http://repositorio.ufc.br/handle/riufc/57322 Tue, 16 Jun 2026 17:40:48 GMT 2026-06-16T17:40:48Z http://repositorio.ufc.br/handle/riufc/86196 Título: Prevalência de fadiga por compaixão e sua associação com a exposição ocupacional à violência e o risco de adoecimento psíquico entre policiais da perícia forense do Ceará Autor(es): Oliveira, Marizangela Lissandra de Abstract: Occupational exposure to violence represents a risk factor for mental illness among public safety professionals, especially in the context of forensic science. Continuous work with trauma victims can cause mental disorders, notably compassion fatigue (CF), a phenomenon composed of Burnout (BO) and Secondary Traumatic Stress (STS). This condition can be mitigated by Compassion Satisfaction (CS), which arises when the professional feels fulfilled by helping others, and is associated with self-compassion and emotional regulation. This study analyzed the prevalence of CF and its association with exposure to violence and the risk of mental illness among police officers of the Forensic Science Department of Ceará (PEFOCE). This is a cross-sectional, analytical study, a subset of the research project "Experienced Violence, Health Conditions and Illness among Civil and Military Police Officers in the State of Ceará," conducted with police officers from PEFOCE. A structured online questionnaire was used, encompassing the FC (outcome) and sociodemographic variables, work characteristics, lifestyle habits, exposure to violence, common mental disorders (CMD), suicidal ideation, and substance use disorder (SUD). Absolute and relative frequencies were obtained; the prevalence ratio (PR) was calculated to analyze the association between exposures and the outcome; multivariate analysis of factors associated with FC was performed; and Spearman's correlation test was used between the BO, ETS, and SC scales. The analysis was performed taking into account the sampling design, using SPSS 21.0 software, considering a 95% confidence interval. The results indicated a predominance of men (67.1%), Black/mixed-race individuals (56.0%), an average age of 39.4 years, religious beliefs (84.1%), and postgraduate education (66.8%). The majority worked in Fortaleza (53.5%), on shift work (88.1%), with more than six years of service (55.3%). Almost half had another job and intended to change jobs (45.3%). Despite a relatively healthy lifestyle (fruit consumption: 82%; physical activity: 79.5%), 39.8% engaged in excessive screen time during their free time. The work environment was marked by high exposure to violence (93.1%), mainly in assisting victims and their families (75.3%). The prevalence of chronic violence was 58.9%, predominantly influenced by police reports (moderate level in 55.2%). Social security showed a favorable profile (only 3% with a low level), acting as a moderating factor. There was a moderate negative correlation between BO and SC (-0.38), and a moderate positive correlation between BO and ETS (0.36). In the bivariate analysis, factors such as living with up to two people and the absence of chemical dependency were protective; while poor financial health, intention to rotate jobs, harmful use of screens, lack of mental health activities, police victimization, risk of injury/death, victim care, mental distress, and suicide risk were risk factors. In the multivariate analysis, the risk factors for CF were: attending to victims of violence (PR=1.407), harmful use of screens (PR=1.326), activities with high cognitive and psychosocial demands (PR=1.504), mental distress (PR=1.672), and intention to rotate jobs (PR=1.280). It is concluded that compassion fatigue is an important health problem among forensic experts, directly associated with occupational exposure to violence and the risk of other mental disorders. The findings reinforce the urgent need to implement institutional strategies focused on prevention, monitoring, and mental health care for this vulnerable population. Tipo: Tese Thu, 01 Jan 2026 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/86196 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/86066 Título: Prevalência e fatores associados ao autorrelato de violência interpessoal física no contexto comunitário entre escolares do 6° ao 9° ano do Ensino Fundamental no Estado do Ceará: análise da PeNSE 2019 Autor(es): Vale, Cecília Regina Sousa do Abstract: Interpersonal violence in the community context represents a significant public health concern during adolescence, with important implications for physical and mental health as well as social development. This study aimed to analyze the prevalence and factors associated with self-reported interpersonal physical aggression in the community context among students enrolled in the 6th to 9th grades of elementary school in the state of Ceará, Brazil, in 2019. This is a cross-sectional, population-based study using data from the 2019 National School Health Survey (PeNSE). The outcome was defined as self-reported physical aggression experienced in the 30 days prior to the survey, occurring in community settings (such as streets or schools) and perpetrated by individuals outside the family context. Independent variables were organized into analytical blocks grounded in a multidimensional theoretical framework, including sociodemographic characteristics, mental health indicators, lifestyle-related behaviors, social bonding variables, and access to health services. All analyses accounted for the complex sampling design of PeNSE. Prevalence estimates and bivariate analyses were initially conducted, followed by multivariable logistic regression to estimate adjusted odds ratios, adopting a 5% significance level. The prevalence of self-reported interpersonal physical aggression in the community context was 14.7%. After multivariable adjustment, the factors that remained independently associated with the outcome were male sex, frequent feelings of loneliness and hopelessness, alcohol consumption, use of other psychoactive substances, and indicators of weak social bonds. The findings highlight the coexistence of individual and contextual vulnerabilities, supporting the proposed theoretical model by demonstrating that mental health conditions, social bonds, and risk behaviors interact in explaining adolescents’ exposure to community-based violence. Interpersonal physical aggression in the community context shows substantial prevalence among schoolchildren in Ceará and is associated with multifactorial determinants, reinforcing the need for intersectoral strategies focused on health promotion, strengthening social bonds, and violence prevention in adolescence. Tipo: Tese Thu, 01 Jan 2026 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/86066 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/85578 Título: Morbimortalidade por doenças tropicais negligenciadas no Brasil, 2000-2024: padrões espaço-temporais, iniquidades e prioridades para a resposta no SUS Autor(es): Ferreira, Anderson Fuentes Abstract: Introduction: Neglected Tropical Diseases (NTDs) are sensitive markers of structural inequalities and serve as proxies for equitable human and social development: where NTDs persist, long-standing barriers to sanitation, adequate housing, education, social protection, and timely, effective health services also persist. In Brazil, their persistence reflects the territorial reproduction of poverty, segmented access to care and surveillance, and insufficient political prioritization of diseases that disproportionately affect Black, Indigenous, rural, and urbanperipheral populations. Despite their relevance, integrated evidence on the country’s NTDrelated morbidity and mortality burden remains limited. Objective: Analyse the magnitude, spatiotemporal patterns, and factors associated with NTD-related morbidity and mortality in Brazil from 2000 to 2024. Methods: Mixed-methods study combining ecological, crosssectional and longitudinal components to analyze epidemiological and operational indicators of NTD-related morbidity and mortality. We used hospitalization data (AIH/SIH-SUS), mortality data (SIM), and case data (SINAN and/or surveys). Selection included underlying and associated causes in SIM and primary and secondary diagnoses in SIH-SUS. Analyses were integratively organized into eight analytical strands: (1) national magnitude and trends in cases and deaths; (2) intersectional inequalities by sex and race/skin color; (3) burden in children (0– 11 and 0–14 years); (4) spatiotemporal persistence of leprosy clusters; (5) rurality and factors associated with risk of death; (6) mortality and in-hospital mortality due to neglected mycoses; (7) mortality, hospitalisations and in-hospital mortality due to paracoccidioidomycosis; and (8) mortality and in-hospital mortality due to ectoparasitoses. We estimated crude and age- and sex-standardized rates (direct method), trends using segmented regression (Joinpoint, Poisson model), and spatial/spatiotemporal patterns (including cluster detection using SaTScan). Associated factors were examined using multivariable modelling. As this study used secondary, de-identified data, submission to a Research Ethics Committee was not required. Results: NTDs showed a high burden in Brazil, with 583,960 cases in 2016–2020 (annual mean 116,792) and 152,894 cases in 2015; in the same periods, high cause-specific rates were observed for conditions such as snakebite envenoming (2016–2020) and Schistosoma mansoni infection (2015). Regarding mortality, 7,978 NTD deaths were recorded in 2015 and 40,857 deaths in 2016–2020 (annual mean 8,171), with Chagas disease as the primary contributor to mortality rates. Inequalities were striking: incidence rates were higher among men and Indigenous peoples, whereas mortality rates were higher among Black men. Among children (2010–2023), the burden was substantial and sensitive to the inclusion of arboviruses: with arboviruses, there were an estimated 1,644,521 cases (0–11 years) and 2,315,516 (0–14 years), with 1,890 and 2,177 deaths, respectively; without arboviruses, there were 222,048 cases (0– 11 years) and 299,024 (0–14 years), with 1,086 and 1,182 deaths, respectively. Spatiotemporal analyses identified persistent leprosy clusters (2001–2023) concentrated in the North and Northeast regions, with 795,802 new cases (adjusted rate: 17.58/100,000). Over 2000–2024, an estimated 253,774 NTD deaths occurred (0.8% of all deaths in Brazil), of which 42,463 were recorded in municipalities classified as rural, with higher risk of death among men, Indigenous peoples, and individuals with no schooling. In addition, conditions often underrepresented in NTD agendas showed relevant burden: neglected mycoses accounted for 22,320 deaths (adjusted rate 0.45/100,000) and 4,471 in-hospital deaths (0.09/100,000); for paracoccidioidomycosis, 4,904 deaths, 18,239 hospitalizations, and 1,136 in-hospital deaths were recorded; for ectoparasitoses, 2,894 deaths and 736 in-hospital deaths were recorded, with rates per 1,000,000 inhabitants. Conclusion: NTD-related morbidity and mortality in Brazil exhibit persistent spatiotemporal patterns and structural inequalities by territory, race/skin color, sex, age, and rurality, with significant variation in the context of COVID-19. These findings support territorial prioritization, strengthened surveillance–care integration, and intersectoral strategies within the Unified Health System (SUS), including a focus on childhood and increased visibility of endemic mycoses and ectoparasitoses as relevant causes of mortality and in-hospital mortality, compounded by the difficulty of accessing medium and high complexity services. This body of evidence provides epidemiological foundations for equityoriented action and the elimination of NTDs, converging with goals for human development and reduced vulnerabilities. Tipo: Tese Thu, 01 Jan 2026 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/85578 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/85576 Título: Fatores sociodemográficos e comportamentais associados à prevalência de infecção por HIV em adolescentes HSH em duas metrópoles do Brasil Autor(es): Sanhueza-Sanzana, Carlos Erasmo Abstract: Introduction: The HIV/aids epidemic among adolescent men who have sex with men (AMSM) continues to increase globally. In Brazil, between 2007 and 2024, 29,187 new HIV infections were reported among adolescents aged 15 to 19 years, of which 65% occurred in males. Despite this, the prevalence of HIV and its associated risk factors remain poorly understood in this population. Objective: To estimate the prevalence of HIV among AMSM aged 15 to 19 years in the cities of Fortaleza and São Paulo and to identify sociodemographic and sociobehavioral factors associated with HIV infection. Methods: This is a mixed-methods study. In the qualitative phase, formative research was conducted to understand adolescents’ perceptions of their vulnerability to HIV/aids and to guide the implementation of the Respondent Driven Sampling (RDS) study between December 2021 and August 2022. In the quantitative phase, 275 AMSM participated. Serological samples were collected for HIV testing. The variables analyzed included: gender identity; sexual orientation; risk behaviors; social network characteristics, socioeconomic and sociodemographic characteristics, care and access to health services, knowledge and use of combined prevention strategies such as Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP), alcohol and drug use; stigma and discrimination; and mental health. The Pearson chi-square test was used to evaluate differences in the proportions of categorical variables associated with HIV infection. Weighted Poisson regression according to social network size was performed. A systematic review and meta- analysis were also conducted to compare the prevalence found in RDS studies conducted in Brazil and other countries. Results: Discrepancies were identified across categories of gender identity and sexual orientation among AMSM, as well as the presence of intersectional stigma and discrimination in family, schools, and healthcare services. AMSM living with HIV described strategies to conceal their serostatus, as well as difficulties adhering to routine testing, and abandonment of antiretroviral therapy (ART). In addition, frequent use of geosocial networks and dating apps to seek partners was observed, associated with inconsistent condom use and limited knowledge of combined prevention methods. The overall HIV prevalence was 2.6% (95%CI: 1.1-6.1) across both cities, 6.3% (95%CI: 2.3-15.9) in Fortaleza, and 2.3% (95%CI: 0.8-6.4) in São Paulo. Among risk factors associated with HIV infection, AMSM aged 18 to 19 years had a 13.8-fold higher likelihood of infection compared to those aged 15-17 years. In addition, having had unprotected anal intercourse in the past 12 months (PR=10.6); self-identifying as bisexual (PR=9.4); and presenting moderate or severe depressive symptoms (PR=7.7) were factors strongly associated with higher likelihood of HIV infection. Conclusion: The high HIV prevalence among AMSM in both cities suggests a resurgence of the epidemic in this population and indicates the urgent need for community-based HIV testing programs, as well as for addressing factors that accelerate HIV transmission among AMSM in urban areas, and expanding the response of combined prevention strategies. Tipo: Tese Wed, 01 Jan 2025 00:00:00 GMT http://repositorio.ufc.br/handle/riufc/85576 2025-01-01T00:00:00Z