André Faro

Raça, racismo e saúde: a desigualdade social da distribuição do estresse

A presente revisao explora os conceitos de raca e racismo, delimitando particularidades quanto ao perfil de saude de individuos ou grupos submetidos a discriminacao ou preconceito racial. Alem disso, pretende-se levantar evidencias da relacao entre racismo e saude a partir dos estudos sobre o estresse. Apresenta-se a desigualdade social como um poderoso fator na causacao de iniquidades em saude, o que fomenta disparidades em relacao a prevalencia de estresse. Sendo o racismo um elemento criador e mantenedor de estressores no âmbito das relacoes sociais, discorre-se sobre como a discriminacao racial implica limitacoes fundamentais na vida dos individuos, o que impacta incisivamente na quantidade de estresse experienciada. Enfim, procurou-se sistematizar o conhecimento acerca das relacoes entre raca e saude, investigando-se o impacto deleterio do racismo sob o principio da distribuicao social do estresse.

Burden of disease in Brazil, 1990–2016: a systematic subnational analysis for the Global Burden of Disease Study 2016

Summary Background Political, economic, and epidemiological changes in Brazil have affected health and the health system. We used the Global Burden of Disease Study 2016 (GBD 2016) results to understand changing health patterns and inform policy responses. Methods We analysed GBD 2016 estimates for life expectancy at birth (LE), healthy life expectancy (HALE), all-cause and cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and risk factors for Brazil, its 26 states, and the Federal District from 1990 to 2016, and compared these with national estimates for ten comparator countries. Findings Nationally, LE increased from 68·4 years (95% uncertainty interval [UI] 68·0–68·9) in 1990 to 75·2 years (74·7–75·7) in 2016, and HALE increased from 59·8 years (57·1–62·1) to 65·5 years (62·5–68·0). All-cause age-standardised mortality rates decreased by 34·0% (33·4–34·5), while all-cause age-standardised DALY rates decreased by 30·2% (27·7–32·8); the magnitude of declines varied among states. In 2016, ischaemic heart disease was the leading cause of age-standardised YLLs, followed by interpersonal violence. Low back and neck pain, sense organ diseases, and skin diseases were the main causes of YLDs in 1990 and 2016. Leading risk factors contributing to DALYs in 2016 were alcohol and drug use, high blood pressure, and high body-mass index. Interpretation Health improved from 1990 to 2016, but improvements and disease burden varied between states. An epidemiological transition towards non-communicable diseases and related risks occurred nationally, but later in some states, while interpersonal violence grew as a health concern. Policy makers can use these results to address health disparities. Funding Bill & Melinda Gates Foundation and the Brazilian Ministry of Health.

Síndrome de Burnout em médicos intensivistas: estudo em UTIs de Sergipe

O objetivo deste estudo foi investigar a presenca de burnout entre os medicos intensivistas, alem de possiveis preditores da sindrome. Foram utilizados o Maslach Burnout Inventory (MBI-HSS) e um questionario para caracterizacao sociodemografica e laboral. A amostra foi composta por 122 medicos intensivistas, atuantes em Unidades de Terapia Intensiva (UTIs) ha, no minimo, seis meses. Os participantes eram predominantemente casados (61,5%), com filhos (66,4%) e idade media em 38,7 anos (DP = 8,39), nao havendo predominância de sexo (50,8% do sexo masculino). Os resultados indicam altos niveis de Esgotamento Emocional e Despersonalizacao, alem de baixos niveis de Realizacao Pessoal. Observou-se que 42,6% dos participantes apresentavam diagnostico positivo para a sindrome e os preditores identificados foram: trabalhar na UTI por necessidade, sentir-se sobrecarregado, vivenciar uma relacao estressante com colegas de trabalho, alem de nao utilizar o horario livre para assistir TV ou para dormir. Considerando o contexto laboral no qual atuam os medicos intensivistas, tais achados contribuem com rol de evidencias empiricas acerca da precarizacao do trabalho no contexto da atuacao em UTI, podendo embasar acoes de prevencao e intervencao junto a essa classe profissional.

A desumanização Presente nos Estereótipos de Índios e Ciganos

We analyzed, in two studies carried out in Sergipe and Alagoas, the dehumanization of Gypsies and Indians. A total of 678 male and female subjects participated. In the first study 378 non-Indians from five cities in Sergipe and Alagoas collaborated, 104 of them living close to the only indigenous tribe in Sergipe. The second involved 300 non-gypsies, 153 of them living close to Gypsy communities. The studies consisted of individual interviews inquiring about social representations and neutral collective beliefs about Gypsies and Indigenous People. We found that indigenous people were represented as exotics and invisible, and neutral collective beliefs or moral exclusion predominated. In relation to gypsies, the dehumanization process was more blatant, predominating moral exclusion and delegitimization.

Análise Fatorial Confirmatória e Normatização da Hospital Anxiety and Depression Scale (HADS)

The main objectives of this study were to perform a confirmatory factor analysis of the Hospital Anxiety and Depression Scale (HADS) and to conduct ROC curves for standardization of cut-off points, in a nonclinical sample. The results showed evidences of the structural validity of HADS and changes were proposed to the diagnostic parameters of anxiety (≥7 points) and depression (≥6 points). Finally, we highlight that caution is needed for the interpretation of the scores and diagnostic decision, especially for the depression measure.

Análise fatorial confirmatória das três versões da Perceived Stress Scale (PSS): um estudo populacional

This study aimed to perform a confirmatory factor analysis of the Perceived Stress Scale (PSS) in the Brazilian versions of 14, 10, 4 items; to analyze their concurrent validity with the General Health Questionnaire (GHQ-12); to map the profile of the stress in a representative sampling; and to establish stress assessment parameters by the standardization of the scores from overall population. The sample was population-based by conglomerate designs and clusters tracts. Thus, 1,154 inhabitants from a capital city of a northeastern state of Brazil participated in the study, mostly female (55.6%), with high school degree (51.7%), employed (72.7%), and nonsmokers (90.6%). The average income and age were BRL 1,200.00 and 29 years old, respectively. By the end, it was found satisfactory adjustments for the three PSS versions but just in its two-factor model; the PSS with 10 items was shown as a harmonious solution between the full and reduced scales considering the relationship between parsimony and statistical robustness of the scale. Furthermore, the PSS ratified its concurrent validity with the GHQ-12. It was also made the scores normalization of the PSS setting up parameters for future comparisons.

Bullying e Homofobia: Aproximações Teóricas e Empíricas

This study aimed at verifying how the phenomena bullying and homophobia approach, comparing homophobia bullying among actors (author, target, target / authors and witnesses) and observing the homophobic content is used in verbal bullying. A descriptive and quantitative study with survey method was performed. 808 young people participated with an average age of 14.9 years (SD = 1.98), coming from nine state schools in Aracaju-SE. They answered a questionnaire containing demographic questions, about bullying, homophobia and a scale manifest and subtle. The results indicated that 32% were defined targets of bullying, 12% authors, 22% target / authors and only 34% of controls. The presence of homophobic content in verbal bullying was the second most frequent form among male participants (20%) and lower incidence among girls (2%). In addition, bullies adolescents had higher scores on the scale of homophobia, compared to targets (p <0.05).This study aimed at verifying how the phenomena bullying and homophobia approach, comparing homophobia bullying among actors (author, target, target / authors and witnesses) and observing the homophobic content is used in verbal bullying. A descriptive and quantitative study with survey method was performed. 808 young people participated with an average age of 14.9 years (SD = 1.98), coming from nine state schools in Aracaju-SE. They answered a questionnaire containing demographic questions, about bullying, homophobia and a scale manifest and subtle. The results indicated that 32% were defined targets of bullying, 12% authors, 22% target / authors and only 34% of controls. The presence of homophobic content in verbal bullying was the second most frequent form among male participants (20%) and lower incidence among girls (2%). In addition, bullies adolescents had higher scores on the scale of homophobia, compared to targets (p <0.05).

Um modelo explicativo para o bem-estar subjetivo: estudo com mestrandos e doutorandos no Brasil

The main objective of the current study is to map the relationships among stressors, stress, coping, and subjective well-being in Masters and PhD students in Brazil. It has also been drawn up an explanatory model of the determination of subjective well-being in the mentioned population. Participants were 2150 Masters and PhD students in Brazil, from the five regions of the country and from all major knowledge areas of CAPES (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior). The instruments used were a questionnaire about stressors in post-graduate programs, the Perceived Stress Scale, the Ways of Coping Scale, and the Scale of Subjective Well-Being. Finally, it was found that the model of subjective well-being, tested by path analysis, denoted satisfactory goodness-of-fit indices and corroborated the theoretical assumption.

Aspectos conceituais da autoinjúria: Uma revisão teórica.

A conduta autolesiva se refere ao comportamento direto e deliberado de autolesao que resulta em prejuizo fisico e psicologico para o individuo. De alta prevalencia e considerado problema de saude publica, esse comportamento tem sido associado a varios fatores biopsicossociais, principalmente na adolescencia, fase em qual tende a emergir e e mais prevalente. A conduta autolesiva e geralmente associada a comportamentos e pensamentos suicidas e, de modo geral, a literatura ainda e heterogenea sobre o fenomeno, assim como formas de mensura-lo. O presente artigo objetivou reunir os principais conceitos e achados teoricos sobre a conduta autolesiva, classificando e descrevendo o comportamento autolesivo em relacao aos periodos desenvolvimentais, principais fatores associados, formas de avaliacao, tratamento/intervencao e prevencao.

IMPLANTAÇÃO DE UM BOLETIM INFORMATIVO COMO PROPOSTA DE HUMANIZAÇÃO NO PRONTO-SOCORRO DE UM HOSPITAL PÚBLICO

The National Policy of Humanization recommends that strategies should be established to accommodate both the patient and the caregiver to minimize the physical and emotional exhaustion is present in every moment of hospitalization. In Sergipe, Unified Health System users have access to an expanded health network in several micro-regions, and the Emergency Hospital of Sergipe Governor João Alves Filho is the local reference of the Urgency and Emergency Network. The emergency unit is organized according to a Risk Rating System to evaluate the severity of patients, by means of colors that comprise the Blue Area, the Green Area, the Yellow Area and the Red Area. This work was directed to the Red Area and aimed to describe the development of an informative report to be used for the reception of family members/visitors. This proposal results from the intervention by the Labour Education Plan for Health/Urgency and Emergency Network as a way to promote humanization among users, their families/visitors and health professionals working in a hospital service. The main conclusions are the approximation of Labour Education Plan for Health/Urgency and Emergency Network students with daily work at the Unified Health System and the ratification of the importance of interdisciplinarity in the planning of hospital care. These elements allowed the proposition of an information report that seeks to systematize simple, but essential information to the development of a more complete care work.