Insegurança alimentar e fatores associados em crianças atendidas em unidades básicas de saúde da cidade de Criciúma- SC

Dissertação apresentada ao Programa de Pós- Graduação em Saúde Coletiva (Mestrado Profissional) da Universidade do Extremo Sul Catarinense - UNESC, como requisito para a obtenção do título de Mestre em Saúde Coletiva.A insegurança alimentar é o direito de todos ao acesso regular e permanente a alimentos em qualidade e quantidade suficiente e está relacionada a fatores sociodemográficos, econômicos e nutricionais, como: menor renda e escolaridade, ausência de vínculo empregatício e de saneamento básico, fome, desnutrição e excesso de peso. Assim, o objetivo do estudo foi avaliar a prevalência de insegurança alimentar e seus fatores associados em crianças atendidas em Unidades Básicas de Saúde da cidade de Criciúma-SC. Trata-se de um estudo transversal, realizado com crianças menores de dez anos de idade atendidas nas Unidades Básicas de Saúde Operária Nova, Mina do Mato, Rio Maina, Pinheirinho, Santa Luzia e Paraíso da cidade de Criciúma-SC. Para avaliar a insegurança alimentar foi aplicada a Escala Brasileira de Insegurança Alimentar. Além disso, foi aplicado questionário para avaliar as variáveis de exposição sexo, idade, cor da pele, escolaridade dos pais, chefe da família, aglomeração familiar, renda familiar, região em que reside o responsável familiar. Para avaliar o estado nutricional, as crianças foram pesadas e medidas e classificadas, conforme recomendação da Organização Mundial de Saúde, em magreza, eutrofia, sobrepeso e obesidade. Foram realizadas análises bruta e ajustada da associação entre insegurança alimentar e as variáveis de exposição estudadas através dos testes Qui-quadrado de Pearson e Exato de Fisher, utilizando o nível de significância de 5%. Para a realização das análises foi utilizado o programa Stata versão 12.1. Observou-se que maioria da amostra (n=82) era do sexo masculino (57,3%), apresentava cor da pele branca (79,3%), e possuía renda de 2 a 3 salários mínimos (56,0%). Cerca de um terço das crianças apresentaram insegurança alimentar leve ou moderada (29,3%), não sendo evidenciadas situações de insegurança alimentar grave. A maior prevalência de insegurança alimentar foi encontrada nos indivíduos de pele não branca (p<0,001) e com renda familiar de até 1 salário mínimo (<0,001). As demais variáveis não mostraram associação com a insegurança alimentar. Em conclusão, pôde-se verificar alta prevalência de IA e de excesso de peso entre as crianças estudadas. Além disso, observou-se que a renda familiar e a cor da pele estiveram associadas à IA desses indivíduos, o que destaca a necessidade de intervenções nas Unidades Básicas de Saúde, visando ampliar os direitos alimentares adequados e atendendo às necessidades essenciais, como educação em saúde, ações de conscientização alimentar. Deve-se ainda repensar em políticas que gerem emprego e renda e, consequentemente, aumento do poder aquisitivo das famílias facilitando maior acesso aos bens de consumo e diminuição de desigualdade social

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

The “home-based exercise for breast and prostate cancer patients during treatment—a feasibility trial” (BENEFIT CA trial): rationale and methodological protocol

Abstract Background Physical activity has been shown to benefit patients undergoing adjuvant cancer therapy. Although exercise interventions may be applied in several settings, most trials have focused on specialized facilities for their interventions. While these approaches benefit the access for individuals living near exercise centers, it hampers the assessment of real-world effectiveness. Therefore, evaluating the feasibility and implementation of home-based models of exercise training, especially in low-to-middle-income settings, may inform future physical activity trials and programs. In this article, we present the protocol for the BENEFIT CA trial, which aims to assess the implementation of a remote exercise intervention for patients with breast cancer or prostate cancer, primarily quantifying adherence to an exercise program. Methods This is a 12-week study, utilizing a non-randomized, single-arm design to assess the feasibility of a home-based exercise training. The intervention is remotely guided, and participants also receive an educational component about cancer and exercise. The study aims to recruit 40 patients diagnosed with breast cancer and 40 patients diagnosed with prostate cancer, all of whom undergoing active hormonal treatment. The primary outcome is the level of adherence, indicated as the proportion of performed exercise episodes. Secondary outcomes include recruitment rates, fatigue, quality of life, and functional capacity. Adverse events will be monitored throughout the study. Because this is a feasibility trial, the statistical analysis plan is based on descriptive statistics, which encompasses an intention-to-treat analysis and a plan for handling missing data. Discussion This is a low-cost feasibility study to orient the design of a wide-range, pragmatic phase 3 trial based on remote exercise intervention. With this study, we aim to better understand the adherence and implementation strategies regarding home-based exercise for the proposed population and, in the near future, move forward to a randomized clinical trial. In addition, this trial may contribute to engage patients with cancer in exercise programs throughout their treatment and beyond. Trial registration This trial has been approved by the Hospital de Clínicas de Porto Alegre Ethics Committee/IRB (48,869,621.9.0000.5327), and it is registered at Clinicaltrials.gov (NCT05258526), registered on February 25, 2022, prior to the beginning of the study

Home based exercise for BrEast and prostate caNcEr patients during treatment: a FeasIbility Trial” (BENEFIT CA trial)

This a PhD project regarding the feasibility of a home based exercise, using a remote approach, for breast and prostate cancer patients undergoing hormonal treatment / manipulation

Resumos em andamento - Saúde Coletiva

Resumos em andamento - Saúde Coletiv

Resumos em andamento - Saúde Coletiva

Resumos em andamento - Saúde Coletiv