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Práticas integrativas e complementares (PICS) para o manejo da dor crônica em pacientes com osteoartrite no sistema único de saúde (SUS) : evidências, percurso assistencial e desenvolvimento de tecnologia digital.

2026-08-04T14:48:10Z

Title: Práticas integrativas e complementares (PICS) para o manejo da dor crônica em pacientes com osteoartrite no sistema único de saúde (SUS) : evidências, percurso assistencial e desenvolvimento de tecnologia digital. Authors: Corrêa, Carina Suzana Pereira Abstract: Traditional, Complementary, and Integrative Medicine (TCIM) utilize natural and holistic methods to treat the individual in a comprehensive way. They view illness as a state of disharmony requiring balance and address both treatment and prevention. This thesis aims to develop evidence-based strategies to enhance the use of TCIM in managing chronic pain among osteoarthritis patients within the Brazilian Unified Health System (SUS) by creating a care pathway, management support tools, and a digital self-care technology. A scoping review identified acupuncture and phytotherapy as the most effective practices. Acupuncture was found to produce a significant reduction in pain with lasting effects, while phytotherapy stood out for the efficacy of Curcuma longa and Miconia albicans, comparable to conventional anti-inflammatory drugs but with a superior safety profile. Given the serious socioeconomic impact of chronic pain as a public health problem, a Clinical Pathway Protocol (CPP) was developed to integrate TCIM into treatment and prevention, establishing a multimodal, evidence-based pathway that promotes shared decision-making between professionals and patients, combines conventional treatments with complementary non-pharmacological therapies, optimizes health resources, and provides holistic care from primary prevention through to the treatment of established pain. To enable the practical application of this evidence, a mobile application for self-management of pain in osteoarthritis patients was developed using the Design Science Research (DSR) methodology, addressing a critical gap identified by the absence of Brazilian digital solutions that integrate TCIM specifically for this condition. The application includes scientific and educational modules, a pain diary, guided TCIM sessions, a reminder system, progress reports, and an accessible interface for elderly users. The research represents an innovative convergence of scientifically validated traditional knowledge, SUS public policies, and digital technology, transforming the passive care model into collaborative self-management and patient empowerment. Nevertheless, the need for greater methodological standardization and scientific validation of TCIM for its broad implementation in SUS clinical protocols is acknowledged. In summary, this thesis contributes to the strengthening of public health policies by demonstrating the applicability of TCIM as effective and sustainable tools in primary care, fostering a paradigm shift in chronic pain management, with a focus on comprehensiveness, co-responsibility, and technological innovation in health.

A relação das políticas públicas de saúde, trabalho, educação e participação da sociedade civil sobre o índice de reincidência penitenciária : um estudo em presídio do estado do Rio Grande do Sul.

2026-05-14T11:56:16Z

Title: A relação das políticas públicas de saúde, trabalho, educação e participação da sociedade civil sobre o índice de reincidência penitenciária : um estudo em presídio do estado do Rio Grande do Sul. Authors: Longo, Samantha Lopes de Moraes Abstract: Introduction: With the third largest prison population in the world, Brazil lacks effective strategies for the reintegration of formerly incarcerated individuals into society. Prison recidivism emerges not only as a legal issue but also as an indicator of social vulnerabilities and failures in public assistance policies, being closely related to the Social Determinants of Health (SDH). General objective of the dissertation: To analyze the rate of prison recidivism and its relationship with resocialization projects, particularly regarding public policies in health, work, education, and civil society participation aimed at the incarcerated population. Abstract of Manuscript I: This study aimed to evaluate the impact of public policies in health, education, and work on social inclusion and prison recidivism, using the Social Determinants of Health as an interpretative framework. A mixed-methods design was employed. The quantitative phase consisted of a retrospective observational study using data from the Penitentiary Information System (2019–2023), including 1,349 formerly incarcerated individuals. The outcome investigated was prison recidivism, defined as return to the prison system after release. The Chi-square test was used to assess associations between recidivism and categorical variables, identifying statistically significant associations with work during incarceration, receiving visits, and age group. These associations were then quantified using Odds Ratios. The qualitative phase involved two focus groups (n=25) with inmates from the State Prison of Lajeado, with textual analysis conducted using Iramuteq and a thematic approach grounded in the Social Determinants of Health. Data integration occurred at the interpretative stage through convergence of quantitative and qualitative findings. The recidivism rate was 86.5%. Working during incarceration (OR=2.44), receiving visits (OR=2.20), and being older than 34 years (OR=1.71) were protective factors associated with lower recidivism. Focus groups highlighted the pursuit of life transformation, emphasizing professional insertion and educational development. These factors act as structural elements of protection; however, stigma and post release barriers, particularly regarding access to employment, limit reintegration. Reducing recidivism requires intersectoral policies and strengthening of post-release social support networks. Abstract of article II: This study aimed to analyze the structural determinants of crime in Brazil, particularly the lack of access to education, poverty, unfavorable living conditions, lack of opportunities, and insecurity, articulated with social inequalities and institutional weaknesses. This is a qualitative and analytical study based on a narrative literature review. The findings reveal a complex scenario marked by increasing violence and overburdening of the prison system. Socioeconomic inequality and weaknesses in public policies related to education, health, and social assistance were identified as central factors in the cycle of crime. Education emerges as a key strategy for prevention and social inclusion, acting as a tool for reducing violence. Addressing crime requires integrated public policies combining prevention, repression, and control, along with investment in education and resocialization programs. Technical Product: The objective was to develop a tool based on machine learning algorithms to predict the risk of prison recidivism by identifying patterns in data from incarcerated individuals, aiming to optimize screening processes and support resocialization strategies within the prison system. The results demonstrated the feasibility of using predictive models as decision-support tools, without replacing professional judgment. Improving data quality and integration is recommended to enhance model accuracy. General conclusion of the dissertation: The high prison recidivism rate (86.5%) highlights structural weaknesses in post-release support, despite the presence of protective factors such as prison labor, receiving visits, and being over 34 years old. The mixed-methods analysis, grounded in the Social Determinants of Health, emphasized that social support networks, access to education, and addressing stigma are central elements for resocialization. Qualitative findings reinforce that individual efforts are insufficient in the face of systemic barriers. Machine learning proved to be a promising decision-support tool, although improvements in information systems are necessary. Reducing prison recidivism requires humanized management, technological investment, and strengthening of intersectoral public policies in the post-release context.

Validação de torre de radiação UV-C contra microrganismos multidroga-resistentes para desinfecção de ambientes hospitalares.

2026-05-08T13:02:46Z

Title: Validação de torre de radiação UV-C contra microrganismos multidroga-resistentes para desinfecção de ambientes hospitalares. Authors: Magdalena, Maitê Souza Abstract: Healthcare-Associated Infections (HAIs) increase morbidity and costs, and the hospital environment is a reservoir of potentially pathogenic microorganisms. Traditional disinfection is prone to failure, and in this context, irradiation with ultraviolet light (UV-C) emerges as an effective and promising adjuvant technology. The general objective of this study was to validate the effectiveness of the automated portable UV-C radiation tower in disinfecting environments in health services against multidrug-resistant (MDR) microorganisms. Manuscript 1: Sought to evaluate the effectiveness of the low-cost UV-C light tower, determining its operational characteristics and the impact of its use as an adjuvant method in the disinfection of operating rooms for the control of MDR microorganisms. The study was conducted in two complementary phases. The first phase, in vitro, used strains of MDR microorganisms to optimize the distance and exposure time parameters of the UV-C device. The second phase, in situ, was a quasi-experimental study carried out in operating rooms of a large hospital. In it, complementary disinfection with the UV-C tower was compared to conventional cleaning and disinfection on high-touch surfaces, using artificially inoculated MDR microorganism strains. Efficacy was measured by the percentage and logarithmic reduction of the microbial load, and the statistical analysis using the Willcoxon test compared the results of the methods. In vitro tests demonstrated that the device was highly effective, achieving logarithmic reductions of up to 6.17 log₁₀ for most strains, with Candida auris requiring the longest exposure time. In the application in operating rooms, complementary disinfection with UV-C resulted in a statistically significant microbial reduction (p=0.0078) compared to conventional cleaning alone. On surfaces where standard cleaning was less effective, UV-C increased the reduction to 100%. By demonstrating the effectiveness of an affordable solution, the study offers an important strategy for infection control, especially because of the possibility of an affordable cost for the health system, where resources are limited. Manuscript 2: The objective of this study was to evaluate the usability of the UV-C Tower equipment, after the handling of the device by health professionals in the process of terminal disinfection of operating rooms. This was a cross-sectional and exploratory study conducted in a teaching hospital in Rio Grande do Sul, Brazil, between August and September 2025. The UV=C light disinfection device was operated by nurses trained in routine terminal cleaning of operating rooms. Usability was assessed using the System Usability Scale and Standardized User Experience Percentile Rank Questionnaire, applied to six professionals. The data were analyzed by measures of central tendency and dispersion. The average score of the equipment in the perception of users was 79.58% on the System Usability Scale, indicating usability classified as good. In the Standardized User Experience Percentile Rank-Questionnaire, the overall score was 81.47%, with emphasis on the dimension of trust (87.50%) and loyalty (79.16%). The results demonstrate a high perception of usability. The high score in dimensions such as ease of learning and trust suggest that the device has a fast learning curve and is well accepted by operators, important factors to ensure adherence to protocols and the correct application of the technology. Studies show that the UV-C light tower is effective and well accepted for the disinfection of operating rooms, acting as an adjuvant method to conventional cleaning in the control of MDR microorganisms. The combination of high microbiological efficacy and good usability indicates its potential to strengthen HAI prevention and control strategies, especially in resource-limited contexts.

Ansiedade em universitários : fatores desencadeadores, instabilidade genômica e a melolística como intervenção não farmacológica.

2026-05-05T14:48:12Z

Title: Ansiedade em universitários : fatores desencadeadores, instabilidade genômica e a melolística como intervenção não farmacológica. Authors: Fiorezi, Juliane Neves Abstract: Introduction: University students are frequently exposed to academic, social, and emotional stressors that may contribute to the development or intensification of anxiety symptoms. These psychological conditions are known to influence biological systems, including immune responses and genomic stability. In this context, non-pharmacological interventions have gained attention for their potential to modulate stress-related biomarkers. Melolistic, a therapeutic approach based on musical and emotional harmonization, has emerged as a promising strategy for stress management, also influencing markers of genomic instability. The present study demonstrates an innovative and original character by exploring non-pharmacological intervention alternatives for anxiety and examining the melolistic approach as a complementary and integrative measure alongside other supportive techniques for these individuals. Furthermore, it reveals new associations between immunological and genomic biomarkers and the various symptoms manifested in anxiety. General Objective: To review and investigate anxiety levels in university students, correlating them with stress biomarkers such as salivary cortisol, immunoglobulin A, DNA damage, and other cellular alterations, as well as to evaluate the effects of melolistic intervention on these parameters. Chapter 1: This chapter aims to identify the factors contributing to the manifestation of anxiety in university students, highlighting multiple triggering elements such as psychological, social, emotional, and academic factors. It also emphasizes the importance of integrated coping strategies, including healthy routines, therapeutic support, and institutional wellness programs. Understanding these elements is essential to promote more balanced academic environments and support students’ overall well-being. Manuscript 1: A total of 51 university students were evaluated (mean age: 21.56±2.65 years old; female prevalence: 66.7%). The results revealed that although overall levels of salivary cortisol (p=0.799) and IgA (p=0.593) did not differ significantly among anxiety severity groups, specific emotional symptoms were associated with measurable biological responses. Moderate to severe anxiety was linked to increased markers of DNA damage, such as micronuclei (p=0.030), and apoptotic indicators, such as pyknotic cells (p=0.049). Additionally, distinct symptoms including panic, restlessness, and irritability showed moderate to strong correlations with stress biomarkers and nuclear alterations (p<0.05). Manuscript 2: The melolistic intervention resulted in statistically significant reductions in anxiety scores (GAD-7 and DASS-21; p<0.001), depression (p<0.001), with a notable decrease in moderate and severe symptoms of anxiety, depression, and stress (p<0.01). There was an improvement in self-reported health perception (p=0.027) and a reduction in perceived stress levels with difficulty in coping (p<0.003). Cortisol levels increased slightly (p=0.039), with no significant changes in salivary IgA (p=0.332). No significant differences were observed in DNA damage markers (micronuclei, p=0.080; nuclear budding, p=0.285). Final Considerations: The findings highlight that anxiety among university students is multifactorial, influenced by psychological, social, emotional, and academic aspects, reinforcing the need for integrated coping strategies in the university context. It was also observed that although overall levels of salivary cortisol and IgA did not differ among anxiety severity groups, specific emotional symptoms showed relevant correlations with stress biomarkers, DNA damage, and cell death. Moderate to severe anxiety was associated with increased markers of DNA damage and apoptosis indicators, suggesting that emotional distress may result in measurable biological changes. Furthermore, the melolistic intervention demonstrated significant positive effects in reducing symptoms of anxiety, depression, and stress, improving health perception and stress management capacity, without influencing markers of genomic instability. The results further reinforce the importance of considering biological markers as complementary tools in assessing the impacts of anxiety on the health of university students, thereby contributing to more integrated prevention and intervention strategies.