https://tede.unisantos.br/handle/tede/39 Thu, 05 Nov 2026 08:31:03 GMT 2026-11-05T08:31:03Z https://tede.unisantos.br/handle/tede/8138 Title: Pré-natal odontológico materno-infantil na atenção primária à saúde: uma revisão integrativa Abstract: The objective of this dissertation was to analyze, in the scientific literature, the contributions of dental prenatal care to the promotion of the oral health of pregnant people and their babies in Primary Health Care (PHC). This is an integrative literature review, conducted through a systematic search in national and international databases, such as: SciELO; PubMed; BVS (LILACS and MEDLINE). The Health Sciences Descriptors and their corresponding Medical Subject Headings in English were used. The study population consisted of pregnant people, and the phenomenon of interest was dental prenatal care in the context of Primary Health Care. The theoretical framework used was the concept of vulnerability. In the data search, 169 articles were found, which were submitted to the Rayyan platform; after data processing, 18 articles remained. Regarding the year of publication, one study was conducted in 2020 and one in 2021, six studies in 2022, five studies in 2023, three in 2024 and two in 2025. Regarding the place of publication, 13 studies originated from Brazil, two from Saudi Arabia, one from Iran, one from South Africa, and one from the United States. There was a predominance of quantitative designs: 12 studies, especially cross-sectional studies, involved secondary data analyses. The qualitative studies corresponded to six investigations, including one documentary study. The studies evidenced low adherence to and insufficient utilization of dental prenatal care, even in the face of high clinical need. The search for dental care by pregnant people occurred predominantly in situations of pain and urgency. The access barriers identified were: fears and myths, failures in professional training, and organizational difficulties in services, structural limitations, such as the absence of Oral Health Teams, and low working hours of dental surgeons, negatively impacting the provision of guidance and educational actions. Final considerations: Based on the National Oral Health Policy and the need to organize care in an integrated and coordinated manner within the Health Care Network, it is essential to strengthen the oral health care pathway within Primary Health Care. Type: Dissertação Thu, 24 Sep 2026 00:00:00 GMT https://tede.unisantos.br/handle/tede/8138 2026-09-24T00:00:00Z https://tede.unisantos.br/handle/tede/8137 Title: Lesões autoprovocadas no Brasil entre 2017 e 2024: perfil sociodemográfico, variação temporal e distribuição regional no contexto da pandemia de COVID-19 Abstract: Self-inflicted injuries constitute an important public health problem associated with multiple social, institutional, and subjective determinants. In Brazil, the strengthening of health surveillance and the expansion of mental health policies contributed to greater epidemiological visibility of these events, especially after the incorporation of violence into the Notifiable Diseases Information System (SINAN). However, challenges related to underreporting, regional inequalities, and the understanding of the recent distribution of notifications in the country still persist. This study aims to analyze the epidemiological profile, temporal variation, and spatial distribution of self-inflicted injuries reported in Brazil between 2017 and 2024. This is a descriptive epidemiological study with a quantitative approach, ecological design, and descriptive temporal analysis, using secondary data obtained from SINAN. Notifications classified as self-inflicted injuries from 2017 to 2024 were included. The analyses comprised descriptive statistics, temporal analysis, and spatial distribution of notifications according to sex, age group, race/color, education level, and region of residence. The results identified 1,010,487 notifications of self-inflicted injuries during the analyzed period, with predominance among females, young adults, White and Brown individuals, and progressive growth of notifications in the post-pandemic period. A higher concentration of records was observed in the Southeast and South regions, as well as a high frequency of events occurring in the household setting and records indicating previous self- inflicted injury. Poisoning/intoxication was the most frequent mechanism of aggression. The findings reveal important sociodemographic and territorial inequalities in the distribution of self- inflicted injuries, reinforcing the need to strengthen epidemiological surveillance, prevention strategies, and mental health care within the Brazilian Unified Health System. Type: Dissertação Mon, 28 Sep 2026 00:00:00 GMT https://tede.unisantos.br/handle/tede/8137 2026-09-28T00:00:00Z https://tede.unisantos.br/handle/tede/8136 Title: Acesso ao cuidado integral: percepções de pessoas vivendo com HIV em contextos de vulnerabilidade social Abstract: Introduction: Care for people living with HIV (PLHIV) within the Brazilian Unified Health System (SUS) involves multiple points of the Health Care Network, linking diagnosis, treatment, and follow-up. At the global level, strategies such as the UNAIDS 95-95-95 targets, together with timely initiation of antiretroviral therapy (ART) and the concept of undetectable = untransmittable (U=U), reinforce the role of treatment in controlling the epidemic. In Brazil, the response to HIV has been marked by expanded access to ART and the organization of specialized services, in dialogue with social movements. In the municipality of Santos (São Paulo, Brazil), the epidemic gained particular historical relevance in the 1980s and 1990s, prompting institutional and community responses that contributed to the consolidation of a care network. Inequalities in access persist, especially in contexts of greater social vulnerability, where living conditions and social position affect the possibilities of diagnosis, treatment, and continuity of care. Objective: To understand how people living with HIV in contexts of greater social vulnerability perceive access to comprehensive health care, identifying their needs, demands, perceptions, and expectations regarding health services. Methods: This qualitative, interpretive study was based on narratives of care experiences and was part of the “Babado Certo!” investigation, a community-based participatory study. In-depth, semi-structured interviews were conducted with 15 PLHIV recruited from a specialized service, a non-governmental organization, and through peer recruitment in Santos, Brazil. Data were collected between December 2025 and April 2026. Interviews were transcribed, anonymized, and analyzed using Content Analysis, following Bardin, with support from MAXQDA software. Interpretation was guided by Ayres’ Care framework. Results: Health needs took on different meanings throughout participants’ trajectories. Clinical control of HIV and adherence to ART emerged as central dimensions, coexisting with needs related to mental health, autonomy, social support, and material living conditions. Treatment trajectories included immediate, delayed, or irregular initiation of ART, as well as interruptions and resumptions associated with different living conditions and experiences. Homelessness, economic difficulties, transportation barriers, and fragile support networks affected the possibilities of continuity of care. Experiences also differed according to the period of diagnosis and treatment, including needs related to aging with HIV. Specialized services remained an important reference for HIV care, whereas experiences with Primary Health Care were heterogeneous and related to geographic proximity, trust, confidentiality, previous experiences, and the perceived ability of services to respond to needs. Welcoming practices, bonds with professionals, social support, and peer relationships contributed to sustaining care. Conclusion: Access to comprehensive care for PLHIV in contexts of social vulnerability is related to the articulation between health needs, living conditions, and care experiences. The availability of treatment and services is fundamental, but their incorporation and continuity in everyday life also depend on the concrete conditions under which people live and receive care. Articulating technical success in controlling HIV infection with the relational dimensions of care and the heterogeneity of experiences may contribute to broader responses to the needs of PLHIV. Type: Dissertação Thu, 01 Oct 2026 00:00:00 GMT https://tede.unisantos.br/handle/tede/8136 2026-10-01T00:00:00Z https://tede.unisantos.br/handle/tede/8135 Title: Entre números e histórias: uma análise sobre a Sífilis gestacional e congênita na Baixada Santista Abstract: Gestational and congenital syphilis remain a public health challenge, despite the availability of effective diagnostic methods and treatment, reflecting social inequalities and weaknesses in prenatal care that sustain vertical transmission. This study aimed to analyze the temporal variation of gestational and congenital syphilis in the Metropolitan Region of Baixada Santista and the perceptions of women who experienced syphilis during pregnancy and whose children were diagnosed with congenital syphilis. This is a mixed-methods study with a convergent-parallel design, descriptive and exploratory in nature, including analysis of secondary data from DATASUS/SINAN (2009–2023) and a qualitative stage based on semi-structured interviews conducted at Hospital Guilherme Álvaro, in Santos. All reported cases were included and analyzed using descriptive statistics, rate calculations, and Joinpoint regression, in addition to thematic analysis with five women. The study was approved by a Research Ethics Committee. The results showed an increase in cases over the historical series, followed by stabilization, with predominance among young women, especially those identified as mixed-race, with a relevant presence of adolescents and a high proportion of missing data. Congenital syphilis remained at high levels, indicating persistent vertical transmission and failures in prenatal care. The narratives revealed lack of knowledge about the infection, feelings of fear and guilt, difficulties in care, and significant emotional impact associated with the child’s illness. The integration of findings demonstrates that the persistence of the condition results from the interplay between social vulnerabilities and weaknesses in the quality of care, particularly in communication, continuity of care, and organization of health services. The findings highlight the need to strengthen prenatal care, with emphasis on timely diagnosis, effective treatment, and health communication, as well as improving the integration between care and surveillance to reduce vertical transmission and promote more comprehensive, equitable, and effective care. Type: Dissertação Thu, 23 Apr 2026 00:00:00 GMT https://tede.unisantos.br/handle/tede/8135 2026-04-23T00:00:00Z