Fonte de financiamento: nenhuma. Conflito de interesses: nada a declarar. ResumoIntrodução: A descentralização das ações de saúde pública, operacionalizada a partir da criação do Sistema Único de Saúde, alterou sobremaneira os sistemas de saúde municipais no Brasil. O objetivo deste estudo foi avaliar de forma qualiquantitativa os sistemas de Vigilância em Saúde (VS) de três municípios mineiros de pequeno e médio porte e associar com os serviços de saúde prestados. Métodos: Um instrumento de coleta de dados estruturado e entrevistas semiestruturadas foram utilizados para avaliar a estrutura e os processos realizados na VS dos municípios, respectivamente. Resultados: Vigilância Epidemiológica, Sanitária e Vigilância da Situação de Saúde apresentaram a melhor estrutura. Vigilância ambiental, Vigilância à Saúde do Trabalhador e Promoção da Saúde possuíam estruturas precárias nos três municípios e, na maioria das vezes, compartilhada com outros setores. Os entrevistados atribuíram a boa execução dos processos de vigilância nos municípios muito mais à proatividade dos profissionais e articulação com outros setores do que propriamente pela estrutura física. Conclusão: A VS nos municípios mineiros ainda é incipiente, porém projetos pioneiros como o ProFVS-MG podem alterar sobremaneira a realidade local. Palavras-chave: vigilância em saúde pública; descentralização; avaliação em saúde. AbstractIntroduction: The decentralization of public health measures, operationalized through the creation of the Sistema Único de Saúde (Unified Health System), greatly altered municipal health systems in Brazil. The aim of this study was to qualitatively and quantitatively evaluate small and medium-size health monitoring systems (HS) in three municipalities of Minas Gerais and associate this with the health services provided. Methods: A data collection instrument of structured and semi-structured interviews was used to assess the structure and processes established in HS municipalities, respectively. Results: Epidemiological Monitoring, Sanitation Monitoring and Health Situation Monitoring had the best structure. Environmental Health Monitoring, Occupational Health Monitoring and Health Promotion had poor structures in the three municipalities, and was frequently shared with other sectors. Respondents principally attributed good performance of monitoring procedures to the proactivity of professionals and collaboration with other sectors, rather than to the physical structure itself. Conclusions: HS in the municipalities of Minas Gerais is still incipient, but pioneering projects such as the SHSP-MG can greatly change the local reality.
Objective: The aim of this study was to evaluate the effects of Mat Pilates training on body composition, resting blood pressure, and lipids, glucose, and adiponectin levels in postmenopausal women with cardiometabolic multimorbidities. Design and method: Forty-seven postmenopausal women between 50 and 70 years were allocated into two groups based on the number of comorbidities: no more than 1 (COM n = 23) and at least 2 comorbidities (MULT n = 24). Both groups performed Mat Pilates three times a week for 12 weeks. Before and after the intervention, resting blood pressure, body composition, and blood samples (lipidogram, adiponectin, glucose, glycated hemoglobin, and uric acid) were evaluated. A two-factor Generalized Estimated Equation was used to compare groups, time, and their interaction (groups∗time). Results: Women in MULT presented higher body mass, body mass index, fat mass, and abdominal circumference than COM (p < 0.01). Blood pressure was reduced (p < 0.05) in both groups. Triglycerides decreased (p < 0.05) in COM and increases in MULT (p < 0.05) over time with no changes in total cholesterol, HDL, or LDL. Uric acid increases (p < 0.01) over time in both groups. Adiponectin had higher (p < 0.01) levels in the COM group and glycated hemoglobin decrease (p < 0.05) over time in both groups without changes in blood glucose. No interaction was found in any analyzed variable. Conclusions: These results suggest that 12 weeks of Mat Pilates training can improve blood pressure and glycated hemoglobin independent of the number of morbidities of cardiometabolic disease, but may not change body composition, lipids, glucose, or adiponectin levels in postmenopausal women.
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