Epidemiology of TB in prisoners: a metanalysis of the prevalence of active and latent TB.

BACKGROUND: Tuberculosis (TB) in prisons usually occurs at higher rates than in the general population, especially in developing countries. TB has been reported as the most common cause of death among prisoners. Studies have shown limitations for early detection of TB in prisons that seem to result from mistaken concepts about TB, delayed diagnosis mainly due to the naturalization of lack of healthcare for this population METHODS: A scoping review was performed using the methodology of the Joanna Briggs Institute to assess "What are the scientific evidences on the epidemiology of TB in the prison system?". Then, a meta-analysis was performed to assess the prevalence of TB (active and latent) TB in prisoners. The results are presented as prevalence, in percentage, through random effects models, with a confidence interval of 95%. RESULTS: Regarding active TB, the results of the metanalysis showed that countries with a high burden of TB had a prevalence of 3.54% [2.71; 4.63], countries not considered to be high burden TB countries had a prevalence of 1.43% [0.86; 2.37]. Latent TB had a prevalence of 51.61% [39.46; 63.58] in high TB burden countries and a prevalence of 40.24% [23.51; 59.61] in countries with low TB burden. In terms of development, in low- and lower-middle-income countries, the prevalence of active TB was 3.13% [1.84; 5.29] and in high- and upper-middle income countries the prevalence was 2.25% [1.70; 2.99]. The prevalence of latent TB in high- and middle-income countries was 43.77% [28.61; 60.18] and of 49.42% [45.91; 52.94] in low and lower middle-income countries. CONCLUSION: Our analysis suggests that TB, and probably other infectious diseases, find fertile ground in prisons where previous acquire social disadvantages seem to thrive-therefore, TB in prisons is a global public health problem and effective strategies are needed to control the disease are needed targeting the prison environment, including rapid health assessments to understand each context and to implement tailored and precision interventions.

The burden of alcohol, tobacco and others drugs among incarcerated population diagnosed with tuberculosis: time trends and spatial determinants in Southern Brazil.

BACKGROUND: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis and is a public health problem worldwide. It is estimated that 90% of the patients diagnosed with TB live in vulnerable environments with limited health resources, such as individuals living in correctional facilities. This study aimed to identify the consumption of alcohol, tobacco, and other drugs among prisoners diagnosed with TB and the spatial determinants and time trends of the phenomenon in southern Brazil. METHODS: A cross-sectional study using data from the Brazilian Notifiable Diseases Information System was carried out. TB cases confirmed from 2014 to 2018 in prisons located in Paraná, Brazil, were selected. The Prais-Winsten procedure was performed to identify time trends by calculating monthly rates and the percentage of monthly variation. The Seasonal-Trend by Loess decomposition method was used to verify the time series and trends. The spatial association was verified with the Getis-Ord Gi* technique, and the risk areas were identified using spatial scan statistics. RESULTS: A total of 1,099 TB cases were found in the studied population. The consumption of tobacco (n = 460; 41.9%), illegal drugs (n = 451; 41.0%), and alcohol (n = 179; 16.3%) stood out. An ascending trend was found for the consumption of alcohol (+ 19.4%/mo. (95%CI: 12.20-23.03)), tobacco (+ 20.2%/mo. (95%CI: 12.20-28.82)), and illegal drugs (+ 62.2%/mo. (95%CI: 44.54-81.97)). Spatial analysis revealed clusters for the use of alcohol, tobacco, and illegal drugs. CONCLUSIONS: This study advances knowledge presenting the burden of drug use and its typology among individuals diagnosed with TB in the prison system. There is a growing trend among patients to use drugs, especially illegal drugs. The clusters show differences between the places where the prisons are located.

Factors associated with status and self-perceived mental health changes in the face of the COVID-19 pandemic in Brazil.

The SARS-CoV-2-triggered Public Health Emergency of International Importance has significantly contributed to emotional and mental health issues. The aim of this study was to identify factors associated with self-perceived mental health changes while facing the COVID-19 pandemic in Brazil. This was a cross-sectional, descriptive, and analytical study that collected data via a web survey using a validated instrument. The study included individuals over 18 years old residing in the 26 federal units and the Federal District from August 2020 to November 2022. The sample was recruited using the snowball technique. Two logistic regression analyses were conducted to identify factors associated with the outcomes of interest. The first analysis considered individuals who rated their mental health condition as poor as the dependent variable, while the second analysis considered individuals who reported changes in their mental health during the pandemic as the dependent variable. The study found that individuals with complete college education and those using tranquilizers or antidepressants were more likely to perceive their mental health as poor (1.97 and 2.04 times higher likelihood, respectively). Increased consumption of ultra-processed foods during the pandemic was associated with a 2.49 higher likelihood of reporting mental health changes. Participants also reported more difficulty sleeping. The negative self-perception of mental health varied across Brazil's regions and changed over time, with different patterns observed before and after the vaccination period. In 2022, most regions of Brazil classified their mental health as "poor." The study highlights the impact of the COVID-19 pandemic on mental health, with increased prevalence of mental disorders and emotional problems among the population. The results highlight the presence of mental disorders and increased reporting of emotional problems among the population due to the impact of the COVID-19 pandemic.

Temporal evolution and spatial distribution of leprosy in a municipality with low endemicity in São Paulo state, Brazil. / Evolução temporal e distribuição espacial da hanseníase em município de baixa endemicidade no estado de São Paulo.

OBJECTIVE: To analyze the spatial and temporal distribution of leprosy in a scenario of low endemicity in the state of São Paulo, Brazil. METHODS: Ecological study with leprosy cases in Ribeirão Preto, between 2006 to 2016. The temporal trend of leprosy detection was verified through the decomposition of time series and identified areas of high and low occurrence of the disease using the Getis-Ord Gi* technique. RESULTS: There were 890 cases, and the detection rate showed an increasing trend in the period from 2011 to 2015, with an average growth of 1% per month. Areas of high occurrence of the disease were identified in the northern region of the city (99% and 95% confidence). CONCLUSION: The temporal analysis showed that the rate of detection of leprosy presented an increasing trend, and the spatial analysis showed that the region of the municipality with the highest occurrence of the disease is characterized by presenting the greatest social inequalities.

Identifying Hotspots of People Diagnosed of Tuberculosis with Addiction to Alcohol, Tobacco, and Other Drugs through a Geospatial Intelligence Application in Communities from Southern Brazil.

(1) Background: tuberculosis (TB) is considered one of the leading causes of death worldwide by a single infectious agent. This study aimed to identify hotspots of people diagnosed with tuberculosis and abusive use of alcohol, tobacco, and other drugs in communities through a geospatial intelligence application; (2) Methods: an ecological study with a spatio-temporal approach. We considered tuberculosis cases diagnosed and registered in the Notifiable Diseases Information System, which presented information on alcoholism, smoking, and drug abuse. Spatial Variations in Temporal Trends (SVTT) and scan statistics were applied for the identification of Hotspots; (3) Results: between the study period, about 29,499 cases of tuberculosis were reported. When we applied the SVTT for alcoholism, three Hotspots were detected, one of which was protective (RR: 0.08-CI95%: 0.02-0.32) and two at risk (RR: 1.42-CI95%: 1.11-1.73; RR: 1.39-CI95%: 1.28-1.50). Regarding smoking, two risk clusters were identified (RR: 1.15-CI95%: 1.01-1.30; RR: 1.68-CI95%: 1.54-1.83). For other drugs, a risk cluster was found (RR: 1.13-CI95%: 0.99-1.29) and two protections (RR: 0.70-CI95%: 0.63-0.77; RR: 0.76-CI95%: 0.65-0.89); (4) Conclusion: it was evidenced that in the communities being studied, there exists a problem of TB with drug addiction. The disordered use of these substances may harm a person's brain and behavior and lead to an inability to continue their treatment, putting the community at further risk for TB.

Tuberculosis among People Living on the Street and Using Alcohol, Tobacco, and Illegal Drugs: Analysis of Territories in Extreme Vulnerability and Trends in Southern Brazil.

(1) Background: Tuberculosis presents an epidemiological trend toward inequality, especially among people in social exclusion and situations of vulnerability. This study aimed to analyze territories with a concentration of people diagnosed with tuberculosis in a street situation and who partake in chronic use of alcohol, tobacco, and illicit drugs. We also analyzed trends in this health condition in southern Brazil. (2) Methods: Ecological study, developed in the 399 municipalities of Paraná, southern Brazil, with all tuberculosis cases in the homeless population registered in the Information System of Notifiable Diseases between 2014 and 2018. For data analysis, we used descriptive statistics, the Prais-Winsten autoregression method for the time series, and the Getis-Ord Gi technique* for spatial analysis. (3) Results: in total, 560 cases were reported. We found a predominance of alcohol, smoking, and illicit drug users, with an increasing trend in the state and clusters of spatial risk in the East health macro-region. (4) Conclusions: We observed territories with critical levels of highly vulnerable people who use psychoactive substances and are in a street situation. The results highlight the importance of incorporating public policies of social protection for these individuals and resolutive health services that receive these cases and assist in eradicating TB.

Acquired and Transmitted Multidrug-Resistant Tuberculosis among the Incarcerated Population and Its Determinants in the State of Paraná-Brazil.

(1) Background: Tuberculosis remains a public health problem in the world. The study analyzed the factors associated with drug-resistant tuberculosis in the prison population of the state of Paraná. (2) Methods: Ecological study of drug-resistant tuberculosis cases registered in the Paraná Information System, Brazil (2008 to 2018). We performed descriptive statistics of quantitative parameters calculated with absolute frequencies. Additionally, we used binary regression logistics, where the odds ratio with its respective confidence interval was calculated. (3) Results: Of the 653 cases registered as cases of tuberculosis in the incarcerated population, 98 were drug-resistant tuberculosis. We observed that educational level of up to 8 to 11 years of schooling, negative bacterial culture (test outcome) and no tobacco use were factors associated with the non-development of drug-resistant tuberculosis, while clinically confirmed pulmonary TB and positive sputum smear microscopy in the fourth month of follow-up showed an association for the development of drug resistance. (4) Conclusions: The study showed that clinically confirmed pulmonary TB and a positive sputum smear microscopy in the fourth month of follow-up were associated with drug-resistant tuberculosis.

Trend and Spatial Distribution of Drug-Resistant Tuberculosis in Liberty-Deprived Populations in the State of Paraná, Brazil.

(1) Background: Tuberculosis remains a public health problem in the world. This study evaluated the temporal trends, distribution, and spatial associations of drug-resistant tuberculosis in liberty-deprived populations in the state of Paraná, Brazil. (2) Methods: An ecological study was developed using all cases of drug-resistant tuberculosis in penal establishments reported by the Brazilian Notifiable Diseases Information System between 2008 and 2018. For the time trend, the Prais-Winsten method was used. To verify the spatial association, the Getis-Ord Gi* technique was used. (3) Results: During the study period, 653 cases of tuberculosis were reported in the studied population, of which 98 (15%) were drug-resistant. Prais-Winsten autoregression identified an increasing trend, with APC = 15.08% (95% CI: 0.02-0.09) from 2008 to 2018; when analyzed from 2012 to 2018, the trend increased even more, with APC = 23.31% (95% CI: 0.01-0.16). Hotspots were also noted in the north, east, and west macro-regions of the state. (4) Conclusions: The presence of drug-resistant tuberculosis, as well as an increasing trend of these cases, was evidenced in all regions of the state among liberty-deprived populations,. The spatial analysis revealed priority areas for drug-resistant tuberculosis in penal establishments.

Patients' perceptions regarding multidrug-resistant tuberculosis and barriers to seeking care in a priority city in Brazil during COVID-19 pandemic: A qualitative study.

This study aimed to analyze the discourses of patients who were diagnosed with multidrug-resistant tuberculosis, the perception of why they acquired this health condition and barriers to seeking care in a priority city in Brazil during the COVID-19 pandemic. This was an exploratory qualitative study, which used the theoretical-methodological framework of the Discourse Analysis of French matrix, guided by the Consolidated Criteria for Reporting Qualitative Research. The study was conducted in Ribeirão Preto, São Paulo, Brazil. Seven participants were interviewed who were undergoing treatment at the time of the interview. The analysis of the participants' discourses allowed the emergence of four discursive blocks: (1) impact of the social determinants in the development of multidrug-resistant tuberculosis, (2) barriers to seeking care and difficulties accessing health services, (3) perceptions of the side effects and their impact on multidrug-resistant tuberculosis treatment, and (4) tuberculosis and COVID-19: a necessary dialogue. Through discursive formations, these revealed the determinants of multidrug-resistant tuberculosis. Considering the complexity involved in the dynamics of multidrug-resistant tuberculosis, advancing in terms of equity in health, that is, in reducing unjust differences, is a challenge for public policies, especially at the current moment in Brazil, which is of accentuated economic, political and social crisis. The importance of psychosocial stressors and the lack of social support should also be highlighted as intermediary determinants of health. The study has also shown the situation of COVID-19, which consists of an important barrier for patients seeking care. Many patients reported fear, insecurity and worry with regard to returning to medical appointments, which might contribute to the worsening of tuberculosis in the scenario under study.

Nurses' perceptions about the influence of the labor environment in the use of psychoactive substances.

BACKGROUND: The work environment of nurses is characterized by physical and mental hazards liable to cause exhaustion and lead them to take psychoactive substances as coping strategy. OBJECTIVE: To investigate nurses' perception of the work environment influence on psychoactive substance intake. METHODS: Exploratory, descriptive and qualitative study with 14 nurses in two public hospitals. Data were collected through semi-structured interviews and subjected to content analysis. RESULTS: Staff and material shortages, submission, lack of autonomy, conflict in interpersonal relationships and power struggles were the main reasons for nurses to take psychoactive substances. CONCLUSION: Nurses are exposed to stressors in the workplace, including understaffing, power struggles, interpersonal conflict and lack of autonomy, which may lead them to take legal or illegal drugs.

INTRODUÇÃO: O ambiente laboral da enfermagem é permeado por riscos físicos e psíquicos, o que contribui para o desgaste do profissional da área da saúde que acaba recorrendo às substâncias psicoativas como estratégia de defesa. OBJETIVO: Conhecer as percepções de enfermeiros sobre a influência do ambiente laboral para o uso de substâncias psicoativas. MÉTODOS: Estudo exploratório-descritivo de abordagem qualitativa, realizado com 14 enfermeiros de dois hospitais públicos. Os dados foram coletados por meio de entrevistas semiestruturadas e submetidos a análise de conteúdo. RESULTADOS: A falta de recursos humanos e materiais, a submissão, a falta de autonomia, relações interpessoais conflituosas e a disputa pelo poder foram apontados como fatores que podem propiciar o uso de substâncias psicoativas. CONCLUSÃO: Os enfermeiros estão expostos a fatores estressores em seu ambiente laboral que podem ser contributivos para o uso de drogas lícitas e ilícitas, que vão desde a falta de recursos humanos até a disputa pelo poder, perpassando pelos conflitos interpessoais e a falta de autonomia profissional.

Spatial analysis of cases of Tuberculosis with Mental Disorders in São Paulo.

OBJECTIVE: To analyze the spatial distribution of Tuberculosis cases with Mental Disorders, identifying factors that determine its occurrence. METHOD: Ecological study, conducted in the municipalities of São Paulo State. Secondary data were used, with the incidence of Tuberculosis and Mental Disorders as dependent variables in the years 2012 to 2015 and independent variables, socioeconomic, health and income transfer data. The Geographically Weighted Regression was applied in this study. RESULTS: It was observed a distinct distribution between cases of Tuberculosis and Mental Disorders in the municipalities of São Paulo State. Among the explanatory factors, the Primary Care Coverage, population of freedom and income inequality were spatially associated with Mental Illness (R2= 0.12); Alcoholism (R2= 0.12) Illicit Drugs (R2= 0.50) and Smoking (R2= 0.50). CONCLUSION / FINAL CONSIDERATIONS: The study advances in knowledge by evidencing the spatial distribution of cases of Tuberculosis and Mental Disorders, evidencing the determining factors for its occurrence in São Paulo State.

Wellness room as a strategy to reduce occupational stress: quasi-experimental study.

OBJECTIVE: To compare occupational stress levels of nurse staff working in the surgical unit before and after the intervention "wellness room". METHOD: Quasi-experimental study with a sample of 60 nurse staff working in a surgical unit of a teaching hospital in the Southern Region of Brazil. The intervention was conducted in a room in the workplace for six months and consisted of sections of aesthetic care, relaxation, lectures and workshops to reduce occupational stress. Data were collected through the Demand-Control-Support Questionnaire before and after the intervention, and the comparative analysis was performed by the Wilcoxon test. RESULTS: After the intervention, there was a decrease in demand and an increase in control and in the social support received at work in all professional categories, but the differences were not statistically significant. CONCLUSION: The intervention "wellness room" reduced occupational stress levels in the sample studied; however, it was not a significant decrease.

Profile of readjusted workersat a public hospital in Southern Brazil.

OBJECTIVE: To establish the sociodemographic, occupational and clinical profile of labor readjusted workers at a public hospital. METHOD: Cross-sectional study conducted with 40 labor readjusted workers at a university hospital in SouthernBrazil. Datacollection was performed by means of an instrument with questions for sociodemographic, occupational and clinical profile. Descriptive analysis of relative and absolute frequencies was performed. RESULTS: Female sex (72.5%), age range 54 to 59 years old (35%) and technical education level (37.5%) predominated. Most labor readjusted workers were members of the nursing staff (62.5%), and the main reasons for readjustment were musculoskeletal mental and behavioral disorders. CONCLUSION: One might infer that labor readjustment might related to factors present in the hospital work environment.

OBJETIVO: Identificar o perfil sociodemográfico, ocupacional e clínico de trabalhadores readaptados de um hospital público. MÉTODO: Estudo transversal com 40 trabalhadores readaptados de um hospital universitário do Sul do Brasil. Para a coleta de dados utilizou-se um instrumento com questões relacionadas ao perfil sociodemográfico, ocupacional e clínico. Foram realizadas análises descritivas com frequências relativas e absolutas. RESULTADOS: Houve predomínio do sexo feminino (72,5%), faixa etária entre 54 e 59anos (35%) e escolaridade de nível técnico (37,5%). A maioria dos readaptados fazia parte da equipe de enfermagem (62,5%) eo principal motivo que desencadeou a readaptação foram os distúrbios osteomusculares, mentais e de comportamento. CONCLUSÃO: Infere-se que a readaptação dos profissionais pode estar relacionada com os fatores vivenciados no ambiente laboral doshospitais.

Evolução temporal e distribuição espacial da hanseníase em município de baixa endemicidade no estado de São Paulo / Evolución temporal y distribución espacial de la lepra en una ciudad de baja endemia en el estado de São Paulo, Brasil / Temporal evolution and spatial distribution of leprosy in a municipality with low endemicity in São Paulo state, Brazil

Objetivo: Analisar a distribuição espacial e temporal da hanseníase em cenário de baixa endemicidade no estado de São Paulo, Brasil. Métodos: Estudo ecológico, sobre casos de hanseníase notificados no município de Ribeirão Preto, entre 2006 e 2016. A tendência temporal da taxa de detecção de hanseníase foi verificada mediante decomposição de séries temporais, e identificadas as áreas de alta e de baixa ocorrência da doença utilizando-se a técnica Getis-Ord Gi*. Resultados: Foram registrados 890 casos, e a taxa de detecção apresentou uma tendência crescente no período analisado, com crescimento médio de 1% ao mês. Identificaram-se áreas de alta ocorrência da doença na região norte do município (99% e 95% de confiança). Conclusão: A taxa de detecção de hanseníase apresentou tendência temporal crescente, e a análise espacial permitiu visualizar que a região do município com maior ocorrência da doença se caracteriza por apresentar as maiores desigualdades sociais.

Objetivo: Analizar la distribución espacial y temporal de la lepra en un escenario de baja endemicidad en el estado de São Paulo, Brasil. Métodos: Estudio ecológico con casos de lepra en Ribeirão Preto, entre 2006 y 2016. La tendencia temporal de la detección de la lepra se verificó a través de la descomposición de series de tiempo e identificaron áreas de alta y baja ocurrencia utilizando la técnica Getis-Ord Gi*. Resultados: Fueron 890 casos y la tasa de detección mostró una tendencia creciente en el período de 2011 a 2015, con un crecimiento promedio de 1% mensual. Se identificaron áreas de alta ocurrencia de la enfermedad en la región norte de la ciudad (99% y 95% de confianza). Conclusión: El análisis temporal mostró que la tasa de detección de lepra presentó una tendencia creciente y el análisis espacial mostró que la región de la ciudad con mayor ocurrencia de la enfermedad se caracteriza por presentar las mayores desigualdades sociales.

Objective: To analyze the spatial and temporal distribution of leprosy in a scenario of low endemicity in the state of São Paulo, Brazil. Methods: Ecological study with leprosy cases in Ribeirão Preto, between 2006 to 2016. The temporal trend of leprosy detection was verified through the decomposition of time series and identified areas of high and low occurrence of the disease using the Getis-Ord Gi* technique. Results: There were 890 cases, and the detection rate showed an increasing trend in the period from 2011 to 2015, with an average growth of 1% per month. Areas of high occurrence of the disease were identified in the northern region of the city (99% and 95% confidence). Conclusion: The temporal analysis showed that the rate of detection of leprosy presented an increasing trend, and the spatial analysis showed that the region of the municipality with the highest occurrence of the disease is characterized by presenting the greatest social inequalities.

Conhecimento teórico-prático da equipe de enfermagem referente à reanimação cardiopulmonar no âmbito intra-hospitalar / Conocimientos teórico-prácticos del equipo de enfermería sobre reanimación cardiopulmonar en el ámbito hospitalario / Theoretical-practical knowledge of the nursing team regarding cardiopulmonary resuscitation in the hospital environment

Objetivo: descrever o conhecimento teórico-prático da equipe de enfermagem referente a reanimação cardiopulmonar no âmbito intra-hospitalar. Método: revisão integrativa, realizada em Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis and Retrieval System Online e Base de Dados em Enfermagem. Foram incluídos artigos originais, disponíveis na íntegra, publicados de 2010 a 2020, em qualquer idioma Resultados: como potencialidade, os profissionais sabem como detectar os sinais de parada cardiorrespiratória e realizar a sequência da reanimação cardiopulmonar do suporte básico de vida. Já como fragilidades, a maioria dos profissionais não sabe como realizar a relação compressão/ventilação do suporte avançado de vida, nem como identificar ritmos cardíacos ou fármacos utilizados. Conclusão: o conhecimento da equipe de enfermagem, referente a temática, encontra-se fragilizado e está relacionado à importância das capacitações nas instituições de saúde.(AU)

Objective: to describe the theoretical-practical knowledge of the nursing team regarding cardiopulmonary resuscitation in the hospital environment. Method: integrative review, performed in Latin American and Caribbean Literature in Health Sciences, Medical Literature Analysis and Retrieval System Online and Nursing Database. Original articles, available in full, published from 2010 to 2020, in any language, were included. Results: as a potentiality, professionals know how to detect signs of cardiorespiratory arrest and perform the sequence of cardiopulmonary resuscitation from basic life support. As for weaknesses, most professionals do not know how to perform the compression/ventilation ratio of advanced life support, nor how to identify cardiac rhythms or drugs used. Conclusion: the nursing team's knowledge regarding the theme is fragile and is related to the importance of training in health institutions.(AU)

Objetivo: describir los conocimientos teórico-prácticos del equipo de enfermería sobre la reanimación cardiopulmonar en el ámbito hospitalario. Método: revisión integradora, realizada en Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Medical Literature Analysis and Retrieval System Online y Base de Datos de Enfermería. Se incluyeron artículos originales, disponibles íntegramente, publicados de 2010 a 2020, en cualquier idioma. Resultados: como potencialidad, los profesionales saben detectar signos de parada cardiorrespiratoria y realizar la secuencia de reanimación cardiopulmonar desde suporte vital básico. En cuanto a las debilidades, la mayoría de los profesionales no saben cómo realizar la relación compresión/ventilación del soporte vital avanzado, ni cómo identificar los ritmos cardíacos o los fármacos utilizados. Conclusión: el conocimiento del equipo de enfermería sobre el tema está debilitado y se relaciona con la importancia de la formación en las instituciones de salud.(AU)

Assistência em urgência e emergência/pronto socorro obstétrico: revisão integrativa / Assistance in urgency and emergency/obstetric emergency care: an integrative literature review / Emergencia y asistencia de emergencia / primeros auxilios obstétricos: revisión integrativa

Objetivo: identificar o perfil das gestantes que buscam atendimento em unidades de pronto socorro a partir das evidências encontradas na literatura. Método: revisão integrativa, com busca de artigos em bases de dados na área da saúde, no período de janeiro de 2007 a dezembro de 2016, nas bases Indice Bibliográfico Español de Ciencias de la Salud, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Medical Literature Analysis and Retrieval System Online. Resultados: dos 3.964 artigos selecionados por meio das bases de dados, 22 pesquisas estavam elegíveis para a leitura na íntegra, destes apenas 4 artigos estavam de acordo com a questão norteadora do estudo. Quanto aos artigos incluídos dois eram de língua portuguesa e um inglesa e espanhola e todos dos últimos 3 anos. Conclusão: a clientela que busca atendimento obstétrico precisa ser mais informada na atenção básica por ocasião do pré-natal sobre os sinais e sintomas que caracterizam emergência e urgência, pois a grande a maioria das gestantes procuraram os serviços de prontos socorros desnecessariamente

Objective: to identify the profile of pregnant women seeking care in emergency room units based on the evidence found in the literature. Method: integrative review, with search of articles in databases in the health area, from January 2007 to December 2016, in the databases Index of Spanish Health Sciences, Latin American and Caribbean Literature in Sciences Health and Medical Literature Analysis and Retrieval System Online. Results: of the 3,964 articles selected through the databases, 22 surveys were eligible for full reading, of which only 4 articles were in agreement with the guiding question of the study. As for the articles included two were Portuguese and one English and Spanish and all of the last 3 years. Conclusion: the clientele seeking obstetric care needs to be more informed in the basic prenatal care about the signs and symptoms that characterize emergency and urgency, since the great majority of pregnant women have sought emergency care services unnecessarily

Objetivo: identificar el perfil de las gestantes que buscan atención en unidades de socorro a partir de las evidencias encontradas en la literatura. Método: revisión integrativa, con búsqueda de artículos en bases de datos en el área de la salud, en el período de enero de 2007 a diciembre de 2016, en las bases Indice Bibliográfico Español de Ciencias de la Salud, Literatura Latinoamericana y del Caribe en Ciencias de la Salud Salud y Medicina Literatura Análisis y Recuperación del sistema en línea. Resultados: de los 3.964 artículos seleccionados a través de las bases de datos, 22 encuestas eran elegibles para la lectura íntegra, de estos sólo 4 artículos estaban de acuerdo con la cuestión orientadora del estudio. En cuanto a los dos artículos fueron incluidos en portugués y en Inglés y Español y todos los últimos tres años. Conclusión: la clientela que busca atención obstétrica necesita ser más informada en la atención básica con ocasión del prenatal sobre los signos y síntomas que caracterizan emergencia y urgencia, pues la gran mayoría de las gestantes buscaban los servicios de prontos auxilios innecesariamente

Estresse ocupacional em equipes saúde da família certificadas e não certificadas com selo de qualidade assistencial / Estrés laboral en equipos de salud familiar certificados y no certificados con sello de calidad asistencial / Occupational stress in family health teams certified and non-certified with assistance quality seal

Resumo Objetivo comparar o estresse ocupacional em trabalhadores de equipes saúde da família certificadas e não certificadas com selo de qualidade assistencial pela Tutoria da Atenção Primária à Saúde. Métodos estudo transversal realizado com 178 trabalhadores das equipes da Estratégia Saúde da Família de dois municípios do Paraná. Os dados foram coletados por um questionário de caracterização e a Job Stress Scale, e analisados descritiva e inferencialmente por meio de regressão logística bruta e ajustada. Resultados os trabalhadores vinculados às equipes certificadas apresentaram chances significativamente maiores de alta demanda psicológica (p<0,001; ORaj: 4,164) e baixo apoio social (p=0,048; ORaj: 1,896) em relação aos das não certificadas. O controle sobre o trabalho não apresentou diferença significativa (p=0,891; ORaj: 1,047). Os participantes de equipes certificadas apresentaram maior chance de job strain (p<0,001; ORaj: 4,956) e entre aqueles de equipes não certificadas predominou o trabalho passivo (p<0,001; ORaj: 0,293). Conclusão os trabalhadores de equipes de saúde com certificação de qualidade na prestação de serviços apresentaram maiores chances de estresse ocupacional em relação aqueles vinculados a equipes não certificadas. Implicações para a prática torna-se premente que os modelos gerenciais de qualidade da assistência considerem a saúde dos trabalhadores envolvidos.

Resumen Objetivo comparar el estrés laboral en trabajadores de los equipos de salud familiar certificados y no certificados con sello de calidad en la atención de la Mentoría de Atención Primaria. Métodos estudio transversal con 178 trabajadores de los equipos del plan Estrategia Salud de la Familia de dos municipios de Paraná. Los datos fueron recolectados a través de un cuestionario de caracterización y de la Job Stress Scale, por medio de análisis descriptivo e inferencial, mediante regresión logística bruta y ajustada. Resultados los trabajadores vinculados a equipos certificados presentaron probabilidades significativamente mayores de alta demanda psicológica (p<0,001; OR: 3,781) y bajo apoyo social (p=0,030; OR: 1,896) en relación a los de equipos no certificados. El control sobre el trabajo no mostró diferencia significativa (p=0,891; ORaj: 1,047). Los participantes de equipos certificadas obtuvieron una mayor probabilidad de padecer tensión laboral (p<0,001; ORaj: 4,956) y entre los de equipos no certificadas predominó el trabajo pasivo (p<0,001; ORaj: 0,293). Conclusión los trabajadores de equipos de salud con certificación de calidad en la prestación de servicios presentaban mayor probabilidad de estrés ocupacional en relación a los vinculados a equipos no certificados. Implicaciones para la práctica es imperativo que los modelos de gestión de la calidad de la atención consideren la salud de los trabajadores involucrados.

Abstract Objective to compare occupational stress in professionals from family health teams certified and non-certified with assistance quality seal by the Primary Health Care Mentoring. Method a cross-sectional study carried out with 178 workers from the Family Health Strategy teams of two municipalities in Paraná. The data were collected through a characterization questionnaire and the Job Stress Scale, and analyzed descriptively and inferentially by means of crude and adjusted logistic regression. Results professionals linked to certified teams had significantly greater chances of high psychological demand (p<0.001; OR: 3.781) and low social support (p=0.030; OR: 1.896) in relation to those from non-certified teams. Control over work showed no significant difference (p=0.891; ORadj: 1.047). Participants from the certified teams had a higher chance of job strain (p<0.001; ORadj: 4.956) and among those from the non-certified teams, passive work predominated (p<0.001; ORadj: 0.293). Conclusion Professionals from teams with quality certification in the provision of services had a greater chance of occupational stress in relation to those linked to non-certified teams. Implications for the practice it is imperative that the management models of quality of care consider the health of the workers involved.

Uso de substâncias psicoativas entre profissionais da enfermagem da atenção básica e instituição hospitalar / Uso de sustancias psicoactivas entre los profesionales de enfermería de atención primaria y los de instituciones hospitalarias / Use of psychoactive substances among basic attention nursing professionals and hospital institution

Objetivo: Comparar o uso de substâncias psicoativas em profissionais da enfermagem da atenção básica e de instituição hospitalar. Método: Estudo transversal, desenvolvido com profissionais de enfermagem, utilizando-se dois instrumentos: caracterização sociodemográfica e ocupacional e o Alcohol, Smoking and Substance Involvement Screening Test. Na análise dos dados, utilizou-se estatística descritiva e o teste qui-quadrado para verificar as associações. Resultados: O consumo de álcool e tabaco na vida e, nos três últimos meses, foi, proporcionalmente, maior entre profissionais da atenção básica. O uso de sedativos foi maior nas instituições hospitalares, sobretudo o uso na vida (p=0,05). O forte desejo de álcool e sedativos esteve presente entre profissionais das instituições hospitalares e para o tabaco foi maior nos profissionais da atenção básica. Conclusão: Ao comparar, nota-se que houve uso distinto de drogas entre os profissionais das instituições hospitalares e os profissionais da atenção básica.(AU)

Objective: to compare the use of psychoactive substances in nursing professionals in primary care and hospital institutions. Method: a cross-sectional study developed with nursing professionals, using two instruments: sociodemographic and occupational characterization and the Alcohol, Smoking and Substance Involvement Screening Test. In the data analysis, descriptive statistics and the chi-square test were used to verify associations. Results: the consumption of alcohol and tobacco in life and in the last three months was proportionally higher among primary care professionals. The use of sedatives was greater in hospital institutions, especially the use in life (p = 0.05). The strong desire for alcohol and sedatives was observed among professionals in hospital institutions, whereas the need for tobacco was greater among professionals in primary care. Conclusion: Different drug uses were observed when comparing professionals from hospital institutions and professionals from primary care.(AU)

Objectivo: comparar el uso de sustancias psicoactivas entre los profesionales de enfermería de la atención primaria y los de instituciones hospitalarias. Método: estudio transversal, desarrollado con profesionales de enfermería, utilizando dos instrumentos: caracterización sociodemográfica y ocupacional y el Alcohol, Smoking and Substance Involvement Screening Test. En el análisis de los datos se utilizo estadística descriptiva y el test de chi-cuadrado para verificar las asociaciones Resultados: el consumo de alcohol y tabaco a lo largo de la vida y en los últimos tres meses fue proporcionalmente mayor entre los profesionales de la atención primaria. El uso de sedantes fue mayor en las instituciones hospitalarias, especialmente el uso a lo largo de la vida (p = 0.05). El fuerte deseo de alcohol y sedantes estaba presente entre los profesionales de las instituciones hospitalarias y el consumo de tabaco fue mayor entre los profesionales de la atención primaria. Conclusión: al compararlos se observa que hubo un uso diferente de medicamentos entre los profesionales de instituciones hospitalarias y los profesionales de atención primaria(AU)

Consumo de álcool entre jovens e adolescentes do Movimento Sem Terra / Consumo de alcohol entre jóvenes y adolescentes en el Movimiento Sin Tierra / Alcohol consumption among young people and adolescents of the Landless Movement

Objetivo: identificar prevalência e fatores sociodemográficos relacionados ao consumo de álcool entre jovens e adolescentes do Movimento dos Trabalhadores Rurais Sem Terra. Método: estudo transversal realizado com 288 jovens, cujos dados foram coletados no II Festival de Artes das Escolas de Assentamento do Paraná, no ano de 2014. Os dados foram analisados descritivamente e a associação pelos testes qui-quadrado, exato de Fisher e razão de prevalência. Resultados: dos participantes, 79,9% referiram consumo de álcool em algum momento da vida, dos quais 98,3% consumiram pelo menos uma vez no último ano. O consumo no último no mês (53,3%) e consumo excessivo episódico (14,4%) esteve associado ao sexo masculino (RP: 1,40; p=0,01; RP: 2,10; p=0,03, respectivamente). Conclusão: jovens do Movimento Sem Terra apresentaram comportamento vulnerável para o consumo de álcool, sobretudo os do sexo masculino.(AU)

Objective: to identify the prevalence and sociodemographic factors related to alcohol consumption among young people and adolescents of the Landless Rural Workers Movement. Method: this is a cross-sectional study carried out with a sample of 288 young people, whose data were collected at the II Arts Festival of the Schools of Rural Settlement of Paraná, in 2014. The data were analyzed descriptively and in the test groups chi-square, Fisher's exact and prevalence ratio. Results: of the participants, 79.9% reported alcohol consumption at some point in their lives, of which 98.3% consumed at least once in the past year. The consumption in the last month (53.3%) and the excessive consumption of episodes (14.4%) were associated with males (PR: 1.40; p = 0.01; PR: 2.10; p = 0,03, respectively). Conclusion: adolescents and young people from the Landless Rural Workers' Movement face vulnerable behavior to alcohol consumption, especially males.(AU)

Objetivo: identificar la prevalencia y factores sociodemográficos relacionados con el consumo de alcohol entre los jóvenes y adolescentes del Movimiento de Trabajadores Rurales sin Tierra. Método: estudio transversal realizado con 288 jóvenes, cuyos datos fueron recolectados en el II Festival de las Artes de las Escuelas de Asentamiento de Paraná, en 2014. Los datos se analizaron descriptivamente y en los grupos por la prueba de chi-cuadrado, exacta de Fisher y razón de prevalencia. Resultados: 79.9% informó el consumo de alcohol en algún momento de vidas, de los cuales el 98.3% consumió al menos una vez en último año. El consumo en el último mes (53.3%) y el consumo excesivo de episodios (14.4%) se asociaron con varones (RP: 1.40; p = 0.01; RP: 2.10; p = 0,03, respectivamente.) Conclusión: los adolescentes y los jóvenes del Movimiento de Trabajadores Rurales enfrentan un comportamiento vulnerable al consumo de alcohol, especialmente los hombres.(AU)

Mortalidade materna: comparativo após implantação da Rede Mãe Paranaense / Mortalidad materna: comparación después de la implementación del Rede Mãe Paranaense / Maternal mortality: comparison after the implementation of the Rede Mãe Paranaense

Objetivo: analisar a mortalidade materna no estado do Paraná após a implantação da Rede Mãe Paranaense. Método: estudo ecológico, com 466 óbitos maternos. As taxas foram analisadas segundo variáveis maternas, macrorregionais de residência e ano de ocorrência. Os dados foram agrupados em triênios de pré-implantação e pós-implantação da Rede. Resultados: a mortalidade materna diminuiu de 61 óbitos/100 mil nascidos vivos antes da Rede, para 39 óbitos/100 mil. Houve redução no número de óbitos para as características estudadas nas macrorregionais, com exceção da faixa etária de 35 anos ou mais na macrorregional Norte, onde houve aumento de 16,7% e das variáveis >8 anos de estudo (21,1%) e com companheiro (9,1%), na macrorregional Noroeste. Conclusão: a mortalidade materna reduziu no estado do Paraná após a implantação da Rede Mãe Paranaense. Ainda há necessidade de adequação das propostas do programa, considerando as características de cada macrorregional.(AU)

Objective: to analyze maternal mortality in the state of Paraná after the implementation of Rede Mãe Paranaense. Method: ecological study, with 466 maternal deaths. Rates were analyzed according to maternal, macro-regional variables of residence and year of occurrence. The data were grouped into pre-implantation and post-implantation triennia of the Rede. Results: maternal mortality decreased from 61 deaths/100 thousand live births before the Rede, to 39 deaths/100 thousand. There was a reduction in deaths for the characteristics studied in the macro-regions, with the exception of the age group of 35 years or more in the North macro-region, where there was an increase of 16.7% and of the variables >8 years of study (21.1%) and with partner (9.1%), in the macro-regional Northwest. Conclusion: maternal mortality decreased in Paraná after the implementation of Rede Mãe Paranaense. There is still a need to adjust the program proposals, considering the characteristics of each macro-region.(AU)

Objetivo: analizar la mortalidad materna en el estado de Paraná luego de la implementación de Rede Mãe Paranaense. Método: estudio ecológico, con 466 muertes maternas que se analizaron según las variables maternas, macrorregionales de residencia y año de ocurrencia. Los datos se agruparon en trienios previos y posteriores a la implantación de Rede. Resultados: la mortalidad materna disminuyó de 61 muertes/100 mil nacimientos vivos antes de la Rede, a 39 muertes/100 mil. Hubo una reducción de muertes por las características en los macrorregiones, con la excepción del grupo de edad de 35 años o más en el Norte, donde hubo un aumento del 16,7% y de las variables >8 años de estudio (21,1%) y con socio (9.1%), en el noroeste macrorregional. Conclusión: la mortalidad materna disminuyó en Paraná después de la implementación de Rede. Todavía es necesario ajustar las propuestas de programa, teniendo en cuenta las características de cada macrorregión.(AU)