rates, and the spatial distribution of premature birth was heterogeneous among municipalities, with the identification of persistent AA-type clusters, highlighting territorial inequalities in the occurrence of premature birth. These results reinforce the need for local and targeted strategies that consider the social and maternal health determinants to reduce prematurity and its impacts in the state of Bahia. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação Thu, 09 Apr 2026 00:00:00 GMT https://repositorio.ufba.br/handle/ri/44399 2026-04-09T00:00:00Z https://repositorio.ufba.br/handle/ri/44398 Título: Práticas de enfermeiras no âmbito da Atenção Primária à Saúde na Bahia Autor(es): Aguiar, Gabriela Patez Primeiro Orientador: Soares, Daniela Arruda Abstract: Introduction: Health practices are activities shaped by the relationships between individuals and social structures. In Public Health, they encompass actions that must be understood within the contexts in which they occur. Nursing, the largest workforce in Brazil’s Unified Health System (SUS), operates in a diverse and unequal national territory. In Bahia, regional particularities directly influence nurses’ practices in Primary Health Care (PHC), making it essential to map and analyze these actions to support policies and address local needs. Objective: To analyze the practices developed by PHC nurses in different socio-spatial contexts in Bahia. Method: This is a mixed-methods study, conducted as part of a nationwide multicenter investigation. Quantitative data were collected between November 2019 and August 2021, while qualitative data were gathered from November 2020 to April 2021. For the qualitative component, 12 municipalities in Bahia were selected, involving 60 professionals, with data collected through semi-structured interviews. For the quantitative component, the sample included 498 professionals, with data collected via a web survey. As an analytical strategy, a matrix was constructed considering five dimensions: actors, modes of organization and operation, health care, and outcomes. Results: Findings show that, in both contexts, nurses play a central role in PHC teams, and that other actors influence their practices, impacting the quality of care as political and community agents, particularly in rural contexts. Although organizational modes prioritize the community, they follow a bureaucratic-normative model, and in rural areas, a clientelistic model remains common. Regarding health care, nurses perform a broad scope of practices and accumulate both care and managerial functions, which contribute to work overload and dissatisfaction with professional recognition, with no significant variations across different socio-spatial contexts. While the relevance of their practices is recognized, working conditions are insufficient given the contexts in which they operate. Final Considerations: The study deepened the understanding of nurses’ practices, highlighting challenges, opportunities, and the influence of a variety of historical and contemporary determinants in the socio-spatial contexts analyzed. It is considered necessary to carry out a comprehensive reflection on the work process of primary health care nurses in Bahia, taking into account the conditions and interferences that shape their practices, the challenges they face, and the impacts of their work on public health. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação Wed, 01 Oct 2025 00:00:00 GMT https://repositorio.ufba.br/handle/ri/44398 2025-10-01T00:00:00Z https://repositorio.ufba.br/handle/ri/44397 Título: Interação entre exercício físico e o tratamento com resveratrol nas alterações hepáticas induzidas pelo diabetes mellitus em um modelo de pós-menopausa experimental Autor(es): Amado, Larissa Cruz Primeiro Orientador: Soares, Telma de Jesus Abstract: Type 1 diabetes mellitus (T1DM) is characterized by hypoinsulinemia resulting from autoimmune destruction of pancreatic beta cells. Hyperglycemia can induce alterations in liver function and structure associated with increased oxidative stress and inflammation. However, liver alterations in T1DM have been less documented, especially in postmenopausal women with T1DM. The search for new strategies is necessary to improve or delay the progression of liver lesions induced by T1DM in the postmenopausal period. In this context, we evaluated the isolated and combined effects of physical exercise and resveratrol (RES) on liver enzyme levels, morphology, redox balance, and inflammation in hepatocytes of ovariectomized (OVX) rats with T1DM. Twenty-four rats were OVX, and diabetes was induced by injection of streptozotocin (STZ/40 mg/kg). Next, the rats were divided into 4 groups (n=6/each): OSD, sedentary diabetic OVX rats; OTD, trained diabetic OVX rats; OSD+RES, sedentary diabetic OVX rats + RES; OTD+RES, trained diabetic OVX rats + RES. The OTD and OTD+RES groups underwent 8 weeks of exercise. Treatment with RES was performed by intraperitoneal injection, at a dose of 5 mg/kg/day, 5 days/week, for 8 weeks in the OSD+RES and OTD+RES groups. The rats were euthanized and the liver was removed for histological, morphometric, immunohistochemical, and oxidative stress studies. The results demonstrate that the interaction of RES with physical training preserved the structure of the liver tissue and reduced total nitrite levels, hepatic expression of NF-κB, nitrotyrosine, and TGF-β. However, in isolation, RES and physical training increased glycogen content, GPx enzyme activity, and reduced laminin immunostaining in the liver tissue of rats in the SDO+RES and OTD groups. RES alone decreased TBARS levels and increased SOD enzyme activity in the liver of OSD+RES rats. In conclusion, our results show that exercise and RES, separately, have hepatoprotective effects, but the interaction of these therapeutic strategies induced additional beneficial effects in the liver of OVX rats with T1DM. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação Tue, 16 Dec 2025 00:00:00 GMT https://repositorio.ufba.br/handle/ri/44397 2025-12-16T00:00:00Z https://repositorio.ufba.br/handle/ri/44145 Título: Validação de conteúdo e pré-teste de indicadores de qualidade do cuidado em população idosa com diabetes mellitus tipo 2 Autor(es): Oliveira, Lara de Souza Primeiro Orientador: Galvão Guimarães de Oliveira, Marcio Abstract: Introduction: Chronic Noncommunicable Conditions (CCNTs) represent one of the main challenges in public health today. Among them, diabetes mellitus (DM) stands out due to its high prevalence, significant socioeconomic impact, and association with multiple complications. Although national and international guidelines provide recommendations for DM management, significant variability in the quality of care provided is observed, especially in primary care. Furthermore, there is a lack of indicators and instruments that allow for a comprehensive assessment of the quality of care provided. Objective: To perform content validation and pre-testing of quality of care indicators in an elderly population with diabetes treated in primary care. Methods: The study was conducted in two stages. In the first, content validation of quality of care indicators was performed through a methodological study based on the Delphi Consensus Technique, using the recommendations available in the American Diabetes Association (ADA) Standards of Care in Diabetes. The second stage consisted of a cross-sectional study to pre-test the validated indicators. This phase took place between September 2024 and January 2025, and included 114 participants aged 60 or older, with a medical diagnosis of type 2 diabetes mellitus (T2DM), who were being followed in public pharmacies in a Brazilian municipality. Results: Eight endocrinologists from three regions of Brazil agreed to participate in the expert panel. Of the 48 recommendations evaluated, 35 reached consensus in the first round, with an agreement rate greater than 85%. The remaining items were reassessed in the second round, resulting in the exclusion of four indicators and the final validation of 44. Of the validated indicators, 27 were assessed through private room interviews, while the remaining 17 were analyzed through the participants' electronic medical records. Important gaps were identified in the management of hypoglycemia, vaccination status, and social aspects. Indicators related to behavioral factors were most frequently explored during consultations. Conclusion: The validated indicators demonstrated viability for assessing the quality of care for elderly people with DM and can be applied in excellent care contexts, allowing the identification of aspects that require improvements in assistance to the population. Editora / Evento / Instituição: Universidade Federal da Bahia Tipo: Dissertação Mon, 28 Jul 2025 00:00:00 GMT https://repositorio.ufba.br/handle/ri/44145 2025-07-28T00:00:00Z