ANA CAROLINA BASSO SCHMITT
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
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- The rehabilitation workforce in Brazil(2024) SIXEL, Taciana Rocha dos Santos; BERNARDO, Debora; MEDEIROS, Arthur de Almeida; BOUSQUAT, Aylene; MOTA, Paulo Henrique dos Santos; SCHMITT, Ana Carolina BassoBackgroundThe surge in individuals facing functional impairments has heightened the demand for rehabilitation services. Understanding the distribution of the rehabilitation workforce is pivotal for effective health system planning to address the population's health needs.ObjectiveTo investigate the spatial and temporal dispersion of physical therapists, speech therapists, psychologists and occupational therapists across various tiers of care within Brazil's Unified Health System and its regions.MethodThis is an ecological time series study on the supply of rehabilitation professionals. Data were obtained from the National Register of Health Establishments from 2007 to 2020. The density of professionals was calculated per 10,000 inhabitants annually for Brazil and its five regions. The Joinpoint regression model was used to analyze the temporal trends of the density of professionals, considering a 95% confidence interval.ResultsIn 2020, the most notable concentrations of psychologists, speech therapists, and occupational therapists in Brazil were observed in the domain of Specialized Health Care, with densities of 0.60, 0.20, and 0.16 professionals per 10,000 inhabitants, respectively. Conversely, the highest density of physical therapists was found within Hospital Health Care, with a density of 1.19 professionals per 10,000 inhabitants. Notably, variations in professional dispersion across different regions were apparent. Primary Health Care exhibited the highest density of professionals in the Northeast region, while the Southern region accounted for the highest densities in all professional categories within Specialized Health Care. The southeast region exhibited the largest workforce within Hospital Health Care. A marked upsurge in professional availability was noted across all categories, notably in the occupational therapy sector within hospital care (AAPC: 30.8), despite its initial low density.ConclusionThe implementation of public health policies played a significant role in the expansion of the rehabilitation workforce at all three levels of care in Brazil and its various regions from 2007 to 2020. Consequently, regional disparities and densities of professionals have emerged, mirroring patterns observed in low-income countries.
- Neurodevelopment in the third year of life in children with antenatal ZIKV-exposure(2021) AIZAWA, Carolina Yuri Panvequio; CARON, Deyse Mayara Rodrigues; SOUZA, Carolina Barbosa de; KOZIMA, Paula Fernanda Augusto; DAMASCENO, Luana; EINSPIELER, Christa; MARSCHIK, Peter B.; BRASIL, Patricia; SCHMITT, Ana Carolina Basso; NIELSEN-SAINES, Karin; HASUE, Renata HydeeWe report cognitive, language and motor neurodevelopment, assessed by the Bayley-III test, in 31 non-microcephalic children at age 3 with PCR-confirmed maternal Zika virus exposure (Rio de Janeiro, 2015-2016). Most children had average neurodevelopmental scores, however, 8 children (26%) presented delay in some domain. Language was the most affected: 7 children (22.6%) had a delay in this domain (2 presenting severe delay). Moderate delay was detected in the cognitive (3.2%) and motor (10%) domains. Maternal illness in the third trimester of pregnancy and later gestational age at birth were associated with higher Bayley-III scores. Zika-exposed children require long-term follow-up until school age.
- Evaluation of the implementation of the Care Network for People with Disabilities in the Brazilian Unified National Health System: a multiple case study(2023) RIBEIRO, Katia Suely Queiroz Silva; SALDANHA, Jorge Henrique Santos; ZANELA, Angela Kemel; FERRARI, Fernando Pierette; FREITAS, Grace Kelly Filgueiras; BARROSO, Ralf Braga; SILVA, Silvia Lanziotti Azevedo da; CHAVES, Sonia Cristina Lima; AQUINO, Victor da Silva; SCHMITT, Ana Carolina Basso; FERNANDES, Tiotrefis GomesThe Care Network for People with Disabilities (RCPCD) was implemented in 2012 as a con-sequence of the actions of the Viver sem Limite (Living without Limits) plan and has been the re-search object of recent studies. However, no pub-lished studies address the degree of implementa-tion of this network. This study aimed to evalu-ate the degree of implementation of the RCPCD in eight states in the five regions of Brazil. This multiple case study performed evaluative research of the degree of implementation of the RCPCD in the states of Amazonas, Bahia, Espirito Santo, Mato Grosso do Sul, Minas Gerais, Paraiba, Rio Grande do Sul, and Silo Paulo. A logical model of the policy and a measurement matrix were devel-oped. The degree of implementation of seven states was moderate, but Amazonas had an incipient degree of implementation. The evaluation of each stage of the process showed important differences, as the regional diagnosis and network adhesion stages presented moderate to advanced degrees of implementation in most states. In the service con-tracting stage, no state had an advanced degree of implementation, and the stage of follow-up and monitoring of the RCPCD was not even reached. The measurement matrix helps evaluate the de-gree of implementation of the RCPCD, and, by recognizing its results, the state steering groups and technical area recommend its use. Actions to improve this implementation, such as strengthen-ing regionalization, establishing regional steering groups, ensuring contracting mechanisms, and de-fining criteria for certification of the care points, are necessary.
- Accidental falls in middle-aged women(2020) STOLT, Ligia Raquel Ortiz Gomes; KOLISH, Daniel Vieira; CARDOSO, Maria Regina Alves; TANAKA, Clarice; VASCONCELOS, Erika Flauzino Silva; PEREIRA, Elaine Cristina; DELLU, Mayra Cecilia; PEREIRA, Wendry Maria Paixao; ALDRIGHI, Jose Mendes; SCHMITT, Ana Carolina BassoOBJECTIVE: To estimate the prevalence of accidental falls in women and to identify possible associations of sociodemographic, clinical and lifestyle variables with falls, in 2007 and 2014. METHODS: Two cross-sectional studies were performed, in 2007 and 2014, within the Projeto de Saude de Pindamonhangaba (PROSAPIN - Pindamonhangaba Health Project), with women aged between 35 to 75 years. Probabilistic samples were selected among women living in the municipality and participating in the Health Family Strategy. Data collection included: face-to-face interview, anthropometric examination and blood test. The outcome variable ""have you fallen in the last six months?"" was raised during the interview. The prevalence of falls in 2007 and 2014 were estimated by score with a 95% confidence interval (95%CI). Multiple logistic regression models were constructed to identify the association of independent variables with the occurrence of falls for each year based on the odds ratio (OR). We used the Stata 14.0 software for statistical analysis. RESULTS: The prevalence of accidental falls were: 17.6% ( 95%CI 14.9-20.5) in 2007 and 17.2% (95%CI 14.8-19.8) in 2014. In 2007, factors associated with falls were: aged 50-64 years (OR = 1.81; 95%CI 1.17-2.80), high school (OR = 1.76; 95%CI 1.06-2.93), hyperuricemia (OR = 3.74; 95%CI 2.17-6.44), depression (OR = 2.07; 95%CI 1.31-3.27), poor sleep (OR = 1.78; 95%CI 1.12-2.82) and daytime sleepiness (OR = 1.86; 95%CI 1.16-2.99). In 2014, they were: aged 50-64 years (OR = 1.64; 95% CI 1.04-2.58), hyperuricemia (OR = 1.91; 95%CI 1.07-3.43) and depression (OR = 1.56; 95%CI 1.02-2.38), plus metabolic syndrome (OR = 1.60; 95%CI 1.03-2.47) and musculoskeletal pain (OR = 1.81; 95%CI 1.03-3.18). CONCLUSIONS: Falls occur significantly in women aged 50 years or over, indicating that they are not restricted to older adults and that there is a need to initiate preventive measures earlier. Both studies showed similar magnitudes of occurrence of accidental falls and reinforced their multifactorial nature. In addition, hyperuricemia may be a potential new factor associated with falls.
- Redecin Brazil: constructing the methodology of a multicentric study to evaluate the care network for people with disabilities(2021) RIBEIRO, Katia Suely Queiroz Silva; BARROSO, Ralf Braga; RAMOS, Barbara Grazielle; FERRARI, Fernando Pierette; SALDANHA, Jorge Henrique Santos; SILVA, Silvia Lanziotti Azevedo da; FERNANDES, Tiotrefis Gomes; SCHMITT, Ana Carolina BassoThis article presents the methodological path of the Redecin study - Evaluation of the Implementation of the Care Network for People with Disabilities (RCPCD) in Brazil. We conducted a multicentric cross-sectional study adopting a hybrid design involving quantitative instruments (document analysis and structured questionnaires) and qualitative methods (interviews with key informants about the implementation of the RCPCD). After discussions with informants from the Ministry of Health and research group, a health region/macro region configuration was adopted, involving all the components of the RCPCD described in the Ministerial Order that created the network. The study was shown to be representative in eight states in the country's five geographical regions. The use of a hybrid design and multiple evidence sources, and the incorporation of the concept of health care network were fundamental to structuring the evaluation as an instrument that aims to support health care decision-making processes.
- Effectiveness of interdisciplinary health education programs for individuals with fibromyalgia: A systematic review(2021) ANTUNES, Mateus Dias; COUTO, Leticia Assis; BERTOLINI, Sonia Maria Marques Gomes; LOURES, Felipe Cayres Nogueira da Rocha; SCHMITT, Ana Carolina Basso; MARQUES, Amelia PasqualFibromyalgia has been increasing worldwide and is considered a public health problem. Nonpharmacological treatment through exercise and education is recommended for fibromyalgia management. In this sense, there is a need for interdisciplinary programs to promote health and improve symptoms in fibromyalgia. The purpose of this study was to verify the effectiveness of interdisciplinary health education programs for individuals with fibromyalgia. This is a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations and was registered at Prospective Register of Systematic Reviews (CRD4201913228). A search was conducted in the following databases: Scientific Electronic Library Online, Lilacs, Medical Literature Analysis and Retrieval System Online, Scopus, Web of Knowledge ISI, Physiotherapy Evidence Database, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and SPORTDiscus. The descriptors used were ""Fibromyalgia"" and ""Health Education."" Clinical trials published between 1990 and 2019 were selected. The Jadad Quality Scale and the Cochrane Risk-of-Bias Tool were used to evaluate the risk of bias and the methodological quality of the clinical trials. The search found 2887 articles, and only two studies were included in the analysis. Both studies conducted the interventions through lectures and group activities. In particular, the topics most frequently approached at the interdisciplinary health education programs were general information about fibromyalgia, body practices, physical activities, and pharmacological approaches. An interdisciplinary health education program can improve pain and quality of life in people with fibromyalgia; however, evidence shows low methodological quality. This systematic review indicates that studies are of low quality, interfering with the effectiveness of interdisciplinary health education programs.
- Increase in fall-related hospitalization, mortality, and lethality among older adults in Brazil(2020) STOLT, Ligia Raquel Ortiz Gomes; KOLISCH, Daniel Vieira; TANAKA, Clarice; CARDOSO, Maria Regina Alves; SCHMITT, Ana Carolina BassoOBJECTIVE: To estimate the trends of fall-related hospitalization, mortality, and lethality among older adults in Brazil and regions. METHODS: This is a descriptive study based on data from the Hospital Information System of the Brazilian Unified Health System. We included records of every older adult, aged 60 years or older, hospitalized for accidental fall from January, 1998 to November, 2015 in all Brazilian regions. We selected the codes E885, E886, E880, E884, E884 from the International Classification of Diseases, 9th revision, and W01, W03, W10, W17, W18 from the 10th revision, and calculated fall-related hospitalization and mortality rates per 100,000 inhabitants, as well as lethality. To estimate trends, we applied the Prais-Winsten regression for time series analysis. RESULTS: During the period, 1,192,829 fall-related hospitalizations occurred, among which 54,673 had a fatal outcome; lethality was 4.5%. Hospitalization rates showed upward trends, with seasonality, in Brazil (11%), and in the Northeast (44%), Midwest (13%), and South regions (14%). The North showed a decreasing hospitalization rate (48%), and the Southeast a stationary one (3%). CONCLUSIONS: In Brazil, fall-related hospitalizations, mortality, and lethality among older adults showed an upward trend from 1998 to 2015, with seasonal peaks in the second and third quarters. Considering we are in plain demographic transition, to improve hospital healthcare and encourage falls prevention programs among older adults is essential.
- Saúde e trabalho de residentes multiprofissionais(2018) ROCHA ESP, Jéssica Santos; CASAROTTO PHD, Raquel Aparecida; SCHMITT PHD, Ana Carolina BassoAbstract Introduction: The Multiprofessional Residency Program (RM) is one of the strategies in Brazil to reorganize the health service. This program was based on the Medical Residencies that are the target of critical notes related to supervision and the residents' health situation. There are few studies in the literature that investigate the health of multiprofessional residents. The aim of this study is to analyze and relate the quality of life (QOL), stress and satisfaction with the work of multiprofessional residents. Materials and methods: This cross-sectional study is with 42 residents of 2014-2015 from five programs of multidisciplinary residency of three levels of care. With online survey, it estimated the prevalence of stress and built multiple linear regressions to verify the contribution of sociodemographic, occupational, stress and job satisfaction variables in the domains of QOL (5 % significance). Results: It was found that 78.9 % of the resident had stress. Residents were partially satisfied in relation to satisfaction with the general work. About the QOL, the amounts presented in all areas were lower than those found in the Brazilian population in general. Conclusion: The partial satisfaction with the work involves the relationship with the peers, professional exhaustion and degree of flexibility and freedom in the resident's participation in the work process. The prevalence of stress in multiprofessional residents was high, the Stress and urban mobility contributed to be negative to the QOL; on the other hand the leisure had a positive influence.