The journal Cadernos ESP was created in 2005 by the Ceará School of Public Health Paulo Marcelo Martins Rodrigues (ESP/CE), with open and free access for the submission and publication of articles, with a consolidated reference in the field of Public/Collective Health with an interface between Education, Technologies and Innovation. It aims to make public the results of research and experiences arising from the management, teaching and services of health. It publishes original articles, integrative reviews, systematic reviews, meta-analyses, brief communications, experience reports, among other sections.
Ceará's Public Health School Paulo Marcelo Martins Rodrigues
SOCIAL REINTEGRATION AND MISSIONARY WORK: A PSYCHOLOGICAL PERSPECTIVE
This experience report, conducted by psychology students in Fortaleza, investigated the impact of religiosity on identity construction and coping with adversity among men in missionary training. Originating from homelessness and with a history of psychoactive substance use, the participants were engaged in a Catholic social reintegration program. Using participant observation and focus groups with the "Wheel of Life" tool, the qualitative research revealed significant improvement in fulfillment, happiness, purpose, and social life following religious engagement. The Christian organization served as a catalyst for transformation, offering support and meaning-making to the assisted individuals. It is concluded that religiosity emerges as an essential resource for alleviating suffering and re-signifying life, grounded in respect and non-stigmatization of vulnerable individuals. The field experience was fundamental for the theoretical and human development of the psychology students.
Experience Report, Update And/Or Technological Innovation
Copyright (c) 2025 Cadernos ESP https://creativecommons.org/licenses/by/4.0
INTERPROFESSIONAL ACTION OF DENTISTRY IN CHILDCARE
Objective: The objective of this study was to report practices of dental consultations integrated with interprofessional childcare. Methods: The practice setting was a basic unit in the municipality of Paracuru-Ceará. Weekly consultations were held between August and September 2024, with 15 children aged 0 to 2 years being attended. Of these, three were selected for reflective analysis. Based on the systematization of experiences, the practice was correlated with scientific evidence collected. Results: Poorly founded beliefs among caregivers were found, leading to poor oral health habits. A greater collaborative dynamic was observed with the nurse, compared to the medical professional. Final considerations: It was concluded that the dentist's role is essential in childcare, based on sharing of knowledge with the multidisciplinary team, a view to promoting health.
THE SOCIODEMOGRAPHIC PROFILE OF BEDRIDDEN PATIENTS IN MADALENA-CE
Objective: To outline the sociodemographic profile of bedridden patients receiving home physiotherapy care at a health unit in the municipality of Madalena-CE. Methods: A descriptive, cross-sectional, and quantitative study conducted at the Specialized Health Care Center (CAES), based on the analysis of 22 patient records attended by the public home physiotherapy service between August and October 2024. Results: The analyzed population presented low education levels and reduced family income. Most patients lived in their own homes, with a predominance of individuals who had incomplete primary education or no formal schooling. A significant dependence on family members was observed, along with a balanced gender distribution. Conclusion: The data reveal a socially vulnerable profile among bedridden patients, highlighting the importance of home physiotherapy as a fundamental strategy for promoting health and maintaining quality of life, especially in contexts of socioeconomic inequality.
KNOWLEDGE AND SELF-CARE AMONG DIABETICS IN PRIMARY HEALTH CARE
Objective: To understand the knowledge and self-care practices of people with type 2 diabetes mellitus attending Primary Health Care. Methods: A qualitative, exploratory, and descriptive study conducted using the focus group technique. Data collection occurred in April 2025, and the analysis was based on the Discourse of the Collective Subject (DCS), differentiating collec-tive discourse from individual statements. The study was approved by the Research Ethics Committee (Opinion No. 7,440,662). Results: Ten patients participated, with a mean age of 60.6 ± 13.85 years, the majority female, with diabetes for at least six months. Participants re-ported dietary changes and medication adherence but faced financial difficulties, low education levels, and lack of motivation for physical activity. Educational groups were highlighted as an important support for self-care. Conclusions: Strengthening educational actions and overcom-ing structural barriers are essential strategies to promote self-care and effective management of type 2 diabetes.
Joice Fabrício de Souza Fabrício de Souza
NOTIFICATIONS OF EXOGENOUS INTOXICATION IN CRATEÚS, CEARÁ
Objective: The objective was to describe epidemiological data on exogenous intoxication, reported by the municipality of Crateús, Ceará, Brazil, from 2014 to 2023. Methods: This is a cross-sectional and descriptive epidemiological study, conducted in September 2024, based on notifications of exogenous intoxications reported in Crateús. Data collection was carried out through Tabnet from the Department of Informatics of the Unified Health System (DATASUS). Results: A total of 600 cases of exogenous intoxication were reported by the municipality of Crateús, with a predominance of females (70%) and mixed race/skin color individuals (67.3%). Medications were the main toxic agent (71.3%), and suicide attempts were the main circumstance (71.8%). The incidence of cases peaked in 2022, with 125.6 cases per 100,000 inhabitants. Final considerations: DATASUS data are essential for situational diagnosis and the creation of public health measures, promoting well-being and guiding decision-making by managers.
Brenda Karen Oliveira Carvalho Oliveira Carvalho
Objective: To report the practice of a therapeutic group in a Psychosocial Care Center (CAPS Geral), with family members/caregivers of patients suffering from mental disorders. Methods: This is a descriptive study, in the form of an experience report, developed by a resident nurse, conducted in the municipality of Camocim–CE, between August 2023 and March 2024. Through the analysis of the content of the field diary of the Laços Group, it was possible to assess the main themes that emerged from the group. Results: After analyzing the material recorded in the field diary, the most prevalent topics during the group meetings were identified, namely: overload; crises; communication difficulties; fragility in support networks; and the importance of psychosocial support for family members/caregivers. Conclusion: The study highlights the importance and impact of therapeutic groups in assisting families, aiming to encourage actions directed at caregivers.
UNDERSTANDING THE BOND BETWEEN NURSING PROFESSIONALS AND PATIENTS
Objective: To investigate the factors that strengthen attachment between nursing professionals and patients in Primary Health Care. Methodology: Descriptive and qualitative research conducted among eight nursing professionals from Arneiroz, in the state of Ceará. Data were collected through semi-structured interviews and analyzed using the technique of content analysis from Minayo. Results: The results reveled that staff turnover, work overload, and Community Health Agents’ undervalue obstruct the strengthening of bonds, while qualified listening, empathy, and continuity of healthcare stand out as facilitators. Final Considerations: We conclude that a humanized patient welcoming is essential for the Family Health Strategy consolidation, although the findings can also support the improvement of Primary Health Care in different contexts across the country.
Objective: To understand the impacts of using auriculotherapy in mental health care. Methods: An integrative review was carried out in the LILACS, Medline/Pubmed and SciELO databases, with the descriptors “Auriculotherapy”, “Complementary Therapies” and “Mental Health”, from December 2023 to February 2024. Results: Among the 302 articles found in the databases, eight articles met the search criteria and were included in the review. The positive impact of auriculotherapy on reducing symptoms of anxiety, stress, and hyperactivity was evidenced, as well as improving mood and reducing the number of cigarettes consumed. Final Considerations: This study allowed us to visualize the positive impacts of auriculotherapy on mental disorders, encouraging its use in this setting to complement the treatment of patients. However, we emphasize the need for more studies in the area, especially longitudinal ones, in order to overcome the methodological barriers to generalizing the results.
The educational context can generate considerable pressure and overload, resulting in psychological distress for educators, manifested by professional exhaustion and demotivation. Therefore, this article aims to share a psychological listening experience carried out with education professionals, seeking to understand their experiences and emotional and institutional demands. This is a qualitative study, configured as an experience report, in which psychological listening was conducted with five educators working in early childhood education. The results showed the devaluation of the educators' work, the overload with demands that extrapolate their pedagogical functions, and the silencing of their anxieties. Despite contextual limitations, the listening demonstrated to be a powerful space for welcoming and reflection. It is concluded that qualified psychological listening is a fundamental tool for the emotional care of these professionals and for psychological training.
Schools, as a fundamental space for comprehensive education and strengthening social ties, face significant challenges in addressing death. Death is inseparable from human development and manifests itself from childhood onwards and accompanies the entire life cycle. This theoretical essay aims to discuss the importance of education about death in the school environment. The methodology used was a theoretical essay, which enabled the construction of a critical analysis based on an argumentative and reflective exposition. It was noted that there is a shortage of scientific production on this topic. We conclude that, although children and adolescents have the capacity to deal with the topic, the school environment remains unprepared to promote open discussions about death. By recognizing and embracing its role as a space for comprehensive education, schools can become agents of transformation, preparing young people not only for life, but also for the acceptance of finitude as an inherent part of the human condition.
HIV research has remained frequent since its discovery. HIV/HBV co-infection is highly significant as it impacts on the natural history of chronic HBV infection, increasing morbidity and mortality. Objective: To identify the prevalence of functional cure in patients with HIV/HBV coinfection and the possible factors associated with this cure. Method: This is a retrospective cohort study conducted between July 2023 and August 2024 in two healthcare centers in Fortaleza. Results: Of the 175 coinfected patients included in the study, only 146 had access to control HBsAg. In the comparative analysis between the two groups, factors such as the absence of positive HBeAg and lack of detection of HBV-DNA were statistically significant for HBsAg clearance. Conclusion: These results suggest that proper control of HBV, particularly in patients with negative HBeAg, is associated with a higher prevalence of functional cure.
IMPACT OF PRIMARY CARE ACTIONS ON SELF-CARE OF HYPERTENSIVE PATIENTS
Objective: To understand how Primary Health Care actions influence self-care among patients with systemic arterial hypertension. Methods: Narrative literature review based on scientific articles, reports, and official documents published between 2016 and 2024 on hypertension management in Primary Health Care. Results: Findings highlight the importance of person-centered care, taking into account social, cultural, and family aspects. Practices such as healthy eating, physical activity, smoking cessation, and moderation in alcohol consumption are essential for self-care. Challenges include lack of symptoms, low medication adherence, and socioeconomic and psychosocial barriers. Conclusions: Effective hypertension management requires multiprofessional actions, health education, and strategies such as personalized care plans. Public policies should reinforce comprehensive care and promote self-care, aiming to reduce morbidity and mortality.
EPIDEMIOLOGICAL PROFILE OF INFANT MORTALITY IN THE STATE OF CEARÁ, BRAZIL, FROM 2013 TO 2023
Objective: To analyze the epidemiological situation of maternal and infant mortality in Ceará, Brazil, from 2013 to 2023. Methods: This is a descriptive epidemiological study, carried out in September 2024 on notifications of Infant Mortality in the State of Ceará, in the period from 2013 to 2023. Data collection was carried out by the Mortality Information System (SIM) and the Live Birth Information System (Sinasc). Results: 16,686 cases were reported, with a predominance of males (54.96%), age group under 24 hours (26.67%), brown race (61.97%), mothers' education level of 8 to 11 years (40.43%), mothers' age of 20 to 24 years (21.11%), mortality rate of 13.822 in 2013 and 11.722 in 2023. Final considerations: Finally, there was a reduction in infant deaths in the State of Ceará, where in 2013, the highest infant mortality rate was recorded.
PHARMACEUTICAL CARE FOR INSULIN-DEPENDENT PATIENTS: AN EXPERIENCE REPORT
Objective: The report aims to describe the experience of a pharmacist resident in home visits to insulin-dependent patients. Methods: This is a descriptive study with a qualitative approach, conducted between November 2024 and January 2025, with patients registered as insulin-dependent at the primary health care unit where the resident worked. The activity was carried out through follow-up to understand the users' knowledge about insulin treatment. Results: During the study, it was possible to identify the patients' level of understanding regarding the correct use of insulin, their lack of knowledge about proper medication storage, and the need for guidance on daily blood glucose monitoring. Final considerations: The study emphasizes the importance of the pharmacist in caring for diabetic patients, as this professional plays a key role in providing guidance on pharmacotherapy, thus contributing to the improvement of patients' glycemic control.
PERCEPTIONS OF THE PHARMACIST'S ROLE IN PRIMARY HEALTH CARE
This study aimed to analyze the discourse of health workers at the Nutrition Center in Tianguá/CE on the importance of pharmacists in the primary care team. This is a descriptive, exploratory field study with a qualitative approach, carried out at the Nutrition Center Basic Health Unit in Tianguá - CE. Data collection took place between August and September 2022. The data was analyzed using Bardin's Content Analysis. Fifteen health workers took part in the study, aged between 30 and 62, and working at the unit for between 4 and 32 years. The analysis of the discourses generated three categories discussed throughout the article. It was concluded that pharmacists are essential professionals in health care and that their work in primary care still needs to be better recognized and integrated into the multi-professional team to guarantee comprehensive care for the population.
PERFORMANCE OF THE MULTIDISCIPLINARY TEAM REGARDING THE APPROACH TO PALLIATIVE CARE IN NEUROLOGICAL PATIENTS
Objective: describe the performance of the multidisciplinary team regarding the approach to palliative care in neurological patients. Methods: descriptive, cross-sectional and quantitative study, carried out from February to April 2024 with the multidisciplinary team of a unit at the General Hospital of Fortaleza. An electronic form was used, with sociodemographic data, six objective questions and one open question about palliative care. Results: 18 professionals participated, 83% were women, 88% were between 25 and 44 years old and 38.8% had 6 to 10 years of experience. Regarding palliative care, 88.9% stated that it promotes the quality of life of patients and families, who face life-threatening illnesses, through the prevention and relief of physical, psychosocial and spiritual suffering; 66.7% stated that they were initiated upon severe diagnosis; 94.4% agreed that it promotes the quality of life of the patient and family through the prevention and relief of suffering; 77.8% stated that care covers the patient, family and caregiver; 77.8% indicated care in hospitals, homes and outpatient clinics; 55.6% believe that invasive measures should not be carried out in patients with therapeutic limitations and in an active process of death. Relief from pain/suffering was the most cited finding in the open question. Conclusion: The team still has a limited understanding of palliative care, highlighting the need to expand knowledge on the topic, especially in relation to neurological patients. Considering that most neurological diseases have no cure and compromise quality of life, it is essential to strengthen this approach. Therefore, the study adds to the literature by expanding this understanding of the application of palliative care in this patient profile.
The diagnosis of childhood cancer imposes significant disruptions on family life, with mothers frequently assuming an intense and often invisible caregiving burden. This experience report aims to describe and analyze this maternal experience, seeking to broaden the discussion on gender, work, and mental health within this context. The qualitative methodology employed participant observation and focus groups with mothers at a philanthropic support home. The results highlighted exclusive dedication, strong identification with the caregiver role, and the invisible labor dimension. The discussion delves into gender asymmetry in care, the internalization of the "maternal instinct," financial dependence, and the suffering from unrecognized symbolic grief. Furthermore, a scarcity of self-care practices was observed. It is concluded that this form of motherhood is a solitary and exhaustive function, demanding renunciations and calling for social recognition and supportive public policies.
Objective: Report the experience from the Extension Laboratory III discipline of the Nursing course at the Centro Universitário do Vale do Jaguaribe, which checked the vaccination cards of athletes from the “Mv Vôlei” project, guiding them on the importance of vaccination. Methods: The study was conducted involving 21 female volleyball athletes aged between 8 and 18 years. The vaccination cards were reviewed, nursing consultations were conducted – including anamnesis, physical examination – and an informative folder on the vaccination was distributed. In addition, welcoming and educational dynamics were used. Results: It was observed that 47.5% of the athletes were up to date with their vaccinations, while the others had significant gaps in immunization, particularly against influenza, diphtheria and tetanus, and yellow fever. Although vaccination is essential for preventing diseases and outbreaks, many adolescents demonstrated resistance or a lack of knowledge regarding the importance of vaccines. Final considerations: The initiative highlighted the need for public policies that promote vaccination campaigns and strategies aimed at reaching specific groups.
Objective: To identify the main risk factors for the use of hormonal contraceptives; To understand the main side effects of oral contraceptives; and To describe the repercussions on the lives of women using them. Methods: Research with 19 women who use hormonal oral contraceptives through individual interviews. Data were interpreted using Bardin Content Analysis. Results: Most of them were advised by a gynecologist regarding the use of contraceptives. Headache and edema were the most reported symptoms. All of them are aware of the benefits and harms of using contraceptives, but there was a lack of guidance regarding the risks of using them. Conclusion: A thorough consultation is essential, with the exercise of reproductive planning and guidance on the use, effects and risks of contraceptives, actions that can and should be performed by a nurse trained in care, communication and education in women's health.
ORAL HEALTH LITERACY AND PERIODONTAL DISEASE IN PREGNANT WOMEN
Objective: To evaluate how Oral Health Literacy is related to periodontal diseases in pregnant women. Methods: This is a descriptive, cross-sectional, quantitative study conducted with pregnant and non-pregnant women from two Basic Health Units in the municipality of Serra Talhada (Pernambuco) which assessed oral health literacy levels, using the “Health Literacy in Dentistry Scale” (HeLD-14) instrument, and evaluated participants' periodontal conditions through intraoral physical examinations, using the rates of the Community Periodontal Index (CPI) and the periodontal attachment loss (CAL). Data tabulated in SPSS 20.0 software were analyzed using Pearson’s chi-square and Kruskal-Wallis tests at a p = 0.05 level. The study was approved by the Research Ethics Committee of the FIS University Center (Opinion No. 7.020.621). Results: Among a sample of 42 participants, a significant association between dental pain and periodontal disease was found. However, no statistically significant relationship was observed between oral health literacy levels and the occurrence of periodontal disease. Conclusion: The findings suggest no association between oral health literacy and periodontal disease. Additionally, pregnancy status did not influence oral health literacy levels in the studied population.
EPIDEMIOLOGY OF TUBERCULOSIS CASES FROM 2013 TO 2023 IN THE STATE OF CEARÁ
Objective: To analyze the epidemiology of tuberculosis in Ceará between 2013 and 2023. Methods: This descriptive epidemiological study used secondary data from the Department of Informatics of the Unified Health System (DATASUS), collected in September 2024. All reported cases were included, segmented by region, race/color, incidence rate, and confirmed cases, excluding duplicates or incomplete records. Results: Ceará reported an annual average of 3,406 new cases of tuberculosis, with 70% concentrated in Fortaleza and an average of 50.75% of the state's incidence. The majority (76.8%) of cases occurred in mixed-race individuals and, between 2013 and 2023, deaths increased from 221 to 240. Final considerations: The number of new cases of tuberculosis remained above average in the period analyzed, evidencing challenges in control, with underreporting and treatment abandonment. Thus, epidemiological studies such as this one can help in decision-making for disease prevention and control.
SOCIAL SERVICE CONTRIBUTIONS IN HEALTH EDUCATION ACTIONS
Objective: To analyze the contributions of Social Services to health education actions, highlighting the relevance of these activities in Primary Health Care (PHC). Methods: This qualitative and descriptive experience report was based on interventions in the waiting rooms of the Catarina Evangelista de Sousa UAPS in Icapuí, Ceará, Brazil. Data were collected through field diaries, documenting reports, experiences and perceptions of users and professionals. Results: Four waiting rooms were created with themes aligned with the calendar of public campaigns. The activities promoted reflection on social rights and health prevention, generating a stronger bond between users and professionals. Final considerations: The experience highlighted the relevance of Social Services in health education, promoting user autonomy and contributing to constructing a more equitable and humanized SUS.
CLINICAL PROFILE OF PATIENTS UNDERGOING SURGERY FOR ENDOMETRIOSIS
Objective: To delimit the clinical and epidemiological aspects of patients with endometriosis in a hospital in Ceará. Methods: Descriptive, retrospective, and cross-sectional study, analyzing data from 108 patients treated surgically. Results: The mean age was 37 years, and 68% of patients had children. Dienogest was the most commonly used medication for clinical treatment. Chronic pelvic pain was the main symptom (77%). In imaging exams, the most affected sites were the uterosacral ligaments, the retrocervical region, and the rectum. Hysterectomies were performed in 62% of cases, and intestinal surgeries in 64% of cases. The mean overall length of hospital stay was 4.2 days, with 10% of minor postoperative complications. Conclusion: The study highlights the complexity of endometriosis cases and the importance of early diagnosis and individualized treatment to improve care and the quality of life for patients.
The aim of this study was to describe the consumption of ultra-processed foods in children aged 2 to 4 between 2018 and 2022. This is an observational, descriptive study using secondary data from SISVAN. The collection took place from February to March 2023. The study population consisted of 1,067,357 children in Brazil/Northeast/Ceará and São Gonçalo do Amarante. The consumption of ultra-processed foods among children in Brazil in 2021 was 88% and 86% in the Northeast, while it was 83% in Ceará and 81% and 92% and 90% in São Gonçalo do Amarante. Given the huge range of ultra-processed foods that are made available to children in this stage of life, it is important to carry out research, discussions and reflections on Food and Nutrition Surveillance in pre-school, with the aim of implementing public policies or reinforcing those that already exist.
PERCEPTION OF DOCTORS AND NURSES REGARDING TUBERCULOSIS-RELATED FACTORS
Objective: to identify, based on the perceptions of doctors and nurses working in the Family Health Strategy, the factors that influence the dynamics of tuberculosis in Quiterianópolis, Ceará, Brazil. Methodology: This qualitative, descriptive and exploratory study was conducted in May 2025 and employed the focus group technique with doctors and nurses from the municipality’s Family Health Strategy. The data were submitted to Bardin’s analysis. Results: The results were presented in two thematic categories, namely: Sociodemographic factors and patient environments and Clinical and behavioral factors of patients. Final considerations: The study showed that social, environmental, and behavioral factors are relevant for adherence to tuberculosis treatment in Quiterianópolis, Ceará, Brazil.
Objective: To promote self-care and mental health among healthcare professionals by providing moments of reflection, relaxation, and knowledge exchange to reduce stress and enhance well-being in the workplace. Methods: Conducted between August 2023 and January 2024 in healthcare units in Caucaia, Brazil, the project included discussion groups on self-care and workers' health, as well as integrative practices. Activities, lasting an average of 30 to 40 minutes, were held in groups or individual sessions and adjusted to the units' routines. Results: Participants reported emotional relief, reduced stress, and increased awareness of the importance of self-care. These low-cost and short-duration practices had a positive impact on professionals' well-being and productivity. Conclusions: The project highlighted the value of self-care in the workplace, delivering immediate results but emphasizing the need for ongoing and structural actions to foster sustainable mental health.
Objective: To evaluate the hepatitis C care cascade in Ceará by diagnosing the current stage of the state regarding the World Health Organization's elimination targets. Methods: Retrospective, ecological, analytical study assessing hepatitis C in Ceará from 2000 to 2024 regarding case notifications, treatments, liver transplants, and deaths. Local, state, and national databases were used. Results: It is estimated that 44,837 individuals have been infected with hepatitis C in Ceará. Only 2,893 cases were reported from 2000 to 2023. Of these, 1,734 (61.8%) patients were treated with direct-acting antiviral drugs. There were 560 liver transplants and 560 deaths reported due to hepatitis C. Conclusions: Ceará reported a small fraction of the estimated hepatitis C cases and treated most of them. The low number of deaths and notifications suggests the need to expand testing and surveillance for this disease in Ceará, aiming for elimination by 2030.
WORKERS HEALTH IN A DECENTRALIZED HEALTH AREA OF CEARA
Objective: to report the experience of a Worker’s Health project carried out with the staff of the Decentralized Health Area (ADS) of Crateús, Ceará, Brazil. Methods: experience report of a Worker’s Health project implemented by professionals from a multidisciplinary residency program. Weekly meetings were held in the institution’s auditorium, including physical exercises and health education, lasting 15 to 20 minutes. Results: the 24 meetings revealed the need for attention to workers' mental, physical, and social health. The project strengthened the public health perspective of collective health residents toward local Public Policies for Workers’ Health. Conclusion: continuity of the project by future residency cohorts is essential to sustain this space for health promotion and professional learning.
Objective: to analyze the strategies developed by the Municipal Environmental Agency of Sobral/CE together with the Working Group in relation to environmental health actions for certification of the Green Municipality Seal Program – PSMV. Methods: a case study was conducted in the municipality of Sobral, Ceará, more specifically the participation of the municipality in the last certification of the Green Municipality Seal, carried out by the Secretariat of the Environment of the State of Ceará. The choice of Sobral is justified because this municipality has participated in the Green Municipality Seal Program (PSMV) since its first edition in 2004. A documentary research with a qualitative approach was conducted to understand the local reality. Results: It was possible to observe that the themes of the implemented projects focused on environmental health stood out. It is worth noting that the projects are developed by the environmental area in partnership with the health department. Final considerations: Thus, the program is an environmental management tool that seeks to educate the population about sustainability and environmental health, since it is focused on citizenship education. And its indicators encourage managers, through their initiatives, to promote improvements in environmental quality in various educational health care scenarios.
EVALUATION OF THE FLU SYNDROME SENTINEL SYSTEM IN FORTALEZA – CE
Objective: Evaluating the Influenza Syndrome Surveillance System in the Fortaleza city – Ceará state, from 2021 to 2023. Method: Epidemiological study on the Influenza Syndrome Sentinel Surveillance System based on a descriptive study with a retrospective approach considering the CDC guidelines for assessing data quality and representativeness. Results: Data analysis showed variations in sample collection in sentinel units, with unsatisfactory performance and a drop in targets from 2022 onwards. Data quality and consistency were classified ‘Excellent’. Fortaleza obtained a satisfactory classification in terms of the proportion of sentinel units. Teams must be continuously trained to ensure quality in respiratory virus surveillance. Conclusion: Sentinel surveillance is essential for monitoring respiratory diseases and identifying circulating viruses, and its success depends on improving data quality and the representativeness of sentinel units.
CONTRIBUTIONS OF TUTORING TO THE TRAINING OF NURSING UNDERGRADUATES
Objective: To identify, in the literature, the contributions of academic tutoring to the academic and professional training of nursing undergraduates in Brazil. Methods: Integrative literature review, with searches conducted in the Virtual Health Library (VHL) using the descriptors “monitoring,” “nursing,” and “teaching,” combined with the Boolean operator AND. A total of 21 articles were selected after applying inclusion and exclusion criteria. Results: The findings showed that tutoring promotes the development of competencies such as communication, leadership, critical thinking, empathy, and autonomy, in addition to supporting teaching initiation and theoretical deepening. Difficulties were also identified, including schedule incompatibility, activity overload, insecurity, and low student participation. Conclusion: Tutoring represents an important formative activity, especially for integrating teaching, research, and community outreach. It should be understood as a shared responsibility among students, faculty, and educational institutions. When well-structured, it strengthens the comprehensive training of nurses and contributes to a critical and transformative professional practice.
ANALYSIS OF CONGENITAL SYPHILIS CASES IN CRATEÚS FROM 2014 TO 2023
Objective: To analyze the epidemiological profile of CS cases in the municipality of Crateús (CE) between 2014 and 2023, highlighting important scenarios and variables regarding the topic addressed and defining forms of prevention based on health care programs. Methods: Cross-sectional epidemiological research carried out in September 2024, using data from SINAN/DATASUS. Eight health and sociodemographic variables were analyzed, including number of new cases, prenatal care, age group, and maternal education, with support from sources such as PubMed, SciElo, and Google Scholar. Results: It was found that the year with the highest rate of confirmed cases was 2022. In addition, the brown race was the most prevalent among cases. Final considerations: The pattern of confirmed cases suggests that recent interventions, potentially driven by public health policies and awareness campaigns, may be beginning to have an effect.
Objective: This study aimed to describe the strengthening of the deinstitutionalization of collective mental health care through Physical Education interventions at the Psychosocial Care Centers in Uruguaiana (southern Brazil). Methods: Throughout public spaces (e.g., squares and parks), body practices were employed as therapeutic strategies from March 2022 to February 2023, within the context of the Integrated Residency Program in Collective Mental Health at the Federal University of Pampa. These actions were intended to promote users’ social inclusion and disrupt the institutionalized logic of care. Results: The interventions created new meanings for care in freedom, consistent with the principles of the Psychosocial Care Network and the anti-asylum model, thereby contributing to the strengthening of social bonds, community belonging, and the confrontation of social stigma. Conclusions: This experience underscores the role of Physical Education in promoting collective mental health and expanding community-based care strategies beyond institutional confines.
HOSPITAL MICROBIOLOGICAL PROFILE BEFORE AND DURING COVID-19
Objective: To compare the microbiological profile of cultures from patients hospitalized in a private hospital in Fortaleza, CE, before (2018/19) and during the COVID-19 pandemic (2020/21). Methods: Descriptive and analytical cross-sectional study using secondary data from an antimicrobial stewardship program. Patients aged over 18 years with cultures collected during the study period were included, excluding one case with incomplete data. Data were tabulated in Excel and analyzed using StataSE. Results: There was a predominance of male patients aged 19 to 59 years. The microbiological profile showed a reduction in the number of positive cultures, an increase in the number of isolated fungal and an increase antimicrobial resistance during the pandemic. Carbapenem-resistant Acinetobacter baumannii isolates increased from 50.88% to 79.83%, and Klebsiella pneumoniae from 29.09% to 54.64%. Conclusion: The COVID-19 pandemic contributed to an increase in antimicrobial resistance, highlighting the need to intensify microbiological surveillance.
REPERCUSSIONS OF SCREEN USE ON MENTAL HEALTH IN EARLY CHILDHOOD
This study aimed to identify the repercussions of excessive screen time on the mental health of children in early childhood. This is an integrative review that selected articles from the Medline, Lilacs, BDENF and SciELO databases. The terms “child”, “screen time” and “mental health” were used as descriptors registered in the Health Sciences Descriptors (DeCS) database, and were associated by the Boolean operator AND. After applying the eligibility criteria for the study, a sample of 12 original articles was obtained, which focused mainly on the study of the complications of excessive screen time on neurodevelopmental delay, worsening of pre-existing disorders or the emergence of symptoms of mental distress in children. This demonstrated the existence of close relationships between excessive screen time and mental health problems in the first years of life.
ANALYSIS OF THE THERAPEUTIC FLOW OF PREGNANT WOMEN IN HIGH-RISK PRENATAL CARE
Objective: To investigate the challenges and potential of the therapeutic itinerary for pregnant women in high-risk prenatal care. Method: An integrative literature review was conducted between March and April 2025, including studies in Portuguese, English, and Spanish published between 2020 and 2025 in the SciELO, SCOPUS, and PubMed databases. Results and discussion: 728 articles were identified; after selection criteria, 13 comprised the final sample. The analysis revealed potential and challenges in the care of high-risk pregnant women, highlighting the fragmentation of the Health Care Network (HCN), the lack of integration between care levels, and the impacts of social inequalities, conditioning and determining factors in health on maternal and child care. Final considerations: The need for restructuring the therapeutic itinerary of the mother-child dyad is evident, with the strengthening of the HCN to ensure comprehensive, equitable, and humanized care.
EVALUATION OF THE ASSOCIATION OF COAGULANTS POLYALUMINUM CHLORIDE (PAC) AND MORINGA IN WATER TREATMENT
Objective: This study aims to evaluate the efficiency of the combination of PAC and Moringa Oleifera Lam coagulants in removing apparent color and turbidity from water, in order to obtain ideal operating conditions for the coagulation/flocculation and sedimentation process. Method: Two stages were performed, each stage having five tests, with analysis of the pH, turbidity, color and alkalinity parameters, performed in the Jar Test. The time and gradient of rapid mixing were, respectively, 60 seconds with a speed of 299 rpm. Slow mixing was divided into two 10-minute periods, with a decreasing gradient of 60 and 50 rpm. After the coagulation and flocculation process, the samples were left to rest for 2 hours so that the particles could sediment. During sedimentation, samples were collected from each jar, with a volume of 20 ml, at the following time intervals: 0, 10, 20, 30, 45, 60, 90 and 120 min. In the analysis of the color and turbidity parameters, there were also two stages. In the first stage, the coagulant aid, Moringa Oleifera Lam, at concentrations of 200, 250, 300, 350 and 400 mg.L-1, was associated with 15 mg.L-1 of fixed PAC. Results: The analyses showed that the concentration of 400 mg.L-1 presented the best efficiency, with values ​​of 69% for color and 92% for turbidity. In the second stage, the test ranges of 15, 30, 45 and 60 mg.L-1 were used for PAC, and a fixed concentration of Moringa Oleifera Lam of 400 mg.L-1. The tests demonstrated the greatest efficiency in the second stage, with the increase in the PAC dosage. Conclusion: Therefore, the tests carried out in Jar Test can be considered of great value, since they will guide the procedures applicable on a real scale.
HEALTH CARE FOR THE LGBTQIAPN+ POPULATION IN PHC
The objective is to map scientific evidence presenting recommendations for comprehensive care of the LGBTQIAPN+ population in Atenção Primária à Saúde (Primary Health Care - APS), based on a scoping review developed according to the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol, registered in the Open Science Framework. The search was conducted across five databases, yielding 543 results, of which 529 were screened. In the end, 19 publications were included in the review. The findings revealed weaknesses in the care provided to sexual and gender minorities, highlighting the harmful impact of stigma within health services. Respect for chosen names, gender-affirmative actions, attention to the specific needs of each group, and multidisciplinary support were among the necessary changes identified by the studies. The results demonstrated that effective transformations in health practices can enable comprehensive care for this population.
Introduction: The flow of care within drug allergies has been an enlightening process when the intention is to promote better quality in the diagnosis of pediatric patients. The Center for the Study of Medication and Food Allergy (CEAMA) has been in partnership for some time now with its theoretical expertise in information on the area of pharmacodermias and their insertion into practice, in collaboration with the Albert Sabin Children's Hospital (HIAS) and the Immunoallergology Outpatient Clinic becomes essential in the daily lives of professionals who work in this environment. Objectives: describe a flowchart of care for suspected pharmacodermias in inpatients and outpatients at the HIAS. Methods: The observational study had three phases from April to December 2023: 1) Meeting to prepare the questionnaire. 2) Distribution of the questionnaire via email to physicians after ethical approval. 3) Preparation of the service flow to optimize the service. Results: 144 emails were sent, with 38 responses received. With the data collected, a flowchart for implementation was created. Conclusion: The creation of the service flow can benefit patients and serve as a reference for other institutions, improving the quality of medical care.
Objective: To understand the perceptions of community health workers regarding training in early childhood development. Methodology: This is a qualitative study conducted in four Primary Health Care Units in Fortaleza, Ceará. Nineteen community health workers (CHWs) participated through non-directive interviews, and the qualitative data were processed using the Hermeneutic Circle approach. Results: The CHWs emphasized the importance of re-signifying theory through practice and noted that the training was highly exhausting due to the large number of activities required within a short timeframe. Personal changes were reported, particularly in how CHWs began to adopt a broader perspective on caring for their own children and other children within their family and work environments. Conclusion: The findings highlight the need for public policies focused on early childhood development training for Primary Health Care professionals, aiming to consolidate new knowledge and practices in child health care.
EXPERIENCE IN THE HEALTH ACADEMY PROGRAM FOR OLDER ADULTS
Objective: To describe, by means of an experience report, the benefits of physical activity observed among participants of health promotion, prevention, and maintenance groups. Methods: Experience report study based on participant observation in two phases: (1) observation and intervention with the group and (2) correlation with bibliographic references on the topic. The group comprised approximately 12 individuals. Results: Identified difficulties included competitive behavior among some younger, more active participants and an inadequate supply of materials for activities. However, benefits were also observed, including improvements in gait, balance, flexibility, and mental health. Final Considerations: The Health Academy Program contributes to the well-being of the local population by providing a space for social integration and offering activities that help prevent and control chronic diseases.
CHILDREN'S THERAPEUTIC GROUP AND MEDIATION OF EMOTIONS IN CHILDHOOD
Childhood, as a phase of emotional development, finds in the therapeutic group an essential tool for strengthening social relationships and learning through play. This study aimed to present the experience of observing the work of psychology in a children's therapeutic group, through an experience report. The results addressed the interactions between the children, highlighting the importance of the group in forming bonds and emotional strengthening. In the discussion, aligned with development theories, issues related to childhood, emotions, violence and experiences lived in a group were articulated. The article highlighted the role of play and the role of psychology in mediating the dynamics, presenting the group as a powerful strategy of expression. The relevance of the text lies in the discussions about the need for therapeutic groups in childhood, considering them spaces for expression and subversion of culturally violent patterns.
CARE STRATEGIES FOR RESISTANT ARTERIAL HYPERTENSION
Objective: To analyze expanded strategies for promoting cardiovascular health and their impact on the quality of life of adults with resistant hypertension. Methodology: This integrative literature review was conducted from January to March 2025, covering studies in Portuguese, English, and Spanish published between 2020 and 2025 in the SciELO, SCOPUS, and PubMed databases. Results and discussion: Fourteen studies were included in the final sample, highlighting the importance of comprehensive approaches, such as health literacy, motivational interviewing, integrative practices, and community actions. Thus, the analyzed interventions highlighted the importance of these tools for therapeutic adherence and promoting the quality of life of patients with resistant hypertension. Final considerations: Educational, integrative, and community strategies were identified as essential in the management of resistant hypertension, given their potential to address the complexities associated with this condition.
Objective: This study aimed to evaluate the profile of users admitted to the CAPS I of Horizonte-CE during the COVID-19 pandemic, in 2020 and 2021. Methods: A quantitative, documentary, and cross-sectional descriptive study was conducted with a sample of 759 medical records, considering biosociodemographic and clinical aspects. Results: Most users were unemployed women aged between 30 and 59 years, with incomplete primary education, and primarily referred by local UBS. Clinically, most users did not have a defined diagnosis or identified psychiatric comorbidities, took antidepressants, and attended more medical consultations than with other professionals. Additionally, high treatment dropout rates and lack of participation in group activities were also observed. Conclusions: The findings suggest differences compared to the literature and underscore the need for greater investment in mental health services and more comprehensive studies in the municipality.
INDICATORS OF THE UAPI PROGRAM TO STRENGTHEN CHILDCARE
Objective: To analyze the indicators of the UAPI Program at a Basic Health Unit in the municipality of Aracati, Ceará. Methods: This descriptive, exploratory, and documentary study was conducted at a Basic Health Unit in a rural area of the municipality of Aracati, Ceará, with parents or guardians of children aged six months to under one year old undergoing childcare follow-up. Results: Twenty-nine parents or guardians of children participated in the study and were assessed on eight UAPI Program indicators. The study highlighted the need for a close and continuous focus on child health. Final considerations: The UAPI Program presents a positive strategy for evaluating units, developing strategic health planning, and promoting better monitoring of children in primary care.
HOSPITALIZATIONS FOR DIABETIC FOOT COMPLICATIONS IN CEARÁ
To analyze hospitalizations and costs due to diabetic foot complications in the state of Ceará between 2020 and 2024. Ecological, quantitative study, with secondary data extracted from hospital information system. Hospitalizations, length of stay, mortality, and costs were analyzed, according to health regions. During the analyzed period, 7,764 hospitalizations were recorded, an increase of 44%. The Fortaleza region concentrated the highest number (3,886). The average length of stay was higher in this region (10 days). The highest mortality rate occurred in the Cariri region (3.27). Total costs increased by 71%, reaching R$ 1,066,662.84 in 2024. Hospitalizations due to diabetic foot complications in Ceará have been increasing, generating a high clinical and economic impact. Primary Health Care must strengthen preventive actions and early care, contributing to the reduction of complications, hospitalizations and costs in the Single health system.
Mirna Neyara Alexandre de Sá Barreto Marinho
EPIDEMIOLOGY OF HIV/AIDS CASES IN CEARÁ IN THE LAST 10 YEARS
Objetivo: Identificar o perfil epidemiológico dos casos de HIV/AIDS no estado do Ceará nos últimos 10 anos, utilizando o sistema de informações de saúde Departamento de Informática do Sistema Único de Saúde (DATASUS). Métodos: Estudo documental, com abordagem quantitativa. Os dados foram coletados eletronicamente, por meio do DATASUS, durante o mês de agosto de 2024, incluindo SINAN e SIH/SUS, analisando variáveis como sexo, cor/raça e faixa etária, além de cálculos de incidência de 2014 a 2023 com dados do IBGE. Resultados: Foram registrados 12.231 casos de HIV/AIDS, com predominância masculina e maior incidência na faixa etária de 40-49 anos. A cor/raça parda teve a maior porcentagem de casos, com 18.356 internações e 1.899 óbitos. Considerações finais: A epidemia de HIV/AIDS é uma preocupação de saúde pública no Ceará, evidenciando disparidades entre grupos sociais, sendo fundamental desenvolver políticas de acesso à saúde.
To describe the process of implementing telemonitoring as a tool to qualify home visits in a Primary Health Care Unit in Fortaleza, Ceará. A survey of clinical and epidemiological data was carried out on patients monitored during home visits, with subsequent analysis of the data discussed by the team, defining patients eligible for telemonitoring. A profile was identified in which the majority of patients are female and 74.5% of the total are over 70 years old. In addition, the majority only have limited mobility, do not use disposable diapers and do not require monitoring by specialized teams. After the survey, it was possible to apply a risk and vulnerability scale and implement telemonitoring, resulting in insulin dose adjustment, identification of respiratory symptoms and improvement in schedule management. It was possible to raise important questions and report the simple and quick use of telemedicine in favor of quality and planning of home care.
TRAINING OF PREGNANT WOMEN WITH DIABETES MELLITUS USING A LOW-COST SIMULATOR
Objective: This study assessed the use of a low-cost simulator to train pregnant women with diabetes mellitus in insulin administration, evaluating its effectiveness in improving knowledge and autonomy. Methods: A mixed-method experimental study was conducted with 50 pregnant women hospitalized for glycemic control. Questionnaires were applied before and after the training, alongside an informational leaflet. Results: After training, 98% of participants identified insulin types and appropriate actions during hypoglycemia. Average correct answers increased from 54% to 82%. Fear was significantly reduced, with 94% reporting they had overcome their fears, and 100% felt capable of self-administering insulin. Conclusion: The low-cost simulator proved to be an effective and accessible tool for educating diabetic pregnant women, enhancing their confidence, knowledge, and self-care skills. This strategy contributed to better glycemic control and potentially improved maternal-fetal outcomes, supporting the systematic implementation of similar educational interventions in obstetric care settings.
MEANINGS OF LIFE AND DEATH AMONG CARDIAC PATIENTS AND THEIR CAREGIVERS
This article is part of a master's research developed in the Graduate Program in Psychology at a federal public university located in the interior of the state of Mato Grosso do Sul, with the aim of understanding the meanings of life and death among both individuals affected by heart diseases and their caregivers. As a preliminary investigation procedure, an integrative review was conducted to understand the state of the art on the topic using the databases Virtual Health Library, Google Scholar, CAPES Journal Portal, and PubMed, focusing on Portuguese-language and open access works. Out of a total of 4,178 publications found, 23 articles were selected after reading the titles and abstracts. From these, a final sample of 18 manuscripts was obtained. The research findings highlighted the fundamental role of emotions in coronary disease. In conclusion, the importance of the integrative review is emphasized both for understanding Brazilian academic production on chronic diseases and as an important tool for detecting possible gaps to be addressed in future research. It is believed that such reflections can contribute not only to the field of health psychology but also to the field of studies and research on chronicity and care practices.