Showing papers in "Cadernos De Saude Publica in 2007"
TL;DR: A theoretical and conceptual management methodology based on reference teams and matrix support is discussed, which aims to build new knowledge for each health professional through a continuing education process.
Abstract: The authors discuss a theoretical and conceptual management methodology based on reference teams and matrix support. Reference team is a structural organization intended to combine managerial power and interdisciplinary work. Matrix support changes the way traditional health systems work, with specialists organically linked to other teams who periodically require specialized consultation. Besides care support, there is another goal: to build new knowledge for each health professional through a continuing education process. The article analyzes the structural, political, cultural, theoretical, and subjective obstacles to this new model.
542 citations
TL;DR: There is a need to go beyond the identification of broad strategies to the design and evaluation of specific policy measures only through experimentation and evaluation to learn what works in raising health care utilization, particularly among the poor in the developing world.
Abstract: Effective health care interventions are underutilized in the developing world, and income-related disparities in use are large. The evidence concerning this access problem is summarized and its demand side causes are identified. Broad strategies that have been proposed to tackle the access problem through changes in economic incentives are considered. It is argued that there is a need to go beyond the identification of broad strategies to the design and evaluation of specific policy measures. Only through experimentation and evaluation will we learn what works in raising health care utilization, particularly among the poor in the developing world.
518 citations
466 citations
TL;DR: The social imagination by which men are viewed as invulnerable leads them to take less care of their own health and expose themselves to greater risk.
Abstract: O estudo tem como objetivo analisar as explicacoes presentes em discursos masculinos para a pouca procura dos homens por servicos de saude. O metodo do estudo baseia-se numa abordagem de pesquisa qualitativa. A representacao do cuidar como tarefa feminina, as questoes relacionadas ao trabalho, a dificuldade de acesso aos servicos e a falta de unidades especificamente voltadas para a saude do homem sao os principais motivos expressos pelos sujeitos para a pouca procura pelos servicos de saude. Conclui-se, dentre outros aspectos, que o imaginario social que ve o homem como ser invulneravel acaba contribuindo para que ele menos se cuide e mais se exponha a situacoes de risco.
363 citations
TL;DR: The main focus of this study was the effect of chronic disease on the functional status (activities of daily living - ADL, instrumental activities of dailyLiving - IADL) among the elderly, controlling for age, gender, living arrangements, education, and comorbidity.
Abstract: The main focus of this study was the effect of chronic disease (hypertension, diabetes mellitus, heart disease, lung disease, cancer, and arthropathy) on the functional status (activities of daily living - ADL, instrumental activities of daily living - IADL) among the elderly, controlling for age, gender, living arrangements, education, and comorbidity. The analysis was based on information provided by the SABE Project, from the city of Sao Paulo, Brazil, including individuals 60 years of age and over (n = 1,769), from January 2000 to March 2001. A multinomial logistic regression model was used. Compared to the absence of dependency category, heart disease (OR = 1.82), arthropathy (OR = 1.59), lung disease (OR = 1.50), and hypertension (OR = 1.39) were the main diseases that affected the IADL dependency category. Lung disease (OR = 2.58), arthropathy (OR = 2.27), hypertension (OR = 2.13), and heart disease (OR = 2.10) had important impact on the IADL and ADL dependency categories. The results were statistically significant (p < 0.05).
289 citations
TL;DR: EPDS was valid only for prevalence of postpartum depression in the 20-25% range, with 60% PPV for the > 13 cutoff point (59.5% sensitivity; 88.4% specificity); the specificities and PPVs for all cutoff points were below those reported by other authors.
Abstract: The aim of this study was to evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening and diagnosis of postpartum depression. Three months after delivery, EPDS was administered to 378 mothers from the 2004 Pelotas Birth Cohort Study, Rio Grande do Sul State, Brazil. Up to 15 days later, mothers were re-interviewed by mental health care professionals using a semi-structured interview based on ICD-10 (gold standard). We calculated the sensitivity and specificity of each cutoff point, and values were plotted as a receiver operator characteristic curve. The best cutoff point for screening postpartum depression was > 10, with 82.6% (75.3-89.9%) sensitivity and 65.4% (59.8-71.1%) specificity. For screening moderate and severe cases, the best cutoff point was > 11, with 83.8% (73.4-91.3%) sensitivity and 74.7% (69.4-79.5%) specificity. For diagnosis, EPDS was valid only for prevalence of postpartum depression in the 20-25% range, with 60% PPV for the > 13 cutoff point (59.5% sensitivity; 88.4% specificity). The specificities and PPVs for all cutoff points were below those reported by other authors. Small numbers and the calculation of PPV in samples with overrepresentation of cases in the majority of studies appear to account for these differences.
234 citations
TL;DR: The data suggest that children exposed to either F or As have increased risks of reduced IQ scores, and a significant association was observed between As in urine and Full IQ scores.
Abstract: Recent evidence suggests that fluoride (F) and arsenic (As) may adversely affect intelligence quotient (IQ) scores. We explore the association between exposure to F and As in drinking water and intelligence in children. Three rural communities in Mexico with contrasting levels of F and As in drinking water were studied: Moctezuma (F 0.8+/-1.4 mg/L; As 5.8+/-1.3 microg/L); Salitral (F 5.3+/-0.9 mg/L; As 169+/-0.9 microg/L) and 5 de Febrero (F 9.4+/-0.9 mg/L; As 194+/-1.3 microg/L). The final study sample consisted of 132 children from 6 to 10 years old. After controlling for confounders, an inverse association was observed between F in urine and Performance, Verbal, and Full IQ scores (beta values = -13, -15.6, -16.9, respectively). Similar results were observed for F in drinking water (beta values = -6.7, -11.2, -10.2, respectively) and As in drinking water (beta values= -4.30, -6.40, -6.15, respectively). The p-values for all cases were < 0.001. A significant association was observed between As in urine and Full IQ scores (beta = -5.72, p = 0.003). These data suggest that children exposed to either F or As have increased risks of reduced IQ scores.
179 citations
TL;DR: The study provides importance references for public policies to prevent teenage pregnancy and identifies socio-demographic behavioral profile of low-income pregnant teenagers associated with various economic, educational, and behavioral factors.
Abstract: To identify the socio-demographic behavioral profile of low-income pregnant teenagers, 1,000 adolescents admitted to a Brazilian public maternity hospital from July 24, 2001, to November 27, 2002, were interviewed. Socio-demographic and behavioral variables were assessed through a questionnaire. Over the 492 days of the study, 24.3% of admissions were adolescents (930 for childbirth and 70 for miscarriage). Mean maternal age was 17 years. Most teenagers (72.9%) lived near the hospital. 930 (93%) belonged to socioeconomic classes C, D, and E. School dropout was identified in 67.3% of the total. 80.1% of the subjects were giving birth for the first time. 81.2% had not planned the pregnancy, and 23.8% had been using some contraceptive method. 67.4% had vaginal deliveries. Some 13.3% of the newborns were premature and 15.9% had low birth weight. 17.3% of these adolescent mothers reported smoking during pregnancy, with 2.8% reporting alcohol and 1.7% illicit drugs. Teenage pregnancy is a complex phenomenon associated with various economic, educational, and behavioral factors. The study provides importance references for public policies to prevent teenage pregnancy.
165 citations
TL;DR: It was showed that improvements in SINASC data quality could make this system a good epidemiological source for identifying risk factors and socioeconomic conditioning factors and improve the quality of data on previous children and maternal occupation.
Abstract: This study evaluates the quality of data in the Brazilian Live Births Information System (SINASC), focusing on the methodological clarity of documentation and adequate data completeness and consistency at the national, regional, and State levels in 2002. The variables analyzed were: skin color/race of newborn, maternal schooling, maternal marital status, maternal occupation, maternal age, prenatal visits, live births, stillbirths, and birth weight. For most of the variables, SINASC shows good data completeness and consistency, but there were serious problems with the quality of data on previous children and maternal occupation. Related to race, there were some methodological problems in the definition and incomplete filling-in for the Federal District (Brasilia) and the States of Sao Paulo, Bahia, and Sergipe. Statistical analysis confirmed a significant association between data completeness and indicators of poverty and inequality. The study showed that improvements in SINASC data quality could make this system a good epidemiological source for identifying risk factors and socioeconomic conditioning factors.
165 citations
TL;DR: The article discusses the contribution by various authors to the discussion forum on Human Aging and the National Household Sample Surveys, featuring studies on access to and utilization of health services by the elderly, the epidemiological pattern of breast cancer in elderly women, and the validity of using proxy respondents in research on self-perceived health status.
Abstract: This article examines the new demographic and epidemiological reality in Brazil, based on data collected and organized in the Health Supplement of the National Household Sample Survey (PNAD-Health). It highlights the urgency of changes and innovations in health care paradigms for the elderly population with a preventive approach based on comprehensive education and care. As key concepts, the article emphasizes the need to preserve autonomy, participation, care, self-satisfaction, and the possibility of elder citizens being active in various social contexts. It also discusses the contribution by various authors to the discussion forum on Human Aging and the National Household Sample Surveys, coordinated by Cadernos de Saude Publica/Reports in Public Health, featuring studies on access to and utilization of health services by the elderly, the epidemiological pattern of breast cancer in elderly women, and the validity of using proxy respondents in research on self-perceived health status, concluding that the PNAD data are consistent and can be used by the scientific community.
158 citations
TL;DR: The authors discusses the underlying theoretical and operational premises in the fields of workers' health and occupational health, highlighting their respective frameworks and epistemological differences, based on Foucaultian archeology.
Abstract: This article discusses the underlying theoretical and operational premises in the fields of workers' health and occupational health, highlighting their respective frameworks and epistemological differences, based on Foucaultian archeology. The theme is particularly relevant, due to: the apparently limited attention to interdisciplinary research approaches in workers' health; various setbacks in public health measures at the social policy level; related weaknesses in the Brazilian trade union movement; and the conceptual misinterpretations drafted into the final report of the 3rd National Workers' Health Conference in November, 2005, convened by the Ministries of Social Security, Health, and Labor. The event resulted from the Workers' Health Conferences held in various States and Municipalities, mobilizing some 100,000 activists throughout Brazil and electing the delegates to the 3rd National Conference.
TL;DR: Individuals who attended public dental care services and those with more time elapsed since their last dental appointment showed a higher prevalence of tooth loss than their counterparts after controlling for demographic and socioeconomic factors.
Abstract: O objetivo deste estudo foi estimar a prevalencia de perdas dentarias em adultos de 35 a 44 anos de idade. Alem disso, foram testadas associacoes entre as perdas dentarias e condicoes demograficas, socio-economicas e com utilizacao de servicos odontologicos. Foram analisados os dados de 13.431 participantes do estudo epidemiologico nacional de saude bucal realizado em 2002-2003. O numero de perdas dentarias (£ 12 e > 12) foi o desfecho investigado. As variaveis independentes incluiram localizacao geografica, genero, cor da pele, idade, renda per capita, escolaridade, tempo decorrido desde a ultima consulta odontologica e tipo de servico utilizado. Foram estimadas as razoes de prevalencia bruta e ajustada atraves de regressao de Poisson. Edentulismo atingiu 9% da amostra; a mediana de dentes perdidos foi igual a 11. Perdas dentarias foram fortemente associadas com individuos residentes em zona rural, com as mulheres, com os mais pobres, com os de menor escolaridade e com aqueles de idade mais avancada. Usuarios do servico publico e aqueles que consultaram dentista ha mais tempo tambem apresentaram maior prevalencia do agravo mesmo apos o ajuste por variaveis socio-economicas e demograficas.
TL;DR: The article analyzes practices, the discrepancies between guidelines and practice, obstacles and advances in the operationalization of activities, and limits to the comparison and potentialities for cross-cutting application of particular epistemological fields like expanded clinical mental health practice and the FHP.
Abstract: In many psychiatric reforms based on the principles of deinstitutionalization of psychiatric patients and the consolidation of territorial systems for mental health care, the emphasis is on a mental health care system that includes the primary care network. In Brazil, the Psychiatric Reform emerged within the country's overall Health Reform, with which it shares common principles for reorienting the model of care. The current article discusses the links between these two movements through actual mental health care practices within the Family Health Program (FHP), based on an ethnographic study with four family health teams, in which the authors prioritize health workers' narratives. The article analyzes these practices, the discrepancies between guidelines and practice, obstacles and advances in the operationalization of activities, and limits to the comparison and potentialities for cross-cutting application of particular epistemological fields like expanded clinical mental health practice and the FHP. The discussion is based on such concepts as the psychosocial care model, comprehensive care, social participation, territoriality, and collective actions.
TL;DR: In this paper, a study of 19 municipalities no Rio Grande do Norte, Brazil, found that a maioria of the municipalities apresentou pouco ou nenhum avanco no modelo assistencial em saude bucal.
Abstract: O objetivo deste estudo foi avaliar a incorporacao da saude bucal no Programa Saude da Familia no Rio Grande do Norte, com base na analise de fatores capazes de interferir no processo de mudanca dos modelos assistenciais em saude bucal. Esta avaliacao tomou como referencia tres dimensoes: o acesso, a organizacao do trabalho e as estrategias de programacao. Foram sorteados 19 municipios no estado. Os instrumentos de coleta foram a entrevista estruturada aplicada a gestores e dentistas, a observacao estruturada e a pesquisa documental. Foi possivel identificar precariedade nas relacoes de trabalho e dificuldades no referenciamento para media e alta complexidade, na intersetorialidade, no diagnostico epidemiologico e na avaliacao das acoes. A maioria dos municipios apresentou pouco ou nenhum avanco no modelo assistencial em saude bucal. Os municipios que demonstraram avancos apresentaram alta expectativa de vida ao nascer, baixas taxas de mortalidade infantil, valores per capita entre os mais altos do Estado e altos valores de IDH-M. Concluiu-se que politicas publicas que contemplam aspectos alem dos pertinentes ao setor saude sao decisivas para uma real mudanca nos modelos assistenciais.
TL;DR: Changes in the nursing work process resulting from implementation of the process referred to as "receptiveness", following introduction of the Paideia Family Health Program in health care units in Campinas, Sao Paulo, Brazil, since 2001 are described.
Abstract: This article describes changes in the nursing work process resulting from implementation of the process referred to as "receptiveness", following introduction of the Paideia Family Health Program in health care units in Campinas, Sao Paulo, Brazil, since 2001. Data were collected through participant observation and semi-structured interviews to examine the nursing work process, specifically in relation to "receptiveness". The analysis was based on two possible definitions of "receptiveness": as an attitude towards users and their needs, and as a device for reorganizing the work process. The study also analyzes "receptiveness" in relation to: organization of the work process, guarantee of accessibility, expanded demands on the health service and health team, changes in the nursing work process, humanization, and bonding.
TL;DR: Factors associated with voice-related quality of life among female teachers in the municipal school system in Belo Horizonte, Southeast Brazil were surveyed using the Voice-Related Quality of Life questionnaire.
Abstract: Voice disorders are common among teachers, with adverse consequences for their work and quality of life. This study focuses on factors associated with voice-related quality of life among female teachers in the municipal school system in Belo Horizonte, Southeast Brazil. A cross-sectional study with 2,133 female teachers was conducted, using the Voice-Related Quality of Life (VRQL) questionnaire, which has two domains: socio-emotional and physical. Teachers were grouped into quartiles based on the distribution of the final score in each domain. Those in the lowest quartile were then compared with all the others for a number of factors, using multiple logistic regression analysis. Less creativity at work and poor relationship with pupils were associated with worse voice-related quality of life in both domains. Mental disorders (GHQ12 > 4) were associated with worse voice-related quality of life in the socio-emotional domain, and intra-class noise with worse voice-related quality of life in the physical domain. Improvements in working conditions are key factors for achieving better voice-related quality of life among teachers.
TL;DR: The present article reviews some central findings: the proportional reduction in cases related to injection drug use; the stability, in recent years, of new cases in the male homosexual/bisexual population; and the relative and absolute increment in heterosexual transmission.
Abstract: The Brazilian AIDS epidemic is undergoing important changes in its third decade. The present article reviews some central findings: the proportional reduction in cases related to injection drug use; the stability, in recent years, of new cases in the male homosexual/bisexual population; and the relative and absolute increment in heterosexual transmission, even though the estimates of incident rates still point to the first two categories mentioned as those most affected by the epidemic. Still should be detached the persistent increase in incidence rates among women and its stability in the younger age groups, probably the result of behavior changes (such as the consistent use among youth of condoms in sexual relations with casual partners and a reduction in cases related to injection drug use). It is well-know that HIV prevalence in the general population has stabilized at less than 1%, which characterizes Brazil as one of the countries with a concentrated epidemic. The article also emphasizes the growth of AIDS morbidity-mortality in the less favored socioeconomic strata and in women, and the stability of the mortality rate among men.
TL;DR: The countries are quite close to achieving the goal of eliminating human rabies transmitted by dogs, and several areas within the countries reported no more transmission of rabies in dogs.
Abstract: Latin American countries made the political decision to eliminate human rabies transmitted by dogs by the year 2005. The purpose of the current study is to evaluate to what extent this goal has been reached. The epidemiological situation and control measures were analyzed and broken down within the countries by georeferencing. The 27 human cases reported in 2003 occurred in some 0.2% of the second-level geopolitical units (municipalities or counties) in the region, suggesting that the disease is a local problem. Several areas within the countries reported no more transmission of rabies in dogs. Nearly 1 million people potentially exposed to rabies received treatment. On average, 34,383 inhabitants per health post receive anti-rabies treatment (range: 4,300-148,043). Nearly 42 million dogs are vaccinated annually. Surveillance is considered fair according to the epidemiological criteria adopted by the study. Samples sent for rabies testing represent 0.05% of the estimated canine population (range: 0.001 to 0.2%). The countries are quite close to achieving the goal.
TL;DR: This estudo propoe articular o tema da nutricao no debate contemporâneo da promocao da saude, analisando o papel dos nutricionistas neste processo.
Abstract: In recent years, health promotion has been introduced as a promising strategy for the public health field. The current study is intended to link nutrition into the recent debate on health promotion, analyzing the role of nutritionists in this process. Given the complexity of the Brazilian nutritional situation due to the nutritional transition currently under way in the country, the health promotion proposal points to both new perspectives and challenges for eating and nutrition. New demands in academic training and the nutritional care model tend to foster a search for partnerships, innovation in eating practices, and nutritional education aimed at the achievement of nutritional citizenship.
TL;DR: Estes resultados permitiram that atividades preventivas e educacionais fossem desenvolvidas pela empresa, de modo a melhorar a qualidade of vida e a produtividade dos funcionarios.
Abstract: This study aimed to assess nutritional status and risk factors for chronic non-transmissible diseases in 1,252 factory employees in Santa Catarina State, Brazil. The following variables were studied: nutritional status, waist circumference, blood pressure, blood glucose levels, age, and schooling. Overweight and obesity were observed in 45% and 10% of the sample, respectively, with a significant association between nutritional status and gender, but not between nutritional status and schooling, adjusted for age. The proportion of high waist circumference was 33%, with a significant difference between genders. High systolic blood pressure (SBP) and diastolic blood pressure (DBP) were present in 18% and 11% of the employees, respectively, with a significant association between genders after adjusting for age. Type II diabetes mellitus was diagnosed in 2% of the sample and altered glucose levels in 4%. After adjusting for age, the only variables significantly associated with waist circumference were SBP and DPB. The results allowed the implementation of preventive and educational activities to improve employees' quality of life and productivity.
TL;DR: Despite the poverty in Latin America and various problems related to inequities and globalization, Chagas disease has been controlled in several areas, a fact that reinforces the countries' self-reliance as discussed by the authors.
Abstract: Chagas disease (American trypanosomiasis) bears a close relationship to multiple social and political aspects involving issues of globalization and inequity. Such relations concern the process of disease production and control in parallel with medical management. Despite the poverty in Latin America and various problems related to inequities and globalization, Chagas disease has been controlled in several areas, a fact that reinforces the countries' self-reliance. Several problems and challenges related to the disease can be expected in the future, mainly concerning medical care for already infected individuals and the sustainability of effective epidemiological surveillance. Both points depend heavily on improved performance by the national health systems, principally in terms of their efficiency and their capacity to overcome inequity. A particularly important role has been attributed to the Latin American scientific and academic community in the implementation and sustainability of efficient control policies. Control activities have now evolved towards internationally shared initiatives, a major new stride forward in the region's political context.
TL;DR: Since the nutritional transition is still under way in Brazil, overweight had a higher impact than obesity on disease prevalence and costs, and overall percentages were similar to those from developed countries.
Abstract: This article estimates the burden of hospitalization associated with overweight and obesity in Brazil. The analysis of all hospitalizations for men and women from 20 to 60 years of age was based on the National Healthcare Expenditure Database (SIH-SUS), covering more than 70% of all hospital admissions. Data were for the year 2001. Attributable fraction of hospitalizations associated with diseases related to obesity and overweight was based on the combined risks of United States and European cohorts. The population-attributable fraction for each disease studied was multiplied by values reimbursed to the hospitals and summed to obtain total direct costs. Overall costs of overweight and obesity represent 3.02% of total hospitalization costs for men and 5.83% for women, corresponding to 6.8 and 9.3% of all hospitalization (excluding pregnancy). Diseases associated with overweight and obesity had a significant impact on hospitalizations and economic costs in Brazil, and overall percentages were similar to those from developed countries. Since the nutritional transition is still under way in Brazil, overweight had a higher impact than obesity on disease prevalence and costs.
TL;DR: The study demonstrates an association between depression and chronic comorbidity among elderly in the city of Salvador, Bahia, Brazil, and health professionals should be alert to the possibility of depressive symptoms in these patients.
Abstract: The aim of this study was to investigate the association between depression and clinical illness among a group of elderly in the city of Salvador, Bahia, Brazil. The study population included 1,120 individuals over 60 years of age treated at a geriatric outpatient clinic. Crude and stratified prevalence ratios were calculated. Data were stratified by gender, age, and nutritional status. Ninety-five percent of the sample presented at least one chronic disease, the most frequent being hypertension (62.2%), osteoarthritis (40%), and urinary incontinence (35%). Depression was diagnosed in 23.4%, more commonly among women (PR = 1.28; 95%CI: 0.99-1.65) and those under 75 years (PR = 1.24; 95%CI: 1.00-1.53). There was an association between number of chronic diseases (> 3) and depression (PR = 1.31; 95%CI: 1.04-1.66). Parkinson's disease was associated with depression, more evident among females (PR = 1.59; 95%CI: 1.05-2.41) and in the 70-79-year age group (PR = 2.02; 95%CI: 1.28-3.20). The study demonstrates an association between depression and chronic comorbidity. Since many elderly present multiple chronic diseases, health professionals should be alert to the possibility of depressive symptoms in these patients.
TL;DR: In this article, the authors analyzed socio-spatial inequalities in the adequacy of Ministry of Health data systems on live births (SINASC) and deaths (SIM) for estimating infant mortality at the municipal level in Brazil.
Abstract: This study analyzed socio-spatial inequalities in the adequacy of Ministry of Health data systems on live births (SINASC) and deaths (SIM) for estimating infant mortality at the municipal level in Brazil. Data from 2000-2002 for all municipalities were analyzed according to population size and geographic region. Five indicators were considered: age-standardized mortality rate; ratio of reported-to-estimated live births; relative mean deviation of the mortality rate; relative mean deviation of the birth rate; and proportion of deaths with undetermined causes. Adequacy criteria were established statistically for eight Brazilian States in which vital statistics were adequate. The results showed important socio-spatial inequalities: in general, the proportion of adequate vital statistics was higher in the Central-South of the country and in larger municipalities. The live birth data system received the best evaluation for three items. The mortality data system requires both a reduction in underreporting and improved data on cause of death in order to orient health programs focused on decreasing inequalities in infant mortality in Brazil.
TL;DR: While little information exists on the economic impact of dengue in the region in terms of disease burden, the estimated loss associated with the disease is on the same order of magnitude as tuberculosis, sexually transmitted diseases, Chagas disease, leishmaniasis, or intestinal helminths; therefore, similar priority should be given in the allocation of resources for d Dengue research and control.
Abstract: In the last two decades, all countries in the tropical regions of Latin America have experienced marked increases in the incidence of both classic dengue and dengue hemorrhagic fever. Major risk factors for the occurrence of dengue in the region, as well as some regional peculiarities in its clinical expression, such as the extensive involvement of older age groups, have been defined. While little information exists on the economic impact of dengue in the region in terms of disease burden, the estimated loss associated with the disease is on the same order of magnitude as tuberculosis, sexually transmitted diseases (excluding HIV/AIDS), Chagas disease, leishmaniasis, or intestinal helminths. Therefore, similar priority should be given in the allocation of resources for dengue research and control. Data on cost-efficacy and cost-benefit analysis of dengue control programs in Latin America are scarce; however, the cost per DALY averted by control programs during endemic periods appears low, as compared to other mosquito-borne diseases like yellow fever, leishmaniasis, or malaria. Additionally, the cost-benefit ratio of the control programs has proven to be positive.
TL;DR: Higher cigarette consumption by girls suggests an increase in smoking by women in the future, which highlights the need for a special focus on this area of psychoactive substances by teenagers.
Abstract: This study assesses the relationship between gender and use of psychoactive substances (alcohol, nicotine, and illicit drugs) by teenagers. In 2002, a cross-sectional study was carried out in the urban area of Pelotas, southern Brazil. Multi-stage sampling was used to obtain a sample of adolescents, 15 to 18 years of age. Subjects were interviewed using a self-applied confidential questionnaire. Smoking was more prevalent among girls, while alcohol consumption in the previous month was more common among boys. Meanwhile, the proportion of adolescents that reported drug use in the previous month was unrelated to gender. Higher cigarette consumption by girls suggests an increase in smoking by women in the future, which highlights the need for a special focus on this area.
TL;DR: In this paper, a qualitative approach and a gender-theory focus was adopted to understand men's feelings towards fatherhood during this period of their lives, and the results showed that the model that men assume as father-providers coexists with that of the man who seeks to be a new father, whose affective bond with the son or daughter begins during pregnancy, thus representing a break with traditional fatherhood.
Abstract: Pregnant and postpartum women frequently complain about the limited involvement of their partners with their children, beginning in pregnancy. The current study thus aimed to understand men's feelings towards fatherhood during this period of their lives. The research adopted a qualitative approach and a gender-theory focus. The universe included men whose children were being treated at a pediatric outpatient clinic, and data were collected through semi-structured home interviews. Subjects' testimony was analyzed using discourse analysis, the basic principle of which is to recognize the most abstract levels of the text, identified by themes organized in blocks of meaning and allowing the construction of empirical categories. Study subjects' social position towards fatherhood shows that the model that men assume as father-providers coexists with that of the man who seeks to be a "new father", whose affective bond with the son or daughter begins during pregnancy, thus representing a break with traditional fatherhood.
TL;DR: Prevalence of overweight and obesity in a group of 11-13-year-old schoolchildren in Capão da Canoa, Rio Grande do Sul State, Brazil was high, confirming the problem's magnitude and severity in Brazil.
Abstract: This cross-sectional study aimed to determine the prevalence of overweight and obesity in a group of 11-13-year-old schoolchildren in Capao da Canoa, Rio Grande do Sul State, Brazil, and to investigate the association with possible risk factors for excess body weight. The sample was stratified, proportional to the number of pupils in each school. Nutritional status was assessed by body mass index (BMI) cutoffs according to age and gender as proposed by Cole et al. (2000). Socioeconomic, demographic, genetic, and behavior variables were analyzed. 719 children from 11 schools were interviewed, of whom there were 541 (75.2%) with normal BMI, 153 (21.3%) with overweight, and 25 (3.5%) with obesity. Statistically significant associations were found with type of school, parents' nutritional status, level of physical activity, and time of sedentary behavior. Prevalence of overweight and obesity in these schoolchildren was high (24.8%), in keeping with the literature, confirming the problem's magnitude and severity in Brazil.
TL;DR: Determinar a prevalencia da dor cronica em idosos servidores municipais e caracterizar esta dor quanto ao local, intensidade, duracao, frequencia do episodio e horario preferencial podem interferir na qualidade de vida dessa populacao.
Abstract: Os objetivos deste estudo foram: determinar a prevalencia da dor cronica em idosos servidores municipais e caracterizar esta dor quanto ao local, intensidade, duracao, frequencia do episodio e horario preferencial. Estudo transversal de base populacional realizado em area urbana de Londrina, Parana, Brasil. A populacao pesquisada foi de 451 idosos servidores municipais. A coleta de dados foi realizada por entrevista domiciliar, aplicada ao idoso. Considerou-se dor cronica toda dor com duracao igual ou superior a seis meses, e idoso, todo servidor com mais de sessenta anos. Constatou-se prevalencia de dor cronica de 51,44%. Os locais de dores mais frequentes foram: regiao dorsal (21,73%) e membros inferiores (21,5%). A dor em regiao dorsal foi descrita como diaria (31,63%), continua ou com duracao entre 1 e 6 horas (19,39%), leve (50%) e sem horario preferencial (56,12%). Dor em membros inferiores foi descrita como diaria (42,27%), com duracao variavel (32,99%) ou continua (22,68%), leve (53,61%) e sem horario preferencial (48,45%). Evidenciou-se alta prevalencia de dor cronica em idosos. As caracteristicas da dor observadas podem interferir na qualidade de vida dessa populacao, impondo sofrimento desnecessario.
TL;DR: Investigation of cases initiating tuberculosis treatment in Recife, Pernambuco State, Brazil found main factors associated with negative treatment outcomes as a whole were age, HIV co-infection, illiteracy, alcoholism, and prior TB treatment.
Abstract: A cohort of cases initiating tuberculosis treatment from May 2001 to July 2003 was followed in Recife, Pernambuco State, Brazil, to investigate biological, clinical, social, lifestyle, and healthcare access factors associated with three negative tuberculosis treatment outcomes (treatment failure, dropout, and death) separately and as a group. Treatment failure was associated with treatment delay, illiteracy, and alcohol consumption. Factors associated with dropout were age, prior TB treatment, and illiteracy. Death was associated with age, treatment delay, HIV co-infection, and head of family's income. Main factors associated with negative treatment outcomes as a whole were age, HIV co-infection, illiteracy, alcoholism, and prior TB treatment. We suggest the following strategies to increase cure rates: further training of the Family Health Program personnel in TB control, awareness-raising on the need to tailor their activities to special care for cases (e.g., literacy training); targeting use of directly observed therapy for higher risk groups; establishment of a flexible referral scheme to handle technical and psychosocial problems, including alcoholism; and increased collaboration with the HIV/AIDS program.