Health Policy, Health Informatics, Health (social science)
51
Scopus Publications
Scopus Publications
Comparison of the sociodemographic and clinical profiles of cancer patients admitted to a tertiary palliative care unit before and during the COVID-19 pandemic Bruno Fernando da Silva Reis, Gisele O’Dwyer, Valeria Teresa Saraiva Lino, Lívia Costa de Oliveira, Karla Santos da Costa Rosa, Simone Garruth dos Santos Machado Sampaio BMC Palliative Care, 2025 OBJECTIVE: To compare the sociodemographic and clinical profiles of patients with advanced cancer admitted to a tertiary palliative care unit before and during the COVID-19 pandemic. METHODS: This is an analysis of data from patients receiving care before (10/21/2019 to 03/16/2020) and during (09/23/2020 to 08/26/2021) the COVID-19 pandemic. Sociodemographic and clinical data were evaluated. Logistic regression analyses were used, with the odds ratio (OR) and 95% confidence interval (CI) as measures of effect. RESULTS: 673 patients were enrolled (204 in the pre-pandemic period and 469 in the pandemic period). The final logistic regression model demonstrated that patients admitted during the pandemic had a greater chance of having white skin (OR: 1.66 [95% CI: 1.15-2.39]), having a gastrointestinal tract cancer (OR: 2.95 [95% CI: 1.55-5.62]) and in skin, bones, and soft tissue (OR: 2.40 [95% CI: 1.13-5.08]), having received prior radiotherapy (OR: 1.83 [95% CI: 1.26-2.55]), and having a higher global PG-SGA SF score (OR: 1.06 [95% CI: 1.02-1.09]). CONCLUSION: Ethnicity, nutritional risk, previous radiotherapy, and type of tumor were associated with advanced cancer during the COVID-19 pandemic. It is unclear what impacts the COVID-19 pandemic had on palliative care. This study presented findings based on one tertiary palliative care facility for patients with cancer. Give the limited literature on the subject, our comparative analysis of data serves as a starting point for a debate on this subject. More studies of a similar nature are needed to enable future comparisons and assist planning for other pandemics.
The journey through mental health crisis care in the city of Rio de Janeiro Maria Fernanda Cruz Coutinho, Gisele O’Dwyer, Clarice Portugal, Mônica de Oliveira Nunes Saude E Sociedade, 2024 The concept of crisis in mental health involves a complex multidimensional formulation, forged in the context of the Brazilian Psychiatric Reform, which is not always taken unequivocally by those involved. However, it is necessary to consider a network capable of providing adequate answers on how to provide care in this situation; thus, networking is an essential condition of this approach. This article discusses the management of the mental health crisis in Psychosocial Care Centers III (CAPS III) in the municipality of Rio de Janeiro, Brazil, from the perspective of central and local health care managers, via semi-structured interviews and analysis based on Giddens’ Theory of Structuring. This study found that the municipality of Rio de Janeiro adopts a crisis care model structured into a centralized care network and integrated network, with an emergency network highly integrated with the Psychosocial Attention Network (RAPS), especially with the CAPS III, and the crisis situations are cared for preferably in specific services. Still, from Giddens’ perspective, CAPS III have the legitimacy to provide care toward mental health crisis.
Analysis of the strategic conduct of managers and professionals involved in oral cancer prevention and control Fernando Lopes Tavares de Lima, Gisele O’Dwyer Physis, 2023 Resumo Gestores e profissionais de saúde são os agentes responsáveis pela implementação das políticas públicas nos serviços de saúde, sendo de fundamental importância compreender as formas como agem no cotidiano. O objetivo desta pesquisa é analisar as condutas estratégicas de gestores e profissionais que intervêm na prevenção e no controle do câncer bucal. Trata-se de pesquisa qualitativa, realizada por meio de 23 entrevistas com gestores e profissionais de cinco municípios da região de saúde Metropolitana I do Rio de Janeiro e três entrevistas com o corpo técnico estadual. Realizou-se a análise da conduta estratégica prevista na Teoria da Estruturação de Giddens. Verificou-se que esses agentes, sensibilizados pelas representações do câncer na sociedade, se mobilizam como potenciais agentes facilitadores do acesso e criam alternativas informais aos protocolos mais restritores. No entanto, essa mobilização não costuma ocorrer no período anterior à suspeita do câncer, constituindo uma contradição importante. Destacou-se a importância da ampliação da atenção primária e do aperfeiçoamento das ações de promoção da saúde, prevenção do câncer e educação permanente para garantia do direito ao acesso ao diagnóstico e tratamento precoce do câncer bucal.
Oral cancer care in the “Metropolitan I” health region in the state of Rio de Janeiro, Brazil: enabling and constraining factors Fernando Lopes Tavares de Lima, Gisele O’Dwyer Ciencia E Saude Coletiva, 2023 The aim was to identify constraining and enabling factors related to the organization of health care networks that influence access to oral cancer diagnosis and treatment. A case study in the “Metropolitan I” health region using data collected from health information systems and 26 semi-structured interviews with health managers and professionals. The data were analyzed using descriptive statistics and strategic conduct analysis, drawing on the theory of structuration proposed by Giddens. The findings reveal that coverage of oral health care in primary care services is generally low and prioritizes specific groups and urgent cases, hampering access to oral cancer diagnosis. While the presence of a network of secondary care services in the municipalities that make up the health region facilitates diagnosis, there are major barriers to treatment. Informal partnerships established with dental schools play an important role in diagnosis, but do not receive funding. The regulation of appointments for diagnosis was not restrictive. In contrast, the regulation of referrals for treatment lacked transparency, was subject to long delays, and shortage of places. Despite advances, constraining factors related to structure and the actions of agents involved in the care process persist, hampering the timely diagnosis and treatment of oral cancer.
Health education in primary care: a look under the perspective of users of the healthcare system Ana Lúcia de Magalhães Fittipaldi, Gisele O’Dwyer, Patrícia Henriques Saude E Sociedade, 2023 Resumo Este artigo tem como objetivo analisar as ações de educação em saúde na atenção primária, sob a perspectiva dos usuários do sistema de saúde, à luz da teoria da ação social de Bourdieu. Trata-se de uma pesquisa qualitativa, realizada em duas Unidades Básicas de Saúde no município do Rio de Janeiro. Utilizou-se como técnicas de investigação a observação participante e a realização de entrevistas semiestruturadas. Foram realizadas doze entrevistas, com três categorias analíticas: autonomia e vulnerabilidade: a trajetória social dos agentes; cuidado ampliado em saúde: significados e tensões vivenciadas a partir dos capitais simbólicos; e vínculo, confiança e afeto: a rede de apoio social. A análise das entrevistas contou com o referencial teórico da análise de conteúdo de Bardin. As ações coletivas propiciaram espaço para diálogo e valorização da fala de todos, e a articulação dos conceitos da sociologia da ação de Bourdieu com a educação em saúde contribuiu para o entendimento da visão do usuário sobre essas práticas sociais. Por fim, são propostas ações efetivas e transformadoras por meio do diálogo e da interação com a dinâmica de vida popular.
Temporal evolution of homicide mortality in Brazilian capitals from 2005 to 2019 Nádia Cristina Pinheiro Rodrigues, Valéria Teresa Saraiva Lino, Leonardo Soares Bastos, Gisele O'Dwyer, Denise Leite Maia Monteiro, Inês Nascimento Carvalho Reis, Vera Cecília Frossard, Mônica Kramer Noronha Andrade Journal of Aggression Conflict and Peace Research, 2022 Purpose This study aims to improve our understanding of violence, focusing on the analysis of the relation between socioeconomic factors and homicide rates from 2005 to 2019 in Brazilian capitals. Design/methodology/approach Multilevel Poisson models were used to estimate the homicide risk in men and women. The response variable was the homicide rate. Fixed effects were estimated for age group, year and gross domestic product (GDP). Findings The average homicide rate over the 2005–2019 period was 5.83/100,000 and 83.72/100,000 for women and men, respectively. In both sexes, the homicide rates increased over the period. The highest mortality rates were observed in North and Northeastern capitals. The peak homicide rates were 2010–2014, the risk of homicide decreased as age increased, and the capitals with GDP lower than US$5,000 showed a greater homicide rate. Originality/value Brazil remains among the countries with the highest risk of homicide, especially in the north and northeast regions, where socioeconomic conditions are more unfavorable. The improvement of socioeconomic conditions may contribute to changing this situation.
Analysis of the Main Groups Victimized by Familiar Violence and by Violence by a Known Person in Brazil Nádia Cristina Pinheiro Rodrigues, Mônica Kramer de Noronha Andrade, Gisele O'Dwyer, Denise Leite Maia Monteiro, Inês do Nascimento Reis, Valéria Teresa Saraiva Lino Journal of Nervous and Mental Disease, 2022 This study aims to evaluate the ratio of the number of cases of family violence and violence by a known person, over the four surveys that took place in 2006, 2007, 2009, and 2011, within the population treated in the Brazilian health services, according to demographic and socioeconomic characteristics. Data from the Vigilância de Violências e Acidentes survey was used. The variables age, victim sex, aggressor sex, race, and schooling level were considered in the analysis. This study pointed out decreasing trend in the number of violence-related care within the older age group. The number of familial violence-related care per victim sex was higher for male victims when the aggressor was female, and conversely, it was higher for female victims when the aggressor was male. The number of violence-related care was mostly higher in non-White people than in White. People with low schooling levels showed the highest ratio of the number of violence-related care.
Performance of the mobile emergency care service from the perspective of managers and professionals: case study in a region of the state of São Paulo, Brazil Catia Cristina Martins de Oliveira, Gisele O’Dwyer, Hillegonda Maria Dutilh Novaes Ciencia E Saude Coletiva, 2022 Resumo Este artigo tem como objetivo analisar a perspectiva de gestores e profissionais sobre o desempenho do SAMU na região do Grande ABC. Trata-se de estudo de caso, de abordagem qualitativa, baseado na formulação de modelo teórico-lógico da intervenção e entrevistas semiestruturadas. O Modelo teórico-lógico traduziu as dimensões de análise do SAMU: regulação, assistência e gestão. O processo de regulação foi entendido como espaço estratégico onde o julgamento da necessidade do paciente e o tempo de despacho da ambulância tem potencial de influenciar nos desfechos dos casos transportados. Na assistência os principais temas que emergiram foram investimento na qualificação da equipe e em telemedicina com a perspectiva de melhorar a qualidade do cuidado e tornar o diagnóstico mais preciso. No âmbito da gestão desafios como integração do SAMU com centros terciários, aperfeiçoamento do sistema de informação e monitoramento e avaliação foram destacados visando qualificar os processos regulatórios alinhando-os aos objetivos propostos na política de saúde. O conjunto de dados analisados reforça a capacidade do SAMU na atenção de urgência na região, no entanto a intervenção precisa superar importantes desafios em busca de melhor prognóstico entre os casos transportados.
Mortality by colon, lung, esophagus, prostate, cervix and breast cancers in Brazilian capitals, 2000-2015: a multilevel analysis Nádia Cristina Pinheiro Rodrigues, Gisele O’Dwyer, Mônica Kramer de Noronha Andrade, Denise Leite Maia Monteiro, Inês do Nascimento Reis, Vera Cecília Frossard, Valéria Teresa Saraiva Lino Ciencia E Saude Coletiva, 2022 This study aimed to analyze the role of period, geographic and socio demographic factors in cancer-related mortality by prostate, breast, cervix, colon, lung and esophagus cancer in Brazilians capitals (2000-2015). Ecological study using data of Brazilian Mortality Information. Multilevel Poisson models were used to estimate the adjusted risk of cancer mortality. Mortality rate levels were higher in males for colon, lung and esophageal cancers. Mortality rates were highest in the older. Our results showed an increased risk of colon cancer mortality in both sexes from 2000 to 2015, which was also evidenced for breast and lung cancers in women. In both genders, the highest mortality risk for lung and esophageal cancers was observed in Southern capitals. Midwestern, Southern and Southeastern capitals showed the highest mortality risk for colon cancer both for males and females. Colon cancer mortality rate increased for both genders, while breast and lung cancers mortality increased only for women. The North region showed the lowest mortality rate for breast, cervical, colon and esophageal cancers. The Midwest and Northeast regions showed the highest mortality rates for prostate cancer.
COVID-19 morbidity and mortality in 2020: the case of the city of Rio de Janeiro Nádia Cristina Pinheiro Rodrigues, Mônica Kramer de Noronha Andrade, Denise Leite Maia Monteiro, Valéria Teresa Saraiva Lino, Inês do Nascimento Reis, Vera Cecília Frossard, Gisele O'Dwyer Jornal Brasileiro De Pneumologia Publicacao Oficial Da Sociedade Brasileira De Pneumologia E Tisilogia, 2020
The increase in domestic violence in Brazil from 2009-2014 Nádia Cristina Pinheiro Rodrigues, Gisele O’Dwyer, Mônica Kramer de Noronha Andrade, Matthew Brian Flynn, Denise Leite Maia Monteiro, Valéria Teresa Saraiva Lino Ciencia E Saude Coletiva, 2017
Temporal and spatial evolution of dengue incidence in Brazil, 2001-2012 Nádia Cristina Pinheiro Rodrigues, Valéria Teresa Saraiva Lino, Regina Paiva Daumas, Mônica Kramer de Noronha Andrade, Gisele O’Dwyer, Denise Leite Maia Monteiro, Alyssa Gerardi, Gabriel Henrique Barroso Viana Fernandes, José Augusto Sapienza Ramos, Carlos Eduardo Gonçalves Ferreira, Iuri da Costa Leite Plos One, 2016
Spatial dynamics of AIDS incidence in the elderly in Rio de Janeiro, Brazil, 1997-2011 Nádia Cristina Pinheiro Rodrigues, Andrea Sobral de Almeida, José Ueleres Braga, Gisele O'Dwyer, Paulo Cavalcante Apratto Junior, Regina Paiva Daumas, Valéria Teresa Saraiva Lino, Mônica Kramer de Noronha Andrade, Denise Leite Maia Monteiro, Mônica Bastos de Lima Barros Cadernos De Saude Publica, 2015
Profile of Brazilian smokers in the national program for tobacco control Nádia C. Rodrigues, Regina D. Neves, Daniela de S. Mendes, Cristiane P. Mendes, Isa H. Martins, Inês N. Reis, Valeria T. Lino, Gisele O’Dwyer, Regina P. Daumas, Tania Maria Esteves, Mônica K. Andrade, Denise L. Monteiro, Mônica B. Barros Revista Brasileira De Psiquiatria, 2015
