The participation of Wajapi women from the State of Amapa (Brazil) in the traditional use of medicinal plants - a case study

Background: the purpose of this study was to analyze the importance of traditional medicinal plants use to Wajapi women in the State of Amapa, Brazil, as well as their practices in the local common illnesses of treatment considering the prevailing practice by non-Indians.Methods: This study was conducted in the Community of the Wajapi Indigenous People, a Brazilian territory located in the central western State of Amapa. Wajapi women were selected for the interview since they have the responsibility to harvest, collect and prepare the preparations. the studied women were residents of four villages. the number of women within these four villages is 24.Results and conclusions: the findings fell into the following three categories: 1) the daily use of medicinal plants by women and main methods of application. in this category, the botanical families found included Leguminosae-Caesalpinoideae, Anacardiaceae, Meliaceae, and Rubiaceae. the main forms of use found were teas, baths, maceration, in natura, and juices; 2) Through analysis of illness and treatment records, a lack of knowledge integration in the health system was shown to be due to a variety of gaps and the need of health professionals to be more aware about the local culture which they intend to work with, what could decrease the prevailing barriers between the social groups involved; 3) Traditional knowledge and possible sustainability can be fostered by stimulating the transmission of traditional knowledge from generation to generation, therefore reducing the dependence on industrialized medicines and also by maintaining an appreciation of those practices among youngsters, who tend to question them.Univ Fed Amapa, Curso Enfermagem, Ctr Ciencias Biol & Saude, BR-68902280 Macapa, Amapa, BrazilUniv Fed Amapa, Lab Estudos Sociais, BR-68902280 Macapa, Amapa, BrazilUniversidade Federal de São Paulo Unifesp, DCET, Setor Ciencias Farmaceut, BR-09972270 Diadema, SP, BrazilUniv Fed Amapa, Lab Pesquisa Farm, Ctr Ciencias Biol & Saude, BR-68902280 Macapa, Amapa, BrazilUniversidade Federal de São Paulo Unifesp, DCET, Setor Ciencias Farmaceut, BR-09972270 Diadema, SP, BrazilWeb of Scienc

CERVICAL ADENOCARCINOMA AND THERAPEUTIC DROPOUTS: THE PERSPECTIVE OF NURSES IN A CITY IN THE EXTREME NORTH OF BRAZIL

Objective: to describe, from the perspective of nurses, the causes of dropout of users in treatment for cervical adenocarcinoma and analyze the proposals to reduce this dropout.Method: the study is descriptive, qualitative, of narrative research type. Seven care nurses, working in a high complexity oncology unit in the city of Macapá, capital of the state of Amapá, Brazil, participated. The study was conducted in the period from December three to 20, 2019. Data were submitted to categorical thematic analysis.Results: two categories emerged: main causes of dropout of users in treatment for cervical adenocarcinoma and nurse strategies for the reduction of treatment dropout byusers.Conclusion: to promote the rescue of the users, the participating nurses propose a Nursing consultation and a multi-professional action plan, respecting the singularities of each woman

ADENOCARCINOMA CERVICAL E ABANDONO TERAPÊUTICO: A ÓTICA DOS ENFERMEIROS EM UMA CIDADE DO EXTREMO NORTE BRASILEIRO

Objetivo: descrever, na perspectiva do enfermeiro, as causas de abandono das usuárias em tratamento do adenocarcinoma cervical e analisar as propostas para diminuir esse abandono.Método: o estudo é descritivo, qualitativo, do tipo investigação narrativa. Participaram sete enfermeiros assistencialistas, atuantes em uma unidade de alta complexidade oncológica. Os dados foram submetidos à análise temática categorial.Resultados: emergiram 2 categorias: as principais causas de abandono das usuárias em tratamento do adenocarcinoma cervical e as estratégias do enfermeiro para a diminuição do abandono do tratamento pelas usuárias.Conclusão: o estudo destacou como as principais causas de abandono: a fragilidade na organização e estrutura dos serviços ofertados, a ausência da família e a falta de conhecimento sobre a patologia. E para favorecer o resgate das usuárias, os enfermeiros participantes propõem consulta de Enfermagem e um plano de ação multiprofissional respeitando as singularidades de cada mulher

Knowledge, Attitude and Practice of Quilombola Women: A Multifactorial Analysis on The Preventive Examination of Uterine Cervical Cancer in Northern Brazil

O Cervical cancer is considered a persistent public health problem, the access to health services, as well as women\u27s adherence to the Pap smear, is one of the main tools to change this scenario, favoring the early detection of the disease. When considering the morbidity and mortality rates, taking into account the color, it is evident that black women need a different look. Given the above, the objective of this work is to analyze the knowledge, attitude and practice of quilombola women in Amapá about the preventive examination for cervical cancer. The study has a quantitative approach, of an applied nature, of the Survey type, having as reference the Knowledge, Attitude and Practice Survey (KAP) on the PCCU exam. The field research was carried out in the Quilombo do Curiaú in the state of Amapá. The data were submitted to the SPSS version 25.0 program, for the description of the statistical results, being considered relevant the results with p<0.05, which made it possible to trace the following socioeconomic and anthropometric profile: age from 18 to 33 years old (43.75 %), Catholic (92.50%), single (52.50%), complete high school (31.35%), without paid activity (41.25%), month family income from 1 to 2 minimum wages (37 .50%) and an average of five family members (36.25%). They present weight 69.34 (Me), height 161.06 (Me), Body Mass Index (BMI) 26.685 (Me), waist circumference (WC) 86.97 (Me), hip circumference (HC) 106 .77 (Me) and CC/HC ratio index 0.8172 (Me). Thus, the study revealed that 42.50% meet the parameter considered normal for BMI and 68.75% have a low risk for the development of Chronic Non-Transmissible Neoplastic Diseases, according to CC/HC. Using the criteria proposed by the KAP survey as a reference, 26.25% had adequate knowledge, 30% had adequate attitude and 37.5% had adequate practice, demonstrating a negative proportional assessment in relation to the PCCU exam. The KAP survey was carried out, which showed that only 36.27% of the women were characterized with Adequate Knowledge, 30.00% with Adequate Attitude and 37.5% with Adequate Practice, highlighting the need for educational actions at this topic with the female quilombola population, with a view to increasing the adherence to the uterine cytopathological examination within these communities

VÍTIMAS DE VIOLÊNCIA SEXUAL ATENDIDAS EM UM SERVIÇO DE REFERÊNCIA

Objetivou-se conhecer aspectos da violência sexual e adesão das vítimas ao seguimento ambulatorial.Estudo transversal, com coleta retrospectiva de dados em um serviço de referência no estado do Paraná. Acoleta foi realizada de fevereiro a maio de 2014 mediante fichas de notificação de 2009 a 2013. Foram atendidos1272 agredidos sexualmente, sendo 53,46% deles com idade entre 12 e 18 anos e 94,65%, mulheres. Em maisda metade dos casos, o agressor era desconhecido (53,38%), a agressão ocorreu nas residências (39,30%)e vias públicas (35%), à noite (50,33%) e, em 96,67% dos casos, houve penetração vaginal. A indicação daProfilaxia Pós-Exposição às vítimas ocorreu em 76,4% e a contracepção de emergência foi administrada em64,77% das mulheres. Apenas 19,54% completaram o seguimento ambulatorial. As evidências indicam anecessidade de estratégias de atendimento que motivem a vítima de violência sexual a finalizar o tratamento.El objetivo del estudio fue conocer aspectosde la violencia sexual y adhesión de las víctimas alprocedimiento ambulatorial. Estudio transversal cuyosdatos fueron obtenidos de modo retrospectivo en unservicio de referencia en el estado de Paraná. Los datosfueron recogidos de febrero a mayo de 2014 por medio defichas de notificación de 2009 a 2013. Fueron atendidos1272 agredidos sexualmente, siendo la edad de 53,46% deellos entre 12 y 18 años y 94,65%, mujeres. En más de lamitad de los casos, el agresor era desconocido (53,38%),la agresión ocurrió en las residencias (39,30%) y localespúblicos (35%), por la noche (50,33%) y, en 96,67% delos casos, hubo penetración vaginal. La indicación de laProfilaxia Pos Exposicón a las víctimas ocurrió en 76,4%y la contracepción de emergencia fue administrada en64,77% de las mujeres. Solamente 19,54% completaronel procedimiento ambulatorial. Las evidencias apuntan lanecesidad de estrategias de atendimiento que ayuden lavíctima de violencia sexual a finalizar el tratamiento.The aim was to investigate aspects of sexualviolence and the victims’ adherence to outpatient follow-up. This transversal study involved retrospective datacollection in a specialized service in the Brazilian state ofParaná. The collection was undertaken between Februaryand May 2014 from the notification files of 2009 – 2013.A total of 1,272 persons who had been the victims ofsexual assault was attended; 53.46% of them were agedbetween 12 and 18 years old, and 94.65% were female. Inmore than half of the cases, the aggressor was unknown(53.38%), the aggression took place in homes (39.30%) andon public highways (35%), at night (50.33%) and, in 96.67%of cases, there was vaginal penetration. Indication of Post-Exposure Prophylaxis to the victims took place in 76.4%of cases and emergency contraception was administeredto 64.77% of the women. Only 19.54% completed theoutpatient follow-up. The evidence indicates the need forattendance strategies which motivate the victim of sexualviolence to complete treatment

Construction of bioethical understanding through cinematographic work: perspective of teachers, students and health workers

The study aim at to analyze the bioethical understanding of teachers, students and health professionals through cinematographic work. A descriptive-interpretative study with a qualitative approach, carried out in an online environment, through an interview guided by a semi-structured script. Data analysis was based on Bardin\u27s referential. The process allowed the identification of two thematic categories: Building bioethical understanding through continuing education; Cinematographic work as a tool for bioethical analysis: perceptions and reflections. The results revealed that dilemmas with ethical implications were experienced by the participants, but with an incipient criticality. The methodological strategy of continuing education, using cinematographic work, allowed reflections and construction of knowledge about bioethics

Homosexuals Adolescents and relationships lived with their relatives: an approach of social phenomenology

Introdução: a adolescência é considerada um período de transformação em que ocorrem mudanças biopsicossociais, incluindo a vivência da sexualidade. Na adolescência, a homossexualidade pode ser causadora de graves conflitos familiares. Nesta fase da vida, a discussão sobre a homossexualidade configura-se como um assunto complexo e delicado de ser tratado, entretanto essa discussão abre oportunidades e caminhos para a compreensão da diversidade da sexualidade humana, considerando sua interface com as questões que envolvem a saúde física, mental e a socialização dos jovens. Neste contexto, faz-se necessário incluir os familiares dos adolescentes porque a família constitui a base para a formação do ser humano na sociedade. Objetivo: compreender a vivência de adolescentes homossexuais frente às relações com seus familiares. Método: estudo qualitativo ancorado na fenomenologia social de Alfred Schütz, realizado com 12 adolescentes homossexuais de ambos os sexos, residentes na cidade de Macapá/Amapá/Brasil. Os depoimentos foram coletados em setembro e outubro de 2015, por meio de entrevistas com as seguintes perguntas orientadoras: Conte-me como foi que você percebeu a sua orientação homossexual. Considerando sua orientação homossexual, conte-me sobre sua vivência com seus familiares. O que você espera do convívio com seus familiares? A análise dos dados foi realizada em conformidade com os passos utilizados pelos pesquisadores da fenomenologia social. Obtiveram-se os depoimentos após a aprovação no Comitê de Ética e Pesquisa da Universidade Federal do Amapá, sob o Parecer nº 1.197.641, em 24 de agosto de 2015. Resultados: a análise dos depoimentos permitiu a elaboração de categorias que representam as características típicas da vivência dos adolescentes homossexuais: aquele que, desde a infância, percebe-se com uma orientação sexual diferente das pessoas do mesmo sexo. A revelação ou não da homossexualidade aos familiares desencadeou dúvidas, inseguranças, gerando um relacionamento conflituoso no seio familiar. Em meio à diversidade vivida em âmbito familiar, eles têm como expectativa ter a orientação sexual aceita pela família, conquistar independência financeira e manter os laços familiares. Conclusões: a vivência de adolescentes homossexuais frente às relações com seus familiares explicitada nesta investigação pode desdobrar-se em reflexões que promovam intervenções no campo da assistência social e de saúde, educação e pesquisa, visando à inclusão desses adolescentes nos diversos cenários sociais, considerando o respeito à diversidade afetivo-sexual.Introduction: Adolescence is considered a period of transformation that occur biopsychosocial changes, including the experience of sexuality. In adolescence, homosexuality may cause serious family conflicts. At this stage of life, the discussion of homosexuality is configured as a complex and delicate subject to be treated, however this discussion opens opportunities and ways for understanding the diversity of human sexuality, considering its interface with the issues involving mental, physical health and socialization of young people. In this context it is necessary to include the relatives of adolescents considering that the family is the basis for the formation of the human being in society. Objective: To understand the experience of adolescent homosexuals in the relationships with their families. Method: A qualitative study anchored in the social phenomenology of Alfred Schütz, held with twelve adolescents homosexuals of both sexes that live in the city of Macapá / Amapá / Brazil. The statements were collected in September and October 2015, through interviews with the following guiding questions: Tell me how did you perceive your homosexual orientation. Considering your homosexual orientation, tell me about your life with your family. What do you expect living with their families? Data analysis was carried out in accordance with the steps used by the researchers of social phenomenology. We obtained the statements after to be approved in the Ethics and Research Committee of the Federal University of Amapá, under the number 1.193.598, on August 24, 2015. Results: The analysis of statements allowed the elaboration of categories that representing the typical characteristics of the experience of homosexual adolescents: That one who since childhood see himself with a different sexual orientation of the people of the same sex. The revelation or not about homosexuality to family has triggered doubts, insecurities, generating a conflictual relationship in the family. Amid the diversity lived in the family there is the expectation to have sexual orientation accepted by the family, gain financial independence and maintaining family ties. Conclusions: The experience of homosexuals adolescents about relationships with their families made explicit in this investigation can unfold in reflections that promote interventions in the field of social welfare and health, education and research aiming at inclusion of adolescents in different social scenarios, considering the respect in the affective-sexual diversity

ADENOCARCINOMA CERVICAL Y ABANDONO TERAPÉUTICO: LA PERSPECTIVA DE LOS ENFERMEROS DE UNA CIUDAD DEL EXTREMO NORTE DE BRASIL

Objetivo: describir, desde el punto de vista del enfermero, las causas de abandono de las usuarias en el tratamiento del adenocarcinoma de cuello uterino y analizar las propuestas para disminuir dicho abandono.Método: El estudio es una investigación descriptiva, cualitativa y narrativa. Participaron siete enfermeros asistenciales, que trabajan en una unidad de oncología de alta complejidad en la ciudad de Macapá, capital del estado de Amapá, Brasil. El estudio se realizó en el periodo comprendido entre el 3 y el 20 de diciembre de 2019. Los datos se sometieron a un análisis categórico temático.Resultados: surgieron dos categorías: principales causas de abandono de las usuarias en el tratamiento del adenocarcinoma cervical y estrategias de los enfermeros para reducir el abandono del tratamiento por parte de las usuarias.Conclusión: para favorecer el resguardo de las usuarias, los enfermeros participantes proponen una consulta de Enfermería y un plan de acción multiprofesional, resaltando las singularidades de cada mujer

Doença de Chagas: itinerário terapêutico de crianças e adolescentes em um município da Amazônia

In Brazil, timely assistance to individuals with Chagas disease is still a challenge to public health. The objective was to analyze the therapeutic itinerary of children and adolescents with Chagas disease in the search for attention and care health. It was adopted a qualitative, descriptive, exploratory approach. Field research was carried out with family members of children/adolescents with Chagas disease in the Reference Center for Tropical Diseases in Macapá, AP. Content analysis supported the identification of three analytical categories: The itinerary in search of a diagnosis; The Itinerary in search of the treatment and control of the disease; Weaknesses and potential of health care services. The results showed that the services are still centered on specialized care and the primary care is not prepared to identify the disease, and the medium and high complexity aren’t qualified for resolutive assistance. Therefore, the therapeutic itinerary of children and adolescents with Chagas disease is marked by challenges that involve timely diagnostic, which can lead to wrong treatments.No Brasil, a assistência em tempo oportuno aos indivíduos convivendo com Doença de Chagas ainda é um desafio à saúde pública. Objetivou-se analisar o itinerário terapêutico de crianças e adolescentes portadores de Doença de Chagas na busca de atenção e cuidado com a saúde. Adotada a abordagem qualitativa, descritiva, exploratória. Pesquisa de campo realizada com familiares de crianças/adolescentes convivendo com Doença de Chagas no Centro de Referência em Doenças Tropicais (CRDT) em Macapá, AP. Análise de conteúdo subsidiou a identificação de três categorias analíticas:  o diagnóstico como desafio inicial do itinerário terapêutico; o Itinerário em busca do tratamento e controle da doença; fragilidades e potencialidades dos serviços de atenção à saúde. Os resultados apontaram que a oferta dos serviços voltados para o diagnóstico da doença ainda está centrada na atenção especializada. Portanto, o itinerário terapêutico de crianças e adolescentes portadores de Doença de Chagas em busca do tratamento e controle da doença é marcado por desafios que envolvem o diagnóstico em tempo oportuno, o que pode repercutir em tratamentos equivocados. A principal fragilidade identificada estava relacionada aos serviços de saúde, pois a atenção primária não está preparada para a identificação da doença, tão pouco a média e alta complexidade estão qualificadas para uma assistência resolutiva. Quanto às potencialidades, estão relacionadas ao sistema de cuidado e atenção à saúde