ANA CLAUDIA CAMARGO GONCALVES GERMANI

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Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina

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  • article 0 Citação(ões) na Scopus
    Characterization of interprofessional education experiences in health education at the University of São Paulo
    (2023) COSTA, Jaqueline Bissolati; MAZZI, Nathalia Romeu de; PEDUZZI, Marina; GERMANI, Ana Claudia Camargo Gonsalves; SILVA, Jaqueline Alcantara Marcelino; AGRELI, Heloise Lima Fernandes; NASCIMENTO, Ariana Gomes; BELBER, Gisele Silvestre; LEONELLO, Valeria Marli
    Objective: To map the experiences of Interprofessional Education (IPE) in Health at the Sao Paulo campus of the University of Sao Paulo. Method: This is a descriptive, exploratory study with a quantitative approach and data collection through an online questionnaire addressed to teachers from eight teaching units and 14 health courses. The data was analyzed using absolute and percentage frequencies. Results: The majority of teachers do not take part in IPE experiences (70.4%). Most of the experiences are between six and ten years old, involving up to four teachers and small groups of students, mostly extracurricular or extension activities. The teaching and assessment strategies are diverse and open to students of all years. Conclusion: IPE experiences involve a small number of students and teachers and, although consolidated in terms of the time they have been offered, are limited to extracurricular spaces. Factors such as improvements in institutional support and teacher development are pointed out as important for making progress in strengthening IPE in the analyzed context.
  • article 16 Citação(ões) na Scopus
    Knowledge gaps and acquisition about HPV and its vaccine among Brazilian medical students
    (2020) COSTA, Annielson de Souza; GOMES, Jessica Menezes; GERMANI, Ana Claudia Camargo Goncalves; SILVA, Matheus Reis da; SANTOS, Edige Felipe de Sousa; SOARES JUNIOR, Jose Maria; BARACAT, Edmund Chada; SORPRESO, Isabel Cristina Esposito
    Objective To analyze factors associated with knowledge gaps and acquisition about HPV and its vaccine among medical students. Method Cross-sectional and analytical study conducted at the University of Sao Paulo Medicine School, in 2016. A convenience sample of students completed a data collection instrument containing questions on knowledge about HPV and its vaccine, and vaccine acceptability. The level of knowledge and acceptability established as a ""good level"" was 80% of correct answers on the questionnaire. Internal validity was calculated with Cronbach's alpha value (alpha) = 0.74. Bivariate and multiple analyzes were performed using the Stata (R) program (Stata Corp, College Station, USA) 14.0. Results To evaluate the internal consistency of the instrument applied, the Cronbach's alpha equation was used, obtaining the alpha value (alpha) = 0.74 for this population. This value attests that the consistency of the answers obtained with this questionnaire is considered substantial and acceptable. Among the 518 medical students who completed the survey, the majority were men 312 (60.4%) with a mean age of 23 (+/- 2.8) years old; 199 (38.3%) of the students were in the final years of graduation (5th and 6th years). Students in the first, second and third year of study had a 51% higher risk of a knowledge gap when compared to students in the final years of graduation [PR 1.51 (1.3:1.8); p < 0.001]. Men were at 22% higher risk of unsatisfactory knowledge than women are [PR 1.22 (1.07: 1.39). There was no knowledge acquisition during medical school in the following questions (p < 0.05), indication of vaccine for individuals with HIV and contraindication in pregnant patients. Conclusion Male medical students, in the first year of medical school, and those who were not vaccinated had significant knowledge gaps about HPV. The novelty of the study includes the finding of non- acquisition of knowledge during the medical school graduation on safety and vaccination schedule and vaccine administration in specific populations.
  • bookPart
    Consulta Periódica de Saúde
    (2016) FERREIRA JUNIOR, Mario; GERMANI, Ana Claudia Camargo Gonçalves
  • article 2 Citação(ões) na Scopus
    Structural determinants of health, race, gender, and social class: a scope review
    (2021) GALVAO, Anna Larice Meneses; OLIVEIRA, Elda; GERMANI, Ana Claudia Camargo Goncalves; LUIZ, Olinda do Carmo
    This article aims at exploring and systematizing the knowledge about structural health determinants. For such purpose, we developed a scope review in the databases Web of Science, Cinahl, Scopus, Lilacs and PubMed; and in the journals International Journal of Epidemiology,Journal of Epidemiology and Community Health,American Journal of Public Health and American Journal of Epidemiology from 2005 to 2018. We used the search terms ""Social Determinants of health"", ""Health services"", ""health policies"", and""inequity"". We identified 1,164 articles, of which 19 were selected. The structural determinants, also called social markers, were race, gender, gender identity, migration and social class. Theoretical perspectives of these articles, directly or indirectly,assumed health as a right. The proposed health policies focused on the positive effect of planning functions, training of service providers, and reduction of barriers to access and participation of excluded groups on equity. We concluded that the scientific literature reinforces that every individual must have the capacity to reach a personal ideal state of health without any distinction of race, skin color, religion,language, nationality, socioeconomic resources, genre, sexual orientation, gender identity,physical, mental or emotional disability, or any other characteristic linked to discrimination or exclusion from social and political opportunities.
  • article 49 Citação(ões) na Scopus
    The impact of urban gardens on adequate and healthy food: a systematic review
    (2018) GARCIA, Mariana T.; RIBEIRO, Silvana M.; GERMANI, Ana Claudia Camargo Goncalves; BOGUS, Claudia M.
    Objective: To examine the impacts on food and nutrition-related outcomes resulting from participation in urban gardens, especially on healthy food practices, healthy food access, and healthy food beliefs, knowledge and attitudes. Design: The systematic review identified studies by searching the PubMed, ERIC, LILACS, Web of Science and Embase databases. An assessment of quality and bias risk of the studies was carried out and a narrative summary was produced. Setting: Studies published as original articles in peer-reviewed scientific journals in English, Spanish or Portuguese between 2005 and 2015 were included. Subjects: The studies included were based on data from adult participants in urban gardens. Results: Twenty-four studies were initially selected based on the eligibility criteria, twelve of which were included. There was important heterogeneity of settings, population and assessment methods. Assessment of quality and bias risk of the studies revealed the need for greater methodological rigour. Most studies investigated community gardens and employed a qualitative approach. The following were reported: greater fruit and vegetable consumption, better access to healthy foods, greater valuing of cooking, harvest sharing with family and friends, enhanced importance of organic production, and valuing of adequate and healthy food. Conclusions: Thematic patterns related to adequate and healthy food associated with participation in urban gardens were identified, revealing a positive impact on practices of adequate and healthy food and mainly on food perceptions.
  • article 7 Citação(ões) na Scopus
    Burnout among primary health care workers in Brazil: results of a multilevel analysis
    (2021) SILVA, Andrea Tenorio Correia da; LOPES, Claudia de Souza; SUSSER, Ezra; COUTINHO, Leticia Maria Silva; GERMANI, Ana Claudia Camargo Goncalves; MENEZES, Paulo Rossi
    Purpose Burnout among health care workers may hamper the quality of care and effectiveness of health systems. Hence, we examined the prevalence of burnout in primary care teams, including community health workers; and investigated associations between individuals' characteristics, team and primary care center factors, and burnout. Methods We carried out a cross-sectional study among primary care teams in the city of Sao Paulo, Brazil (n = 2940). We randomly selected 66 primary care centers. The Maslach burnout inventory was used to investigate burnout. We used multilevel modelling to examine the associations between individuals' characteristics, team and primary care center variables with burnout. Results We addressed 351 primary care teams, with 11.4% of participants presenting severe burnout. The variance in burnout among primary care workers was partially explained by individuals' characteristics, and by team and primary care center factors. Severe burnout was associated with the following: (1) individuals' characteristics: being black, being younger, a higher length of employment in primary care, and presenting a lack of feedback from supervisors; (2) team factors: working in deprived areas and not receiving the support of a multidisciplinary team; and (3) primary care center factors: inadequate infrastructure (less than one office available per team), and having a bad/very bad relationship with the community council. Conclusions To reduce burnout among primary care teams, stakeholders should: (1) train managers/supervisors on leadership styles that prioritize performance feedback, support, and communication skills; (2) allocate catchment areas to teams according to each community's vulnerability; (3) provide a multidisciplinary team to support primary care workers; and (4) offer suitable facilities and infra-structure.
  • article 0 Citação(ões) na Scopus
    A espiritualidade/religiosidade como desafio ao cuidado integral: aspectos regulatórios na formação médica brasileira
    (2021) TROFA, Gabrielle Cordeiro; GERMANI, Ana Claudia Camargo Gonçalves; OLIVEIRA, Janaine Aline Camargo de; ELUF NETO, Jose
    Abstract The aim of this study was to assess the quality of oral care provided in Brazilian primary care and identify associated contextual socioeconomic factors. This is a cross-sectional study whose unit of analysis was all the oral care teams that participated in an external assessment for the second cycle of the Access and Quality Improvement Program - Primary Care. Quality was measured in the following dimensions: access, resolution, work process, care coordination and infrastructure. The quality criteria of the external assessment were grouped into these dimensions and weighted using Item Response Theory. The indicator of oral care quality was the result of grouping latent variables. Descriptive analyses were performed by region and association between “Oral Care Quality” and the Municipal Human Development Index (HDI), with 5% significance. Only 25% of the oral care teams were considered good. The infrastructure dimension obtained the best results and care coordination the worst. There was no statistically significant difference between municipalities with high and low HDIs. Quality assessment is vital to ensure the continuous improvement of quality healthcare.
  • article 9 Citação(ões) na Scopus
    The physiotherapy workforce in the Brazilian Unified Health Care System
    (2021) RODES, Carolina Hart; DARE, Joao Vitor Lovato; ARAUJO, Bruna Carolina de; GRACIANI, Leonardo; JOAO, Silvia Maria Amado; GERMANI, Ana Claudia Camargo Goncalves; SCHMITT, Ana Carolina Basso
    Background Maintaining sufficient health care workforce is a global priority to achieve universal health coverage. Therefore this study addresses the availability of physiotherapists in Brazil. Objective To describe secular trends of the physiotherapy workforce-to-population ratio in the Unified Health System, considering public and private sector and care level (primary, secondary, tertiary) in Brazil and its regions. Method Descriptive exploratory quantitative study based on secondary sources. All data related to the distribution of physiotherapists between August 2007 and September 2016 regarding facilities types, location and public and private sectors was obtained from the Brazilian National Registry of Health Care Facilities. Data related to the population of Brazil was extracted from Brazilian Institute of Geography and Statistics. The physiotherapy workforce-to-population ratio was calculated by the number of physiotherapists per 1000 population (public and private sector and care level) by ANOVA test. The distribution trends are represented on maps. Annual growth rates were estimated with Prais-Winsten linear regression models, with a significance level of 0.05, autocorrelation was checked by the Durbin-Watson test. Results The physiotherapists ratio in Brazil was 0.22/1000 population in 2007 and 0.41 in 2016, showing growth of 86%, with an increasing trend of 0.5% on an annual average. The public sector had the biggest physiotherapy workforce in the country in 2007 and 2016. The primary health care had the smallest physiotherapy workforce-to-population ratio (2007: p > 0.001 and 2016: p = 0.003), even though it had the largest growth trend in annual average (0.9% p > 0.001), followed by public and private tertiary health care sectors (0.8% p > 0.001). The workforce in secondary health care was bigger in the private sector than in the public sector (0.6% p > 0.001 vs. 0.2% p = 0.004). Overall, all regions had greater growth of physiotherapy workforce-to-population ratio in public primary and tertiary health care sectors, and private secondary health care sector, mainly the Southeast, South and Central-West regions. Conclusion Although the physiotherapy workforce in Brazil is relatively small, there was a trend towards growth with differences among care levels, and public and private sectors. The physiotherapy workforce-to-population ratio is bigger in the private secondary health care sector, followed by public tertiary, secondary and primary health care sectors. Sub-national regions show similar trends to the national estimates, with minor variations by region.
  • article
    Interdisciplinaridade, interprofissionalidade e diversidade racial na formação antirracista do profissional de saúde: vozes e aprendizados
    (2022) GERMANI, Ana Claudia; FAVARATO, Maria Helena; OLIVA, Isabel Leme; GERALDO, Rafael Marques; OLIVEIRA, Júlio César de; AYRES, José Ricardo de Carvalho Mesquita
    ABSTRACT This is a critical-reflective report on the experience of an elective course aimed at training health professionals in fighting racism. It was offered during the COVID-19 pandemic to undergraduate students from all the health subspecialties at the University of São Paulo. From the description and reflection on the proposed teaching and evaluation activities, we sought to recognize and learn/apprehend the contribution of the integration of knowledge (interdisciplinarity), professions (interprofessionality), and racial diversity in the teaching-learning process aimed at fighting racism. The perspectives of students, monitors, and teachers are reported. The support of guest teachers allowed this initiative to address racism and its influences on the health of black people, and the educational strategies encouraged students’ cultural production. The initiative proved to be a possibility for introducing changes in health education in favor of both comprehensive care and interprofessional collaboration in dismantling racism.
  • article 3 Citação(ões) na Scopus
    Talking about inequities: A comparative analysis of COVID-19 narratives in the UK, US, and Brazil
    (2023) EVERED, Jane A.; CASTELLANOS, Marcelo E. P.; DOWRICK, Anna; GERMANI, Ana Claudia Camargo Goncalves; RAI, Tanvi; SOUZA, Alicia Navarro de; QURESHI, Kaveri; CONCEICAO, Maria Ines Gandolfo; CABRAL, Ivone; GROB, Rachel
    Disproportionate mortality and morbidity burdens of the COVID-19 pandemic and coinciding media coverage of public acts of violence perpetrated against people of color in 2020 precipitated reckonings with structural inequities in global, national, and local contexts. This cross-country comparative analysis aims to describe how people voice and make sense race, racism, and privilege in their experiences with COVID-19 infection in the United States, United Kingdom, and Brazil. Anchored by continuous reflection on our individual and collective positionality, we conducted an inductive comparative analysis conceptually situated in intersectionality and critical race theory. Countries used a shared qualitative methodology to collect and analyze 166 narratives of people with experience of COVID-19 infection from 2020 to 2023. We selected 19 cases that illustrate crossnational differences in peoples' acknowledgment and narration of structural privilege and disadvantage in their observations of COVID-19 in their countries and in their personal experiences. People in the US had the most fluency with voicing race directly. In Brazil, while some respondents (especially younger people) demonstrated high racial consciousness, others struggled to identify and talk about racial relationships. In the UK, people voiced racial identifications, though often within white norms of politeness and an accompanying sense of discomfort. The findings overall illustrate moments the interview becomes or does not become a space for voicing social categories and systemic underpinnings of difference in COVID-19 infections and healthcare experiences. We reflect on cross-country differences in historical and contemporary racialized discourse and elaborate on implications of focusing on voicing in qualitative research.