Papers by Renata Boscaini David
Brazilian Journal of Health Review, 2021
RESUMO O presente trabalho relata fatores observados em visita domiciliar à puérpera do bairro Ci... more RESUMO O presente trabalho relata fatores observados em visita domiciliar à puérpera do bairro City Petrópolis em Franca SP. O intuito da realização das mesmas foi identificar fatores de risco, criar vínculos, conhecer o arranjo familiar e social, o processo de recuperação do parto, adaptação à criação da criança, dentre outros, com enfoque na abordagem dos sentimentos e opiniões da mesma acerca dos assuntos explorados. O instrumento usado para registro dos dados foi baseado no registro de saúde orientado por problemas-ReSOAP. De acordo com Gusso e Lopes, o ReSOAP permite a obtenção rápida de informação e compreensão dos problemas de saúde mais relevantes. O objetivo da ferramenta, além do registro de dados, é permitir análise, comparações, realização de prognósticos das alterações clínicas, emocionais e comportamentais, a partir do qual é possível efetuar uma análise e elaborar um plano de ação visando a resolução dos problemas elencados. A coleta de dados efetuou-se por entrevista direta com a paciente e seu marido no ato das visitas, bem como pela análise de registros realizados pela agente comunitária.
International Journal of Environmental Research and Public Health, 2021
Poor accessibility of healthcare facilities is a major barrier for people with disabilities when ... more Poor accessibility of healthcare facilities is a major barrier for people with disabilities when seeking care. Yet, accessibility is rarely routinely audited. This study reports findings from the first national assessment of the accessibility of primary health care facilities, undertaken in Brazil. A national accessibility audit was conducted by trained staff of all 38,812 primary healthcare facilities in Brazil in 2012, using a 22-item structured questionnaire. An overall accessibility score was created (22 items), and three sub-scales: external accessibility (eight items), internal accessibility (eight items), information accessibility (six items). The main finding is that the overall accessibility score of primary care facilities in Brazil was low (mean of 22, standard deviation (SD) of 0.21, on a 0–100 scale). Accessibility of different aspects of the healthcare facilities was also low, including external space (mean = 31.0, SD = 2.0), internal space (18.9, 1.9) and accessibilit...
PREFÁCIO Recebi, com alegria, o honroso convite para participar desse momento de
Revista Brasileira de Bioética, 2019
Este trabalho descreve o acesso à saúde por mulheres com deficiência (McD) à luz do conceito de e... more Este trabalho descreve o acesso à saúde por mulheres com deficiência (McD) à luz do conceito de estigma de Goffman1, a partir da Pesquisa Nacional de Saúde (PNS). O perfil da morbimortalidade e do acesso à saúde são impactados pelas desigualdades de gênero, sob o aspecto dos atributos biológicos e culturais, bem como os agravos à saúde decorrentes da associação entre estereótipos de gênero e estigmas específicos, e acabam por comprometer o exercício da cidadania, sobretudo relacionado ao direito à saúde.
European Respiratory Journal, Sep 1, 2013
Body: Resistance training is golden evidence for the treatment of systemic muscle disorders in CO... more Body: Resistance training is golden evidence for the treatment of systemic muscle disorders in COPD patients. Aims:Analyze the percentage gain in functional capacity in COPD patients undergoing resistance training and correlate this data with muscle strength.We assessed 44 stable COPD(FEV1%53,25±20,81; age 65,84±8,63; BMI 25,51±4,21;) undergoing resistance training for 8 weeks.27 subjects (FEV1%57,70±23,68 ;age65.81 ± 8.6;BMI25.99 ± 3.9) underwent conventional resistance training(CT) and 17(FEV1% 46,19±12,88; age 65.88 ±9.0;BMI 24.74±4.6) trained with elastic tubing (ET).Functional capacity was evaluated by the six-minute walk test(6MWT) and muscle strength by dynamometry.The CT was performed at moderate intensity at 60-80% of 1 maximum repetition(3 x 10) and ET group trained at sets of 2-7 repetitions, individually determined by resistance to fatigue test, both performed knees flexion and extension, shoulders flexion and abduction and elbow flexion.Statistical analyses were performed using test T Student for parametric date or Mann Whitney for non parametric date and correlations by the Spearman coefficient. Results:The comparison between groups showed significant difference(p=0.02) in the 6MWT.The ET group demonstrated 14,74% gain and the CT 7,86%.It was observed a positive correlation between functional capacity and knee extension: CT(r=0.53); ET(r:0.64), shoulder flexion: CT(r=0.39), ET(r=0.69), shoulder abduction: CT(r=0.39), ET(r=0.59), elbow flexion:ET(r=0.55). Conclusion:The elastic tubing, compared to conventional training, proved to be more efficient in improve functional capacity and also showed a higher correlation with muscle strength in COPD patients.
Body: Smoking is considered to be the leading cause of preventable death in the world. There is a... more Body: Smoking is considered to be the leading cause of preventable death in the world. There is an association of smoking and clinical respiratory symptoms in individuals who have not been diagnosed with any respiratory diseases. Aims: evaluate frequency and correlate clinical symptoms, lung function and mucociliary clearance in smokers. Methods:73 smokers aged between 40 and 70 years old, inserted in a smoking cessation program were divided in: Smoker group (n=47) with normal lung function and Obstrutive Group: smokers with obstructive disorders (n=26). They underwent an evaluation for clinical symptoms assessment (dyspnea, fatigue and cough) and measurement of exhaled carbon monoxide (COex) and nasal mucociliary clearance (MC). Results: A negative correlation (r =-0,39) between MC and lung function (FEF25-75% estimated) in the obstructive group has been identified. In the smoker group, 59,6% of individuals were symptomatic, and out of these 19,1% presented all clinical symptoms evaluated. Besides in the group with obstructive disorders, it was identified that 61,5% of individuals were symptomatic and out of them, 30,8% reported all clinical symptoms. Moreover, there was a higher predominance of females in both groups (smokers: 68,1% and 57,7% in obstructive group) and clinical symptoms in smokers of 51 to 60 years old. Conclusion: Although many smokers showed normal lung function, it could be observed that they present clinical symptoms which may generate significant impact on their health condition. This finding allows us to act in a preventive manner in order to provide guidance about the importance of smoking cessation and the need to minimize the harmful effects of tobacco consumption.
Background: The most effective method of aerobic training in COPD is continuing under investigati... more Background: The most effective method of aerobic training in COPD is continuing under investigation. In healthy individuals, periodized aerobic training has been considered superior than traditional methods; however, its effect on COPD patients has not yet been elucidated. Aim: To evaluate the effect of periodized aerobic training on aerobic power and autonomic modulation in COPD patients. Methods : 16 COPD patients were included in the study and randomized to either periodized training (PTG; N=10) or control group (CG; N=6). Aerobic power (cardiopulmonary exercise testing) and autonomic function (heart rate variability) were assessed at baseline and after 12 weeks of training. Linear periodized aerobic training was conducted in 3 mesocycles with a 4 weeks duration each. Comparison between baseline and 12 weeks was performed using paired Student9s t test or the Wilcoxon test, in case of non-normally distributed data. Results: After 12 weeks of periodized training, PTG presented a huge increase in peak oxygen consumption in either total (0.72±0.39 to 1.9±1L/min; P=0.01) or relative values (VO 2peak , 9.4±4 to 27.2±16.8 ml/kg/min; P=0.01) and it was also observed an increase in the parasympathetic response (HF index, 62.3±46.8 to 113.2±62.1 ms; P =0.04). In addition, after training it was observed an increase in maximal speed reached during peakVO 2 (5.5±1.2 to 6.3±1.3 km/h; P=0.006) in PTG. No significant difference for any outcome was observed in CG (P>0.05). Conclusion: Periodized aerobic training promoted enormous benefits on the aerobic capacity and autonomic modulation in patients with COPD.
Body: Chronic Obstructive Pulmonary Disease (COPD) patients exhibit modifications in mucociliary ... more Body: Chronic Obstructive Pulmonary Disease (COPD) patients exhibit modifications in mucociliary clearance (MCC) that contribute to sputum production and airway inflammation, which predispose this population to recurrent infections. It's known that ex-smokers with normal lung function may present MCC reversibility after smoking cessation, however in COPD ex-smokers it's unknown. Aim: To evaluate and to compare the MCC of smokers, COPD smokers and COPD ex-smokers. Methods: We evaluated 112 subjects, divided in five groups: severe COPD (n=22), moderate COPD (n=20), COPD smokers (17), current smokers (n=27) and non-smokers (n=26). Severe and moderate COPD patients were ex-smokers (FEV1% = 37,8±6 and 61±7; 60±49,7 and 62±45 pack/years; duration of smoking cessation = 11±10 and 6,2±3,7 years; respectively). COPD smokers and current smokers were maintaining the habit (FEV1% = 48,7±16,8 and 90,7±7; 31±24,8 and 40±21 pack/years; respectively). Non-smokers with normal lung function were matched for age. We evaluated MCC by Saccharin Transit Time (STT) test. Tests were conducted between 8 and 9 AM within air temperature and relative humidity controlled. Statistical analyses were performed using Kruskal-Wallis test followed by Dunn's test. Results: STT was higher in COPD smokers and current smokers compared to both groups of COPD ex-smokers and non-smokers (p=0,001). There was no difference in STT between severe and moderate COPD ex-smokers, and their values of STT were similar to non-smokers. Conclusion: COPD ex-smokers showed better MCC compared to current smokers and COPD smokers, also presented MCC similar to non-smokers. These results suggest that quitting smoking, even in people who developed COPD, leads to MCC's reversibility.
Revista Brasileira de Saúde Materno Infantil, 2011
OBJETIVOS: descrever os estados comportamentais dos recém-nascidos com peso inferior a 1500 g, em... more OBJETIVOS: descrever os estados comportamentais dos recém-nascidos com peso inferior a 1500 g, em ventilação mecânica, antes, durante e após o cuidado mãe canguru (CMC). MÉTODOS: estudo do tipo quase experimental em que os estados comportamentais definidos como sono profundo, ativo, sonolência, alerta inativo, alerta ativo e choro de acordo com a Escala Neonatal de Brazelton foram avaliados em três momentos: 15 minutos antes do CMC, 30 minutos após o início da exposição e 15 minutos após o CMC num total de uma hora de exposição. Quarenta e quatro recém-nascidos pré-termo (poder estatístico >0,9), com idade gestacional média de 29 semanas e peso médio de 1096 g, intubados e estáveis do ponto de vista hemo-dinâmico, foram selecionados por amostra de entrada contínua. RESULTADOS: evidenciou-se o favorecimento do sono, principalmente o sono profundo (52,3%), comparado aos períodos antes (6,8%) e após (13,6%) (p<0,001) o CMC. Além disso, os recém-nascidos apresentaram sinais de dor...
ConScientiae Saúde, 2014
Introdução: O tabagismo pode ser tratado com eficácia por terapias com enfoque na abordagem cogni... more Introdução: O tabagismo pode ser tratado com eficácia por terapias com enfoque na abordagem cognitivo-comportamental, sendo imprescindível a descrição minuciosa desta. Objetivo: Descrever um programa de cessação tabagística com novos procedimentos e avaliar seu índice de sucesso. Métodos: Participantes de um programa de cessação tabagística, baseado em terapias cognitivas comportamentais e farmacológicas, foram acompanhados por um ano, e a taxa de cessação avaliada foi, no mínimo, de seis meses, após pararem de fumar. Foram implementados os seguintes procedimentos: intensificação na frequência dos encontros (duas vezes semanais); data de cessação pré-estabelecida pelos terapeutas do programa, primeiro encontro com apresentação do tratamento, esclarecimento de dúvidas e motivação dos pacientes e participação de ex-tabagistas para incentivar os iniciantes. Resultados: Dos 145 indivíduos que participaram do estudo, observou-se um índice de sucesso de 64,42% durante o acompanhamento. Co...
Introduction: Although cellulite has been related to being overweight and having unhealthy eating... more Introduction: Although cellulite has been related to being overweight and having unhealthy eating habits, normal weight patients can also present with cellulite. Objective: To assess the effects of three different diets in the reduction of cellulite grading in normal weight women. Methods: Forty-three women were randomized into 3 groups: Group 1 followed a lowcarbohydrate diet; Group 2, a high protein content diet; and Group 3, a control diet with standard amounts of macronutrients. Body weight for each patient was recorded and cellulite grading was assessed with the Cellulite Severity Scale. Results: Patients in Group 2 had, on average, lower cellulite grading for the right and left gluteus compared to patients in Groups 1 and 3. Patients in Group 2 also saw a reduction in body weight and a reduction in cellulite grading on the thighs during the course of the study. Conclusion: Patients in Group 2 had improvement in cellulite grading, possibly related to the reduction in body weigh...
Surgical Cosmetic Dermatology, 2014
Embora seja conhecida a positiva relação entre o agravamento da celulite pelo excesso de peso e h... more Embora seja conhecida a positiva relação entre o agravamento da celulite pelo excesso de peso e hábitos alimentares incorretos, pacientes com peso normal também podem apresentar celulite. Objetivo: Avaliar o efeito de três diferentes dietas na redução do grau de celulite em mulheres com peso normal. Métodos: Quarenta e três mulheres foram randomizadas para três diferentes grupos: o grupo 1 seguiu dieta com teor de carboidratos reduzido; o grupo 2, dieta com alto teor de proteínas; e o grupo 3, dieta-controle com quantidades normais de macronutrientes. O peso das pacientes foi aferido, e o grau de celulite foi avaliado pela escala de gravidade de celulite. Resultados: As pacientes do grupo 2 apresentaram grau de celulite mais baixo nos glúteos direito e esquerdo em relação às pacientes dos grupos 1 e 3. Ao longo do tempo, as pacientes do grupo 2 tiveram redução no grau de celulite nas coxas. Conclusão: As pacientes do grupo 2 apresentaram melhora no grau de celulite, provavelmente relacionada à perda de peso e consequente redução do tecido adiposo. Estudos maiores e mais abrangentes serão necessários para corroborar esse dado e estabelecer a relação entre a composição de diferentes dietas e a melhora da celulite. Palavras-chave: celulite; lipodistrofia; dietoterapia.
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Papers by Renata Boscaini David