Showing papers in "Cadernos De Saude Publica in 2008"
TL;DR: In this article, the authors analyze the use of saturation sampling as a methodological concept, frequently employed in descriptions of qualitative studies in various areas of knowledge, particularly in the field of health care, and discuss and confront the following topics: definition of sampling closure by theoretical saturation, difficulties in the acceptance and operationalization of intentional samples, adequate size of the intentional sample, the significance of valuing what is repeated or the differences contained in the sample reports, inadequate uses of expressions containing the term saturation, and finally possible metaphors for understanding the concept.
Abstract: The transparency and clarity of research reports, emphasizing the data collection stage, are considered important parameters for evaluating the scientific rigor of qualitative studies. The current paper aims to analyze the use of saturation sampling as a methodological concept, frequently employed in descriptions of qualitative studies in various areas of knowledge, particularly in the field of health care. We discuss and confront the following topics: definition of sampling closure by theoretical saturation; difficulties in the acceptance and operationalization of intentional samples (with examples), adequate size of the intentional sample, the significance of valuing what is repeated or the differences contained in the sample reports, inadequate uses of expressions containing the term saturation, and finally possible metaphors for understanding the concept.
1,146 citations
TL;DR: In this article, an adaptacao transcultural for o portugues da Escala de Katz de independencia em atividades da vida diaria, completamente desenvolvida e testada, provou ser equivalente a original in ingles.
Abstract: Desenvolvimento e analise do desempenho de uma adaptacao transcultural para o portugues da Escala de Katz de independencia em atividades da vida diaria. Duas traducoes e duas retrotraducoes analisaram as equivalencias conceitual, de itens e semântica para a escolha da versao final. A equivalencia operacional foi avaliada em um estudo piloto, testando-se a confiabilidade e a consistencia interna da versao adaptada por meio de reteste no mesmo dia em 156 pacientes ou apos sete dias da primeira entrevista. A resolucao de diferencas sutis em alguns itens levou a equivalencia cultural. A versao final foi considerada facil de se entender e de aplicar. A concordância corrigida para o acaso (kappa ponderado) foi de 0,91. O alfa de Chronbach variou de 0,80 a 0,92. A versao em portugues da Escala de Katz de independencia em atividades da vida diaria, completamente desenvolvida e testada, provou ser equivalente a original em ingles. Os itens apresentaram consistencia interna e as taxa foram confiaveis.
370 citations
TL;DR: The objective of the present study was to validate the Brazilian version of SRQ-20 and the 5 items for alcohol-related disorders as compared to the SCID-IV-TR (Structured Clinical Interview for DSM- IV-TR) as the gold standard.
Abstract: The SRQ (Self-Reporting Questionnaire) is a psychiatric screening tool that originally included 30 questions. The Brazilian version of SRQ-20 (a version that includes the 20 items for non-psychotic mental disorders) was validated in the early 1980s. The objective of the present study was to validate the Brazilian version of SRQ-20 and the 5 items for alcohol-related disorders as compared to the SCID-IV-TR (Structured Clinical Interview for DSM-IV-TR) as the gold standard. The study was conducted in Santa Cruz do Sul, a small town in southern Brazil, with 485 subjects (54.8% females, mean age 40.04 years). The 5 items for alcohol-related disorders showed low sensitivity (66%). The optimum cutoff value for SRQ-20 was 7/8, with 86.33% sensitivity and 89.31% specificity. The discriminant power of SRQ-20 for psychiatric screening was 0.9, and Cronbach's alpha was 0.86.
339 citations
TL;DR: In this paper, a revisao re-evaluation of the influence of determinants demografico-biologic (idade, sex, socio-economic, and socio-culturais) on atividade fisica de adolescentes is presented.
Abstract: A atividade fisica e um comportamento importante na promocao de saude e na prevencao de doencas. Para que se desenvolvam programas eficazes no incentivo a pratica de atividade fisica em adolescentes, torna-se necessario que se identifiquem os fatores que a determinam. Este estudo pretende rever alguns dos aspectos do estado atual do conhecimento acerca da influencia de determinantes demografico-biologicos (idade, sexo, estatuto socio-economico) e socio-culturais (familia, pares e professor de educacao fisica) na atividade fisica de adolescentes. Nesta revisao apenas foram incluidos estudos efetuados com amostras superiores a 100 adolescentes com idades entre os 10 e os 18 anos, que tenham adotado delineamentos de pesquisa transversal e que tenham utilizado questionarios. Os principais resultados e conclusoes foram que: a idade parece estar negativamente associada a atividade fisica; o sexo masculino tende a estar mais envolvido nessas atividades; o estatuto socio-economico elevado parece ser um fator protetor do risco de inatividade fisica; a participacao da familia e dos pares em atividades fisicas parece estar positivamente associada as atividades por parte dos adolescentes; o professor de educacao fisica parece nao representar um fator propiciador da atividade fisica.
229 citations
TL;DR: The urbanization of visceral leishmaniasis in Brazil has been related to environmental changes, migration, interaction and spread of sylvatic reservoirs and infected dogs to areas with no transmission, and adaptation of the vector Lutzomyia longipalpis to the peridomiciliary environment.
Abstract: The urbanization of visceral leishmaniasis in Brazil has been related to environmental changes, migration, interaction and spread of sylvatic reservoirs and infected dogs to areas with no transmission, and adaptation of the vector Lutzomyia longipalpis to the peridomiciliary environment. From 1980 to 2005, Brazil recorded 59,129 cases of visceral leishmaniasis, 82.5% of which in the Northeast region. Visceral leishmaniasis gradually spread to other regions of the country: in 1998 these other regions reported 15% of all cases, but by 2005 this proportion had increased to 44%. From 1998 to 2005, indigenous cases were reported in 1,904 different municipalities of the country (34.2%). Reservoir and vector control pose major challenges for disease control, since there is a need for better knowledge of vector behavior in urban areas, and control activities involve high operational costs. In recent years the Brazilian Ministry of Health has supported research on the laboratory diagnosis of infection and disease in humans and dogs, treatment of patients, evaluation of the effectiveness of control strategies, and development of new technologies that could contribute to the surveillance and control of visceral leishmaniasis in the country.
220 citations
218 citations
TL;DR: Intervening in this contemporary public health dilemma requires prioritizing a unified nutritional agenda focused on the entire course of life, breaking the vicious circle that begins during the intrauterine period and lasts throughout life.
Abstract: Brazil, like other developing countries, is currently experiencing a nutritional transition that is often determined by poor eating. Population-based surveys have shown a continuing downward trend in undernutrition in this country, together with increases in excess weight at different stages of life. Monitoring the nutritional profile helps generate an attitude of surveillance and orientation of health promotion activities. The Family Health Strategy, together with various situational aspects in Brazil, has shown tangible results in the reduction of undernutrition; still, poor eating has played a major role in the increased prevalence of obesity and other chronic non-communicable diseases, besides having a heavy impact on individual quality of life and placing a significant burden on the Unified National Health System. Intervening in this contemporary public health dilemma requires prioritizing a unified nutritional agenda focused on the entire course of life, breaking the vicious circle that begins during the intrauterine period and lasts throughout life.
197 citations
TL;DR: The article concludes that the information on cocaine and crack consumption in Brazil is still incipient, but that the scientific community can already draw on a relevant theoretical corpus that can be used to update current public policies on this issue.
Abstract: This article aims to systematize the profile of cocaine and crack users in Brazil. The study adopted a literature review of the MEDLINE, LILACS, Cochrane Library databases and CAPES thesis/dissertation database. Data were grouped in thematic categories: national household surveys, surveys of specific population groups, profile of patients that seek treatment, and mortality and morbidity. Within each category the principal findings from the Brazilian literature were described and then discussed. The article concludes that the information on cocaine and crack consumption in Brazil is still incipient, but that the scientific community can already draw on a relevant theoretical corpus that can be used to update current public policies on this issue.
195 citations
TL;DR: A high percentage of elderly citizens in Joaçaba show low functional capacity, leading to dependency, and health programs that delay the onset of such disabilities could contribute to healthier aging.
Abstract: The goal of this study was to estimate the prevalence of low functional capacity and associated factors in Joacaba, Santa Catarina State, Brazil, in 2003-2004, using a household survey (n = 345). Subjects who demonstrated difficulty in performing 6 or more activities or inability to conduct 3 of the activities according to the scale proposed by Rikli & Jones were defined as having low functional capacity. A questionnaire covering socioeconomic, demographic, housing, and self-perceived socioeconomic variables was applied. The study included distribution of the target variables' simple frequency, chi-square association tests, and multiple logistic regression analysis. The response rate was 92.7%, with a low functional prevalence of 37.1% (95%CI: 32.0-42.2). Mean age was 69.5 years. After adjusting for confounding variables, the factors associated with low functional capacity were: age > 70 years, female gender, and negative self-perceived socioeconomic status. A high percentage of elderly citizens in Joacaba show low functional capacity, leading to dependency. Health programs that delay the onset of such disabilities could contribute to healthier aging.
180 citations
TL;DR: A transicao etaria brasileira gera oportunidades e desafios que, se nao aproveitados e enfrentados, no momento devido, levara o pais a seriissimos problemas, nas proximas decadas.
Abstract: A trajetoria da populacao brasileira, na primeira metade deste seculo, tanto em termos de seu volume, quanto de sua estrutura etaria, ja esta praticamente definida, pois, tanto a transicao de mortalidade quanto a da fecundidade ja se encontram muito avancadas. Enquanto a populacao idosa (65 e mais anos de idade) aumentara a taxas altas (entre 2% e 4% ao ano), a populacao jovem tendera a decrescer. Segundo projecoes das Nacoes Unidas, de 3,1% da populacao total, em 1970, a populacao idosa brasileira devera passar a aproximadamente 19%, em 2050. Paralelamente, conviverao dentro das populacoes jovem e adulta subgrupos etarios com crescimento negativo e positivo. A transicao etaria brasileira gera oportunidades e desafios que, se nao aproveitados e enfrentados, no momento devido, levara o pais a seriissimos problemas, nas proximas decadas.
176 citations
TL;DR: The study presents an assessment of primary health care access and receptivity from the perspective of patients and health professionals, comparing traditional primary care units and family health units in three State capitals in Northeast Brazil.
Abstract: This article is part of the evaluation study on the Project for Expansion and Consolidation of the Family Health Strategy, conducted by the Center for Public Health Research at the Federal University in Rio Grande do Norte, Brazil, from March to December 2005. The study presents an assessment of primary health care access and receptivity from the perspective of patients and health professionals, comparing traditional primary care units and family health units in three State capitals in Northeast Brazil. The methodology included focus groups with content analysis. The results identified increased access, but there is still a disproportion between potential supply, capacity to meet the demand, and difficulties with referral in both the family health units and traditional primary care units. As an operational technology, receptivity is still under construction in the family health units, with varying levels of adherence to both the concept and the strategies for reorganizing daily work practices. Meanwhile, receptivity is totally absent from the traditional primary care units. The study suggests that qualitative analyses be included in health assessment in order to better explain the subjective aspects of the various actors.
TL;DR: Adolescents in Florianopolis show EAT+ rates similar to those observed in other regions of Brazil, and dissatisfaction with body image is shown as the strongest independent risk factor for symptoms of anorexia nervosa.
Abstract: The objective of this study was to identify the prevalence of symptoms of anorexia nervosa (EAT+) and dissatisfaction with body image among female adolescents in Florianopolis, Santa Catarina State, Brazil. The proportional sample (1,148 adolescents) was stratified according to position of schools in the socio-geographic regions and public/private school classification, and was subsequently distributed according to primary and secondary schools. EAT+ was identified through the Eating Attitudes Test and evaluation of body image through the Body Shape Questionnaire. Prevalence rates for EAT+ and dissatisfaction with body image were 15.6% and 18.8%, respectively. EAT+ was associated with age (10-13y) (OR = 1.542; p = 0.046); overweight/obesity (OR = 2.075; p < 0.001); dissatisfaction with body image (OR = 14.392; p < 0.001); and public schools (OR = 1.423; p = 0.041). Multiple logistic regression showed dissatisfaction with body image as the strongest independent risk factor for symptoms of anorexia nervosa (OR = 16.7; p < 0.001). Adolescents in Florianopolis show EAT+ rates similar to those observed in other regions of Brazil.
TL;DR: It is concluded that sedentary lifestyle is highly prevalent and that disadvantaged socioeconomic groups are more likely to be sedentary.
Abstract: Shifts in Brazil's demographic structure have expanded the country's elderly population and consequently increased the rates of chronic diseases. This paper describes the prevalence of sedentary lifestyle and associated factors in a cross-sectional study, including 4,060 non-elderly and 4,003 elderly adults in 41 cities in seven States of the country. Prevalence of sedentary lifestyle was 31.8% (95%CI: 30.4-33.2) in non-elderly adults and 58.0% (95%CI: 56.4-59.5) in the elderly; sedentary lifestyle was more frequent in the Northeast and among males. Low family income was associated with higher prevalence of sedentary lifestyle in both non-elderly and elderly adults, while low schooling was only observed among the elderly. There was an inverse association between self-reported health status and sedentary lifestyle. Mean prevalence of sedentary lifestyle was higher in areas covered by pre-PROESF units in comparison to other health system models. We conclude that sedentary lifestyle is highly prevalent and that disadvantaged socioeconomic groups are more likely to be sedentary.
TL;DR: In this article, the authors examined issues of human mercury exposure and adverse health effects throughout the Amazon region, and an extensive review was conducted using bibliographic indexes as well as secondary sources.
Abstract: This paper examines issues of human mercury (Hg) exposure and adverse health effects throughout the Amazon region. An extensive review was conducted using bibliographic indexes as well as secondary sources. There are several sources of Hg (mining, deforestation, reservoirs), and exposure takes place through inhalation or from fish consumption. There is a wide range of exposure, with mean hair-Hg levels above 15µg/g in several Amazonian communities, placing them among the highest reported levels in the world today. Dietary Hg intake has been estimated in the vicinity of 1-2µg/kg/day, considerably higher than the USEPA RfD of 0.1µg/kg/day or the World Health Organization recommendation of 0.23µg/kg/day. Neurobehavioral deficits and, in some cases, clinical signs have been reported both for adults and children in relation to Hg exposure in several Amazonian countries. There is also some evidence of cytogenetic damage, immune alterations, and cardiovascular toxicity. Since fish provide a highly nutritious food source, there is an urgent need to find realistic and feasible solutions that will reduce exposure and toxic risk, while maintaining healthy traditional dietary habits and preserving this unique biodiversity.
TL;DR: According to the results, chronic conditions associated with disability in the study population are preventable, and severely disabled elderly had less extra-family social support.
Abstract: This study assessed factors associated with functional disability in old age in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil. The theoretical model was based on predisposing (socio-demographic), extra-individual (social support, use of health services), and intra-individual factors (health conditions). The study was conducted in a probabilistic sample of 1,786 subjects aged > 60 years. The dependent variable was disability defined as mild (some difficulty) or severe (total dependence) in performing at least one basic activity of daily living. Prevalence of disability was 16% (8% mild; 8% severe). Age and worse self-rated health were independently and positively associated with mild and severe disability. Self-reported hypertension and arthritis were associated with mild disability, while diabetes and stroke were associated with severe disability. Severe disability was independently and negatively associated with number of visits by friends in the previous 30 days. According to the results, chronic conditions associated with disability in the study population are preventable, and severely disabled elderly had less extra-family social support.
TL;DR: In this article, the authors focus on the experience with primary health care as a strategy for reorganizing the health care model, based on reforms in this direction and their implementation in the Brazilian case.
Abstract: This paper focuses on the experience with Primary Health Care as a strategy for reorganizing the health care model, based on reforms in this direction and their implementation in the Brazilian case. The article identifies a shift in the discourse concerning health sector reforms, with a return to emphasis on primary care and integration of services. The Brazilian context demands reflection on the possibilities for synergy between this strategy and other social policies and the factors needed to ensure adequate performance. Evaluation research has suggested that primary care activities are slightly superior as compared to traditional health care units, despite persistent difficulties in access, physical infrastructure, team formation, management, and organization of the network. These difficulties correlate with a low level of public financing, persistent segmentation of the system, and weak integration of primary care services with other levels of care. From the technical perspective, a reasonable target is to guarantee the strategy's continuity with the necessary adjustments, conditioned by the dynamics of the health care technical models involved in the dispute.
TL;DR: Os resultados revelam importante iniquidade em saude, reforcando a necessidade oficial de politicas para ampliar o acesso principalmente para populacoes de menor poder aquisitivo.
Abstract: O objetivo deste estudo foi avaliar a prevalencia de acesso a medicamentos de uso continuo para tratar hipertensao arterial sistemica, diabetes mellitus e/ou problemas de saude mental e fatores associados. Foi desenvolvido estudo transversal no âmbito do Projeto de Expansao e Consolidacao Saude da Familia (PROESF) em 41 municipios do Sul e Nordeste do Brasil. A amostra incluiu 4.060 adultos e 4.003 idosos residentes na area das unidades basicas de saude (UBS). A prevalencia de acesso a medicamentos de uso continuo em adultos foi de 81% e em idosos, 87%. O maior acesso entre os adultos da Regiao Sul esteve associado com maior idade, melhor nivel economico, tipo de morbidade cronica e participacao em grupos na UBS; entre os adultos do Nordeste, com hipertensao arterial sistemica exclusiva ou combinada com diabetes mellitus; entre os idosos do Sul, com maior escolaridade; entre os idosos do Nordeste, com maior idade, maior escolaridade, nao fumantes, vinculo com a UBS e modelo de atencao Programa Saude da Familia (PSF). Os resultados revelam importante iniquidade em saude, reforcando a necessidade de politicas para ampliar o acesso principalmente para populacoes de menor poder aquisitivo.
TL;DR: The use of translations and back-translations carefully evaluated by experts and incorporating suggestions from the target population allowed the development of a Brazilian version of the ECOHIS that is semantically equivalent to the original instrument.
Abstract: The North American instrument Early Childhood Oral Health Impact Scale (ECOHIS) was created to assess the oral health-related quality of life of preschool children and their families. Its use in Brazil requires prior cultural adaptation, and semantic equivalence is one step in this process. The objective of this study was to evaluate the semantic equivalence between the ECOHIS and its Brazilian version. The methodology included six steps: translation of the ECOHIS into Portuguese, done by two translators; a pre-test, in which the two translations were tested in a group of 20 parents/guardians of children 2-5 years of age; unification of the two versions; two back-translations done independently by two translators; review of the translations and back-translations; and production of a final version of the questionnaire. The two translated versions were very similar, and after completion of all steps a final version of the ECOHIS was obtained. The use of translations and back-translations carefully evaluated by experts and incorporating suggestions from the target population allowed the development of a Brazilian version of the ECOHIS that is semantically equivalent to the original instrument.
TL;DR: Habits related to the vectorial competence of Lutzomyia longipalpis are discussed, along with evidence confirming the importance of this sand fly species in the epidemiological chain of visceral leishmaniasis in Brazil, and a new epidemiological profile for visceral leishes is postulated.
Abstract: The article discusses habits related to the vectorial competence of Lutzomyia longipalpis, along with evidence confirming the importance of this sand fly species in the epidemiological chain of visceral leishmaniasis in Brazil. A new epidemiological profile for visceral leishmaniasis is also postulated, associated with domestic environments and the role of Lu. longipalpis in this process, its sylvatic origin, and its capacity to adapt to a wide range of habitats. Another sand fly species, Lu. cruzi, is mentioned as a vector of visceral leishmaniasis in some municipalities in Central Brazil, based on studies in endemic areas of the country.
TL;DR: Key research areas need to be prioritized: the role of dogs in expanding transmission in cities, community trials to evaluate new insecticides, and research on the ecological and molecular determinants of Leishmania chagasi transmission.
Abstract: The available hypotheses or explanations for the urbanization of American visceral leishmaniasis are insufficient. An alternative hypothesis is that changes in the ecology and biology of the vector, Lutzomyia longipalpis, might explain all the new urban epidemiological features of the disease. To tackle the knowledge gaps in this process, certain key research areas need to be prioritized: the role of dogs in expanding transmission in cities, community trials to evaluate new insecticides, and research on the ecological and molecular determinants of Leishmania chagasi transmission. Investment of public funds should focus on the development of a human vaccine, since such a vaccine now appears to be within reach. Even small effects from a vaccine could substantially reduce the impact of the disease, which in the last quarter century has challenged and defeated both the scientific community and the public health field around the world.
TL;DR: Prevalence of anemia among children and overweight/obesity among adults showed similar tendencies over time and recent evidence of reduction in anemia can be attributed to flour supplementation with iron and folic acid.
Abstract: Objetiva-se analisar a prevalencia crescente das anemias e do sobrepeso/obesidade, como tendencias conflitantes da transicao nutricional do Brasil. Fez-se uma selecao de 28 trabalhos publicados sobre anemia em criancas e mulheres em idade reprodutiva, considerando representatividade estatistica, padronizacao de tecnicas laboratoriais e criterios recomendados pela Organizacao Mundial da Saude. O sobrepeso/obesidade em adultos foi avaliado pelo indice de massa corporal (IMC): entre 25 e 29,9kg/m² (sobrepeso) e > 30kg/m² (obesidade). Para analise das tendencias, foram comparados tres inqueritos, 1974/1975 (36,4%), 1989 (53,5%) e 2002-2003 (51,9%), para a prevalencia de sobrepeso/obesidade. No estudo mais representativo sobre anemias em criancas (< 11g/dL), a prevalencia elevou-se de 22% (1974) para 46,9% (1995-1996). Nas gestantes (< 11g/dL), os resultados variaram entre 14,7% e 40,4%. Conclui-se que as prevalencias de anemia em criancas e sobrepeso/obesidade em adultos apresentaram tendencias semelhantes de evolucao temporal. Evidencias mais recentes de reducao das anemias poderiam ser atribuidas ao enriquecimento das massas alimentares com ferro e folato. As anemias e o sobrepeso/obesidade estariam associados as mudancas no consumo alimentar, como substrato da transicao nutricional.
TL;DR: The serological results showed that dogs are important sentinels for the presence of R. rickettsii in areas where the tick A. aureolatum is the main vector of Brazilian spotted fever.
Abstract: The present study provides a rickettsial serosurvey in 25 dogs and 35 humans in an endemic area for Brazilian spotted fever in the State of Sao Paulo, where the tick Amblyomma aureolatum is the main vector. Testing canine and human sera by indirect immunofluorescence against four Rickettsia antigens (R. rickettsii, R. parkeri, R. felis and R. bellii) showed that 16 (64%) of canine sera and 1 (2.8%) of human sera reacted to at least one of these rickettsial antigens with titers ³ 64. Seven canine sera and the single reactive human serum showed titers to R. rickettsii at least four times those of any of the other three antigens. The antibody titers in these 7 animals and 1 human were attributed to stimulation by R. rickettsii infection. No positive canine or human serum was attributed to stimulation by R. parkeri, R. felis, or R. bellii. Our serological results showed that dogs are important sentinels for the presence of R. rickettsii in areas where the tick A. aureolatum is the main vector of Brazilian spotted fever.
TL;DR: In this paper, the association between food insecurity and certain socioeconomic and demographic variables that measure social inequality was analyzed, such as income, schooling, race, family structure, household characteristics, and sewage conditions.
Abstract: This study aimed to analyze the association between food insecurity and certain socioeconomic and demographic variables that measure social inequality: income, schooling, race, family structure, household characteristics, and sewage conditions. A sample of 456 families in Campinas, Sao Paulo State, was interviewed using the Brazilian Food Insecurity Scale (EBIA). Family food insecurity was associated with: more children < 18 years; precarious housing; overcrowding; lack of sewage system; low income (< 2 times the minimum wage); head-of-household with no schooling; no university graduate in the family; and race (black). Directly measuring food insecurity is important for monitoring inequality, and can be used either with other socioeconomic and demographic indicators or alone to identify social vulnerability in population groups.
TL;DR: In conclusion, injuries from motorcycle accidents deserve attention, especially to plan preventive measures to help control their occurrence in the State of Piauí itself.
Abstract: The number of accidents involving motorcycles has increased in Brazil. The objective of this study was to identify the type of victims of these accidents who were treated at an emergency department in Piaui State, Brazil. The sample included 430 such victims in this quantitative study. Most were male, 15-24 years of age, and from the State of Piaui itself. 301 of the victims were drivers of the motorcycles, 81 were passengers, and 48 were struck or run over by the motorcycles. 76.05% of the accidents occurred from Thursday to Sunday. 80.75% had temporary sequelae, and 53.33% of the accidents occurred at night. In 69.3% of the cases, victims suffered lacerations; 51.4% fractures; 27.44% hematomas; and 20.7% head trauma. Among the accident victims, motorcycle drivers, and those suspected of alcohol consumption, 52.07% were not wearing a helmet at the time of the accident. Most of the victims were discharged from hospital, while 14 died. In conclusion, injuries from motorcycle accidents deserve attention, especially to plan preventive measures to help control their occurrence in the State.
TL;DR: There appears to be a consensus that some light-to-moderate physical activity is not a risk factor and may even be considered a protective factor for some outcomes, however, some studies found an association between specific activities and inadequate birth weight, prematurity, and miscarriage.
Abstract: A systematic literature review was conducted to investigate the effects of physical activity during pregnancy on selected maternal-child health outcomes. The search included articles published from 1980 to 2005 in the MEDLINE and LILACS databases using key words such as physical activity, physical exercise, pregnancy, and gestation. The methodological quality of 37 selected articles was evaluated. It appears to be a consensus that some light-to-moderate physical activity is not a risk factor and may even be considered a protective factor for some outcomes. However, some studies found an association between specific activities (e.g., climbing stairs or standing for long periods) and inadequate birth weight, prematurity, and miscarriage. Few studies found an association between physical activity and maternal weight gain, mode of delivery, or fetal development. Further research is needed to fill these gaps and provide guidelines on the intensity, duration, and frequency of physical activity during pregnancy.
TL;DR: In this article, a cross-sectional school survey was conducted in a representative random sample of 1,170 seventh-graders from municipal schools in the city of Gravatai, Rio Grande do Sul State, Brazil.
Abstract: This study analyzes alcohol, tobacco, and other drug use by seventh-graders in municipal schools in the city of Gravatai, Rio Grande do Sul State, Brazil, and associated factors. A cross-sectional school survey was conducted in a representative random sample of 1,170 seventh-graders from municipal schools. The bivariate Cox regression model, modified for cross-sectional studies, was used to evaluate associations between specific factors and outcomes. Prevalence rates for lifetime consumption of alcohol, tobacco, and other drugs were 60.7%, 16.9%, and 2.4%, respectively. Consumption rates in the previous 30 days were: alcohol, 33%; tobacco, 4.4%; and other drugs, 0.6%. The study showed an association with substance use by family and friends. Prevalence of tobacco and alcohol use during the previous 30 days was associated with feelings of sadness, loneliness, insomnia, and suicidal ideation. Use of other drugs was associated with loneliness and suicidal ideation.
TL;DR: The overall result did not show significant differences between perceptions of family health care facilities as compared to traditional primary care facilities, but perceptions of health professionals were consistently more favorable than those of users.
Abstract: This study analyzes perceptions of performance by primary health care facilities with and without the Family Health Program in municipalities with more than 100,000 inhabitants. Questionnaires from the Primary Care Assessment Tool developed by John Hopkins University and adapted to Brazil, contemplating eight dimensions of primary health care, were applied to users and professionals from a sample of 36 family health care facilities and 28 traditional primary care facilities. Thirty health professionals with university education, 207 with secondary education, 490 adult users, and 133 family members answered the questionnaires. The overall result did not show significant differences between perceptions of family health care facilities as compared to traditional primary health care facilities, but perceptions of health professionals were consistently more favorable than those of users. Comparing the scores for each dimension, family health care facilities always scored better (with the exception of level of access), but the difference in scores between facilities with and without the Family Health Strategy was only statistically significant for all three categories of respondents in relation to the items "family focus" and "community orientation".
TL;DR: Logistic regression techniques showed that hoarseness was statistically associated with > 24 classroom hours per week, work in more than one school, and having to make an effort to speak, and vocal cord nodules were associated with working > 5 years as a teacher.
Abstract: This study aimed to identify risk factors for voice disorders (hoarseness in the previous six months as an initial manifestation, and vocal cord nodules as a more severe manifestation of overt disease) among teachers. The cross-sectional study included 747 women teachers from elementary and middle schools in the public school system in Vitoria da Conquista, Bahia State, Brazil. Data were collected using a self-applied, standardized questionnaire. Hoarseness in the previous six months was reported by 59.2% of teachers and vocal cord nodules by 12.9%. Logistic regression techniques showed that hoarseness was statistically associated with > 24 classroom hours per week, work in more than one school, and having to make an effort to speak. Vocal cord nodules were associated with working > 5 years as a teacher, work in more than one school, working at another job besides teaching, and having to make an effort to speak. In conclusion, voice disorders are frequent among schoolteachers and are associated with multiple occupational risk factors, besides purely biological ones.
TL;DR: The methodology and results of the implementation of a Surveillance System for Non-Communicable Disease Risk Factors in Adolescents appeared to be feasible and indicated high prevalence of risk factors for non-communicable diseases.
Abstract: This paper presents the methodology and results of the implementation of a Surveillance System for Non-Communicable Disease Risk Factors in Adolescents. A random sample of 8th-grade students (n = 1,684) enrolled in municipal schools in Rio de Janeiro, Brazil, was studied. Students were asked to complete a confidential questionnaire on food consumption, physical activity, sedentary leisure-time activities, and tobacco consumption. Prevalence estimates of risk factors were calculated for the entire sample and by gender. Non-response rates ranged from 1.1 to 8.9%. The findings included low consumption of fruits (45.8%) and vegetables (20.0% and 16.5% for salads and cooked vegetables, respectively), regular consumption of soft drinks (36.7%) and candies (46.7%), extensive time on TV, computer, and videogames (71.7% spend at least 4h/day at these activities), low frequency of regular physical activity (40%), and 6.4% prevalence of smoking. Girls showed less physical activity and more smoking. The system appeared to be feasible and indicated high prevalence of risk factors for non-communicable diseases.
TL;DR: The literature review on breastfeeding is provided, selecting studies that have helped explain its benefits for maternal and child health and the implications of breastfeeding for health of both the infant and mother; and the effectiveness of key interventions to encourage breastfeeding.
Abstract: This paper provides a literature review on breastfeeding, selecting studies that have helped explain its benefits for maternal and child health. A search for articles published since 2000 was conducted, including relevant studies for the advancement of knowledge in previous decades. An Internet search of the PubMed and SciELO databases was performed to select the studies. Besides the aspects on which there is widespread agreement, controversial results were also included, as well as intriguing ones from the field of neurobiology. Public policy recommendations have undergone substantial changes following those new discoveries. Some studies have also been conducted to search for the most cost-effective measures to promote breastfeeding practices. This paper highlights: current recommendations on child feeding; the importance of breastfeeding for early childhood; the implications of breastfeeding for health of both the infant and mother; and the effectiveness of key interventions to encourage breastfeeding.