Nuances da Atenção Primária à Saúde (APS) no contexto da pandemia da COVID-19 no Brasil : revisão integrativa

INTRODUÇÃO: No Brasil, a pandemia assumiu contornos peculiares, com elevado número de casos de COVID-19 e expressivo número de óbitos, neste contexto, a Atenção Primária à Saúde reafirma-se enquanto importante dispositivo para a organização das respostas de enfrentamento à COVID-19. OBJETIVO: Compreender como os serviços de Atenção Primária à Saúde organizou-se no Brasil para o enfrentamento da pandemia. MÉTODOS: Trata-se de uma revisão integrativa com abordagem qualitativa, a partir da estratégia PICO, a pergunta de pesquisa foi: Como a Atenção Primária em Saúde tem se organizado durante a pandemia da COVID-19 no Brasil? Sendo, o (P) – a pandemia da COVID-19 no Brasil, o (I) – a organização e o (CO) – a Atenção Primária em Saúde. Os descritores selecionados a partir do DeCS – Descritores em Ciências da Saúde foram: “Atenção Primária à Saúde” e “Infecções por Coronavírus”. RESULTADOS: Foram realizadas buscas nos dias 05 e 18 de julho de 2021, foram identificados 44 produções, sendo 38 destas na BIREME e 06 no Scielo. Neste momento, evidencia-se o caráter descritivo das produções, mapeando na perspectiva dos profissionais, as modificações ocorridas, as adaptações e dificuldades vivenciadas no cotidiano da organização da atenção à saúde no âmbito da APS. A partir da leitura e análise do corpus desta revisão, identificou-se algumas temáticas que predominaram na produção sobre a organização da Atenção Primária à Saúde neste contexto da pandemia, as quais foram organizadas nas seguintes categorias: “A APS no enfrentamento da pandemia”, “Integração das Ações de Vigilância e Atenção Básica”, “Possibilidades na Integração Ensino-Serviço-Comunidade”, e “Reorientação de Serviços da Atenção Primária”. CONCLUSÃO: As experiências de organização da APS no período assinalam para a sua capacidade inventiva, inovadora e resolutiva, apontam tendências de transformações no modo como o cuidado é prestado, com incorporação massiva de tecnologias de comunicação para intermediar o acesso, acompanhamento, participação e orientação dos usuários.INTRODUCTION: In Brazil, the pandemic took on peculiar contours, with a high number of cases of COVID-19 and a significant number of deaths. 19. OBJECTIVE: To understand how Primary Health Care services were organized in Brazil to face the pandemic. METHODS: This is an integrative review with a qualitative approach, based on the PICO strategy, the research question was: How has Primary Health Care organized during the COVID-19 pandemic in Brazil? Being (P) - the COVID-19 pandemic in Brazil, (I) - the organization and (CO) - Primary Health Care. The descriptors selected from DeCS - Descriptors in Health Sciences were: “Primary Health Care” and “Coronavirus Infections”. RESULTS: Searches were carried out on July 5th and 18th, 2021, and 44 productions were identified, 38 of them in BIREME and 06 in Scielo. At this moment, the descriptive character of the productions is evidenced, mapping, from the perspective of the professionals, the changes that have occurred, the adaptations and difficulties experienced in the daily life of the organization of health care within the scope of the PHC. From the reading and analysis of the corpus of this review, we identified some themes that predominated in the production on the organization of Primary Health Care in this context of the pandemic, which were organized into the following categories: "PHC in coping with the pandemic", “Integration of Surveillance and Primary Care Actions”, “Possibilities in Teaching-Service-Community Integration”, and “Reorientation of Primary Care Services”. CONCLUSION: The experiences of PHC organization in the period point to its inventive, innovative and resolute capacity, point to trends of transformations in the way care is provided, with massive incorporation of communication technologies to mediate access, monitoring, participation and guidance of users

“Afectados por el tacto”: sentidos atribuidos por hombres a las prácticas de prevención del cáncer de próstata

The aim of this study was to identify and analyze meanings attributed to practices related to prostate cancer prevention among men. A qualitative methodology was employed, with semi-structured interviews being conducted with 21 men in the city of Vitoria da Conquista, Bahia, between July and August of 2017. Data analysis was based on a dialectical hermeneutic approach. We found that practices related to prostate cancer prevention were based on scarce information and permeated by a sense of fear of the disease, which was thought of as a death sentence. Additionally, these feelings were compounded by the repercussions of rectal examination, perceived as a violation of one’s masculinity. We were able to observe that practices devised to prevent prostate cancer reflect the repercussions of conceptions of masculinity regarding men’s health care, where manliness and toughness can be susceptible by the touch.El objetivo del estudio fue identificar y analizar los sentidos atribuidos por hombres a las prácticas relacionadas con la prevención del cáncer de próstata. Se realizó un estudio cualitativo, con entrevistas semiestructuradas, en el que participaron 21 hombres del municipio de Vitória da Conquista, Bahía. El período de recopilación de información fue entre julio y agosto de 2017. El análisis de los datos se basó en los principios de la hermenéutica-dialéctica. Se percibió que las prácticas relacionadas con la prevención del cáncer de próstata se elaboran con escasa información y permeadas por sentidos que remiten al miedo a la enfermedad, asumida como una sentencia a la vida, y a las repercusiones del tacto rectal, asimilado como una violación de la condición masculina. Se constató que las prácticas elaboradas para prevenir el cáncer de próstata reflejan las implicancias de la masculinidad en el cuidado de la salud de los hombres y, sobre todo, que la dureza masculina puede sentirse interpelada a partir de un tacto

Impacts on Men’s Health/Mental Health

Publisher Copyright: Copyright © 2022 de Sousa, Moreira, da Silva Santana, Araújo, Borges, Almeida, das Mercês, da Silva, Teixeira, Lourenção, Gomes, de Santana Carvalho, de Sousa, de Almeida, Viana and Pereira.Objective: This study aims to analyze sociohistorically how the normative patterns of hegemonic masculinity produced impacts on men’s health/mental health in the context of the COVID-19 pandemic. Methods: A qualitative study from a socio-historical perspective was conducted with 50 men based on an online survey. A semistructured form was applied. The data were analyzed by the Collective Subject Discourse method, interpreted in the light of the context of epidemic disease and hegemonic masculinity. Results: The experience of the pandemic exposed the normative patterns of masculinities from the consummation of acts representative of the pandemic context, which incited men to deny the existence of COVID-19 disease and to delay the understanding and adoption of measures to protect and control COVID-19. As a repercussion, men presented conflicts in the regulation of emotions; presented emotional suppression; were more reactive; felt threatened regarding the loss of the role of family provider, virility; and revealed a sense of invulnerability, added to the weakening of self-care. Conclusion: The discourse revealed that the men’s behaviors are consistent with the characteristics of hegemonic masculinity, but express signs of recognition that this behavior causes harm to themselves and their health.publishersversionpublishe

Psychological Distress in Men during the COVID-19 Pandemic in Brazil: The Role of the Sociodemographic Variables, Uncertainty, and Social Support

Objective: To analyze the relationships between sociodemographic variables, intolerance to uncertainty (INT), social support, and psychological distress (i.e., indicators of Common Mental Disorders (CMDs) and perceived stress (PS)) in Brazilian men during the COVID-19 pandemic. Methods: A cross-sectional study with national coverage, of the web survey type, and conducted with 1006 Brazilian men during the period of social circulation restriction imposed by the health authorities in Brazil for suppression of the coronavirus and control of the pandemic. Structural equation modeling analysis was performed. Results: Statistically significant direct effects of race/skin color ( = 0.268; p-value < 0.001), socioeconomic status (SES) ( = 0.306; p-value < 0.001), household composition( = 0.281; p-value < 0.001), PS ( = 0.513; p-value < 0.001), and INT ( = 0.421; p-value < 0.001) were evidenced in the occurrence of CMDs. Black-skinned men with higher SES, living alone, and with higher PS and INT levels presented higher prevalence values of CMDs. Conclusions: High levels of PS and INT were the factors that presented the strongest associations with the occurrence of CMDs among the men. It is necessary to implement actions to reduce the stress-generating sources as well as to promote an increase in resilience and the development of intrinsic reinforcements to deal with uncertain threats.info:eu-repo/semantics/publishedVersio

SARS-CoV-2 in Brazil and Psychosocial Repercussions on Men’s Health: Health Literacy Is Important

This study aimed at analyzing the psychosocial repercussions of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic on the health of men living in Brazil. For this, we carried out a socio-historical and qualitative study, with the participation of 200 men who answered an online questionnaire. The data collected were processed in the NVIVO12® software, structured by the Collective Subject Discourse method, and analyzed from the epidemic disease theoretical framework proposed by Charles Rosenberg. Our results showed that the SARS-CoV-2 pandemic brought about repercussions of different dimensions that compromised the health of men living in Brazil. The repercussions evidenced were behavioral changes and emergence of new habits due to the pandemic; uncomfortable family situations; impaired affective and sexual relationships; harms in marital relationships; and insecurity and psychological distress. It is important to implement strategies that maximize men’s health literacy, promoting better communication in terms of health, and search for help and suitable information about health/mental health.info:eu-repo/semantics/publishedVersio

The Ninth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the SDSS-III Baryon Oscillation Spectroscopic Survey

The Sloan Digital Sky Survey III (SDSS-III) presents the first spectroscopic data from the Baryon Oscillation Spectroscopic Survey (BOSS). This ninth data release (DR9) of the SDSS project includes 535,995 new galaxy spectra (median z=0.52), 102,100 new quasar spectra (median z=2.32), and 90,897 new stellar spectra, along with the data presented in previous data releases. These spectra were obtained with the new BOSS spectrograph and were taken between 2009 December and 2011 July. In addition, the stellar parameters pipeline, which determines radial velocities, surface temperatures, surface gravities, and metallicities of stars, has been updated and refined with improvements in temperature estimates for stars with T_eff<5000 K and in metallicity estimates for stars with [Fe/H]>-0.5. DR9 includes new stellar parameters for all stars presented in DR8, including stars from SDSS-I and II, as well as those observed as part of the SDSS-III Sloan Extension for Galactic Understanding and Exploration-2 (SEGUE-2). The astrometry error introduced in the DR8 imaging catalogs has been corrected in the DR9 data products. The next data release for SDSS-III will be in Summer 2013, which will present the first data from the Apache Point Observatory Galactic Evolution Experiment (APOGEE) along with another year of data from BOSS, followed by the final SDSS-III data release in December 2014.Comment: 9 figures; 2 tables. Submitted to ApJS. DR9 is available at http://www.sdss3.org/dr

Relationships between landscape structure and vegetation diversity in secondary forests in the cuestas region, Charqueada and São Pedro, São Paulo

O estado atual do desmatamento de florestas primárias e o restabelecimento de florestas secundárias no Brasil variam de acordo com a região do país. Enquanto alguns domínios têm perdido grandes extensões de cobertura original, como a Floresta Amazônica e o Cerrado, outros têm registrado um aumento na área ocupada por florestas, como é o caso da Mata Atlântica no estado de São Paulo. O processo de regeneração de florestas secundárias tem sido registrado nos últimos 30 anos, devido ao abandono de pastagens e iniciativas de restauração florestal. Dessa forma, o objetivo principal deste estudo foi investigar se florestas secundárias regenerando em pastagens abandonadas diferem em relação à composição e diversidade de espécies florestais sob duas condições distintas de característica da paisagem: áreas com elevada proporção de cobertura florestal no entorno (>30%) e áreas com baixa proporção de cobertura florestal no entorno (30%) and isolated areas, with low proportion of forest cover around (<10%). Based on images of 1972, old-forest remnants were delimited. After, the vegetation map produced for 1972 was overlapped to a land cover map of 2018 to record the expansion and decrease of vegetation. Based on these two maps, we evaluated the modifications in the landscape structure, during the 46-years period. After that, we selected eight areas, being four structurally connected and four, structurally isolated. At each area we evaluated composition, species richness, diversity, equability, density, dispersal syndrome and aboveground biomass. Contrary to expectations, our results showed that regenerating plants in isolated areas have higher proportion of animal-dispersed seed species than connected areas. We also found differences in the plant composition of regenerating communities between connected and isolated areas. Our findings indicate that structural conditions of the landscape can influence functional groups of the regenerating plants in the cuestas region, making the landscape context an essential parameter to be considered in conservation and restoration plans, especially in highly fragmented landscapes

“Afectados por el tacto”: sentidos atribuidos por hombres a las prácticas de prevención del cáncer de próstata

The aim of this study was to identify and analyze meanings attributed to practices related to prostate cancer prevention among men. A qualitative methodology was employed, with semi-structured interviews being conducted with 21 men in the city of Vitoria da Conquista, Bahia, between July and August of 2017. Data analysis was based on a dialectical hermeneutic approach. We found that practices related to prostate cancer prevention were based on scarce information and permeated by a sense of fear of the disease, which was thought of as a death sentence. Additionally, these feelings were compounded by the repercussions of rectal examination, perceived as a violation of one’s masculinity. We were able to observe that practices devised to prevent prostate cancer reflect the repercussions of conceptions of masculinity regarding men’s health care, where manliness and toughness can be susceptible by the touch.El objetivo del estudio fue identificar y analizar los sentidos atribuidos por hombres a las prácticas relacionadas con la prevención del cáncer de próstata. Se realizó un estudio cualitativo, con entrevistas semiestructuradas, en el que participaron 21 hombres del municipio de Vitória da Conquista, Bahía. El período de recopilación de información fue entre julio y agosto de 2017. El análisis de los datos se basó en los principios de la hermenéutica-dialéctica. Se percibió que las prácticas relacionadas con la prevención del cáncer de próstata se elaboran con escasa información y permeadas por sentidos que remiten al miedo a la enfermedad, asumida como una sentencia a la vida, y a las repercusiones del tacto rectal, asimilado como una violación de la condición masculina. Se constató que las prácticas elaboradas para prevenir el cáncer de próstata reflejan las implicancias de la masculinidad en el cuidado de la salud de los hombres y, sobre todo, que la dureza masculina puede sentirse interpelada a partir de un tacto

Implementação da Política Nacional de Atenção Integral à Saúde do Homem: desafios vivenciados por enfermeiras

Objective: To analyze the challenges experienced by nurses in the implementation of the National Policy for Comprehensive Attention to Men’s Health. Method: Descriptive, qualitative study, carried out with nurses working in Primary Health Care in a city in the state of Bahia, Brazil. Individual interviews were carried out and then analyzed using the Discourse of the Collective Subject, in the light of the guidelines of the National Policy for Comprehensive Attention to Men’s Health. Results: A total of 40 nurses participated. The challenges for the implementation of the policy are related to the inoperability of government actions, weaknesses in municipal management, underfunding and discontinuity of actions. Conclusion: Nurses face complex macro-management challenges in the implementation of the National Policy for Comprehensive Attention to Men’s Health in Primary Health Care.Objetivo: Analizar los desafíos vividos por las enfermeras en la implementación de la Política Nacional de Atención Integral a la Salud del Hombre. Método: Se trata de un estudio descriptivo y cualitativo realizado con enfermeras que trabajan en la Atención Primaria de Salud en un municipio de Bahía, Brasil. Se llevaron a cabo entrevistas individuales y se analizaron con el método del Discurso del Sujeto Colectivo, a la luz de los lineamientos de la Política Nacional de Atención Integral a la Salud del Hombre. Resultados: Participaron 40 enfermeras. Los retos para la aplicación de la política se concentran en la inoperancia de las acciones gubernamentales, la debilidad de la gestión municipal, la infrafinanciación y la discontinuidad de las acciones. Conclusión: Las enfermeras se enfrentan a complejos retos de macrogestión para implemObjetivo: Analisar os desafios vivenciados por enfermeiras na implementação da Política Nacional de Atenção Integral à Saúde do Homem. Método: Estudo descritivo, qualitativo, realizado com enfermeiras que atuam na Atenção Primária à Saúde em um município da Bahia, Brasil. Realizou-se entrevista individual, analisada pelo método do Discurso do Sujeito Coletivo, à luz das diretrizes da Política Nacional de Atenção Integral à Saúde do Homem. Resultados: Participaram 40 enfermeiras. Os desafios para a implementação da política concentram-se na inoperância das ações governamentais, fragilidades da gestão municipal, subfinanciamento e descontinuidade das ações. Conclusão: As enfermeiras enfrentam desafios complexos de macrogestão na implementação da Política Nacional de Atenção Integral à Saúde do Homem na Atenção Primária à Saúde