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Insônia entre adolescentes: influência dos fatores socioeconômicos, comportamentais e de saúde mental

Fri, 10 Apr 2026 00:00:00 GMT

Título: Insônia entre adolescentes: influência dos fatores socioeconômicos, comportamentais e de saúde mental Autor: ABREU, Thaysa Gois Trinta Primeiro orientador: BATISTA, Rosângela Fernandes Lucena Abstract: INTRODUCTION: Insomnia, among sleep disorders, is increasingly frequent among adolescents and can bring negative repercussions for physical and mental health, compromising their development throughout the life cycle. Although evidence indicates an association between socioeconomic factors, risk behaviors, and psychological distress with changes in sleep patterns, such determinants have often been investigated in isolation, limiting the understanding of their interrelationships. OBJECTIVE: To analyze how socioeconomic, behavioral, and mental health factors are directly and indirectly related to the occurrence of insomnia in Brazilian adolescents. METHODOLOGY: This is a cross-sectional study with 2,515 adolescents, using data from the 1997/98 birth cohort of São Luís, Maranhão. The latent variable insomnia was assessed based on two components from the Pittsburgh Sleep Quality Index: sleep duration and efficiency. Latent constructs were also built for socioeconomic status, substance use-related behaviors, and internalizing disorders. Structural equation modeling was used to estimate direct and indirect effects among the investigated factors. RESULTS: It was observed that 3.98% of adolescents reported sleeping less than 5 hours per night, and 6.79% showed low sleep efficiency. Internalizing disorders showed a positive direct effect on insomnia, establishing themselves as the main proximal determinant of insomnia. Screen time and adolescent occupation also had positive direct effects on the outcome, while sex and socioeconomic status exerted indirect effects mediated by internalizing disorders. CONCLUSION: Insomnia in adolescents emerges as a result of the interaction between structural and behavioral determinants, centrally mediated by psychological distress, and understanding this dynamic enables the development of public policies aimed at the comprehensive health of this population. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

CUIDADOS DE ENFERMAGEM EM IDOSOS COM DOENÇA DE PARKINSON: UMA REVISÃO SISTEMÁTICA COM METANÁLISE

Mon, 30 Mar 2026 00:00:00 GMT

Título: CUIDADOS DE ENFERMAGEM EM IDOSOS COM DOENÇA DE PARKINSON: UMA REVISÃO SISTEMÁTICA COM METANÁLISE Autor: LEITE JUNIOR, Vitaliano de Oliveira Primeiro orientador: SOUSA, Santana de Maria Alves de Abstract: Population aging has accelerated worldwide and in Brazil, leading to a substantial increase in the number of older adults and a corresponding shift in disease patterns, characterized by a growing burden of chronic noncommunicable and neurodegenerative conditions. Among these, Parkinson’s disease (PD) is the second most prevalent neurodegenerative disorder in later life and is associated with functional impairment, reduced quality of life, and increasing dependence. In this context, nurses play a pivotal role in care coordination, health education, rehabilitation, and support for people living with PD and their caregivers. However, evidence regarding the effectiveness of nursing interventions remains fragmented. This study aimed to evaluate the effectiveness of nursing interventions for older adults with Parkinson’s disease on clinical, functional, and quality-of-life outcomes through a systematic review and metaanalysis. A systematic review with meta-analysis was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA Statement. The protocol was registered in PROSPERO (CRD420251007372). Searches were performed in CENTRAL, MEDLINE/PubMed, EMBASE, CINAHL, and Web of Science. Study selection, data extraction, and methodological procedures were conducted independently by two reviewers. Quantitative synthesis was performed using random-effects models, with assessment of heterogeneity, publication bias, and subgroup analyses. Meta-analyses were conducted in R software using standardized mean differences (SMDs). Twelve studies published between 2002 and 2024 were included, representing diverse healthcare settings. The identified nursing interventions were grouped into five main categories: telenursing and remote monitoring, home-based care with interdisciplinary coordination, educational and psychosocial interventions, rehabilitation-focused care aimed at improving functional performance, and advance care planning and palliative care. Meta-analysis demonstrated a moderate and statistically significant effect of nursing interventions on motor function (SMD = −0.59; 95% CI: −0.93 to −0.25; p < 0.001), with no observed statistical heterogeneity (I² = 0%). No statistically significant effects were found for quality of life (SMD = 0.02; 95% CI: −0.09 to 0.13; p = 0.707) or depressive symptoms (SMD = −0.19; 95% CI: −0.52 to 0.14; p = 0.252), although heterogeneity remained low (I² = 0%). Nursing interventions appear to improve motor function in older adults with Parkinson’s disease, particularly when delivered through structured, continuous, and person-centered care models. However, their effects on quality of life and depressive symptoms remain inconclusive. Further studies with greater methodological standardization and more robust intervention protocols are needed to strengthen the evidence base for nursing care in Parkinson’s disease. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

Tendência da mortalidade neonatal no nordeste brasileiro de 2014-2023

Fri, 10 Apr 2026 00:00:00 GMT

Título: Tendência da mortalidade neonatal no nordeste brasileiro de 2014-2023 Autor: SANTANA, Marta Silva de Primeiro orientador: BATISTA, Rosângela Fernandes Lucena Abstract: INTRODUCTION: Neonatal mortality corresponds to death between zero and 27 days of life, constituting a significant public health problem, especially in developing countries. In Brazil, the highest rates are concentrated in the North and Northeast regions, highlighting marked inequalities compared to the South and Southeast. OBJECTIVES: To analyze the trend of neonatal mortality and its elements, as well as its distribution in the Brazilian Northeast region from 2014-2023. METHODOLOGY: This ecological time-series study analyzed the behavior and trends of neonatal deaths in Northeast Brazil from 2014 to 2023, using secondary data obtained from the Mortality Information System. The data were categorized and organized for descriptive and regression statistical analysis using Rstudio® software with a Prais-Winsten regression model. Causes were analyzed according to the groups in Chapter 10 of the International Classification of Diseases. RESULTS: A total of 62,600 neonatal deaths were recorded, of which 76.8% occurred in the early period and 23.2% in the late period, peaking in 2017 and 2018 with the highest concentration in Bahia and Pernambuco. Deaths were mainly concentrated among male newborns (55.3%), mixed-race infants (70.7%), and those with extremely low birth weight (34.1%), predominantly among children of young mothers (20-29 years old), mixed-race infants (70.7%), and those with intermediate education levels (47.9%). Deaths due to perinatal conditions and congenital malformations were prominent. Early neonatal deaths were the majority, with rates remaining unchanged throughout the decade, while late neonatal deaths increased after 2020, and total rates remained similar throughout the period, even slightly increasing. Bahia and Sergipe showed the highest rates, while Ceará and Alagoas recorded the lowest. In the later period, Sergipe and Piauí led the indicators, contrasting with Rio Grande do Norte and Alagoas, which showed the lowest marks. The overall trend in total neonatal mortality for the Northeast region is one of stability (p=0.633). Among the states, Paraíba showed an increasing trend (APC=1.49%; p=0.021), Rio Grande do Norte a decreasing trend (APC=-1.18%; p=0.008), and the remaining states remained stable. For the early neonatal period, there was a decline in Rio Grande do Norte (APC=-1.85%; p=0.015) and Piauí (APC=- 1.21%; p=0.045) and an increase in Sergipe (APC=1.54%; p=0.020). In the regional panorama, the rates stabilized (p=0.187). For the late neonatal period, there is systemic progression in the region (APC=1.70%; p=0.001); among the states, progression is observed in Bahia (APC=3.24%; p=0.002). Peak growth was observed in Paraíba (APC=3.17%; p=0.010) and Alagoas (APC=1.42%; p=0.049), while mortality remained stable in the other states. CONCLUSION: Neonatal mortality remained stable in the Northeast, with variations between states: a reduction in Rio Grande do Norte and Piauí, and an increase in Paraíba and Sergipe. A notable increase occurred in the late neonatal period in Alagoas, Bahia, and Paraíba, and regionally as a whole. Early deaths due to preventable perinatal causes predominated, indicating persistent challenges and shortcomings in care, requiring improved care. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação

O ensino de epidemiologia nos cursos de graduação em Enfermagem do Brasil

Fri, 27 Mar 2026 00:00:00 GMT

Título: O ensino de epidemiologia nos cursos de graduação em Enfermagem do Brasil Autor: RODRIGUES, Evandicleude Ferreira de Carvalho Primeiro orientador: OLIVEIRA, Bruno Luciano Carneiro Alves de Abstract: Introduction: Epidemiology constitutes an essential foundational component in the education of nurses. However, significant gaps remain in the knowledge regarding the provision of this discipline within undergraduate Nursing programs at Brazilian higher education institutions. Objective: To analyze the teaching of Epidemiology in the pedagogical projects of undergraduate Nursing programs at public higher education institutions in Brazil. Methods: This was a cross-sectional, document-based study employing a qualitative-quantitative approach. Data was collected from the Pedagogical Projects of Undergraduate Nursing Programs at public higher education institutions in Brazil. A total of 124 programs from 87 higher education institutions were included. Eligible institutions were officially accredited and registered in the e-MEC system, had a score equal to or higher than 3 in the 2023 National Student Performance Examination (ENADE), and had their pedagogical project publicly available. Quantitative data were analyzed using descriptive statistics with support from Microsoft Excel and RStudio software. Qualitative analysis was conducted using Bardin’s content analysis framework, supported by IRaMuTeQ software for data coding, categorization, and thematic class generation. Results: Epidemiology was identified in all programs analyzed. However, substantial variability was observed in its curriculares organization. In most institutions (72.2%), epidemiology was offered as a standalone discipline, whereas in others (27.8%), it was integrated into thematic axes related to Public Health, Biostatistics, and Health Surveillance. Additional variations were identified in course workload, year of offering, and types of bibliographic references adopted. Content analysis revealed three thematic classes. Terms related to epidemiological indicators, measures, and analytical methods predominated (49%), followed by content addressing the application of Epidemiology to health planning, management, and practice (38.6%). Expressions associated with health conditions and determinants of the health–disease process in Public Health appeared less frequently (12.4%). Statistically significant regional differences were observed among thematic classes (p-value = 0.012). The theoretical-descriptive dimension of the discipline was the most prevalent nationwide (73.0%), particularly in programs located in the North and Northeast regions. Approaches emphasizing health planning and management, either independently or integrated with the quantitative applicability of the discipline, were more predominant in the Midwest, Southeast, and South regions. Only five programs nationwide included all thematic classes within their course syllabi. Conclusion: The study demonstrates heterogeneity in the teaching of Epidemiology in public undergraduate Nursing programs in Brazil. Although the discipline is present in all analyzed programs, there is variability in curricular organization and a predominance of a conceptual and technical-operational approach in course syllabi, to the detriment of discussions addressing public health conditions and determinants. This scenario may pose challenges to the comprehensive education of nurses. The incorporation and integration of thematic classes, longitudinal distribution of the discipline throughout the curriculum, and strengthening of its critical-analytical depth across different stages of training emerge as strategies to reinforce a comprehensive perspective of Epidemiology and to reduce fragmentation in undergraduate Nursing education in Brazil. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação